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| THE SCIENTIFIC ADVISORY SYSTEM: DIABETES AND DRIVING LICENCES INQUIRY |
MEMORANDUM BY THE ROYAL SOCIETY OF EDINBURGH The Royal Society of Edinburgh is pleased to respond to the Select Committee’s request for comments on Diabetes and Driving Licences in connection with its Inquiry into the Scientific Advisory System. The RSE is Scotland’s premier learned society, comprising Fellows elected on the basis of their distinction, from the full range of academic disciplines, and from industry, commerce and the professions. Our expert knowledge in this instance, however, is limited and based on the advice received from only a few Fellows. Diabetes is statistically insignificant as a cause of vehicular accidents and there is a great deal of difference, which is often unrecognised, between an accident involving a person with a given pathological condition and one which is due to that condition. However, this is of little concern to those who become involved in the one chance in a million circumstance. Blame is inevitable irrespective of its rarity and there is little purpose in the argument that the overall importance of diabetes fades into insignificance as compared with that, say, of alcoholism. The current regulations may seem to use a hammer to crack a nut. Nonetheless, it cannot be denied that the danger is there, albeit small, and that it cannot be ignored. The only question surrounds the nature and extent of the regulations. With regard to the extent to which current policy is supported by evidence, there could be a dispute with the blanket ban of vehicles in category C 1 on the basis of their size alone. The end result of an accident involving a class C1 vehicle can be much less serious than that of one involving a high speed domestic car for which there is no blanket restriction. The vast majority of diabetics are aware when they are going into a hypoglycaemic attack; for example note the high proportion of diabetes-associated accidents which result in minimal injury. Therefore, a distinction based on the weight of a vehicle alone seems to be illogical. The same does not apply to seating capacity. Far more lives are at stake in a mini-bus. Many of the passengers will be unaware of the driver' s condition and many would have elected not to drive with him/her had they known of it. The risk of danger may still be small but the consequences of that small risk will be much greater. The ban on diabetic drivers for category D1 vehicles could therefore be justified - certainly in a professional capacity. The logic, however, of allowing voluntary mini-bus driving does seem doubtful; the danger to a group of boy-scouts is the same as that to a load of fare-paying passengers. In addition, all diabetic holders of a driving licence are issued with a medical questionnaire, which is specific about the nature of the onset of hypoglycemia, when making application every three years for the renewal of that licence. If this medical questionnaire is regarded as adequate to distinguish between those insulin-dependent diabetics who do suffer from unsignalled onset of hypoglycaemia and those who do not, for the purposes of issuing a licence to drive a domestic car, it seems illogical to suggest that similar tests would not be capable of making the same distinction between applicants for licences for other vehicles. Additional Information Further information is available from the Research Officer, Dr Marc Rands |