Dialogue Volume 14 Issue 2 2018 - Page 29

ROAD SAFETY Highway Traffic Act strengthens medical reporting requirements I n Ontario, physicians are required by law to report patients who may be medically unfit to drive. The Ministry of Transportation has clarified the reporting obligation related to fitness to drive by specifying the medical and visual conditions and functional impairments that trigger a mandatory report. The medical reporting requirements in the Highway Traffic Act (HTA) have been strengthened to: enhance road safety; clarify which conditions health-care practitioners are required to report; and improve the ministry’s ability to identify potentially unsafe drivers. Effective July 1, 2018, it will be mandatory for physicians, nurse practitioners and optometrists to report certain high risk medical conditions, functional impairments and visual impair- ments. Health-care practitio- ners are also permitted to make discretionary reports for any person who, in the opinion of the health-care practitioner, has or appears to have a medical condition, functional impair- ment or visual impairment that may make it dangerous for the person to drive. As of July 1, the following are prescribed medical conditions, functional impairments and visual impairments that would trigger a manda- tory report: 1. Cognitive impairment: a disorder resulting in cog- nitive impairment that, o affects attention, judgment and problem solv- ing, planning and sequencing, memory, insight, reaction time or visuospatial perception, and o results in substantial limitation of the person’s ability to perform activities of daily living. 2. Sudden incapacitation: a disorder that has a mod- erate or high risk of sudden incapacitation, or that has resulted in sudden incapacitation and that has a moderate or high risk of recurrence. 3. Motor or sensory impairment: a condition or disor- der resulting in severe motor impairment that affects co-ordination, muscle strength and control, flexibil- ity, motor planning, touch or positional sense. 4. Visual impairment: where prescribed regulatory standards are not met. 5. Substance use disorder: a diagnosis of an uncon- trolled substance use disorder, excluding caffeine and nicotine, and the person is non-compliant with treatment recommendations. 6. Psychiatric illness: a condition or disorder that currently involves acute psychosis or severe ab- normalities of perception such as those present in schizophrenia or in other psychotic disorders, bipolar disorders, trauma or stressor-related disor- ders, dissociative disorders or neurocognitive disorders, or the person has a suicidal plan involving a vehicle or an intent to use a vehicle to harm others. Physicians and other health- care practitioners are not required to report if it is their opinion that the impairment is of a distinctly transient or non- recurrent nature. There is also an exception related to aging: reporting is not required where there are incremental changes in ability that, in the opinion of the health-care practi- tioner, are attributable to a process of natural aging, unless the cumulative effect of the changes constitutes a condition or impairment described above. A new medical reporting form for use by physi- cians, nurse practitioners and occupational therapists will be used for both mandatory and discretionary re- ports. The form has been approved by the Ministry of Health and Long Term Care and the Ontario Medi- cal Association, and will be available on the Ministry of Transportation’s website as of July 1, 2018. The reporting obligation can be found in Ontario Regulation 340/94, s. 14.1(3). In the event of ques- tions, please ob tain independent legal advice. MD ISSUE 2, 2018 DIALOGUE 29