Risk of dying in a road accident doubles after the age of 70
Telling a patient that he (or she) is no longer fit to drive and must surrender his licence is one of the most unpleasant tasks a doctor has to fulfil.
The patient almost always takes it badly. He protests, often angrily, that he has been driving for over 60 years and that, without his car, life will become difficult, impossible or not worth living for him at all. He doesn’t need a young whippersnapper of 50 to tell him what he can and can’t do.
In this situation, the close relatives are often the doctor’s best allies. They have often wanted precisely this for the sake of the old person’s safety. They say that they will remove the sparkplugs or otherwise incapacitate the patient’s car.
Some 22 per cent of fatalities on the road are of people over the age of 70, while 13.6 per cent of the population are of that age. Since those over 70 are likely to drive fewer miles than those who are under it, the relative danger of being involved in a fatal road accident while driving when old is probably twice what it is for those younger than 70 – who include those of the most dangerous age group of all, 17-24-year-olds.
A paper from British Columbia examined the rate of road accidents that drivers who had been implanted with cardioverters and defibrillators were involved in during the six months after the implantation.
These devices monitor the heart rhythm, and administer a shock automatically to bring it back to normal if it becomes irregular and likely to cause syncope or even death.
Naturally, these devices are more commonly implanted in the elderly, for it is they who suffer most from irregularities of heartbeat.
On the principle of precaution, those implanted with one of these devices either because they are liable to suffer an episode of irregular heartbeat, or because they have already suffered one and are therefore likely to suffer another, are prohibited from driving immediately afterwards, for one month in the first category and for six months in the second.
The authors of the paper discovered that, in the six months after implantation, those with the devices had about 20 per cent fewer road accidents involving either police attendance or an insurance claim than matched controls.
From this, they drew what seems to me a very strange and unwarranted conclusion: ‘These results suggest post-implantation driving restrictions could be shortened, making them less burdensome, without introducing excessive traffic safety risks.’
There is undoubtedly a tendency in modern society not to lift restrictions when they cease to be necessary, either because the risk has disappeared or because it never really existed in the first place.
Excessive caution is a malady of our times, and it is easy to see why. If a restriction is lifted and results in an increase in what the restriction was supposed to prevent, those who ordered the lifting of the restriction will be blamed; whereas, if the restriction is not lifted, no one will ever know that it is unnecessary, and so no one will be blamed. That is why it is easier to impose a restriction than to lift it.
But the results in the paper do not support the reduction or lifting of driving restrictions after the implantation of the devices, though it remains possible that they are unnecessary in the first place.
To establish the risk of accident after implantation, it would be necessary to know how many people in the implantation group infringed the restrictions and how many miles they drove. For example, if only ten per cent of them disobeyed the restrictions and furthermore drove only a few miles, their accident rate on the figures provided would be extremely high.
To put it kindly, the false conclusions of the authors are mildly shocking.
