Dear Senator Portantino:
I am writing on behalf of the members of the American Epilepsy Society to
express our steadfast support for SB 357, a bill that aims to protect a
therapeutic clinician-patient relationship by granting physicians more
latitude when reporting patients to the Department of Motor Vehicles
(DMV) in California. It also aims to remove language from the Vehicle
Code that discriminates against specific conditions, including epilepsy.
The American Epilepsy Society is the primary national professional society
for epilepsy specialists. Our nearly 5,000 members are professionals
engaged in the understanding, diagnosis, study, prevention, treatment,
and cure of epilepsy. Our membership includes physicians, advanced
practice providers, allied health professionals, and researchers spanning
the basic, translational, and clinical areas.
California is one of only six states that has yet to modernize their laws
affecting drivers with epilepsy. These outdated laws discriminate against
drivers with epilepsy by mandating clinicians report these drivers to the
DMV, with little regard for seizure frequency, control, or severity.
According to research, in states with mandated clinician reporting,
patients may be apprehensive to seek care for fear of losing their licenses,
which can lead to withholding important information from their clinician.
In California, according to a 2003 study1 by the American Academy of
Neurology, 16 percent of patients who never had their licenses suspended
and 50 percent of patients who previously had their licenses suspended
withheld information from their clinician. According to the findings of
another study, patients with epilepsy “were six times more likely to
compromise their own medical care in favor of driving illegally (49% vs 8%) serving neither the publics nor the patient’s safety interests.”2
When a
person with epilepsy withholds such important information from their
clinician, they may significantly compromise their healthcare access
and risk an increase in seizure activity. Epilepsy is a life-threatening
condition, especially when untreated or undertreated.
The American Epilepsy Society supports discretionary clinician
reporting of individuals with medical conditions that may impact
driving competence and feels strongly that mandated reporting of all
cases of epilepsy is inappropriate. This position is elaborated on in a
1994 consensus statement3 jointly written by the American Epilepsy
Society, the American Academy of Neurology, and the Epilepsy
Foundation. Discretionary reporting would allow clinicians the latitude
to report a patient’s driving-related condition to driving authorities
when it appears that the condition might pose a safety risk to the
patient or others. Mandatory reporting requirements may have a
negative effect on the patient–clinician relationship leading a patient
to feel pressured to hide critical medical information, potentially
leading to more uncontrolled seizures, which may pose a greater risk
to public safety.
Patients and clinicians must be able to communicate in a safe and
trusted environment. By reforming the state law to make reporting
discretionary, SB 357 seeks to maintain appropriate public safety
standards without jeopardizing access to care for individuals with
epilepsy and other conditions.
Thank you for your continued leadership on this issue.