A Comparative Study of Domestic and Foreign Guidelines for Assessing the Fitness to Drive of Individuals with Mental Disorders

doi:10.3969/j.issn.1671-2072.2024.02.012

Chinese Journal of Forensic Sciences ›› 2024 ›› Issue (2): 89-98.DOI: 10.3969/j.issn.1671-2072.2024.02.012

• Forensic Forum • Previous Articles Next Articles

A Comparative Study of Domestic and Foreign Guidelines for Assessing the Fitness to Drive of Individuals with Mental Disorders

WANG Shujian¹, LI Haozhe¹, ZHANG Shengyu¹, LING Xindi^{1, 2}, ZHANG Qinting¹, CAI Weixiong¹

1. Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Key Laboratory of Forensic Science, Ministry of Justice, Academy of Forensic Science, Shanghai 200063, China; 2. School of Basic Medical Sciences, Fudan University, Shanghai 200032, China

Received:2023-12-20 Published:2024-03-15 Online:2024-03-16

国内外精神障碍者驾驶适宜性评定指南比较研究

王书剑¹，李豪喆¹，张盛宇¹，凌歆迪^1，2，张钦廷¹，蔡伟雄¹

1. 司法鉴定科学研究院上海市法医学重点实验室司法部司法鉴定重点实验室上海市司法鉴定专业技术服务平台，上海 200063；2. 复旦大学基础医学院，上海 200032

通讯作者: 张钦廷（1975—），男，主任法医师，博士，主要从事法医精神病学研究。E-mail：zhangqt@ssfjd.cn 蔡伟雄（1967—），男，主任法医师，博士，主要从事法医精神病学研究。E-mail：caiwx@ssfjd.cn
作者简介:王书剑（1994—），男，助理研究员，硕士，主要从事法医精神病学研究。E-mail：wangsj@ssfjd.cn
基金资助:
中央级公益性科研院所资助项目（GY2023Z-4）；“十四五”国家重点研发计划课题（2022YFC3302001）；上海市“科技创
新行动计划”社会发展科技攻关资助项目（20DZ1200300）；上海市法医学重点实验室资助项目（21DZ2270800）；上海市司法鉴定专业技术服务平台资助项目。

Abstract

Abstract: Road traffic safety has become a global public concern, especially increasing attentions are directed towards issues about individuals with mental disorders driving motor vehicles. The United Kingdom, Canada and the United States have formulated specific guidelines for assessing the fitness to drive of individuals with mental disorders.These nations have implemented systematic approaches to assess their fitness to drive, in order to enhance road traffic safety. This paperpresented a concise overview of the existing systems of driving fitness assessment, introduced the guidelines and standards in the countries mentioned above, and discussed the current issues in China accordingly. By summarizing and comparing both domestic and foreign guidelines, the authors aimed to provide a reference for refining methods for assessing the fitness to drive of individuals with mental disorders in China.

Key words: mental disorder, fitness to drive, forensic psychiatry, guideline, comparative study

摘要： 道路交通安全问题已成为全球性的公共安全问题，其中精神障碍者驾驶机动车引发的一系列问题亦逐渐受到重视。为规范机动车驾驶人的驾驶活动、保障道路交通安全，多个国家均制定了相应的驾驶适宜性评定指南或标准，形成了针对精神障碍在内的各类疾病患者驾驶适宜性评定的系统性方法。从英国、加拿大和美国三国现行有效的评定指南或标准入手，对其目前的驾驶适宜性评定体系作简要介绍，结合当前我国驾驶适宜性评定的现状和存在的问题，进一步探讨国外现行评定体系与方法对于我国的启示与借鉴意义。

关键词: 精神障碍, 驾驶适宜性, 法医精神病学, 评定指南, 比较研究

CLC Number:

DF795.3

WANG Shujian, LI Haozhe, ZHANG Shengyu, LING Xindi, ZHANG Qinting, CAI Weixiong. A Comparative Study of Domestic and Foreign Guidelines for Assessing the Fitness to Drive of Individuals with Mental Disorders[J]. Chinese Journal of Forensic Sciences, 2024(2): 89-98.

王书剑, 李豪喆, 张盛宇, 凌歆迪, 张钦廷, 蔡伟雄. 国内外精神障碍者驾驶适宜性评定指南比较研究[J]. 中国司法鉴定, 2024(2): 89-98.

References

[ 1 ] World Health Organization. Global status report on road safety 2018[EB/OL].[2024-01-23].https：//www.who.int/publications/i/item/9789241565684.
[ 2 ] World Health Organization. Global plan for the decade of action for road safety 2021-2030[EB/OL].[2024-01-23].https：//www.who.int/publications/m/item/global-plan-for-the-decade-of-action-for-road-safety-2021-2030.
[ 3 ] 公安部交通管理局.全国机动车达4.3亿辆驾驶人达5.2亿人新能源汽车保有量达1821万辆[EB/OL].[2024-01-23].https：//www.mps.gov.cn/n2254314/n6409334/c9-244746/content.html.
[ 4 ] 张尊爱，孔德山.机动车驾驶人精神病鉴定的启动与鉴定结果运用的探讨[C]//法医临床学专业理论与实践——中国法医学会·全国第十九届法医临床学学术研讨会论文集.北京：中国法医学会，2016：394-395.
[ 5 ] World Health Organization. New political declaration to halve road traffic deaths and injuries by 2030 is a milestone achievement[EB/OL].[2024-01-23].https：//www.who.int/news/item/30-06-2022-new-political-declaration-to-halve-road-traffic-deaths-and-injuries-by-2030-is-a-mi-lestone-achievement.
[ 6 ] HARRIS M. Psychiatric conditions with relevance to fitness to drive[J]. Advances in Psychiatric Treatment， 2000，6：261-269.
[ 7 ] KUJANSUU A， RAUTIAINEN S， HAKKO H， et al. Drivers’ psychiatric disorders and fatal motor vehicle accidents in Finland[J]. Journal of Psychiatric Research， 2017，84：227-36.
[ 8 ] 王书剑，郑雨滋，何勇，等.123例涉嫌道路交通犯罪的司法精神病学鉴定案例分析[J].法医学杂志，2020，36（6）：784-790.
[ 9 ] TANIDA K， POPPEL E. A hierarchical model of operational anticipation windows in driving an automobile[J]. Cognitive Processing， 2006，7（4）：275-287.
[10] BRUNNAUER A， GEIGER E， LAUX G， et al. Driving simulator performance and psychomotor function of schizophrenic patients under flupentixol， risperidone or haloperidol： Results from a clinical study[J]. Psychopharmakotherapie， 2005，12（3）：91-96.
[11] SEGMILLER F M， BUSCHERT V， LAUX G， et al. Driving skills in unmedicated first-and recurrent-episode schizophrenic patients[J]. European Archives of Psychiatry & Clinical Neuroscience， 2015，267（1）：83-88.
[12] FUERMAIER A B M， DAFNE P， HUNTJENS R J C， et al. Simulated car driving and its association with cognitive abilities in patients with schizophrenia[J]. Schizophrenia Research， 2019，204：171-177.
[13] LAM L T， NORTON R， CONNOR J， et al. Suicidal ideation， antidepressive medication and car crash injury[J]. Accident Analysis & Prevention， 2005，37（2）：335-339.
[14] LEVINE J， CHENGAPPA K R， BRAR J S， et al. Illness characteristics and their association with prescription patterns for bipolar I disorder[J]. Bipolar Disorders， 2001，3（1）：41-49.
[15] MCNAMARA C， BUCKLEY S E. The road to recovery： Experiences of driving with bipolar disorder[J]. British Journal of Occupational Therapy， 2015，78（6）：356-363.
[16] ASLAKSEN P M， ORBO M， ELVESTAD R， et al. Prediction of on-road driving ability after traumatic brain injury and stroke[J]. European Journal of Neurology， 2013，20（9）：1227-1233.
[17] CULLEN N， KRAKOWSKI A， TAGGART C. Functional independence measure at rehabilitation admission as a predictor of return to driving after traumatic brain injury[J]. Brain Injury， 2014，28（2）：189-195.
[18] CULLEN N， KRAKOWSKI A， TAGGART C. Early neuropsychological tests as correlates of return to driving after traumatic brain injury[J]. Brain Injury， 2014，28（1）：38-43.
[19] MARTIN J L， GADEGBEKU B， WU D， et al. Cannabis， alcohol and fatal road accidents[J]. PLoS One， 2017，12（11）：e0187320.
[20] PASCALI J P， VAIANO F， PALUMBO D， et al. Psychotropic substance abuse and fitness to hold a driving license in Italy[J]. Traffic Injury Prevention， 2019，20（3）：244-248.
[21] SCHEEN A J. Alcohol and car driving[J]. Revue Médicale de Liège， 2019，74（5/6）：258-264.
[22] ORRIOLS L， PHILIP P， MOORE N， et al. Ben-zodiazepine-like hypnotics and the associated risk of road traffic accidents[J]. Clinical Pharmacology & Therapeutics， 2011，89（4）：595-601.
[23] Driver and Vehicle Licensing Agency. Assessing fitness to drive： a guide for medical professionals[EB/OL].[2024-01-23].https：//www.gov.uk/government/publications/assessing-fitness-to-drive-a-guide-for-medical-profession-als.
[24] Canadian Medical Association. Determining medical fitness to operate motor vehicles[EB/OL].[2024-01-23].https：//driversguide.ca.
[25] Canadian Council of Motor Transport Admininstrators. National safety code standard 6： Determining driver fitness in Canada[EB/OL].[2024-01-23].https：//www.ccmta.ca/web/default/files/PDF/National%20Safety%20Code%20Standard%206%20-%20Determining%20Fitness%20to%20Drive%20in%20Canada%20-%20February%202021%20-%20Final.pdf.
[26] HILL L L， LAUZON V L， WINBROCK E L， et al. Depression， antidepressants and driving safety[J]. Injury Epidemiology， 2017，4（1）：10.
[27] National Highway Traffic Safety Admininstration. Driver fitness medical guidelines[EB/OL].[2024-01-23].https：//www.nhtsa.gov/sites/nhtsa.gov/files/811210.pdf.
[28] 中华人民共和国公安部.机动车驾驶证申领和使用规定[EB/OL].[2024-01-23].https：//app.mps.gov.cn/gdnps/zc/content.jsp?id=8282932.
[29] 国家卫生计生委.严重精神障碍发病报告管理办法（试行）[EB/OL].[2024-01-23].http：//www.nhc.gov.cn/jkj/s5889/201308/bd5d4e6d9fa14a96bb0dc01dababd75b.shtml.
[30] 中华人民共和国公安部.机动车驾驶证业务工作规范[EB/OL].[2024-01-23].http：//www.zhangpu.gov.cn/cms/html/zpxrmzf/2022-12-15/426494945.html.
[31] 北京司法鉴定业协会.驾驶人员精神状态委托司法鉴定规范指南（试行）[EB/OL].[2024-01-23].https：//mp.weixin.qq.com/s/omMKNaQoi-c2DFBoWV4Ahg.
[32] 施利承，戴家隽.驾驶员职业适性检测现状与进展[J].交通医学，2010，24（2）：142-146.

[1]	XIAO Ping, FENG Shiyao. Research on Appraisal Opinions in Japanese Medical Treatment and Supervision Procedures [J]. Chinese Journal of Forensic Sciences, 2024, 0(2): 18-24.
[2]	LI Liliang. Current Status and Forensic Appraisal Progress of Sudden Unexplained Death in Individuals with Mental Disorders [J]. Chinese Journal of Forensic Sciences, 2024, 0(2): 47-54.
[3]	ZHANG Yukuan, SHI Shaopei, WANG Yachen, SUN Nianfeng. Comparative Study on the Standards for Forensic Examination of Handwriting [J]. Chinese Journal of Forensic Sciences, 2024, 0(1): 99-106.
[4]	XING Ting. Research on the Standardization of Technical Evidence Examination in Procuratorial Organs [J]. Chinese Journal of Forensic Sciences, 2023, 0(6): 8-15.
[5]	ZHANG Qinting. Progress on the Study of Post-concussion Syndrome and Psychiatric Impairment Assessment [J]. Chinese Journal of Forensic Sciences, 2021, 0(1): 39-47.
[6]	TANG Tao-1, ZHANG Qin-Ting-1, 2 , CAI Wei-Xiong-1, HUANG Fu-Yin-1, FAN Hui-Yu-1. Intellectual Impairment Assessment of Patients with Mild Psychiatric Impairment Due to Road Traffic Accident [J]. , 2014, 0(3): 36-39.
[7]	LI Kang, LI Xiao-Jun, CHANG Bai-Nian. A Comparative Study of the Novel Fluorescent Cyanoacrylate Powder and the Cyanoacrylate Glue-Fluorescent Staining for Developing Latent Fingerprints [J]. , 2014, 0(1): 80-85.
[8]	. Issues on Appraisal in Criminal Compulsory Medical Procedures [J]. , 2013, 0(6): 94-98.
[9]	. A study on the correlation between coma and social ability as well as daily living activity after traumatic brain injury [J]. , 2013, 0(5): 37-39.
[10]	LI Yu-1, LIANG Quan-Zeng-2. The Exploration of Medical Appraisal of Mental Disorders [J]. , 2013, 0(3): 0-0.
[11]	GUAN Wei, ZHANG Qin-ting, TANG Tao, HUANG Fu-yin. Diagnosis of Mental Disorder due to Drug Abuse in Forensic Psychiatric Appraisal [J]. Chinese Journal of Forensic Sciences, 2012, 0(6): 24-27.
[12]	ZHANG Yan, LI Dong, GE Lu-zou, ZHANG Ji, CHANG Lin. Construction of the Hearing System in Forensic Psychiatry Appraisal [J]. Chinese Journal of Forensic Sciences, 2012, 0(2): 17-21.
[13]	TANG Tao, ZHANG Qin-ting, GUAN Wei. The Qualification for Disability Assessment of Intellective Defects [J]. Chinese Journal of Forensic Sciences, 2012, 0(2): 37-47.
[14]	LI Chang-cheng, . Research about Mental Evaluation in Criminal Procedure [J]. Chinese Journal of Forensic Sciences, 2011, 0(5): 7-10.
[15]	TANG Tao, ZHANG Qin-ting, CAI Wei-xiong, WU Jia-sheng. Assessment for Mental Disorder and Disability due to Brain Injury Caused by Traffic Accidents [J]. Chinese Journal of Forensic Sciences, 2011, 0(5): 33-36.

A Comparative Study of Domestic and Foreign Guidelines for Assessing the Fitness to Drive of Individuals with Mental Disorders

国内外精神障碍者驾驶适宜性评定指南比较研究

PDF

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics