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See: [https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/)  \nFor further permissions, contact [permissions@cma.ca](permissions@cma.ca).  \nLibrary and Archives Canada Cataloguing in Publication  \nCMA driver's guide : determining medical fitness to operate motor vehicles.– 10th edition.  \nIncludes bibliographical references.  \nISBN 978-1-897490-56-3 (PDF)  \nAutomobile driving–Physiological aspects–Handbooks, manuals, etc. Automobile drivers–  \nMedical examinations–Handbooks, manuals, etc. Automotive medicine–Handbooks, manuals, etc.  \nI. Canadian Medical Association, issuing body  \nDisclaimer: This guide is for information purposes and is not a substitute for medical diagnosis, and physicians are encouraged to use their best clinical judgment to determine a patient’s medical fitness to drive. The naming of any organization, product or alternative therapy in this book does not imply endorsement by the Canadian Medical Association or CMA Impact Inc., nor does the omission of any such name imply disapproval by the Canadian Medical Association or CMA Impact Inc. Neither the Canadian Medical Association nor CMA Impact Inc. assumes any responsibility for liability arising from any error in oromission from the book, or from the use of any information contained in it.  \nÉgalement disponible en français.  \nCMAJ Driver’s Guide—10th Edition  \nContents  \nvii Acknowledgements  \nvii Scientific Editorial Board  \nvii Contributing authors  \nviii CMA staff  \nviii CMAJ Group staff and contractors  \n1 Section 1: Introduction  \n1 1.1 A guide for physicians  \n1 1.2 Functional assessment  \n2 1.3 Medical standards for fitness to drive  \n2 1.4 Methods  \n3 1.5 The physician’s role  \n3 1.6 Public health  \n4 1.7 Levels of medical fitness required by the motor vehicle licensing authorities  \n5 1.8 Driver’s medical examination report  \n5 1.9 Physician education on driver evaluation  \n5 1.10 Payment for medical and laboratory examinations  \n6 1.11 Classes of drivers’ licences and vehicles  \n6 1.12 Contact us  \n7 Section 2: Functional assessment—emerging emphasis  \n7 2.1 Overview  \n7 2.2 Standards  \n8 2.3 Assessment  \n2.3.1 Office assessment  \n2.3.2 Functional assessment  \n9 2.4 Finding an occupational therapist  \n10 Section 3: Reporting—when and why  \n10 3.1 Overview  \n13 3.2 Reporting  \n14 3.3 Patient’s right of access to physician’s report  \n15 Section 4: Driving cessation  \n15 4.1 Overview  \n15 4.2 Voluntary driving cessation  \n16 4.3 Involuntary driving cessation  \n16 4.4 Planning for retirement from driving  \n17 4.5 Strategies for discussing driving cessation  \n18 4.6 Compliance  \n19 Section 5: Alcohol  \n19 5.1 Overview  \n19 5.2 Assessment: Clinical history  \nContents | i  \n22 Section 6: Drugs  \n22 6.1 Overview  \n23 6.2 Clinical history  \n23 6.3 Common drugs  \n6.3.1 Sedatives and hypnotics  \n6.3.2 Non-prescription antihistamines, motion-sickness medications, and muscle relaxants  \n6.3.3 Opioids  \n6.3.4 Central nervous system stimulants  \n6.3.5 Hallucinogens  \n6.3.6 Inhalants  \n6.3.7 Antidepressants and antipsychotics  \n6.3.8 Antiseizure medications  \n6.3.9 Conscious sedation in an outpatient setting  \n6.3.10 Anti-infective agents  \n6.3.11 Anticholinergics  \n6.3.12 “Designer drugs” and herbal preparations  \n6.3.13 Antiparkinsonian drugs  \n6.3.14 Cannabis – recreational and medical use  \n29 Section 7: Aging  \n29 7.1 Overview  \n30 7.2 Red flags—the 3Rs  \n30 7.3 Hidden diseas","cbCaic0LLlYGC5jQ","https://ap.wps.com/l/cbCaic0LLlYGC5jQ","pdf",1832145,155,"English","# Section 1: Introduction\n## A guide for physicians\n## Functional assessment\n## Medical standards for fitness to drive\n## The physician’s role\n## Public health\n## Levels of medical fitness required by the motor vehicle licensing authorities\n## Driver’s medical examination report\n## Physician education on driver evaluation\n## Payment for medical and laboratory examinations\n## Classes of drivers’ licences and vehicles\n## Contact us\n# Section 2: Functional assessment—emerging emphasis\n## Overview\n## Standards\n## Assessment\n## Finding an occupational therapist\n# Section 3: Reporting—when and why\n## Overview\n## Reporting\n## Patient’s right of access to physician’s report\n# Section 4: Driving cessation\n## Overview\n## Voluntary driving cessation\n## Involuntary driving cessation\n## Planning for retirement from driving\n## Strategies for discussing driving cessation\n## Compliance\n# Section 5: Alcohol\n## Overview\n## Assessment: Clinical history\n# Section 6: Drugs\n## Overview\n## Clinical history\n## Common drugs\n## Sedatives and hypnotics\n## Opioids\n## Hallucinogens\n## Cannabis – recreational and medical use\n# Section 7: Aging\n## Overview\n## Red flags—the 3Rs\n## Hidden disease\n## Multiple comorbidities\n# Section 8: Dementia\n## Overview\n## Earlier Canadian dementia guidelines\n## Updated guideline recommendations\n## Reporting according to stage of dementia\n## Cognitive screening tools\n## When fitness to drive remains unclear\n## Counselling and disclosure\n## Follow-up after loss of licensure\n## Countermeasures\n## Driving and Dementia Roadmap\n# Section 9: Sleep disorders\n## Overview\n## Assessment\n## Obstructive sleep apnea\n## Narcolepsy\n## Other sleep disorders\n# Section 10: Psychiatric disorders\n## Overview\n## Functional impairment\n## Assessing fitness to drive\n## Specific disorders\n## Psychoactive drugs\n# Section 11: Nervous system\n## Overview\n## Syncope\n## Seizures\n## Head injury and seizures\n## Disorders affecting coordination, muscle strength, and control","[{\"question\":\"What is the document’s purpose for clinicians?\",\"answer\":\"It provides guidance for physicians to determine a patient’s medical fitness to operate motor vehicles using clinical judgment and defined medical standards.\"},{\"question\":\"How does the guide structure assessment and standards for driving fitness?\",\"answer\":\"It emphasizes functional assessment and outlines medical standards, methods, and different levels of fitness required by motor vehicle licensing authorities.\"},{\"question\":\"Which medical conditions are specifically addressed for driving fitness decisions?\",\"answer\":\"Alcohol use, drug effects, aging, dementia, sleep disorders, psychiatric disorders, and nervous system conditions such as seizures and syncope are covered with assessment and reporting considerations.\"}]","CMA Driver’s Guide - Determining Medical Fitness to Operate Motor Vehicles - 10th Edition | PDF",391]