Author reply

We thank Regal[1] for his interest and his kind comments regarding our paper.[2] Our principal aim was to highlight several key ethical issues faced by Australian physicians (e.g. reporting obligations, negative consequences of driving cessation). Regal raises a challenging, yet unresolved, dilemma: which test best determines safe driving capacity? Although an in-depth appraisal of existing tests was beyond the scope of our paper, we did refer to two seminal reviews. The Australian and New Zealand Society of Geriatric Medicine (ANZSGM)[3] and the American Academy of Neurology (AAN)[4] have comprehensively reviewed the existing literature regarding assessment of fitness to drive of individuals with dementia. Neither organisation supports sole reliance upon occupational therapy assessments in determining driving safety. As quoted in our paper, the AAN systematic review concluded that 'there is no test result or historical feature that accurately quantifies driving risk'.