To the Editor.
—The conclusions by Dr Fitten and colleagues1 that cognitive impairment is a better predictor of driving skills in Alzheimer and vascular dementia populations rather than age or medical diagnosis is informative.Despite the fact that prediction of risk for future vehicular crashes remains an uncertain science, physicians are sued for allowing older patients to drive. They appear to expand the physician's legal duty of care to the public at large. For example:
A woman and her three children were struck by an automobile. They filed a lawsuit against the driver. During discovery they learned that the driver had adult-onset diabetes (noninsulin treatment), and they filed a third-party claim against the physician2 asserting that the diabetes caused a "temporary lapse of consciousness" at the wheel with subsequent loss of control. The court affirmed that the physician had no duty to report a patient's diabetes to the state's