R. Mattern

Expertises on the fitness to drive motor vehicles is very largely regulated by the Driving License Regulations, the Guidelines for Expertises and by the fulfillment of the specification for agencies that are to be accredited for export reporting on fitness to drive. Furthermore, it is subject to instruments of quality assurance. This legal framework is intended to ensure that the objective of juridical reliability and equality before the law is achieved. From the viewpoint of forensic medicine, the expert reporting therefore does not differ in practice from the procedure of the major fitness-to-drive expertise agencies as far as it applies to first-instance reports. The procedure of expert reporting by what has so far been termed "senior experts" (some of these are forensic physicians, most are other medical specialists or are psychologists) differ from the first-instance reports above all in that the time required for the investigations and formulating the results is usually higher, and there is corresponding remuneration. For this reason, it appears plausible to expect a high quality. Instead of obtaining these from senior experts, the driving license authorities can now call for additional reports from specifically appointed "persons with a pre-eminent qualification" on the instruction of the supreme state authority. This wording of the expertise guidelines continues to promote the expectation of special quality engendered by the earlier term "senior expertise". What are the criteria for the quality of the expert report and what can jeopardize these criteria? Quality criteria may on the one hand be the comprehensibility and plausibility of the report, and on the other hand the positive performance in traffic of drivers who have been given a positive report. The first requirement can be met by time-consuming meticulous analysis and experience in export reporting, but also by the time-saving use of knowledge-based computer programs. The suitability of the criterion of positive performance in traffic is called in question by a bias resulting from the fact that only drivers who have received a positive report can prove their fitness. It cannot be established how many of the drivers who have been rejected for cogent reasons would be able to prove their driving fitness if they had the chance to do so. The scientific validation of the prognostic characteristics of diagnostic methods and epidemiological data will therefore be of very great importance in future research.