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Doctors should evaluate liver disease patients for cognitive impairment, address driving safety
Date:3/18/2011

There are potential legal ramifications for physicians of patients who drive with cognitive impairment, according to a study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

Between 20 and 60 percent of patients with cirrhosis (a condition in which the liver is permanently scarred or injured by chronic conditions and diseases) are affected by a peculiar kind of cognitive impairment, also known as hepatic encephalopathy (HE), which can range from mild to overt. This impairment can include cognitive alterations with selective attention, visuomotor ability, psychomotor speed and the ability to suppress behavior. Mild HE has also been associated with an increased number of car accidents and traffic violations.

Doctors studied state requirements for reporting HE, and investigated whether lawsuits have been completed against physicians or patients for motor vehicle accidents that were related to HE.

"We found that hepatic encephalopathy is not specifically addressed in any state vehicle code," said Stanley Martin Cohen, MD, of Loyola University Medical Center and lead author of this study. "In the absence of definite laws, the responsibility for identifying potentially hazardous drivers, and the associated liability, might still lie with the physician." To view Dr. Cohen further discuss his research findings, go to http://www.youtube.com/watch?v=eJdkbQvCE_Y.

Dr. Cohen and colleagues contacted motor vehicle departments from all 50 states and examined motor vehicle codes and legal databases to search for HE-related lawsuits. They found that definitions of a medically impaired driver varied considerably. No state specifically mentioned HE or patients with advanced liver disease.

Only six of the states had mandatory reporting laws for drivers who have medical impairments, and 25 o
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Contact: Alissa J. Cruz
media@gastro.org
301-272-1603
American Gastroenterological Association
Source:Eurekalert

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