Distrust of Authorities: Experiences of Outcome and Processes of People Who Had Their Driving License Withdrawn Due to Visual Field Loss

Self-Perception and the Relation to Actual Driving Abilities for Individuals With Visual Field Loss

Background

In Sweden, individuals with visual field loss (VFL) have their driving license withdrawn. The literature clearly indicates that individuals with VFL are unsafe drivers on a group level. However, many drivers with VFL can be safe on an individual level. The literature also suggests that self-perception, beliefs, and insights of one’s own capabilities are related to driving performance. This study had three aims: (1) To investigate self-perceived driving capability ratings for individuals with VFL; (2) to compare these ratings between groups with different medical conditions associated with VFL (stroke, glaucoma, and diabetes); and (3) to relate the self-perception ratings to actual driving performance in an advanced driving simulator.

Methods

Participants comprised 723 individuals whose driver’s license had been withdrawn because of VFL and 92 normally sighted elderly individuals. All participants completed a background survey, rated difficulties with different traffic situations, rated their strengths and weaknesses as drivers, and rated aspects that were important for causing traffic accidents. Of the VFL group participants, 264 also completed a simulator-based driving test that they knew could lead to renewal of their driving license. VFL participants and normally sighted was at the same age when they completed the simulator driving test.

Results

Overall, individuals with VFL rated their capabilities as high on all instruments and scales used, even higher than the elderly normally sighted control group. The only VFL etiology group that rated lower than other groups was the diabetes group. Safety orientation and internal control orientation values were best at discriminating between VFL participants in terms of self-perception of driving performance. Participants categorized as “high” in terms of safety skills and internal control were more modest in their ratings. Finally, participants who passed the simulated driving test did not differ from those who failed, in any of the self-perception measures.

Conclusion

Self-perception ratings among individuals with VFL were higher than those of normally sighted elderly individuals. Self-assessed skills did not predict driving performance. Groups with different VFL etiologies rated similarly. Self-ratings of driving abilities cannot be used to assess actual driving performance. Actual driving tests (on road or in the simulator) are necessary to discriminate between safe and unsafe drivers with VFL.

Predictive Value of the Esterman Visual Field Test on the Outcome of the On-Road Driving Test

Purpose

As the prevalence of age-related visual field disorders and the number of older drivers are rising, clear criteria on visual field requirements for driving are important. This article explores the predictive value of the Esterman visual field in relation to the outcome of an on-road driving test.

Methods

A retrospective chart review was performed for driver's license applicants who, based on their visual field, performed an on-road driving test. Cases (N = 101) with a failed on-road driving test were matched with 101 controls with a passed outcome. The Esterman visual field was divided in regions, and the number of points missed per region was counted. Logistic regression models and receiver operating characteristic (ROC) curves were computed for each region.

Results

Most regions presented a significantly increased odds for failing the driving test when more points were missed. The odds ratio for the whole visual field was 2.52 (95% confidence interval, 1.53–4.14, P < 0.001) for all the participants. However, ROC curves failed to reveal distinct fail–pass criteria based on the number of points missed, as revealed by a large amount of overlap between cases and controls.

Conclusions

These findings confirm the relation between visual field damage and impaired driving performance. However, the Esterman visual field results were not conclusive for predicting the driving performance of the individual driver with visual field defects.

Translational Relevance

In our group of participants, the number of on-road driving tests cannot be further reduced by a more detailed definition of fail–pass criteria, based on the Esterman visual field test.

Costs and Consequences of Traffic Fines and Fees: A Case Study of Open Warrants in Las Vegas, Nevada

Traffic stops and tickets often have far-reaching consequences for poor and marginalized communities, yet resulting fines and fees increasingly fund local court systems. This paper critically explores who bears the brunt of traffic fines and fees in Nevada, historically one of the fastest growing and increasingly diverse states in the nation, and one of thirteen US states to prosecute minor traffic violations as criminal misdemeanors rather than civil infractions. Drawing on legislative histories, we find that state legislators in Nevada increased fines and fees to raise revenues. Using descriptive statistics to analyze the 2012–2020 open arrest warrants extracted from the Las Vegas Municipal Court, we find that 58.6% of all open warrants are from failure to pay tickets owing to administrative-related offenses—vehicle registration and maintenance, no license or plates, or no insurance. Those issued warrants for failure to pay are disproportionately for people who are Black and from the poorest areas in the region. Ultimately, the Nevada system of monetary traffic sanctions criminalizes poverty and reinforces racial disparities.