ABSTRACT
Participation in road traffic in Germany is governed by various laws and acts. Physicians are obliged to decide whether, in the presence of medical conditions and handicaps, a patient is fit to drive a car safely. Following myocardial infarction this decision is generally made by specialized cardiologists (specialization in social medicine) in rehabilitation centers. If a patient does not undergo rehabilitation after an acute event, this decision must be made by the invasive cardiologist, who is often not skilled in this kind of assessment. The second problem faced in Germany is the discrepancy between outdated legal regulations, modern cardiology and the current standard of medical knowledge, especially in terms of treatment for acute coronary syndrome. According to current legal regulations, no patient at all is allowed to drive a car in Germany after any form of myocardial infarction, regardless of ejection fraction, for at least 3 months. In contrast, a working group for the German Society of Cardiology published a position paper in 2010 in which patients could be allowed to drive a car 2 weeks after an AMI with an EF >30. The third problem in this context in Germany is that, due to a decision by the Federal High Court of Justice, physicians are not only responsible to inform the patient, if he is not allowed to drive a car, but also have to assure that he does not leave the hospital or practice by car, if he is not allowed to. If the patient however opposes, drives home and has an accident, the physician is liable for the damages. The fourth and final problem lies in the fact that most cardiologists in Germany are neither skilled in legal traffic assessment, nor are they familiar with this field and its problems.
