AICARM does not let go of the issue and renewal of driving licenses for pacemaker and defibrillator wearers. The outlines of the story are known: anyone who has a system of this type must declare it to the motor vehicle offices and to their own insurance to avoid consequences in the event of an accident. From that moment begins a real journey into the labyrinth of bureaucracy and inefficiency, unfortunately so widespread in Italy. Journey that is repeated over time based on the duration of the renewal, duration granted according to the guidelines used by the local Medical License Commission. And it is precisely on the guidelines adopted by the medical commissions that AICARM is focusing its attention. In fact, it appears that there is not just one "Guideline", but more than one and that none of these is present in the Public Register of Guidelines set up at the Istituto Superiore di Sanità or the "SNLG - National Guidelines System".
In this regard, and to find out whether the SNLG contains a guideline that can be applied to patients with cardiomyopathy with pacemakers or defibrillators, AICARM has officially written to Professor Silvio Brusaferro, President of the Istituto Superiore di Sanità. We were told that "in the National System of Guidelines there are no Guidelines concerning the issue or renewal of driving licenses in subjects with an ICD defibrillator".
This answer confirms that, in addition to the regional fragmentation of our healthcare, in this case we also have one fragmentation of guidelines. Paradoxically, each Medical Commission could adopt a different one, effectively fueling the regulatory chaos we are dealing with. To put it bluntly: “Many guidelines, no guidelines”. In light of these findings, and in the interest of patients with cardiomyopathy that AICARM Onlus intends to represent, we are evaluating further actions to protect impartiality and equal treatment to which patients with a defibrillator or implanted pacemaker are also entitled.
In the meantime, and to defuse what is happening, we report parts of a letter from a nice friend of AICARM who tells us a very little "Divine Comedy" of the heart patient looking for a license renewal. Enjoy the reading!
“Il first round Dantesque consists of making an appointment with the Special License Commission of the Local Health Unit where you reside: waiting lists last many months and if in the meantime your license expires you have to pay a "bounty" to obtain an extension.
Il second round Dantesque is the endless plethora of fees, levies and medical certificates to be prepared before the visit: they take away time, patience and money.
Then we move on to third round, the visit, which often takes place in the manner of a Fantozzi film.
To finally get to the center of Hell, where the "sentence" is pronounced: a year, a year and a half, six months of license renewal... just like Minos with the sinful souls (Inferno, Canto V):
Stavvi Minòs horribly, and growls:
examines the faults in the intrata;
judges and sends according to which he clings.
I say that when the ill-born soul
comes before them, all confess;
and that connoisseur of sins
sees what place of hell is from it;
cignesi with the tail many times
however degrees it wants it to be put down.
Minos in an illustration by Gustave Doré
