By Dr Ananya Mandal, MD
Over the last few decades the attitude towards epilepsy has undergone a sea change. There has been progress in diagnosing and treating epilepsy effectively. Despite these advances, epilepsy continues to evoke fear, discrimination and negative stereotypes. There are several legal issues that an epileptic needs to be aware of in order to prevent unfair and unjust treatment to them. In many patients regular treatment with medications can help in keeping the seizures in check and patients can lead a near normal life.
Some of the issues include:
Qualified workers with epilepsy may be denied job opportunities due to stereotyped views risks of seizures at the workplace. This is one of the biggest problems faced by epileptics worldwide. Now because of laws like the Americans with Disabilities Act (ADA), most employers are no longer allowed to ask job applicants whether they have disabilities like epilepsy and its severity. Laws also prevent employers from discriminating on the basis of disabilities.
Colleges may refuse to make academic adjustments to ensure greater participation of epileptic patients and bar them from activities that are perceived to be dangerous. Schools and day-care facilities may refuse to take the responsibility of a child with epilepsy and refuse to administer medication when necessary. The Individuals with Disabilities Education Act (IDEA) says that every child with a disability is entitled to a free, appropriate public education. Students with epilepsy may not need special education but may need scheduling and special attention.
Those with epilepsy are erroneously viewed as aggressive or intoxicated and may be arrested unjustly. Complex partial seizures in particular may appear aggressive and are sometimes misunderstood by police. Wearing an emergency medical bracelet or other medical identification may help prevent this type of inappropriate arrest.
A parent with epilepsy during divorce proceeding may be denied custody of his or her child. Case law states that epilepsy may not be the sole basis for denying custody to a parent. It may be a factor while considering the child’s best interests but does not prevent him or her being a good parent.
Driving and Driver’s licensing
Every state places its own restrictions on driving by persons with certain medical conditions like epilepsy. In most states of USA the person needs to be seizure-free for three to six months up to 1 year to be allowed to drive. In the UK, it is the responsibility of the patients to inform the Driver and Vehicle Licensing Agency (DVLA) if they have epilepsy. The rules suggest that those that continue to have seizures or who are within 6 months of medication change may have their licence revoked. A person must be seizure free of a 'daytime' seizure for 12 months (or had only 'sleep' seizures for 3 years or more) before they can apply for a licence. The laws are similar elsewhere in the world with variations.
Air travel and piloting
Those with epilepsy are usually prohibited from piloting aircraft unless they are absolutely seizure free. In the United States, a history of epilepsy is generally disqualifying for the medical certification of pilots. There are no restrictions of epileptics to travel by air.
Another major problem faced by epileptics is obtaining affordable health insurance. Finding affordable life and auto insurance is also a challenge.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)