I didn't say the article said he passed out. I said he has a condition that can make him pass out. I also added that drinking alcohol exacerbates the condition.
If all 2 million of those individuals are engaging in behaviors that exacerbate their condition, thus making it more likely they will pass out behind the wheel, I think the doctor should consider reporting them to the BMV to have their licenses revoked. Since each situation is different, the doctor is going to have to use his/her own judgment.
I think you have put your finger on it right there. I don't think many people would disagree that someone with a dangerous condition should not be driving unrestricted. The problem is the doctor's judgment, at least in this case. As I noted, I just don't think this rises to the level of license revocation. The question is what "exacerbates" a condition and how much "more likely" does an incident need to be to justify restriction of driving privileges? I mean, you could spin out all kinds of ridiculous theories.... someone with contact lenses or allergies is more likely to experience a vision problem (lens getting dirty, dust in eye); someone who is obese is at greater risk for heart attack (especially if he/she smokes), pregnant women can experience diabetes complications, dizziness, or fainting spells.... I don't think anyone would want to go that far. In this case, the problem seems to be that he drinks alcohol (maybe or maybe not before driving) and this "could" exacerbate his condition (unclear to me that it definitely did so). Does that cross the line? I don't think it does. I wonder if the doctor would have done the same if the guy drank a lot of coffee; caffeine also is an exacerbating factor, but I don't think he could have called it "substance abuse." The problem with using the doctor's judgment is that it leads to such wildly disparate results, but I don't know what the answer should be. The legislature could enact more definite standards for license review, but that's dicey too.