A lot of this is driven by insurance agencies and data from investigations of events. I don't have insight into that. Insurance companies, these days, tend to be very data driven.
It would be great if there was a way to test for competence. Some drugs cause long term issues with decision making and being able to see what's likely to happen. This reminds me of a job I had years ago framing houses. I remember some of the work men firing nails from a nail gun into a nearby woods. An area where neighborhood kids happen to play.
That's poor decision making and a liability. How do you test for complex things like that?