William Payne was accused at a fatal accident inquiry of lying by not telling the DVLA about the blackouts, which could have stopped him driving.
The 54-year-old was yesterday questioned in public for the first time about the deaths of Mhairi Convy, 18, and Laura Stewart, 20.
The pair were struck by Payne’s Range Rover after it mounted a pavement in Glasgow city centre in December 2010.
The lawyer acting for their families later told Payne that “responsibility rests squarely” with him for the loss of two “innocent” young women.
Last year prosecutors dropped criminal proceedings against Payne in connection with the incident.
The fatal accident inquiry examined the circumstances of the deaths, which happened in Glasgow’s North Hanover Street on 17 December 2010.
Payne was questioned by Dorothy Bain, the QC representing the families of the two women, but he refused to answer many of them.
Sheriff Andrew Normand, presiding over the inquiry, earlier told him that he did not have to answer any which may show him to be guilty of a crime or offence.
Miss Bain asked him about the renewal of an HGV licence in July 2010 – five months before the accident.
The QC said the “no” box was ticked on a document asking if Payne had suffered any blackouts in the last five years.
However, the court heard a number of claims that Payne had collapsed during that time, including once while taking his dog to the vet.
Miss Bain accused Payne of being “totally and utterly unreliable about his medical history”.
She went on: “If you had answered ‘yes’ [on the document], you would not have been allowed to drive.
“You were reckless to the safety of other people using the streets because, as we have seen today, you are just looking out for number one.
“That should be your mantra: number one, that is what matters.”
The QC added: “Your selfishness has taken the lives of two young women. Two young women perfectly innocently going out doing their Christmas shopping.
“You could have prevented that by telling the truth.”
Payne replied that he could not answer what was put to him.
The QC later referred to Payne’s police interview after the accident, in which he claimed he was “sorry”.
Miss Bain said to Payne: “You could have been stopped driving in the July. Do you know what would have happened?
“You would not have to be sorry or even be here today, as Mhairi Convy and Laura Stewart would be alive.
“The responsibility rests squarely on your shoulders.”
He replied: “I cannot answer that question.”
Asked last night about the issues raised during the inquiry, a Crown Office spokesperson said: “The Crown reserves the right to re-raise criminal proceedings should there be a material change in circumstances. We will continue to keep the families advised of the status of the case and any future developments.
“It would be inappropriate to comment further.”
The inquiry continues.