The inquiry into the crash has heard that Harry Clarke, 58, lied about previous blackouts in order to get driving jobs.
Asked to say sorry that this "led to the deaths of... innocent people", Mr Clarke replied: "No, I can't say that."
He did not answer all questions as he may still face a private prosecution.
Two of the bereaved families have indicated they intend to take action against Mr Clarke for alleged dangerous driving after the Crown Office said it would not prosecute him.
The fatal accident inquiry (FAI) at Glasgow Sheriff Court is looking at Mr Clarke's health, the bin lorry and its route.
The inquiry has already heard that Mr Clarke was unconscious at the wheel of the Glasgow City Council bin lorry when it veered out of control on Queen Street on 22 December, killing six people and injuring 15 others.
It has also heard that he suffered an earlier blackout at the wheel of a stationary bus in 2010 when he worked for First Bus as a driver.
This episode, and his history of dizziness and other ailments, were not disclosed to Glasgow City Council and the Driver and Vehicle Licensing Agency (DVLA).
In his second and final day of evidence, Mr Clarke was cross-examined by Dorothy Bain QC, who is acting for the bereaved Morton family.
She accused him of telling "a pack of lies" about his history of blackouts and accused him of showing "reckless indifference" by not disclosing earlier fainting episodes.
After he refused to answer questions relating to his medical history, the QC asked if he would like witnesses to tell the truth if his own daughter had died.
Mr Clarke refused to answer.
Ms Bain said the six victims would still be alive if he had been honest about his medical past because he would never have been given jobs as a driver.
"You should never have been behind the wheel and you knew that," she told him.
"You took a chance and it has taken the lives of six people. The difference is you had a choice."
Ms Bain said the phrase "I'm all right Jack" summed up Mr Clarke's attitude.
The QC said that it was "incredible and beyond belief" that following the bin lorry tragedy, Mr Clarke had pursued getting his licence back.
She ended her cross-examination by saying that if Mr Clarke had told the truth "all this could have been prevented".
Mr Clarke was then cross-examined by Mark Stewart QC, representing the bereaved McQuade family.
He again refused to answer any questions about his medical history.
The QC asked him to "take the risk" of answering questions, but Mr Clarke said he did not want to answer.
Ronald Conway, the lawyer for the bereaved Tait family was next to cross-examine Mr Clarke.
He questioned Mr Clarke about the 2010 fainting incident when he was a bus driver. He again refused to answer.
Mr Conway said that if he had not been challenged by an inspector, who attended the scene having been notified by a passenger, Mr Clarke would have just driven on and not mentioned it.
The witness did not comment.
The lawyer then noted that Mr Clarke got a doctor's appointment that day, adding "desperate situations require desperate remedies".
Referring to earlier evidence where it was said Mr Clarke had told his doctor he fainted in the First Bus canteen, Mr Conway said: "You span the doctor a line about queuing in a hot canteen.
"You then told the occupational doctor at work that your own doctor said you were fit to drive.
"You could not believe your luck when you got away with it, could you?"
Again, Mr Clarke did not answer.
The lawyer went on: "Just another little white lie for you. No harm done."
Mr Conway said that after Mr Clarke left First Bus and got a job with Glasgow City Council, 2010 had "receded into history".
"You pretended it never happened," he said, adding: "The past has a way of catching up with all of us."
He asserted that Mr Clarke has a "high susceptibility" to fainting.
Alluding to the consequences of Mr Clarke not disclosing this, he said: "The little white lie of April 2010 is actually a big black lie."
He continued: "Mr Clarke, I would give you the chance to say 'I'm sorry I told lies in April 2010 and I know and accept that those lies led to the deaths of those innocent people'.
"Can you say that Mr Clarke?"
He replied: "No I can't say that."
Mr Conway concluded his cross-examination by saying that if Mr Clarke had told the truth he would never have been behind the wheel of the bin lorry.
With his evidence to the FAI concluded, Mr Clarke left the witness stand.
The inquiry will resume on Tuesday, when closing submissions will begin.
The driver who blacked out at the wheel of a Glasgow bin lorry before it killed six people has refused to say sorry for "lies" he told about his health.