from my OLD, dead hands

How will they take your car keys when you're an elderly driver?  The issue has been in the news the past few days, due to the release of AAA Roadwise Review, a CD-ROM by the American Auto Association:

"The AAA Roadwise Review: a Tool to Help Seniors Drive Safely Longer is an easy-to-use, scientifically validated screening tool available on CD-ROM. Through a series of explanatory video segments and interactive measures, AAA Roadwise Review guides users through the program. Working with a partner, users can progress at their own pace, repeating the instructions and pausing the program as needed. ...

"Assessments measure the user's ability to see in low light and scan across a field of view, visual acuity, flexibility and other skills proven to be among the leading predictors of crash risk among older drivers. In addition, the program offers information on how to improve or compensate for functional abilities that tend to decline over the years. Users are encouraged to repeat the review periodically, recording their results for easy comparison over time."

I'm wondering where my federalist and libertarian webfriends stand on the issue of how, when, and by whom action should be taken to deal with the increasing problem of unsafe elderly drivers.  Yesterday, my local newspaper, The Schenectady [NY] Daily Gazette, compared elderly driving with social security as a "third rail" of American politics.  (Editorial, "When Miss Daisy shouldn't be driving," Jan. 15, 2005, A9, $$) Noting that this is already a major public health problem, the Gazette opines:

"Ideally, all drivers over the age of 70, when vision, reflexes and judgment tend to decline significantly, would be subject to more frequent testing.  Eye exams aren't enough; some sort of driving test is also needed.  For those who have trouble, a provisional license, with limitations such as no night or highway driving, is a possibility.  Some older persons already impose these restrictions on themselves.  But many aren't aware they have problems, or refuse to do anything about it if they are."

In June, 2003, Oregon instituted a law requiring doctors to notify DMV when a patient has medical problems that make the patient unfit to drive.  That same year, Florida stated requiring drivers over 80 to have their vision tested when their licenses are renewed. (USA Today article, Dec. 01, 2003)  On the other hand, New York State keeps making the license renewals last longer and longer.  Last year, they sent my 85-year-old father (whose keys were taken away four years ago, at his doctor's orders, and his family's) a renewal registration for eight years -- with only the need for a new eye exam, which he could probably pass.

Although I paraphrased Charlton Heston above, I don't know what his position would be on carkeys rather than guns.  His old Hollywood rival, Kirk Douglas, on the other hand, is perhaps the most high-profile example of why strict review and mandatory reporting are necessary.   Douglas is involved this month in a trial (John Robert vs. Kirk Douglas, #SC077501) stemming from an auto accident he caused at age 85 (before the deadly Farmers Market accident).  As one press account notes:

"There are many who believe Kirk Douglas at 85 should not have been driving any car due to his many recent medical problems. In recent years Kirk Douglas has had (2) pacemakers, partial paralysis, daily medication, stroke(s), bad knees, compressed spine, attempted suicide and broken back. This is in addition to passing out in public. Many of the above conditions are considered by the DMW for license revocation when reported by Doctor/or family."

Should the federal government get into these issues -- beyond research and collecting data?  Is control of the Interstate Highway system a sufficient justification for federal intervention?  What kind of responsibility do the states have to act -- not only by instituting better testing and evaluation of older citizens, but also by helping to plan for options and substitute services that will be needed as millions of the elderly become unable to drive?

In a column in August 2003 for Liberty for All, in the wake of the killing of 10 at the Santa Monica Farmers' Market, Rachel Mills made some very good points:

A lot of adult children would feel so tremendously relieved if the state would take on that role in their parents' lives. Then they wouldn't have to be the bad guy. The state should require driving tests after such-and-such age to get people off the road who shouldn't be there.

I'm not so opposed to that, I guess. But one thing worries me, that always worries me when the state swoops in and "fixes our problems." We might stop worrying about those problems ourselves and simply defer to the higher judgment of the state instead of listening to the screams of common sense resounding deafeningly in our ears.

The Cass County [MO] Libertarian did a survey on elderly drivers in August 2003. Forty-nine percent of those who responded said state governments should not be involved, leaving the issue for private insurance companies, who would decide who to cover and how much to charge.  Twenty-four percent said states should require drivers over a specified age to pass an annual driving test. 

• Click here to find your local AAA affiliate, if you're interested in purchasing the AAA Roadwise Review CD-ROM (it would have made a great Christmas gift for a lot of nanas and papas).  I've seen it listed at $5 to $10 for members, and $7 to $15 for non-members.
• p.s.  A few years ago, when health problems caused me to be quite confused in traffic, I grounded myself completely for 18 months.  The experience -- after over 30 years of driving -- made me realize how important it is to make comprehensive personal plans (and backup plans) for the day when I can no longer drive.   I was pleased to see, however, that I could be responsible enough to hang up my keys before they were taken from me after a major tragedy on the road.

Update (Jan. 17, 2005): I found some items of interest that I want to suggest for those thinking about possible solutions:

1. A five-year old Missouri statute allows family members, law enforcement and physicians to report impaired drivers, granting those who report confidentiality and immunity from prosecution, but also requiring signed affidvaits and documentation, with punishment for false reporting. In the period ending September 30, 2004, a total of 2,007 reports were made. and roughly 35%, or about 700 drivers, had action taken against them. This would include license revocation or a license restriction, such as day driving only.  For more information, see the Concerned Americans for Responsible Driving (CARD) web-site.
2. Canadians are facing similar problems as their population ages, with various provinces taking different approaches, attempting to balance road safety with individual rights.  You'll find details in this CBC story, which notes that "But they have more accidents per kilometre driven than any other age group. The accidents tend to be in daytime in good conditions."

3. In an FAQ about elderly drivers, Insurance.com states:

   "When measured by crashes per mile driven, drivers between the ages of 25 and 64 have a fairly constant rate of accidents. This rate begins to rise at age 70, and goes up rapidly at age 80. Even more alarming is the fact that drivers 85 and older are 11 times more likely to be killed in a crash than any other age group. This is generally attributable to increased physical frailty.

   "These factors cause insurance premiums to rise for drivers entering their 60s, and to increase thereafter. This increase is often moderated by other factors, which may include discounts for fewer miles driven per year."

Comments

[markm]

My greatgrandfather drove himself to work (at the heating and cooling company he founded) every day until he was nearly 90. Eventually, my greatuncles (who worked for him) discovered that, at the end of the day, he was going around the parking lot trying his keys in different cars until he found his. His eyesight had become so bad he couldn't even tell parked cars apart! It was past time to take his keys away, but if there hadn't been family members around to notice, he might have continued driving (on Kansas City surface streets, some of them pretty busy) until he caused a serious accident.

As for eye exams: the standard optometrists exam, which is also used by driver's license bureaus, is a good test of your ability to read stationary, well-lit letters. It's not so good a test of the visual requirements for driving. I've always passed at 20-20 with ease. But even thirty years ago, I knew that my depth perception and ability to distinguish objects that are moving quickly, dimly lit, or low contrast was poor.

[john robert]

As the victim involved in the accident with Kirk Douglas I believe you have done an excellent job. I took my own father off the road after 3 strokes. There was no reason that a Kirk Douglas should have been driving without a DMV review. He was in far worse health than the Farmers Market guy. His wife, under whom the car was registered
and his 10 yr family docor should have reported him to the DMV. I had to drop the suit because in Beverly Hills area it was like suing Santa Claus. 'you know, Santa's done a lot of good, give him a pass'

[michael jones]

Driving is something great! It is in my heart and i am really glad when i have the opportunity to do a road test with a fast car!