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DIFFICULT MORAL QUESTIONS
Question 42: Should a man stop his elderly mother from driving? My mother is eighty and in fairly good physical and mental condition for her age. She shops for herself, does household chores well, and visits regularly with friends and relatives. She has been a widow for more than ten years, and has adjusted well. However, there are problems. She no longer can remember which day of the week it is, and often is confused about where she is in her day’s routine. She is not up to dealing with problems as they arise—for example, we do not feel we can leave her in charge of our two-year-old child, even for two or three hours. Having lost a great deal of her short-term memory, she repeats the same questions over a period of days or even several times in an hour. She is not irritable, and in all other respects, given her age, is quite healthy. Her vision (with glasses) and hearing remain good for her age. Due mostly to Mother’s forgetfulness, we have moved her to an apartment only about half a mile from our house. The move has placed her within easy reach. Our older children are encouraged to visit her regularly and they do, both to keep an eye on her and give her a hand with things. In addition, she has given me a power of attorney and her checkbook, and I handle all her financial affairs. This arrangement has been satisfactory, although she does feel some resentment about her loss of independence—for example, not being able to cash a check when buying groceries. Due to various impairments, elderly people sometimes cause serious accidents. I recently read a report of an accident in which a man of eighty-three, trying to round a corner in a large parking area, lost control of his car for no apparent reason, ran over the curb, and plowed into a group of small children, killing three and injuring several others. My wife and I also have read about elderly people with poor memories driving off intending to go to the grocery store and being found hours or days later hundreds of miles away, alive and well but confused. As time passes, my sister and I worry more that something like this could happen with Mother. However, we have reservations about simply taking her car away. She will be tied down (we live in a suburban area without mass transit), and the burden on my wife and me will be great (we have eight children under sixteen). Further, does Mother have a property right to her car, or more precisely, to its benefits in terms of mobility and convenience? I know I would be justified, even obliged, to take the car away if she had a serious accident or wandered off. But must I act before that occurs? Finally, if I do take the car away and her mental health deteriorates as a result, would I not be responsible? I expect I would feel: “I shouldn’t have taken this from you, too.” This question may not be a moral one; it may fall more within the province of psychological evaluation. But even a competent psychologist cannot evaluate Mother’s condition precisely enough to say, for example, “Six months from now, she will not be able to exercise control of her driving.” Analysis: Whether a person with diminishing capacities should continue driving is a question of fairness, and whether a family member should prevent such a person from driving also is a question of fairness. The questioner may be too inclined to restrict his mother’s autonomy. Still, if she continues driving despite increasing risks, he eventually will have to judge whether to exercise his power to limit or stop her driving. That judgment mainly concerns the fairness of accepting the risks posed to others by her driving; in making it, the questioner should also take into account the burdens to everyone concerned of her no longer driving. If he judges that the risks to others can be accepted fairly, he should allow his mother to accept any risk to herself. But if he judges that he cannot fairly accept the risks to others, he should do what he can to minimize the negative impact on his mother of restricting or stopping her driving. The reply could be along the following lines: Taking for granted that your mother possesses her car legitimately and fairly, she certainly has a property right to it, and so she has a prima facie right to use it for the benefits of mobility and convenience. But that does not settle anything, since such rights are not absolute and, in any case, your mother has given you a power of attorney, which you could use to sell her car. Nor does it make any difference whether anyone can predict that at some future date she will be unable to “exercise control of her driving.” Rather, the crucial question concerns the risks your mother’s driving imposes on others right now. What you say in stating your question seems to indicate, on the one hand, that she still is mentally competent and acting responsibly, and, on the other, that you feel impelled to make many decisions for her. While her short-term memory is declining and she may not be able to keep pace with your two-year-old child (I no longer could do that myself!), her motor skills may still be adequate to drive (you say she does her household chores well). Your reference to the possibility that your mother might have a serious accident suggests she has not yet had one, and I assume she has been a good driver, does not drive after drinking, and has not been convicted of an above-average number of traffic law violations. So, especially if she avoids expressways and downtown traffic and drives only under favorable weather conditions to familiar destinations, the risk of a serious accident probably is not excessive.137 Since in many ways persons can fulfill themselves only by shaping their own lives, many risks are warranted to allow children, persons who are retarded, and the declining elderly to make their own decisions. Perhaps your sincere concerns about safety, together with a tendency to be somewhat too cautious, are leading you to take too much responsibility for your mother. If so, the straightforward way to deal with your anxieties would be to discuss them frankly with her, while respecting her judgment in the matter. Treating her as a responsible person is likely to encourage her to act responsibly. Conversely, treating her as less responsible than she is might well diminish her self-respect and lead her to act imprudently.138 In some communities, the American Automobile Association, the American Association of Retired Persons, or some other organization offers a driving refresher course for senior citizens. If such a course is available and you can get your mother to take it, she might either improve her driving so that it is acceptably safe or come to see she should quit. Perhaps, however, you already have tried such approaches, and she has insisted on continuing driving. In some places, the public authorities periodically retest all drivers or those over a certain age, identify drivers whose limitations impose excessive risks on others, and either restrict their driving or withdraw their licenses. If such a system is in effect where you live, that may solve the problem for you. Perhaps, on the other hand, the law does not provide any solution, in which case the answer will be that only you can restrict your mother’s driving or take her car away, and unless you do, she will go on driving, with increasing risks. In that case, your question actually is how to judge whether her decision is so unreasonable that you must exercise your power to prevent her from running risks she really should avoid. Why should this be your responsibility? Because you have accepted the role you describe. Morally, even if not legally, this role is something like that of a parent of a not fully competent, though not infantile, child. Someone filling such a role must compensate for any failure of the child—or the declining parent—to recognize his or her responsibilities, and must act to safeguard others’ rights. Everyone’s driving imposes some risks on others. The risks are greater with some groups of people than others, and insurance companies to some extent adjust rates accordingly. But even the driving of most less competent drivers does not impose unfair risks on others, provided those drivers are licensed and insured, and they drive as carefully as they can. Still, some people simply should not be on the road. The question therefore is whether your mother’s driving already imposes unfair risks on others. To answer that, the Golden Rule must be applied. Eventually, you will be elderly and declining. At what stage do you think your children should take away your car? Again, your mother’s driving does involve risks to others. How do you feel about the risks imposed on you and your children by the driving of other people about as competent as your mother? In attempting to answer the latter question, you might find a good indicator in the views of sensible, sympathetic people, less emotionally involved than you, who have ridden with your mother or observed her driving—say, her friends or neighbors and your teenaged children. In applying the Golden Rule in cases of this sort, it is necessary to consider the urgency of a legitimate need to engage in the risky behavior and the burdens on everyone involved if the risky behavior were given up. So, take into account a realistic expectation of both the inconvenience for you and your wife and the hardship for your mother if you take her car away. But one also must take into account the natural tendency to overestimate burdens to oneself and those near and dear while underestimating risks to strangers. So, ask yourself how good an excuse the expected hardship to your mother and the inconvenience to you would seem to impartial observers if she continues driving and causes an accident that does grave harm to others. If you conscientiously judge it more likely than not that her continuing to drive imposes no unfair risks on others, you should not prevent her from driving. Most accidents she might be in would be as likely to harm others as herself; and so, if her driving does not unfairly impose risks on others, it does not unreasonably involve risks for her. If she ends up hundreds of miles away, that would only be an inconvenience—and might be the occasion to persuade her to give up the car, though I doubt it would justify taking it away. But if you consider it more likely that her driving does impose unfair risks on others, I think you should restrict her driving or even take the car away, both in their interests and in hers. And that should not wait until she has a serious accident, since the injustice already is present in accepting the risk. The effects on your mother of taking her car away also would partly depend on how you did it and how she saw it. Perhaps her primary care physician or someone else friendly with her could propose the idea and get her to accept it. Perhaps she would better accept it from you if you explained to her precisely how you reached your conscientious judgment. Maybe neither approach would be appropriate, but you must do your best to think of the most suitable way. If you do what you can to soften the blow, I doubt it will have any profound psychological effect on her, though it probably will grieve her for a time. Also, your mother probably would find the loss of her car more acceptable if you could make other provisions for her mobility, say, by setting up an account for her with a local taxi company.139 You would be freed of concerns about her driving, and she would remain free to go and come as she pleases. Considering the savings from her no longer owning and operating a car, such an arrangement might well prove economical. Having done your best to make the right judgment, do not blame yourself for acting on it even if the results are bad. That works both ways. If you think it more likely that your mother’s driving is not unfair to others and do nothing, perhaps she will cause an accident resulting in injury or death to someone; but it will be an accident, not your fault. If you think her driving is unfair to others and restrict it or take her car away, and her mental health deteriorates, that too will not be your fault. Finally, do what you can to sustain your mother’s faith and strengthen her hope. How well elderly people accept their inevitable limitations and losses as they decline partly depends on what, if anything, continues to give their lives meaning. While suffering never is pleasant, Christians waiting in joyful hope for heaven can patiently endure far more than people who lack lively hope or, even worse, foresee nothing but continuing and increasing decline. |