Establishing Regulatory Guardrails for Elderly Drivers

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Scholars urge state lawmakers to strengthen driving regulations for seniors to address public safety concerns.

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Seniors are outliving their ability to drive safely by an average of seven to 10 years. This issue recently received attention in New Jersey, where within a single week, three drivers over the age of 90 were involved in tragic accidents, two of which were fatal.

In a forthcoming article, Sharona Hoffman and Cassandra Burke Robertson, law professors at Case Western Reserve University School of Law, argue that the growing elderly population in the United States poses a significant public safety concern. They contend that seniors’ cognitive decline—a gradual loss of mental abilities such as memory and concentration—affects their ability to drive safely and increases the risk of accidents. Hoffman and Robertson propose changes to state laws to protect the public while ensuring seniors maintain their personal autonomy for as long as possible.

As individuals age, they are more likely to experience cognitive decline. The severity of this decline can vary significantly. Some seniors can maintain high levels of functionality, while others face complete impairment in their daily activities, particularly with diseases such as Alzheimer’s and dementia.

Driving is a complex task that requires various cognitive skills, including quick reaction time and spatial recognition. Older drivers experiencing cognitive decline are more likely to fail on-road driving tests and to be involved in car accidents, claim Hoffman and Robertson. Despite this risk, between 22 and 46 percent of elderly individuals still drive.

Some states have attempted to address this issue through their driver license renewal laws. Hoffman and Robertson claim, however, that many of these laws are not effective in identifying drivers with cognitive decline or assessing seniors’ ability to drive. Instead, they state that these laws only add requirements for older drivers, such as in-person renewals, more frequent renewals, or mandatory vision tests upon reaching a certain age.

Hoffman and Robertson acknowledge that crafting comprehensive laws for seniors drivers is challenging because cognitive decline varies among seniors. Cognitive decline can begin to occur at different ages, and it can progress rapidly or gradually overtime. This variability presents challenges in lawmakers’ ability to establish laws that balance public safety risks with elderly driver autonomy.

Indeed, “giving up the car keys can mean giving up wellbeing,” warn Hoffman and Robertson.

Health deterioration accelerates when seniors stop driving because they lose functional independence, personal autonomy, and opportunities for social interaction, all of which are beneficial to their quality of life. These risks make family members reluctant to take the keys away and deter seniors from giving up driving voluntarily, Hoffman and Robertson explain.

Hoffman and Robertson argue that states cannot depend on self-regulation to tackle this issue.

Hoffman and Robertson instead recommend that states implement laws that require physicians to refer patients diagnosed with cognitive decline for formal driving assessments and to report patients who require driving restrictions to the Department of Motor Vehicles (DMV). DMV officials would then note these restrictions on an individual’s driver’s license, or, in circumstances where necessary, would revoke an individual’s driver’s license, suggest Hoffman and Robertson.

This approach addresses individual cognitive decline rather than imposing blanket regulations on the entire senior population, contend Hoffman and Robertson. They state that formal driving assessments would identify the specific needs and capabilities of each driver and provide targeted driving restrictions, which in turn, would preserve seniors’ mobility while reducing safety risks.  Bottom of Form

Physicians who comply with their duty to refer patients would receive immunity from liability if their patient is involved in an accident, Hoffman and Robertson explain. They contend that, by providing this security, physicians would likely endorse the law and facilitate its adoption.

Since this proposed law involves the sensitive topics of age and medical status, Hoffman and Robertson caution that opponents may attempt to challenge it under the 14th Amendment’s Equal Protection Clause or the Health Insurance Portability and Accountability Act (HIPAA). They argue, however, that these challenges would likely fail.

First, states can defend their statutes against challenges under the Equal Protection Clause—which protects both disability and age discrimination from state actions—by demonstrating that the “statute is rationally related to a legitimate state interest.” Hoffman and Robertson argue that their proposed state law serves a “legitimate state interest” because it helps maintain road safety.

Second, Hoffman and Robertson argue that HIPAA—which regulates physicians’ disclosure of a patient’s medical information—would not prevent adoption of their proposed legislation. They point out that HIPAA contains exceptions for disclosing information without patient authorization, including when reporting is mandated by law, necessary for public health activities, or essential to avert a serious threat to health and safety. Hoffman and Robertson claim that their proposed law could fit into any one of these exceptions.

With the senior driving population projected to grow to an estimated 62 million by 2030, Hoffman and Robertson urge state lawmakers to consider the significant public safety risks that some senior drivers pose. They propose a state law that leverages the physician-patient relationship to identify seniors experiencing cognitive decline and to impose appropriate, customized driving restrictions.