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L. Jaime Fitten, MD

Arch Intern Med. 2003;163:2132.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

CONGRATULATIONS to Dr Fain on her excellent contribution to this debate. She makes several good points, for example, the ease with which statistics can be used to support one position or another. Furthermore, she underscores the competing ethical standards of respect for individual autonomy vs benefit or good for the collectivity that are at the heart of this debate, and she argues forcefully in clear favor of the virtues of individual autonomy.

From my perspective, I see this confrontation of values on which the debate hinges as much more dilemmatic and difficult to resolve. I differ from Dr Fain in that I believe that she fails to adequately consider the impact on driving ability of the exponentially increasing vulnerability of elders to diseases that impair cognition, mobility, and vision such as Alzheimer, Parkinson, and cerebrovascular disease, severe osteoarthritis, macular degeneration, and others. These conditions can have . . . [Full Text of this Article]

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