Cars symbolize a person’s ability to control their own life—and for the elderly, revoking driving privileges embodies how their autonomy is often sacrificed for the sake of safety. Cars are a classic symbol of freedom, providing people with greater mobility. That association is even stronger for the elderly, who particularly rely on cars to be mobile and who value their independence more than most, knowing that they likely cannot maintain that independence for much longer. For example, Felix Silverstone is an 87-year-old man who relishes being able to drive. One day Gawande accompanies Felix on an errand and gets nervous, knowing that the very old are the highest-risk drivers on the road. But as Felix drives and rolls down his window, Gawande observes how Felix is “glad simply to be on the road.” The association between the car and freedom provides Felix with a sense that he still has autonomy in his life—even if his driving may not make for the safest situation.
This lack of safety is evident in another case, that of Alice Hobson. Alice gets into a car accident in her late 80s when she mistakes the accelerator for the brake. Luckily no one is hurt, but it is this incident that contributes to Alice realizing that she needs assistance and can no longer live independently. Although she wants to maintain autonomy, her lack of control over the car means that she has to give up some of that autonomy in order to maintain safety. This association is strengthened when Alice moves into a retirement home and thinks that her car is stolen the very next day. When it turns out that she simply parked it in the wrong lot, she is mortified and gives up her car. This simultaneous loss of freedom with the car, and the loss of autonomy at the retirement home, shows how so many people like Alice are forced to give up some of their control and freedom in pursuit of maintaining their safety.