By Prof. Dr. Dragan Danilovski
Legislative amendments are being announced that would restrict the driving of motor vehicles based on age. They open the issue of institutionalized age discrimination — “ageism.”
Age as an administrative criterion for restricting rights creates a dangerous precedent: it introduces a category of citizens with reduced rights. Citizens whose autonomy is treated as conditional rather than as a fundamental right.
Age discrimination in law and bioethics is recognized by one simple sign: individual assessment is replaced by a general presumption.
And the presumption here would be that old age means incapacity. That is ethically and scientifically unsustainable!
Is aging a violation? Can aging be grounds for suspending personal autonomy?
Aging is biology — variable, unpredictable, individual. Anyone with experience in clinical practice knows that functional ability cannot be read from an “ID card.”
Biological age does not coincide with chronological age. Someone may be a high-risk driver at 20. Another may have stable psychomotor and cognitive functions at 90.
Cognitive and psychomotor capacities should, of course, be subject to evaluation. Medicine has instruments for this: examinations. Tests. Individual evaluation. Risk stratification. In modern systems, driving ability is determined through functional assessment when there are indications.
But never through an administrative decision — made on the basis of a presumption.
That is precisely why medicine is the key filter for risk assessment, not a legal “lawnmower” that cuts down everyone above a certain line.
Worldwide, this type of automatic restriction exclusively by age practically does not exist. The only cited exception is Peru.
If a measure were introduced that is almost nonexistent in international practice, it could be perceived as discrimination and punishment for aging itself.
Any restriction of a right must pass the test of legitimate aim, necessity, and proportionality.
Traffic safety is an absolutely legitimate aim.
However, introducing a legal age limit that would treat all persons above a certain age as potentially incapable is not necessary and would represent a serious precedent!
Why? Because clinical practice already confirms daily that the risk for safe vehicle operation is determined through individual assessment, based on health status and functional capacity, using precise medical instruments and tests.
Additionally, such a solution marginalizes medical expertise, which alone has the competence to assess fitness to drive.
Such a measure would also send a message of institutional distrust toward one’s own citizens.
And not only that.
For many people in later years, driving represents an essential component of autonomy. A boundary between autonomous and dependent existence. A means of access to healthcare services, of maintaining family and social ties, and of preserving the sense that they remain active participants in the community.
Restrictions perceived as unjust (even as punishment) can lead to social isolation, loss of life motivation, and psychological destabilization.
Psychiatric and gerontological literature has long indicated that the sudden loss of autonomy is associated with an increased risk of depression, anxiety, and feelings of hopelessness.
For some of the most vulnerable individuals, such conditions may also be accompanied by the emergence of suicidal ideation.
These effects are real clinical phenomena that create additional burdens for families and the healthcare system.
This must be taken into account when creating public policies.
From a legal perspective, such solutions must be aligned with constitutional and European standards.
Article 9 of the Constitution guarantees equality of citizens, and Article 54 requires that any restriction of rights be necessary and proportionate.
The European Convention on Human Rights, through Article 14 and Protocol No. 12, establishes the prohibition of discrimination.
The Charter of Fundamental Rights of the European Union, in Articles 21 and 25, emphasizes protection against unequal treatment and the dignity of older persons.
These norms constitute obligations, not recommendations!
The concept of “Active Ageing” of the World Health Organization emphasizes autonomy, mobility, and active participation in society as prerequisites for healthy aging.
Policies that restrict mobility without careful assessment of consequences create a risk of unforeseen public health and psychosocial effects.
From the perspective of social ethics, such solutions are perceived as punishment for aging itself!
The Assembly should ensure a broad and substantive professional debate, with the involvement of medical, legal, and public health expertise.
It is also necessary for the Faculty of Medicine, the Macedonian Medical Association, and the Medical Chamber to present a clear and unequivocal position and to actively participate in the professional debate when adopting the legal amendments. Issues relating to functional capacity and health risks naturally belong within the domain of the profession, which has an obligation to contribute its authority and knowledge.
The decisions made today will determine the framework within which each of us will age tomorrow.