Yes, this topic again: the aging professional who lacks the courage, integrity and common sense to “hang it up” before too much harm is done.
Ethics Alarms had explored the issue with judges (Scalia and Ruth Bader Ginsberg, among others), baseball players (Albert Pujols, for example), lawyers (Rudy Giuliani), actors (Bruce Willis), singers (Joni Mitchell, and so, so many others) and Presidents of the United States. It’s always the same tragic tale with different details: someone who has always been remarkable at a difficult, powerful and often high-profile job can’t bring herself or himself to retire with dignity, even when it should be obvious that age is leaching their abilities from them.
That’s psychologist Marcia Brenner above. She looks pretty good for 100; heck, she looks good for 80. But she is still a practicing psychologist, even though, a New York Times profile tells us, “she has started to notice an upsetting tendency. She’d find herself asking for details about her patients’ lives that she once knew so intimately.” Of her loss of memory she tells the Times [Gift link!], “It’s terribly frustrating, but there’s nothing I can do except to say, ‘Remind me, tell me again, repeat that.’ I do the best I can not to display my distress.”
What does she mean, “there’s nothing she can do”? She can retire, that’s what she can do. That’s what she should do, indeed has an obligation to do.
Yet, the Times tells us, “she feels she would let her patients down if she retired.” Well, of course she feels that way: this is the delusion that all aging stars in all fields are prone to convince themselves. Her son says, “It goes back to an Eastern European hospitality thing [the family origins are in what is now Belarus]…. “You don’t say no to a guest or somebody asking for help.”
Wow, what a cool rationalization to justify malpractice! “It’s an effort,” Dr. Brenner says. “But I automatically get into a work mode. When I’m into a session, I can be my old self.” Talk about a Freudian slip. Her being her old self is the problem. What her patients needs is her younger self, and that professional is not only long gone, but would laugh at the idea of her future self still working into her second century.
The son, a psychiatrist himself, is convinced that his mother still has the gifts that made her so valuable to her patients. And again, of course he is: he’s spectacularly biased, and like his mother, incapable of looking at the ethics dilemma objectively and rationally. She is in the position of Ned Beatty’s pathetic dementia-suffering judge in a memorable episode of “Law and Order” that I have referenced before in this context, who knows that once he’s no longer on the bench, he’ll be virtually useless.
Somebody, apparently not her son, and definitely not her 96-year-old husband, also a psychologist and one who still has a paying patient, needs to explain to Dr. Brenner that she needs to do the most professional thing of all immediately, as hard as it might be.
Quit.
Ethics Alarms 
Sir,
And who do you propose is to determine when another person should retire?
Is that you? Some Committee? Or, a legislatively mandated Compulsory Retirement Age?
Would it not be best to “Let one’s Clients vote with their feet?”
RDK
Rationalization. One that allows every too-old professional to go on until they drop, like Scalia and Ginsberg. A number (like, say, 75, the new 65?) may be arbitrary, but more practical than leaving the decision up to the people most unable to be objective.
two examples: Floyd, who I have mentioned before, was an excellent trial lawyer who stepped back from trial work when he realized that his hearing problems made trial work difficult. At that point, he took on the task of mentoring young lawyers.
more recently: Fred. Fred was with me for years. As he was declining in his practice, we carried him along with us.
then, the riots happened and we parted ways. He had a long time friend/client with office space
then, we got to a permanent spot and invited Fred back
he was ready to retire.
fred gave up his license
why?
because Fred was everyone’s friend
everyone trusted him and sought his advice.
and, he wanted to help people
His law license was a liability
he gave up his license because it was the only way he could tell people that he could not help them
so, I answer his phone now
and I am honored to do so
and I worry, because part of the profession of law is helping people, but sometimes you try to help too many
but, someday, I need to follow the examples of Floyd and Fred
-Jut
Great comment, Jut.
At age 70 and beyond. All government employees and all holders of professional licenses should be required to take a cognitive evaluation once per year.
Those with marginal scores should be counseled. Those with failing scores should be removed from their positions, and licenses should be revoked.
All elected officials should have their scores published in a searchable directory. The directory should be updated annually and published by June 1st of each year.
I think it’s very telling, perhaps even Signature Significance, that Dr. Brenner herself is admitting that her memory lapses are interfering with her effectiveness in treating her patients–but still won’t retire. She even admits to hiding it from her patients by doing “the best [she] can not to display [her] distress.”
–Dwayne
Yep, hiding problems that make it difficult to do her job is unethical. Her patients deserve someone who is focused on their treatment, not in trying to figure out how to maneuver around forgetting a patient’s last sentence.
how old is the son? He must be approaching retirement himself.
Since psychiatry/psychotherapy/most psychology is pure pseudo-scientific-on-the-verge-of-horoscope quackery where even the most sound psychologist is really performing the role a person’s friend ought to be performing, then a 100 year old practitioner is no more unethical than a 50 year old one.
Good point.