Diabetes and Driving: How Predictive Technologies Will Alter Ethical and Legal Responsibilities

In 2023, a 67-year-old man with long-standing type 1 diabetes experienced a severe hypoglycemic episode and drove into an outdoor dining area in Victoria, Australia, killing 5 people and injuring several others. Although the charges against the driver were dismissed, future cases involving new continuous glucose monitors enhanced with artificial intelligence that allow users to anticipate impairment before it occurs may have different outcomes. These biopredictive technologies transform hypoglycemia from a background risk into a more foreseeable event. This generates new conditional obligations to act on predictive warnings and, in some cases, obligations on those with higher risks to acquire such technologies. Furthermore, these individual responsibilities can generate corresponding state obligations to subsidize access and update licensing frameworks, ensuring safety without exacerbating inequity or stigma.