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Injuries and deaths arising from traffic accidents constitute one of the most costly aftermaths of the introduction of technology in modern society. Countermeasures are only now emerging from a pre-scientific stage but promise to reduce the extent of morbidity and mortality, and also greatly to expand basic understanding of human behavior and the management of complex systems.
Highway crash research today stands approximately where the physical sciences stood two centuries ago and medicine stood fifty years ago. To move forward with any expectation of closing the gap it is essential to establish carefully elaborated and comprehensive national goals against which to measure performance.
Emergency medical services comprise a major unmet immediate need in the general public health field. A federal aid program should be enacted to establish emergency medical transportation and care as an ongoing public service available to all persons everywhere, and maintained at advanced levels of quality.
The Highway Safety Act of 1966 requires that states shall provide comprehensive highway safety programs, including driver education. Unfortunately, the present state of knowledge as to the effectiveness of driver education provides no certainty, and much doubt, that the return on this enormous prospective effort will be commensurate with the investment. A broad and systematic enquiry is needed into the general question of how driving behavior is acquired, and how drivers can be taught not only to operate automobiles, but also to understand the major problems of highway safety, including its crash and post-crash aspects.
Research findings increasingly demonstrate that alcohol is involved in a large percentage of automobile crashes. While a number of the drivers involved are young persons and social drinkers, a very substantial proportion are, in fact, alcoholics. Traditional punitive measures can be expected to have little effect on behavior that arises from illness. The problem requires a massive federal program concentrating on the disease of alcoholism.
The onset of uncontrollable violent behavior, an understandable but at present little understood disorder, almost certainly contributes to a significant number of automobile crashes. The National Institute of Mental Health should establish a center for the study of violent behavior in response to increasing scientific interest in maladaptive behavior of this kind.
Public acceptance of highway safety programs is central to their success. Thus while seat belts are at present the most effective available protection against injury and death in automobile crashes, they are used by only a minority of drivers.
The unprecedented volume of highway crash litigation has brought the American judicial system to the point of crisis. A presidential commission should be established to review the process of accident investigation, enforcement of traffic laws and the litigation of claims arising from highway crashes.
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