Bmj Usa: Letter

RAPID RESPONSES FROM BMJ.COM

BMJ 2003; 327 doi: https://doi.org/10.1136/bmjusa.01070002 (Published 19 November 2003) Cite this as: BMJ 2003;327:E53

This article originally appeared in BMJ USA

As of June 25th, 62 rapid responses had been posted on bmj.com in response to the editorial on banning “accidents.” Barry Pless and I distilled the negative commentary into 10 key arguments, and prepared responses to each of them, which we posted as our own rapid response. A sampling of the original rapid responses (after editing), along with our reply, is presented below.—EDITOR

“Accident” should not be purged

  1. Judith M Green, senior lecturer in sociology (judith.green@lshtm.ac.uk)
  1. London School of Hygiene & Tropical Medicine, London, UK
  2. The Lancet Infectious Diseases, London, UK
  3. Monash University, Victoria, Australia
  4. Orkney Islands Council, UK
  5. National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
  6. Johns Hopkins School of Public Health, Baltimore, Maryland, USA
  7. BMJ

    Editor—The irrationality of the lay public, who need to be educated in the “facts” of injury epidemiology, is a seductive thesis, but sadly it has no basis in evidence. Detailed qualitative work1 2 has demonstrated that the “lay” public largely share the understanding of public health professionals—that accidents are predictable, and ultimately preventable, at least in theory, and that luck has little part to play in the distribution of injury. They also understand the prevention paradox: that population-level knowledge of the risk factors for accidental injury is of little help in explaining any specific individual event, except perhaps in retrospect.

    Attempts to create a terminology with unnecessary neologisms, unique to medical journals, are likely to alienate further those professionals who work with communities on accident prevention.3 We already have a perfectly adequate generic term to cover the range of events that may injure people. It is “accident,” a term which has shifted in meaning considerably over time2 to reflect changing medical and social understanding of risk and predictability.

    Accident looking for somewhere to happen

    1. John McConnell, editor (john.mcconnell@lancet.com)
    1. London School of Hygiene & Tropical Medicine, London, UK
    2. The Lancet Infectious Diseases, London, UK
    3. Monash University, Victoria, Australia
    4. Orkney Islands Council, UK
    5. National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
    6. Johns Hopkins School of Public Health, Baltimore, Maryland, USA
    7. BMJ

      Editor—My first reaction to attempts to replace simple words whose meaning is innate to all native English speakers with circumlocutory contrivances (“prostitute” with “commercial sex worker” springs to mind) is to reach for my dictionary. To quote from Chambers English Dictionary (7th ed, 1989): “n. ac'cident that which happens: an unforeseen or unexpected event: a chance: a mishap: an …

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