Intended for healthcare professionals

Personal Views Personal views

Where are the protests?

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7346.1165 (Published 11 May 2002) Cite this as: BMJ 2002;324:1165
  1. Roger Browninghttp://www.roadpeace.org/, trustee of RoadPeace, the national charity for road traffic victims

    Had I, before the road crash that killed our daughter, pushed my imagination to the limit I might, just might, have got a sense of the devastating impact of losing a loved one in such a way; a life crushed and gone without so much as a goodbye. But I could never have imagined just how long the effects of that day would last. Eight and a half years after our young daughter died, the lives of my wife and me have still not returned to normal. And I can now say with certainty that they never will.

    Police investigations of road death are often indifferent and court sanctions are usually paltry

    There has been a massive shift in how we view the world. Our whole frame of reference has moved: what was once funny is no longer amusing, what was once enjoyable is best avoided and friends and family have fallen by the wayside as they failed to measure up in the eyes of what have become two damaged human beings. Not physically scarred, but damaged none the less.

    A “normal” bereavement takes a natural course; there is the immediate grief, which, over time, is lessened and life usually returns to normal. With a fatal road crash, the sudden loss of life, often in extremely violent circumstances, is far harder to cope with, a difficulty compounded by the way society dismisses it.

    It is left largely to victims, those least able to fight, to struggle to change attitudes

    Save for the impact on the immediate family, a death or injury on the road changes nothing. No one notices. A train or aircraft crash prompts massive, costly efforts to avoid repetition. A death on the road barely makes the local newspaper. The steady drip of road casualties—about 3500 people, mainly young, die each year in the United Kingdom and tens of thousands are injured—fails to capture the public's interest even though this toll hugely outstrips that of other transport systems. And every government minister's vow to prevent another tragedy on the rail network or in the air reminds the families of road victims just how “insignificant” their loss is—nothing more than a byproduct of modern society, a casualty in a low grade war that nobody much cares for.

    The institutions that should act in victims' interests also fail them. Police investigations of road death are often indifferent and court sanctions are usually paltry. The driver responsible for the death of our daughter was fined £250—a common penalty for drivers who kill—and she was free to drive away from court as there was not even a thought to take away her licence, even though her inability to drive safely had been clearly demonstrated.

    Studies by Noreen Tehrani, a chartered psychologist, into the social and psychological impact of a crash on victims have identified a link between the way the crash is investigated and handled by the judicial system and the magnitude of traumatic stress symptoms. Victims, both bereaved and injured, who felt they had not received appropriate support were found to have the highest levels of post traumatic stress.

    Tehrani's results showed that many victims experienced distressing psychological symptoms years after a crash. The psychological wellbeing of victims could also be undermined or supported by the way the police, magistrates, hospitals, insurance companies, and others responded to requests for help.

    Attitudes to road death and injury have to change. The tearing apart of thousands of lives every year is not an acceptable price to pay for what is, when it comes down to it, merely an easier and more convenient lifestyle. But why is there this indifference? Where are the protests from, for example, the accident and emergency staff who must treat countless torn bodies, from psychologists and psychiatrists who treat countless damaged minds, from police officers, who have to scrape the inevitable result of speed from the tarmac? It is left largely to victims, those least able to fight, to struggle to change attitudes.

    I am convinced that our perception of the car will alter. It may take many years but, generations from now, people will look back at this time and wonder at how we let things get so out of hand.

    Mass use of the car is little more than 50 years old and society is slow to change. But as the toll of dead and injured mounts it can only be a matter of time before we all say enough is enough.