Seatbelts

Surgery

How far should Government legislate to protect individuals against their own folly and to look after the interests of the community? The area between private right and public interest, the long spectrum between anarchy and totalitarianism, is the very stuff of democracy and of the art of government. At different times, in different places and circumstances, the common body of laws has to interfere in many issues of daily and national life: vaccination of migrants, quotas for rural production, pollution, safe driving, commercial practice-all these and many more need laws. Should the wearing of safety belts be made compulsory by a law?

There is no doubt about the protective value of safety belts in the most evident epidemic in our community of the present time. The, statistics from many sources are too overwhelming. Yet few drivers and passengers wear safety belts, which raises two large -questions. What are the reasons for this, and what should Government be expected to do?

Public attitudes are formed only partly by information from experts. They depend more on folk-lore based on newspapers, talk at work, over morning tea, in hotels, and wherever else people meet. A disheartening fact is that few policemen and few ambulancemen, the two groups with most bread-and-butter, blood-and-gore evidence at their very fingertips, wear safety belts, and private opinion in these two groups is not universally for the wearing of safety belts. With this state of affairs, why should ordinary citizens, or teenagers and those in their early twenties who are the groups most at risk, follow more informed advice?

Casual conversation, as opposed to research so far, reveals many strong feelings. A driver only goes slowly, or on short trips, or has an unblemished record. He has seen, or heard of, accidents in which the victim died because of a safety belt or survived by not wearing one. Safety belts would encourage even more reckless driving. A car occupant trapped in water or fire could not release himself in time. It is too much of a bother to put one on for a short trip. They ought to ("aorta syndrome" again) make it compulsory. A belt presses on the stomach and worsens the occupant's stomach ailment. On a hot day, it presses sticky clothes uncomfortably against. the sweating body, or crushes a fashionable dress. A belt has to be loosened to turn the head right round while backing a car. Or one just forgets.

The present writer is a vehement supporter of safety belts and takes frequent opportunities to argue, for them; he has even earned a modest sum from a newspaper for a lengthy article on the subject. Yet last November, the same writer suffered a broken rib, just over the spleen, after colliding head on with a petrol tanker at fairly low speed; the safety belt had been loosened a few miles earlier to change the station of a second-hand car radio fitted at the far left side of the dashboard. The human brain, though a useful organ, has its lapses.

The cost of traffic injury to the community is enormous. The total figure should be reckoned with greater exactitude and made much more widely known. It does not lie merely in the whimpering figure by the roadside and time lost from work; it includes also mountains of paper work and enormous legal effort.

And what of the results less easily measured? It is agreed now that loss of a husband or wife and bereavement lead to earlier death of the spouse. What happens to the parents of a teenage boy or young man killed on the roads? What of the anxiety, depression, tension, the various bodily symptoms leading to many barium-meal X-ray examinations and other tests, symptoms that last or occur not months, but years or even decades after the loss of a child by traffic accident?

The Minister for Transport in New South Wales, like others in similar positions, is concerned with this question at the present time. A report circulated to his colleagues in the State Parliament, prepared by Sir William Hudson, raises the perplexing question of compulsion. Among many groups whose opinions and expert knowledge will be noted before legislative decision, doctors dealing with traffic accidents would have views strongly favouring compulsion.

The political decision is a difficult one, because good politics must be the art of the possible. A law that is unpopular and too difficult to enforce is a bad one. Some will feel it as a personal infringement, others as plain wrong. Would it be as effective as the law against elbows protruding from car windows, or would it fizzle out like prohibition of alcohol in the United States forty years ago? The idealist must remember Mark Twain's sad-humorous comment that to do good is noble, but to tell others to do good is also noble and much easier. Australians are not noted for a wish to conform to authority, and it is a sobering thought that the most conforming populations in our time have included those of pre-war Germany and Japan.

Whatever the law will be, public education is paramount while the slaughter continues. Official information, the example of police and ambulance drivers and drivers for large organizations, the help of newspapers and other media (who never state whether the dead victims had safety belts on) must all be sought vigorously.

The detailed ergonomics of further seat-belt design must be analysed. Must the belt have a deliberate two-handed action to secure, or could it be slotted into place with one hand? Can the action of securing a seat belt be made so simple for the driver that. he. feels not even a momentary delay in setting off on a short trip? What are the special needs of the taxi-driver over many hours each day, and of others in special situations?

Safety enforcement in industry meets many barriers. Goggles are left off during grinding, safety helmets omitted even by the factory manager, who then sustains a cut head. One theory is that a safety measure represents an insult to the user's virility, despite the headgear of mediaeval knights, of racing-car drivers, or even of Prince Philip on the polo field. The use of logical information depends in the end on the emotional attitude of the individual.

Yet another interesting sidelight is that safety-belted car occupants seem to be involved in even fewer car accidents than would be expected in arithmetical terms. Do the careful drivers adopt yet another sensible precaution, or does the securely packaged feeling make the driver think and function better? In a lengthier analysis, one would include a wide variety of other factors-ignition circuits completed by the fastened safety-belt, the possible suicide urge of some drivers, inertia reels, and the whole wider question of road safety.

These are some of the more difficult factors that our legislators will have in mind already. The act of decision is up to them. Much is at stake.

OBSERVER

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"Points of View"

Compulsory wearing of safety belts

The Medical Journal of Australia September 12, 1970 p.505-6

The surgeons of Melbourne, Australia led the world in pressuring politicians to legislate for safety belts and other life-saving measures to do with road traffic. The heroes included Sir Edward (Bill) Hughes and Gordon Trinca, Dr. John Lane of Melbourne and Dr. Jack McLean who continues to direct the Road Safety Research Institute at the University of Adelaide.

This was a time when some people would argue the dangers of safety belts - being trapped underwater or in a fire, or uncomfortable, or crushing clothing. Some motorcyclists ("temporary Australians") argue in similar terms against safety helmets.

For me this was easy writing. As Mark Twain said a century ago, To do good is noble. To tell others to do good is also noble and much easier. It took me longer to learn to put on my seat-belt automatically.

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