Report by Traffic Safety Commission Doubts Traditional 'Causes' of Accidents

The following are excerpts from the report of the Secretary's Advisory Committee on Traffic Safety of the Department of Health, Education and Welfare, made public last week. The Committee was chaired by Daniel P. Moynihan, Director of the Joint Center for Urban Studies.

THE impact of technology on human society--on all forms of life--is both the pre-eminent experience of the modern age and, of necessity, a prime concern of contemporary government. The most conspicuous effect of technology has, of course, been to enable vastly greater numbers of persons to be alive at one time, and to provide for those living in the more industrial societies a standard of consumption and amenity never before known, and until recently only barely conceived. Almost without exception the first-order effects of newly introduced technology tend to be regarded as "benefits" to mankind. Especially in societies characterized by a high degree of private enterprise, there are very great rewards to be had from such innovation, and there follows a lively competition to maintain the pace of change. Unavoidably, however, change introduces a measure of disequilibrium into the larger social system: second-, third-, and fourth-order effects take place, and while some of these are also beneficial, and some neutral, others are seriously harmful. As often as not, these harmful effects are experienced by persons who did not necessarily share in the original benefits, and only rarely are those who introduce the new technology automatically held accountable for the less desirable side effects. It thus becomes increasingly the task of government to trace out the interconnection between the beneficial and the harmful effects of technology, and to seek to offset the latter.

The responsibility of government to protect the citizen against the hazards of the technological environment is obviously most clear when those hazards arise from technology introduced by the government itself, for example, in the case of the release of radioactive materials into the atmosphere. Similarly, it is not to be avoided with respect to activities that in their nature require a high order of public regulation and surveillance. Hence, traffic safety has been a matter of public concern almost from the first appearance of the automobile. In their nature, automobiles have required the use of (and eventually the construction on an unprecedented scale) of public streets and highways. Further, from the beginning, this use was accompanied by a very high level of injury and death among drivers, passengers, and pedestrians.

In 1895, for example, when there were only four gasoline-powered vehicles in the United States, two were in St. Louis, Missouri, and managed to collide with such impact as to injure both drivers, one seriously. Thus was introduced a form of pathology that was to grow steadily from that year to this. It was accompanied by countermeasures not less pervasive in their impact on society.

It is necessary to stress that public measures to control and alleviate the problem of automobile injuries and deaths quickly reached vast proportions. Just as the automobile rapidly permeated and soon began to transform American society, so did the measures adopted to deal with the problem of automobile accidents. It is reasonable to state that fairly soon the average adult American citizen came to have more direct dealings with government through the licensing and regulation of the automobile than through any other single public activity. Not all these dealings were especially uplifting, and some acquired implications all the more ominous because they so quickly came to be regarded as natural. Thus in the course of the regulation of highway traffic, the incidence of arrest by armed police in the United States has undoubtedly reached the highest point for any civilization, democratic or totalitarian, in recorded history. While ours is assuredly a free society, it has nonetheless become commonplace for an American citizen to be arrested by an armed officer of the law. Indeed, so frequently have such arrests become--in 1965 the California Highway Patrol alone made one million--that that experience has ceased to be regarded for what it is at law and has come to be looked on as a rather routine accompaniment of modern life. One may well question whether the instincts of a free people will not one day be impaired by the habit of being arrested without protest; certainly the pervasiveness of automobile-related regulatory activity is a matter about which all must agree.

Next to its extent and complexity, the present system of motor vehicle regulation is remarkable principally for the lack of evidence of its effectiveness--at least so far as the limited studies of the subject can be said to provide evidence of success or failure. It is part of the folklore of American government--perhaps of modern government generally--that serious and significant government intervention in social processse is invariably accompanied by the development of large bureaucracies and intricate regulatory mechanisms and the only way to avoid the latter is eschew the former. That is to say that active government must be Big Government, and only laissez-faire principles can achieve lean administration. Students of public administration have for some time rejected this view, arguing that government bureaucracies are just as likely to burgeon for lack of energetic social policies as in consequence of them. There is no area in which this truth has been more relentlessly displayed than in the field of traffic safety. Year by year as the number of automobiles and drivers grew, so did the number of accidents and injuries, and so did the records, the regulations, and the regulators. The only thing that did not accumulate was reliable research evidence as to what was going on. Beginning in the late 1930's, an outward appearance of stability was achieved when the number of annual motor vehicle fatalities leveled off at some 40,000 per year. Possibly this was due in part to improvements in the quality and availability of medical treatment of trauma in the aftermath of research developments associated with World War II. The number of automobile injuries, however, continued to rise steadily. By mid-century, somewhere between one-quarter and, in some estimates, as many as one-half of the automobiles manufactured were destined to be involved eventually in a personal injury accident; and something very like that proportion obtained for drivers as well. Automobile-induced trauma achieved an endemic quality, very much as smallpox, an affliction that more often maimed than killed, was endemic in earlier centuries. As scientific method successfully conquered one after another of the great infections diseases, the absolute and relative role of accidents of all types grew steadily greater until, at mid-century, they had become the principal cause of death for persons 1-34 years of age and a massive cause of nonfatal injuries.

A SERIES of research findings in the 1950's established beyond further doubt that a high proportion of automobile accidents, perhaps especially fatal accidents, involve alcohol. In association with other research establishing the significant pharmacological effect on driving skill and judgment of even low levels of blood alcohol content, and considering that three-quarters of the adult population of the United States uses alcohol in greater or lesser quantities, it readily came to be assumed, in the words of Dr. Julian A. Waller, "that the majority of drinking accidents are caused by the majority of drinking drivers, namely, the social drinkers." On this basis widespread and comparatively severe legislation was enacted to discourage drinking while driving....

Such legislation has not only been enacted but is being enforced, apparently, with considerable vigor, no doubt reflecting the judgment of the law enforcement authorities and the public alike that drinking is indeed a major cause of accidents, and one for which drivers must uniquely be held accountable....

Only recently has it begun to be perceived that for a great many persons the heavy use of alcohol, to the point of repeated intoxication, is less a matter of wrongdoing than of illness. Even more recently physicians have begun to speak of persons who "have alcoholism," much as others might be described as "having tuberculosis." Very much as in the case of automobile accidents, society appears to be verging toward a redefinition of this issue: what has hitherto been seen as a problem of public order is increasingly being defined as one of public health. Nor surprisingly, the relationship between these two public health problems is being increasingly perceived....

Even on the surface, the proposition that every tenth oncoming vehicle encountered on the highway is likely to be driven by an alcoholic is less than reassuring, but on closer examination the matter appears even more serious. Following on the research findings that demonstrated the high proportion of alcohol-related accidents, a second generation of studies now begins to establish that a wholly disporportionate number of such accidents involve not just drinking drivers but, in fact, alcoholic drivers. Reports from Sweden, Germany, Canada and Australia, as well as those carried out in the United States, increasingly converge on the probability that social drinking is nothing like the problem it has been thought to be, while pathological drinking is a very much greater one.

SOMEWHERE during the course of the past generation the belief that "80 per cent of all auto accidents are the fault of the driver" became established in the conventional wisdom of the traffic safety field. Repeatedly the institutions that have encouraged this belief have been challenged to produce acceptable evidence that it is so. Just as repeatedly the challenge has been ignored. Although the use of alcohol by drivers is known to be the chief factor in the initiation of fatal crashes, this constant emphasis on the culpability of drivers probably has the effect of lessening anxiety about the driving task: if accidents are the fault of drivers, then the individual has some control over his future. The gods of the highway punish only those who behave badly. It is also possible to speculate that this focus of attention on the responsibility of those who purchase and operate motor vehicles has had the further utility of distracting attention from the responsibilities of those who manufacture and sell them. In any event, the traffic safety legislation of 1966 adopted a different perspective, and recently tremendous attention has been paid to the fault of the vehicles themselves not so much in initiating crashes, but in determining the injuries that do occur in the accident process. Yet this too can be a distorting process if it draws attention away from the driver altogether, for it can hardly be doubted that personal characteristics affect driving behavior and that for some portion of the driving population this is a determining factor.

The concept of "fault," however, may be of less value here than that of "intent" or "objective," in the sense that for many persons some of the time, and for some persons most of the time, driving is a form of aggression. It is a socially approved, or at least provided, outlet for violent behavior. Some years ago, the British novelist L.P. Hartley envisioned a future world in which public automobile accidents were staged much as the ancient Romans once held gladiatorial games. Certainly the constant broadcasting of the "holiday death toll" over festivals such as Christmas has had something of this quality.

Certainly automobile manufacturers, especially in their advertising directed to young consumers, have unabashedly associated their products with various forms of violent or aggressive behavior, and continue to do so. The contrast between the formal "safe driving" advise that the manufacturers make available to the public and the message of some of their advertising suggests that this is indeed conscious and deliberate company policy. Thus, a driving pamphlet issued by General Motors declares:

Next to a loud and generously used horn, the favorite way for infantile motorists to sound off is with a noisy exhaust.... As one way of rating your own driving ability, check how quietly you drive. The fewer unnecessary noises you make, the sounder your driving.

But a teenage automobile advertisement for a model manufactured by the same company has quite a different message:

There's a Tiger loose in the streets. The moan (of the engine) gets drowned out in its turn by a booming exhaust note that someone ought to bottle and seal as pure essence of car.

...While little can be said with confidence about "normal" aggressive behavior, it is fairly clear that there are persons who from time to time experience episodes of uncontrolled violence and that such persons are different from normal persons, much in the way that persons with alcoholism can be said to be different. Indeed there appears to be some overlap. The characteristics of persons who from time to time end up in situations where they "cannot control themselves" are only now beginning to be studied but there appears to be a repeated association between pathological intoxication, unrestrained physical attacks on other persons, sexual assault, and multiple automobile accidents. This has been termed the "dyscontrol syndrome." It may be that the popular conviction that automobile accidents are the fault of drivers arises from the perception of aggressive behavior on the part of others (and one's self) in situations where it is clearly intended. Dr. Thomas Allison has suggested that men are more likely than women to drive in this manner and, further, that "Often an habitual traffic violator is impulsive when under stress, and is irresponsible in all his living experiences."

It seems evident that drivers with periodically uncontrollable impulses to violence, like persons with alcoholism, cannot be much helped by advice to act differently. It appears that they cannot control what they do, possibly for reasons that are commonly conceived as psychological, and possibly also because of biological abnormalities as yet imperfectly understood....

When and if more is learned of this subject, it will be possible to apply such knowledge to the problem of traffic safety, and, further, to begin looking more closely at the still shrouded subject of homicide and suicide by motor vehicle.

THERE has been only the most cursory attention paid to what in truth may be the single most important secondary effect of the automobile, namely its impact on the American legal system. Even where the matter has been given attention, this has normally been directed only to the problem of the greatly increased number of personal injury cases which courts are required to process because of automobile accidents. However, at the present time, and given more or less recent developments in the behavioral sciences, two further questions must be asked.

1. Have the staggering delays in the judicial process brought about by accident litigation caused a deterioration in confidence in the legal system on the part of the American public?

2. In the present state of the law, is it possible to adjudicate automobile accidents in a manner that corresponds to the realities of the event, and if not, has this led to a further deterioration in confidence in the legal system?

It is not at this time possible to answer either of these questions. All that can be said for certain is that the courts are inundated with personal injury cases and that delays are growing--in one jurisdiction at least the judicial process for civil cases has come to a (temporary) halt.

The statistics are alarming in their proportion. There are some 13,600,000 accidents a year. Some 30 million citations for violations of the traffic laws are issued to residents of the United States each year. It now takes an average of 32.4 months to obtain a civil jury trial for a personal injury case in the metropolitan areas of the nation. In Suffolk County, New York, it is 50 months. In the Circuit Court of Cook County, serving Chicago, it is 64 months plus. The clerk of the Suffolk Superior Court in Massachusetts, where the present delay in such civil cases is almost four years, forecast in early December 1967 that it will soon increase to five years. In New York City, as of June 30, 1967, there were 26,397 civil trial cases, most involving personal injury suits according to the New York Times, awaiting action in the State Supreme Court. This led to intolerable delays in the processing of criminal trials as well. In December 1967, the Presiding Judge of the Appellate Division announced he was suspending civil trials in Bronx County for at least the month of January. In a forthcoming study Howard James reports that there is a current backlog in Texas of more than 212,000 civil cases.

At very least it must be said that the American judicial system is not working well. Some would argue that it is in fact breaking down. Automobiles are mostly to blame