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For example, commenting on the mandatory helmet law debate, A Brotherhood Against Totalitarian Enactments (ABATE) has said it does not “advocate that you ride without a helmet when the law is repealed, only that you have the right to decide.” Of course, these autonomous decision-making rights are not absolute, and may be limited when the choice of an individual unfairly burdens others or puts them at significant risk.
The Institute of Medicine defines public health as “what we, as a society, do collectively to assure the conditions in which people live can be healthy.” In making claims such as “my body, my choice,” helmet law opponents imply that their actions affect no one else.
In the year after the repeal of universal helmet laws, Arkansas and Texas fatalities increased by 21 percent and 31 percent, respectively, Kentucky saw a 50 percent increase in motorcyclist fatalities, and Louisiana’s fatality rate increased by more than 100 percent, prompting the Louisiana legislature to reenact its universal helmet law in 2004.
According to estimates from the NHTSA, between 19, helmets saved the lives of 19,230 motorcycle riders, and if everyone killed in a motorcycle crash had worn a helmet, an additional 12,320 lives would have been saved.
Similarly, when universal laws were repealed in favor of partial laws, Florida saw its compliance drop from 99 percent to 53 percent, and in Louisiana compliance went from 100 percent down to 52 percent.
Furthermore, the NHTSA found that in states with laws requiring only minors to wear helmets, less than 40 percent of underage riders who were fatally injured wore a helmet, indicating that despite a law requiring helmet use it is difficult to determine whether a rider is underage, thereby hampering enforcement.
And, although the number of organs recovered from motor vehicle accidents each year is fairly small and would increase nationwide organ donation numbers by less than 1 percent, opponents of mandatory helmet laws could claim that the autonomous decision to ride without a helmet may provide a societal benefit that offsets the associated societal burdens.
For patients on donor recipient waiting lists, there would be decreased wait times, decreased emotional and physical suffering for recipients and their loved ones, and decreased use of expensive life-sustaining technologies and health care resources over time.
In 2002, a Consortium of the American Board of Internal Medicine, The American College of Physicians, and The American Society of Internal Medicine partnered with the European Federation of Internal Medicine and developed a new Charter for Professionalism.
And, while they emphasized the three fundamental principles—patient welfare, autonomy, and social justice—the authors noted that in any contract between medicine and society, physicians should provide expert advice to society on matters of health and public safety.
Not only have helmet laws affected injury and fatality rates, but also health care costs both for riders and for the general public, because injured riders use shared health care and insurance resources and uninsured riders often rely on public assistance programs to pay their hospital and rehabilitative care bills. Department of Transportation Crash Outcome Data Evaluation System suggest that in three states that have universal helmet laws, inpatient charges for patients with brain injury due to motorcycle crashes would have increased from ,325,000 to ,095,000 if no helmet law had existed.
Illustrative of such shared insurance burdens is the reported 34 percent increase in the average insurance payment on motorcycle injury claims in Michigan since the 2012 repeal of the state’s helmet law. These statistics demonstrate not only the efficacy of helmet use in mitigating damages in the event of a crash, but also the direct link between the repeal of universal helmet laws and an increase in TBI, death, and use of scarce health care resources.