Barry Pless, have written an emotional editorial about the topic in the British Medical Journal, insisting that tougher penalties should be applied to drivers who break the law regarding cellphone usage for texting and talking while driving because they pose an increasing risk of danger to all motorists as well as pedestrians. Although both doctors admit that there have been no definitive studies about the effect of distracted driving on causing accidents and fatalities, they are calling on Canadian lawmakers to do something drastic to stop the increase of what they consider is extremely dangerous behavior with deadly consequences, Pless said Tuesday from Montreal. So part of the responsibility lies with the law makers to make sure the penalties are severe, he said, noting that New York state has proposed legislation that would double a young drivers licence suspension from the current six months for texting while operating a vehicle. If youre a kid and you know youre going to lose your licence for a year and you have a reasonable expectation of being caught, then one hopes that you will be persuaded not to do it. Even though there have been public service campaigns mounted to alert people to the dangers of distracted driving caused by the illegal use of cellphones while driving, the doctors feel it has barely made a dent in the publics consciousness about the problem. They are both urging that lawmakers enact much stricter penalties, such as suspending drivers licenses for one year. Below is an excerpt from editorial : Time to act: theyre responsible for a quarter of crashes in the US Although a review of the recent literature found that the evidence for a causal association between mobile phone use while driving and crash related injuries was not clear cut,1 with a quarter of crashes in the United States now attributed to mobile phone use, we cant wait for perfect evidence before acting.2 In 1997, Redelmeier and Tibshirani found that mobile (cell) phone use was associated with a quadrupled risk of crashes,3 although last year a study cast doubt on some components of the association.4 While most early studies unequivocally supported the view that mobile phones made driving more dangerous, some later reports arrived at contradictory conclusions, especially with regard to hands-free phones.5 Part of the confusion may be due to the mix of laboratory and observational epidemiological studies that characterise this field. Nevertheless, given the proliferation of mobile phones, the prevalence of distracted driving is undoubtedly increasing. Texting is obviously the riskiest activity because the distraction is cognitive and visual; handheld phone use (particularly when making or receiving calls) comes next; and hands-free use is probably the least dangerous. Convincing causal associations are notoriously difficult to determine, particularly in this area. Causality can be inferred only from randomized trials, and it is doubtful if a real world trial could be designed that would receive ethical approval. Laboratory studies using such designs are possible (and plentiful) but not persuasive. However, physicians and policy makers must often make decisions and act before they have solid proof. We therefore decided to proceed by taking as given that the risk was causal, substantial, and likely to grow unless more successful preventive measures are introduced. Possible interventions include the usual suspects: education, legislation, and technology . Education is the preferred choice of many, especially governments, because it is inexpensive, inoffensive, and politically easy. Generally, health education is of two kinds: counseling of individual patients by health professionals or more broadly targeted media campaigns. Evidence supporting the effectiveness of patient education is limited.6 In some domains, such as smoking cessation, physician counseling can be surprisingly effective.7 8 Counseling may be more effective when provided in an appropriate context, such as in the use of seat restraints with parents of newborns.9 Experience suggests that patients in the emergency room after an injury are also more open to receiving messages about preventive strategies and equipment.
Physician-assisted suicide remains illegal in Canada
She fears the point at which discomfort will turn to misery. And she fears that if death does eventually become preferable to life, the means of accomplishing will prove impossible under current legal restrictions. Putting a plastic bag over your head is not 100-per-cent foolproof, she says. If I started getting breathless, Im not sure I could do it. Violent acts arent an option for her either. What she wants and knows she cant have is a physician to help her. I think of it quite a lot. If I knew somebody could give me a pill, Id have a much happier life. I cant think of many things that would make me happier than to hear that physician-assisted dying is legal. But I dont count on it. When animals are suffering, we put them down. Why dont we do the same for humans? Medical tradition and the health-care mythology portrayed in TV doctor dramas celebrate the saving and maintaining of a heartbeat at all costs. That may be the right choice for many patients.
The Canadian contribution to the US physician workforce
3. Commission on the Future of Health Care in Canada. Rural and remote communities. In: Romanow RJ, editor. Building on values: The future of health care in Canada. Saskatoon (SK): Commission on the Future of Health Care in Canada; 2002. p159-69. Available: http://www.hc-sc.gc.ca/english/pdf/romanow/pdfs/HCC_Final_Report.pdf (accessed 2007 Feb 6). 4. Canadian Labour and Business Centre. Physician workforce in Canada: literature review and gap analysis. Ottawa: Canadian Labour and Business Centre; 2003. Available: http://www.physicianhr.ca/reports/literatureReviewGapAnalysis-e.pdf (accessed 2007 Feb 6).