In a wrestling match, competitors can only oppose peers of their weight class-not because a smaller wrestler is an inferior wrestler, but because the inherent strength imbalance and unfairness created by the weight difference makes the larger wrestler much more likely to injure their smaller adversary. When a seventy-ton, eighteen-wheeler exceeding sixty miles per hour crashes into a four-thousand-pound passenger vehicle, the larger vehicle is much more likely to damage the car and most importantly its passengers. Considering most of the danger in these collisions is caused by the enhanced potential for destruction of the massive semi-trucks, there should be strict regulation of trucking companies, and vigorous tort remedies available to the accident victims. Like the bigger wrestler, large semi-trucks should be restricted to ensure safety and avoid severe injury or death to those in smaller, compact vehicles.
Semi-truck accidents are common, and often fatal. “For every 100 million miles driven on U.S. road ways, there are 2.3 deaths and 60.5 injuries caused by big rigs.” Most semi-truck accidents are very likely to be deadly, especially for the passengers of the smaller vehicle-about 98 percent of all such accidents result in at least one fatality. “In two-vehicle crashes involving passenger vehicles and large trucks, 98 percent of the fatalities were occupants of the passenger vehicle.” Even those who survive such a catastrophic crash are often burdened with medical bills and legal concerns. They are prone to traumatic brain, spinal cord, and burn injuries, broken bones, and amputation. Survivors often have to temporarily leave work due to this sudden loss of ability to move, speak, or work. These life-altering injuries may require expensive care for the rest of their lives. Many victims also suffer mental anguish varying from loss of consortium to depression. All told, “fatal tractor trailer accidents cost Americans more than $20 billion each year, $13.1 billion of which is the cost associated with loss of quality of life.”
Louisiana has special reason to be concerned about these crashes. The state contains the world’s busiest port, as well as one of the nation’s busiest East-West interstates. Semi-trucks are constantly using Louisiana’s highways to haul goods such as rice, cotton, and forest products, and minerals such as oil, natural gas, sulfur, and salt, to name a few. Thus, Louisiana has a special interest in protecting its citizens from trucks coming from, or headed for, out-of-state destinations.
There are many reasons that cause semi-truck crashes, however the most common is human error. “Nearly 90 percent of commercial truck accidents are caused or worsened by some sort of human error….”
The weight that these vehicles carry deeply effect the way they must be operated and the caution necessary to safely reach their destination. Regardless of their awareness of the strict weight and load rules, some companies, in an attempt to save money or assure deliveries arrive on time, will encourage drivers to carry larger loads than that which is permitted.
Overweight vehicles contribute to undue stress on the vehicle, which, over time, can cause parts of the truck to malfunction or dismantle, usually during operation. This is difficult to detect when these vehicles have been on the road for longer than their authorized time. No matter how experienced the driver is, if he hauls a load larger than the limit he will also have difficulty braking because the truck now needs more time and distance to successfully stop.
Considering the long periods of time semi-trucks spend in operation, failed maintenance, equipment violations and defective trucking parts are likely to cause accidents due to the installation of inferior quality components and other imprudent ways companies cut costs.
Improper loading and negligent hiring of an unqualified driver can also cause accidents. Furthermore, it can be difficult to steer the now heavier vehicle which generally causes trucks to “jackknife”; this is when a truck loses traction and skids sideways, causing the vehicle to form a V shape, like closing a pocket knife.
Even trucks within the legal weight can cause catastrophic accidents when seemingly minor human errors occur. In some situations a driver’s mere inabilities to adjust to hazardous weather conditions contribute to accidents. Countless people have made poor decisions when they are inexperienced or inadequately trained, and drivers of these monstrous vehicles are no different. Due to semi-trucks difficulty maneuvering, the manner in which they are operated carries serious responsibilities in determining the best way to manage emergency situations. All drivers, no matter what vehicle they are in, are at times simply too distracted to properly manage their vehicle. Semi-truck drivers are more likely to disobey laws on talking or texting while driving, because they go for longer periods of time without seeing or speaking to their loved ones.
Another major contributor to semi-truck accidents is the pressure trucking companies put on their employees to meet deadlines and make their quotas. These semi-truck drivers are then compelled to disobey traffic laws and drive relentlessly if they want to keep their job. This unnecessary stress produces exhaustion and fatigue which creates reckless behavior including exceeding the required time limit for being on the road. “Driver fatigue is responsible for roughly 30 percent of all commercial truck accidents.” Many companies pay their employees for the miles driven, therefore to make extra money, drivers will pick up jobs they can’t handle and are then racing to meet the deadline. In these situations drivers become fiercely aggressive and fail to yield for passenger vehicles.
Given all these causes, there are various steps we can take to reduce the dangers of semi-trucks accidents. While ideally we would put them on their own roads, this would be too costly and unattainable in older cities that don’t have the space to forfeit, New York City, for example. If trucking companies reduced the size of their vehicles, the roads would be similar to the fairness found in a wrestling match, where, in case of a crash, everybody has a chance at survival. Again, this would be very costly for trucking companies and less efficient in terms of transporting the nation’s freight, but it still might be less than the cost each year of semi-truck accidents.
Nevertheless, there are easier ways to reduce accidents. For example, there are a plethora of advanced safety equipment that should be required, such as, governing trucks’ speed limit through a speed control system, emergency braking assistance, night vision support, and an improved warning system to prevent drivers from falling asleep. We should also consider giving incentives to transport operators willing to pay for the safest quality vehicle.
Improved driver training on both ends will also decrease the likelihood of these fatal collisions because both drivers have a better understanding of what is required to operate each other’s vehicles. Truck driver, Kevin Blomer, a six-year truck driver, states blind spots are all over when driving a large vehicle and “…drivers need to be aware, it’s harder for us to maneuver around them.”
We could severely decrease this prevalent problem if the government mandated rear view cameras for these vehicles that desperately need this technology, especially considering many semi-truck mirrors aren’t equipped for them to see vehicles in their blind spots, or around their own vehicle.
A very practical way to train drivers of both vehicles is to incorporate computer-based training into driving schools. Testing systems could be consistently updated and will prove to be cost effective because it will provide accurate training absent real accidents and personal injuries. The computer can accurately portray different noises and weather conditions while trainers watch from a separate location. The recording allows drivers to watch their own reactions and self-critique, making this more suitable for teaching on all levels.
Installation of drive cams can also decrease accidents by giving routine feedback on actual driver performance, and monitoring driver’s reactions to certain situations. They can also aid in identifying risky and negligent errors that need to be corrected, and drivers will have to be more attentive because they are now being held accountable for their actions.
Lastly, there should be consistent check points to catch drivers of overweight trucks. When weighing stations are no longer working drivers have more time to get away with being overweight or overworked. There should also be mandatory breathalyzer tests at each station to catch anyone who decided to open up a bottle while driving.
Finally, when preventative measures fail, and accidents do happen, it is important to implement strong tort remedies both so the injured will be compensated and so truck companies will be deterred from making future decisions that increase safety risks in order to cut costs.
Charles Darwin famously theorized that natural selection produces “survival of the fittest,” in which organisms that are better adapted for their local environments survive. While semi-trucks are in a sense “better adapted” to survive crashes, we do not want and should not have “survival of the fittest” on Louisiana’s roads. Instead, we should have increased regulation and robust tort remedies to protect Louisiana’s drivers from the potential for harm.
Inches. In terms of measurement, inches may seem insignificant in the great vastness of the world around us. In some circumstances, however, inches can mean the difference between life and death. In August of 2001, the lives of both me and my daughter were not only saved but changed within a matter of inches.
It was a clear, cool night in the city of Appleton, Wisconsin. My daughter and I were returning home after spending time visiting friends. Under the dim glow of the city’s street lights, a car approached us in what I erroneously believed was the turning lane. Too late did I realize that the vehicle bearing down on us was in our lane and we were facing an imminent head-on collision. In a split-second decision, I slowed in the hope that damage from the impact would be isolated to the front of our car, lessening the risk of injury to my daughter who was strapped in a car seat behind me, unaware of the events that were unfolding. The vehicle struck our car with such force that the metals became intertwined. As the driver of the offending vehicle accelerated to flee, the harsh sound of shrieking metal punctured the night as both drivers’ side doors were nearly ripped off the frame in places. The person responsible drove off into the night, leaving behind nothing but an eerie silence. Dazed and confused, I was unable to open my door so I crawled through the passenger’s door and ran to the back of the vehicle where my daughter sat, unmoving and silent. Her eyes were open but non-responsive and not a single tear had she shed. I tore the door open almost pulling it from the hinges as my panic turned to terror. After checking for injuries, I gathered her up and held her. Only then did she begin to cry and the relief that I felt buckled my knees as I collapsed into the grass, still holding her in my arms, on the side of the road in view of my mangled vehicle.
Inches. I will never know how our lives would have been affected by a matter of inches one way or the other. However, I do know how those first few inches of impact caused by a drunk driver dramatically changed the course of our lives—for both good and bad. The accident caused cerebral brain damage, otherwise identified as traumatic brain injury in my daughter Lyndsay who was only seven months old at the time. The damage has caused severe developmental delays in her growth and fine motor skills as well as her speech and cognitive functioning. The challenges of being a single mother increased exponentially upon the realization of what obstacles my daughter would face and continues to face on a day-to-day basis. For much of the first year after the accident, I was advised that there was no hope for my daughter and that I should place her into a care facility that would be better equipped to handle a child with her special needs. I found that advice to be ironic considering the lady who was driving drunk walked away with a $454 fine: no suspension of her driver’s license, no jail time, and no apologies. I was told that my daughter was severely retarded and that there was no hope for her to ever enjoy a fulfilling life. I was told that I was ill-equipped to handle a disability of this magnitude on my own and that my daughter would receive better care by individuals who specialized in children with similar challenges. It took only one look in my daughter’s eyes to know that this tragedy would not separate us and that there was no person on the planet that cared about her success more than I did, and still do.
My daughter is now twelve years old and we still struggle together every day. The first indication of the magnitude of that August night in no way prepared me for the challenges that we have faced during these 12 years and, no doubt, many years to come. Progress has been slow and at times extremely painful. My daughter is now too heavy to carry and must use a wheelchair for transport. I feed her, bathe her, and change her as she requires maximum assistance with most tasks that people without a disability often take for granted. Although she is capable of speech, it is rare to hear her sweet voice communicate her needs and wants. It is hard for others to grasp how desperately I long to hear her say “mama” or “I love you.” There are not enough words to describe the complexity of issues that arise, for example, what is hurting when she is sick or whether she has a loose tooth that needs to come out. Most people do not understand nor do they want to.
Growing up in the South, the fact that prejudice and hate still exists is no surprise but I was equally unprepared for those same issues to be directed at my child for a disability that was caused by the poor decision of another. In a unique way, I am better able to understand the humiliation of being segregated. This hatred unfortunately is not limited to only nonverbal behavior. Many voice their disgust with no consideration that my child has feelings and is capable of understanding their repulsion. Many like to play what I have termed the “guess the disability” game. The cruelties of these people are not only emotionally devastating but also add to the difficulties of raising a child with special needs. Despite it all, we continue to survive and thrive.
Unlike some parents that hide their disabled children from the world, I make no apologies for my daughter because I know what a joy she truly is. She is extremely smart and uses her disability in ways that would make others envious if they took the time to get to know her. I do not limit the opportunities available to her and we take advantage of what life has to offer. She has been involved in horse therapy, t-ball, and basketball through special programs established for kids like her. Together, we volunteer in many community programs and, with each event, we are helping to change those negative attitudes toward people with disabilities. My daughter’s smile and good nature is infectious and in a crowded room she shines as bright as the sun, melting even the coldest of hearts. No matter how long it takes to make a difference in our lives and the lives of others, she continues to teach others the real meaning of life one person at a time.
Through this tragedy, my daughter has taught me about courage. Her courage has empowered me to work harder to reach goals that may seem impossible. It is that courage that helps me to defend her in the face of injustice in whatever form it takes. The truth is that over these years she has shown me a world that I would have never known existed. In spite of the challenges that we face, we have met some truly amazing kids. We have helped parents who are just starting out on the path that we began so many years ago, that cool, August night when we survived that unexpected encounter with a drunk driver. It takes courage amidst all the tragedy to continue to do what is right. It takes tenacity and determination to overcome those unanticipated obstacles that life may bring. It takes resolve to embrace the challenges instead of taking the easy road and falling back on anger and hatred. Our motto has become that when the elevator to success is broken, we will just use the stairs. How many stairs there are left to take is unknown but the destination is still within reach. All it takes is courage.
How has cerebral palsy impacted your life of that of a loved one?
Josie, the youngest of 13 children was the last addition to what she describes as a “typical model family” in 1960. She was raised in a patriarch household: her mother stayed at home to rear the children while her father was the primary authority figure. She describes an early happy upbringing that was altered by a tragic incident resulting in her father’s blindness. Her father moved away from the family to attend blind school. Her mother, left to both financially and physically care for 13 children, suffered a nervous breakdown. Josie and her siblings were all divided among relatives until her mother was released from the mental institution in 1963. Josie’s mother and father attempted to reconcile and as they were re-adjusting to life as a family, her mother was concerned that Josie was still not walking at the age of 4. Soon afterwards, Josie was diagnosed with cerebral palsy. An official cause has never been determined although she recalls being told that she was bluish at birth.
Josie underwent several surgeries and wore a body cast for months. She endured some very hurtful experiences from her siblings who resented caring for her. Instead of feeding her, they would eat her food or hit her when their parents weren’t around. Comments like, “we wish you weren’t born,” or “we can’t play outside with our friends because of you” were sprinkled heavily throughout those years. Once the body cast was removed she was fitted for braces that she wore for six years. Josie started elementary school and her siblings pushed her in a wagon to and from the neighborhood school. They would purposely turn the wagon over or leave her in the wagon to play with their friends. Thus, one of her most pleasant childhood memories was getting the braces removed! This symbolized freedom and self-reliance. Moreover, her parent’s attempt at reconciliation was successful and they began attending church as a family unit. The biblical principles that were instilled in Josie then would help sustain her through life’s trials and tribulations. She credits her faith in God for her ability to cope with the next of many challenges: her fight to stay in mainstream education.
Josie started junior high school in 1972. There were two court cases that sparked a debate in the United States regarding the education of children with disabilities. Pennsylvania Association for Retarded Children (PARC) v. Commonwealth of Pennsylvania (1971) and Mills v. Board of Education, DC (1972) both initiated ideas about educating children with disabilities. However, the proposals that schools should provide a free public education that was “appropriate to the child’s capacity” and that “a regular public school class” was more beneficial to a child than a “special public school class” were not implemented into law until 1975 with the signing of The Education for All Handicapped Children Act (Public Law 94-142). Therefore, the principal of Josie’s junior high school conferred with her mother about placing her into special education classes with no prior testing done. Josie’s mother said no, certain that her physical handicap did not affect her ability to learn. Finally, Josie was asked to pass a standardized test in order to stay in regular education classes….and she did! She remained in regular classes, and graduated in 1979. However, this did not complete her formal education. Josie subsequently earned an AAS in Executive Secretary, AS in Computer Technology Systems, BS in Psychology, and will be completing her Masters in Mental Health Counseling in May, 2013.
Josie’s accomplishments are not without challenge. The type of cerebral palsy that affects her is bilateral spastic with an unsteady gait. Her muscles are tight and do not stretch; her joints do not open and close fully. Her legs make scissor like movements as she walks and she experiences muscle weakness in her thighs. Her muscle and joint pain is increased by cold or stress. She was given a prognosis of being wheelchair bound by age 50, but she is still able to walk at age 52. She says that occasionally, living with cerebral palsy can be depressing; it impairs her ability to socialize at will since she is unable to afford a car with assistive technology. Although she has achieved much and defied many odds, she has one last goal: to learn to drive. For Josie, being able to drive herself is synonymous with the day she was able to remove her braces! It represents another level of freedom and so she is patiently waiting for that opportunity. Until then, she remembers her mother’s parting advice: “There is no need to stop. Just put one foot in front of the other.”
What causes cerebral palsy and what preventative measures can be taken to reduce the risks?
Soleimani (2011) defines cerebral palsy as a “group of disorders in the development of movement and posture in the developing brain.” This condition is called a non-progressive disorder because the damage to the brain does not worsen over time, although the symptoms may. Cerebral Palsy (CP) is now the number one physical disability in the United States, affected approximately 2 out every 1000 births. It is estimated that 70% – 80% of children develop CP in the womb with an additional 20% developing it at some point during the birthing process due to a lack of oxygen (UPCA, 2013). Likely causes according to Meyer and Shapiro (1999) are “prenatal events such as genetic disorders; intrauterine infections (e.g. German measles); exposure to toxins; malformations of the brain structure; complications of multiple births, and abnormalities of blood flow to the brain.”Click here to learn more about cerebral palsy injuries.
There should be a multifaceted approach to preventing cerebral palsy. For developing babies in utero, “it is possible that interventions which either prolong gestation or decrease the risk of preterm delivery will also decrease the risk of cerebral palsy (O’Shea, 2011).” Interventions that hold promise for reducing the prevalence of cerebral palsy include “antenatal steroids given to mothers expected to deliver prematurely, and treatment of mothers who are expected to deliver prior to 30 weeks gestation with magnesium sulfate (O’Shea, 2011).“ Most near-term or full-terms babies develop cerebral palsy as a result of cerebral hypoxia and ischemia. Preventions include “hypothermia for neonates diagnosed with hypoxic-ischemic encephalopathy, and caffeine for extremely low birth weight infants (O’Shea, 2011).”
What are some of the latest developments in cerebral palsy treatment and assistive technology?
The latest developments in treating cerebral palsy include the Feldenkrais Method (a combination of physical therapy, psychology, and martial arts), dolphin therapy centers, hyperbaric oxygen therapy, space suit therapy (defy gravity to induce proper alignment), and hippotherapy (horse movement and rhythm aligns the body). Assistive technology allows people with cerebral palsy to have increased mobility and more effective communication using software to operate household appliances, travel, have a career, attend school, and even drive a car. Assistive technology exemplifies the mission of the United Cerebral Palsy Association: “Life without limits for people with disabilities.”
I came into this world in a very adventurous manner. I was born two months pre-mature when the placenta broke off too soon and caused internal bleeding. Luckily, both my mother and I survived this ordeal, but not without consequences. Because I was premature, my lungs had not fully developed, which cut off precious oxygen to the brain. To make matters worse, I contracted meningitis in the NICU. When I was born in 1990, there was a meningitis outbreak in the hospital. The doctor predicted that I would have severe brain damage, and probably mental disabilities. I was eventually diagnosed with cerebral palsy. This diagnosis has brought challenges that have been different from, but not necessarily more difficult than my peers. My cerebral palsy limits me physically. I depend on a wheel chair to navigate and assistants to help with daily living skills. Luckily, my mental capacities have not been affected. Cerebral palsy comes with a wide variety of symptoms. Usually it is very mild and causes people to walk with an abnormal gate, or it can be very severe and limit a person’s mental capacity as well. Sometimes, the brain damage can trigger uncontrollable muscle spasms while other times it may prevent a person from making slow muscle movements. For me personally, I am affected both ways. I do have muscle jerks and I also have trouble with slow muscle movements. As a kid, I underwent a lot of surgeries to eliminate some of these symptoms. I endured a dorsal root rhizotomy to eliminate my spastic muscle movements. It did work in the sense that I no longer had muscle spasms in my foot, but it did not stop the other muscle jerks because those were triggered by external noises or emotional impulses. This was my last surgical attempt to fix my physical disability, and since then I have been determined to live with my cerebral palsy.
Being physically limited has made me learn how to rely on others for help. Over the years I have had to learn how to be able to vent my frustrations without hurting others and to adjust being around people all the time. Having to rely on people all the time requires that I place a great deal of trust in complete strangers. I have been abandoned by people I have hired to help me and it has affected my relationship with others. I am trying to learn to trust others even in social relationships, which means being more open to giving people second chances. Because of what I’ve been through, it’s hard for me to forgive people when they fail to show up. I also struggle with finding authentic friendships because I’m always wondering if people are nice to me for genuine reasons. I have also learned to embrace disappointment and failure. My graduate education, plus self-reflection has made me keenly aware that I have a fear of failure. I think this fear stems from the failed surgical operations and the disappointment that stems from such a failure. While rationally I know that the success or failure of the operation does not reflect my ability, I internally see myself as broken. Alternatively, I see my disability of cerebral palsy as a catalyst that has propelled me to achieve great things in the past and to continue to achieve in the future. I think without my disability I wouldn’t have been as motivated to succeed in order to prove people wrong. Another aspect that people fail to realize is that people with cerebral palsy are fully capable of participating in numerous activities. It always surprises me when people seem impressed over little things I do, or they, at first, doubt my intelligence only to be proven wrong. I can truly say that I do not think that I would be where I am today without having learned the lessons that come from living with cerebral palsy. I have learned to deal with adversity, challenges, difficulties, and I have learned what it means to be dependent on others.
Because of my perception of my disability as something to be overcome, I have always been successful academically. In undergrad I made dean’s list for three semesters. At graduation, I received most outstanding philosophy student award. I accomplished straight A’s in the first year of divinity school at Regent University. Currently I am one of the first year representatives for the Christian’s Legal Society in the School of Law at Regent University.
So cerebral palsy does not just affect an individual, but it also affects their family. I think it has taught my brother to be more accepting of people who are different. I am very lucky to have a very supportive family. My mom has always challenged me and has never allowed me to use my disability as an excuse. Because of her leadership, I was able to be an independent person, although I think it is in my personality to be independent. By independent, I mean that I am making my own decisions and living on my own. I do not rely on my parents for financial support. I also hire my own attendant care. So while, yes, I do depend on people for daily living skills, I am independent in my decisions and in my educational pursuits.
As I attend law school, after graduating from the University of Virginia in three years, I know that my disability will help me to be a better advocate, and will possibly shape my career goals. I have considered representing people with disabilities. It is my hope that through my achievements and my life story that people will come to know that one can have a quality life despite their disability.
About a year ago, a Massachusetts teenager was sentenced to 2.5 years in prison for causing a fatal accident that took the life of a 55 year old man. The cause of the accident: texting while driving. This tragic accident is just one of the many accidents that distracted driver campaigns have sought to prevent.
Distracted driver campaigns, sometimes referred to as “don’t text and drive” campaigns, have gained steam in recent years. “Don’t text and drive” campaigns focus primarily on educating drivers and raising awareness about the dangers of texting and driving. This concern in raising awareness about the dangers of texting while driving has coincided with the dramatic increase in cell phone usage over the past decade. Today, the improvement in cell phone technology means that many drivers have the equivalent of a personal computer with internet access sitting in their pockets. No doubt, the risk of distracted driving is high.
The dangers of texting while driving are well-documented. The federal government notes that those who text while driving are 23 times more likely to be involved in an accident compared to those driving while not distracted. Studies also show that a driver’s eyes are off the road for an average of 4.6 seconds while he or she is sending or receiving text messages. To better understand how dangerous those 4.6 seconds are, the federal government notes that at 55 miles per hour, those 4.6 seconds are similar to driving the length of a football field – blindfolded. Studies even reveal that texting while driving can be more dangerous than drunk driving. The dangers of distracted driving are most evident among teen drivers, and indeed, a recent increase in teen driver deaths caused by distracted driving has sparked alarm among some lawyers.
These dangers have not gone unnoticed by the public. General public opinion continues to support legislation that prohibits texting while driving. And yet, despite the consensus on prohibiting texting while driving and the evident dangers of the practice, statistics indicate that many people – especially teens – still continue to do so. Perhaps most surprising, many do so despite being aware that texting while driving – and distracted driving in general – is dangerous. Thus, while “don’t text and drive” campaigns arguably have increased awareness about the dangers of texting while driving, many drivers continue to ignore the risks to the detriment of themselves, other drivers, and pedestrians.
What Can Be Done?
While general public opinion shows wide support on prohibiting texting while driving in general, there seems to be less societal outrage about the practice itself. Perhaps cell phone usage and text messaging have become so ubiquitous that people don’t feel moral outrage about the practice. Or perhaps it’s that people minimize the dangers of their own multitasking.
Some have reasoned that increased awareness campaigns can help address the problem. For example, there has been wide praise for cell phone companies promoting “don’t text and drive” campaigns. The argument goes that if drivers understand that cell phone companies discourage texting while driving, then perhaps drivers will listen and be more careful on the road. If people were more aware about the dangers of texting while driving, then perhaps they would be more careful.
However, most people inherently understand that looking away from the road to answer a text probably isn’t the safest action a driver can take while driving. Indeed, the fact that public opinion polls show wide support for banning texting while driving shows that people are aware of the dangers of texting while driving. The problem, then, isn’t so much about just raising awareness. Rather, the bigger problem is that drivers continue to text while driving, despite knowing the dangers that are present.
“Don’t text and drive” campaigns should focus, not just on raising awareness, but also on increasing societal outrage at the practice and increasing the social stigma associated with texting while driving, much in the same manner that has occurred with drunk driving. To do this, “don’t text and drive” campaigns can borrow ideas from successful anti-drunk driving campaigns.
The history of anti-drunk driving campaigns provide a good model for how “don’t text and drive” campaigns could work. In the 1980’s, drunk driving reached levels that some thought were of epidemic proportions. The number of serious or fatal car crashes caused by drunk driving reached an all-time high in 1982. In response, legislatures not only implemented harsher penalties, but interest groups also embarked on grassroots campaigns to increase the social stigma of drunk driving. Societal outrage with drunk drivers increased and today, there is a wide consensus that drunk driving is not only dangerous, but also inherently wrong to do. Of course, drunk driving accidents still occur, but there at least appears to be more societal outrage at fatal drunk driving accidents, providing a possible deterrent effect Society views drunk drivers as widely irresponsible and for many, there is a social duty to stop drunk drivers, whether it’s reporting a drunk driver on the road, acting as a designated driver, or simply taking the car keys away from a friend. For distracted drivers on the other hand, the response seems to be more of annoyance, rather than societal outrage. This must change if “don’t text and drive” campaigns are to have a positive effect in preventing fatal accidents.
Texting while driving campaigns can take cues from anti-drunk driving campaigns. Enforcement of “don’t text and drive” laws has been spotty and is difficult. Thus, the focus must be on, not just warning drivers of the dangers, but also in getting third parties and the general public as a whole to join in on enforcement efforts. For example, studies show that as many as 40% of American teens admit to being in a car where the driver used a cell phone in a way that put people in danger. If societal outrage at texting while driving were higher, this number could be far lower. Pressure from friends and family is the surest way to encourage drivers to be more careful at the wheel. “Don’t text and drive” campaigns should encourage passengers to stop drivers from texting while driving, similar to how passengers are encouraged to stop friends from drunk driving. Indeed, one state has even borrowed ideas from anti-drunk driving campaigns and launched a campaign to encourage “designated texters.” Campaigns such as these may do more to help spark societal outrage and lead to a change in how people drive in the long run.
“Don’t text and drive” campaigns have increased awareness about the dangers of texting while driving, yet the problem continues to persist. “Don’t text and drive” campaigns have the potential to work, but they require more than just raising awareness. They require help from society as a whole. Anti-drunk driving campaigns have sparked societal outrage at driving drunk. ”Don’t text and drive campaigns” should borrow features from anti-drunk driving campaigns in order to spark societal outrage and increase the social stigma of texting while driving. If texting while driving campaigns focus more on sparking societal outrage and encouraging pressure from society as a whole to prevent texting while driving, driving habits may begin to change for the better.
How has cerebral palsy impacted your life or that of a loved one?
I have cerebral palsy. Specifically, it presents as left hemiparesis, the condition of physical weakness and decreased coordination in the muscles on the left side of my body. However, due to the minor nature of my case and the effectiveness of my treatment program, no one really notices the physical effects notices anymore. The most honest thing I can say about my experience with cerebral palsy is that it has been simultaneously, paradoxically, significant and insignificant. Cerebral palsy has not often had any direct impact on my life, but when it does, the impact has been profound.
No one is entirely sure what caused me to have cerebral palsy. There are a number of different potential causes, including prenatal stroke, prenatal disease, and perinatal malpractice. One guess I find plausible is that my mother was sick with hand, foot, and mouth disease shortly before I was born. Whatever the cause, I have a number of lesions in the right side of my brain, which causes hemiparesis in my left side. Practically speaking, this means three basic things. Most importantly, the muscles in my left leg were too tight as a child, and this caused my leg to not grow to its full length. The muscles in my left leg are also rather weaker than those in my right. Additionally, the muscles in my left arm are weak and I lack some coordination in that hand. Finally, I have what an ophthalmologist characterized as a “wandering” left eye: my left eye can see as well as my right, but I lack some control as to the direction the eye moves.
The effects the three issues have had on my life are as varied as the body parts. Having an eye that wanders has occasionally interfered with my depth perception or caused minor headaches due to the resulting sight issues, but I have learned to compensate over the years, and my control over the eye has increased with time and practice. These days, I usually do not even notice any issues unless someone else points out that my eyes are not looking at the same thing, and few people seem to even notice that. My arm, meanwhile, has no real effect on my life because I am still capable of using my left arm and hand almost as well as any other right-handed person.
My leg has made things a bit more complicated than either my hand or my eye. There is no question that my left leg is shorter and weaker than my right. I can hardly balance on my left leg at all, have horrible balance overall as a result, and have limited range of motion in my left foot and ankle. As a direct result of all of this, I have a slightly strange gait, was once a very slow runner, and took longer than many children to master such basic athletic skills as riding a bike, kicking a ball, jumping off a ledge, or climbing a tree. In 2001, my orthopedic surgeon performed surgery to slow the growth of my right leg so that the left could catch up somewhat. I do not understand the procedure fully, knowing only that it involves deliberately altering the growth plate of the femur in the longer leg. What I mainly remember is waking up in pain after the surgery, spending six weeks in a splint, and continuing to have pain for nearly six months while I worked to regain range of motion in my “good” leg.
In many ways, though, I have been very blessed. The limitations I have experienced, though real, are nowhere near as significant as they are for many cerebral palsy patients. I have been able to participate in many normal life activities in spite of my leg, and my arm and eye function almost normally and have never seriously interfered with school, work, or recreation. I am well aware that many of my fellow patients have difficulty performing even basic functions such as walking, talking, and even feeding themselves, none of which have ever been an issue for me. Thus, in one way, my cerebral palsy has been almost insignificant.
However, even with the minimal physical effects, having cerebral palsy has had a profound impact on me psychologically. Some of my earliest memories are related to my leg. I was nearing five years old when the doctor noted that I did not put my left heel down while walking. At the time, my parents were missionaries in Papua New Guinea. Due to some odd test results, the doctor thought I might be suffering from a progressive disorder called tethered spinal cord, and sent the entire family back to the United States as soon as possible so that I could receive medical treatment. The diagnosis of cerebral palsy meant that the emergency trip had not been necessary, but all my five-year-old self knew was that I needed to see a doctor, and my need had forced a serious change on the rest of my family.
Over the years in the United States, I was subjected to a variety of tests, spent some time in physical therapy, and was initially given a splint to restrict the motion of my leg while I was wearing shoes (to force my heel to touch the ground). After the splint came a cast, intended to increase the restriction. The cast led to questions. First and second graders are naturally two things – inquisitive, and naïve. “Did you break your leg?” “If you didn’t break your leg, why are you wearing a cast?” “How can you be walking when your leg is in a cast? Don’t you need crutches?” And I was simply different: weeks in a cast meant weeks of limited participation in physical activities, which required explanation to all of my teachers. I was, and remain, rather shy, and preferred not to have the attention. I only had the cast for a month, but by that point everyone knew there was something strange about me. I went to the doctor when I was not sick, and it meant missing several hours of school at a time. I was unusual, and I hated it.
After the cast I only had to wear a splint at night, but from age 8 to age 14, every pair of shoes I owned had a half-inch lift built into the sole. My family returned to Papua New Guinea for a few years when I was 8, and there my shoes were especially unique. They became one of the few things I could not afford to lose. My friends never wore shoes, not even at school, but I had to wear them almost everywhere. Once again, I was unusual. Fortunately, my parents allowed me to occasionally go without my shoes, so long as I did not lose them, and that made matters easier. On the other hand, my other limitations were notable, and there are few things to make a young boy feel more self-conscious than finishing last in every single race, being the only person who cannot walk the balance beam, and so forth.
When my family returned to the United States again, I was in fourth grade, and had one rule set firmly in my mind: do not talk about the cerebral palsy unless you have to. It was a foolish rule, based off a misguided desire to be “normal,” failing to recognize that anyone who was told was nothing but understanding. Nevertheless, I maintained that rule until the last day at school before my surgery. I was in seventh grade in a very small, private middle school, and was about to be absent for a week. Everyone wanted to know why, and I finally told them. They were sympathetic, they were helpful for my entire recovery period, and never once did anyone make me feel emotionally uncomfortable. The whole recovery period was annoying because of the physical limitations, but had none of the social problems I was expecting.
I think that day marks when I began to be comfortable talking about having cerebral palsy. It was no longer possible for me to fake being “normal,” but I began to realize that I no longer cared. I have found over the years it is only an issue if I make it one, so I stopped paying attention to my limitations and began to explore my abilities. As time has progressed, cerebral palsy has just become another thing about me. I tell people, or not, without concern.
The underlying truth of my experience is that the psychological effects of our problems are often more important than the problems themselves. The wisdom and distance of years have shown me how minor and relatively insignificant my case has been, but it has nevertheless had a profound impact on my sense of identity. For some of us, the psychological effects of having cerebral palsy are more important than the actual limitations the condition causes.
Assistive technologies that enable an amputee to not only walk, but run and dance, are obviously incredible. New prosthetic limbs simulate natural gait. Brain-Computer Interfaces allow people who are completely paralyzed, “locked in,” to communicate. Enable Talk Gloves (only $75!) translate sign language to spoken words. The recent trend of technological advancements is so remarkable—and accessible—that it may even, as one prominent roboticist boldly claims, largely eliminate disabilities during the 21st century. However, whether his prediction can come true requires an examination of the definition of the term disability. To illustrate, it is helpful to view how these technologies and the legal definition of disability will interact from the perspective of a single, generally disabling, condition, such as cerebral palsy.
Background of Cerebral Palsy
Cerebral palsy is a neurological condition characterized by abnormal movements, muscle tone, or posture. It is caused by a brain injury or abnormal brain development, most typically during pregnancy, but some cases arise in infancy or very early childhood. The underlying injury is permanent but doesn’t worsen over time (non-progressive), so the person’s symptoms are relatively the same throughout their life. Common symptoms include: poor muscle coordination during voluntary movements, such as reaching for things; abnormally stiff or floppy muscle tone; spasticity, which means exaggerated reflexes or too tight muscles; and an abnormal gait, such as dragging one foot, walking on toes, or a“scissored” gait. Many people with cerebral palsy also suffer from other conditions related to developmental brain abnormalities, such as excessive drooling, difficulty eating and swallowing, seizures, and intellectual disabilities.
There are a variety of treatments for cerebral palsy, but there is no cure. Most treatments are “disability management.” The available treatments typically aim to minimize the symptoms of cerebral palsy and improve the person’s functional abilities. This includes medication, physical and occupational therapy, surgery, and speech therapy. Assistive devices such as wheelchairs, walkers, and computers with attached voice synthesizers play a critical role in treatment of cerebral palsy.
Robotic Limbs and the Americans with Disabilities Act
Hugh Herr—the same roboticist mentioned above—suggested at a recent conference organized by the Economist that we may soon see people opting to amputate limbs in order to replace them with higher functioning robotic ones. People with cerebral palsy are one population that may be interested in taking such a drastic step. Some people with cerebral palsy experience symptoms throughout their entire body, while others’ muscular coordination disabilities affect only one side of their body or are isolated in one limb. Those individuals with isolated symptoms could replace the affected limb. If Mr. Herr’s prediction is taken to the extreme, individuals who experience spastic movements throughout their entire body may be able to replace all of the affected nerves and enjoy smooth coordinated movements.
If people with cerebral palsy opt to replace limbs or more, will their disability be eliminated in the eyes of the law? The answer turns on how disability is defined. As the law stands now, to qualify for protection under the Americans with Disabilities Act (ADA), a person must meet the statute’s definition of an individual with a disability: “a person who has a physical or mental impairment that substantially limits one or more major life activities, … a history … of such an impairment, or a person who is perceived … as having such an impairment.” The ADA is a civil rights law that aims to protect people with disabilities from discrimination and to ensure that they have access to public services and benefits. Individuals’ status as “disabled” under the ADA is determined on a case-by-case basis. Being labeled “disabled”comes with complex social and legal consequences and benefits. Accordingly, it is not clear whether those people whose disabilities have been ‘eliminated’ would want to continue to be considered disabled. Further, whether people should be permitted to retain their “disabled” status under the ADA after a functional “elimination” of their disability is a legal, political, and ethical conundrum. Two elements of the ADA’s definition appear to preserve those individuals’ option to retain their “disabled” label under the ADA—the “history” and “percieved … as having” criteria. Accordingly, the ADA’s current definition decreases the likelihood that Mr. Herr’s prediction is correct. .
The “history” portion of this broad definition seemingly permits a person who has adopted a robotic limb to continue to be considered disabled. Thus, as long as the definition includes “history,” Mr. Herr’s prediction that disabilities will be largely eliminated cannot come true under the ADA. This suggests that it may be time to rework the ADA’s definition, a difficult task. At what point would it be proper to consider a person no longer disabled, despite their history? One lawyer-bioethicist argues that existing mobility assistive devices, such as wheelchairs, should already be treated as part of the owner’s body under the law in the event that a third party harms it. But should that argument work in reverse? Once a device that permits its user to function at the same level as people who don’t have histories of disability can be fairly considered part of the body, should that user no longer be considered disabled? How integrated into the body would that device need to be? As assistive technologies become more lifelike and commonplace, it seems that the definition should be changed to make way for a future in which disabilities can be considered largely eliminated.
The “perceived… as having” portion of the definition poses an additional barrier to actualizing Mr. Herr’s prediction. For example, if a person suffers from multiple symptoms or disabilities (like most people with cerebral palsy) how many of their symptoms would need to be ‘cured’ by robotics for that person to no longer be considered disabled? What would happen if a person with cerebral palsy no longer had spastic muscle movements in their arms thanks to robotics, but continued to suffer from the characteristic tongue thrusting or facial symptoms such that others could identify them as someone who suffers from cerebral palsy. However, given the powerful effect of stigma, whether it would be appropriate to remove that portion of the definition is loaded issue that regulators must approach extremely cautiously.
The definition of “Disability” and Legal Autonomy
A person who is considered disabled from a legal autonomy perspective is someone who lacks legal capacity to perform certain acts. For example, a person with a communication disability or an intellectual disability as a result of cerebral palsy may not be able to perform the legal acts of communicating consent or making decisions about finances. Such persons are often appointed guardians or other advocates who assume responsibility for their legal decision-making. However, as assistive communication devices are improved and become more popular, fewer people with cerebral palsy will require legal proxies or those proxies will play a smaller role. Helpfully, the Model Rules for Professional Conduct have already established a good precedent for accommodating those changes. The rule for assisting clients with diminished mental capacity requires that a lawyer try to involve the client as much as possible, and to frequently reassess the client’s capacity to make independent decisions.
So, Mr. Herr may be right with respect to disability in the legal autonomy context. For people with cerebral palsy who are disabled because of physical communication impairments, advancements in and increased popularity of devices like the ECO2, a form of “augmentative and alternative communication” (AAC) that creates verbal speech from the user’s head movements, may very well eliminate their disability. Brain-computer interfaces are an even more advanced form of the same idea. Further, people with cerebral palsy who have less legal autonomy because of an intellectual disability (approximately 40% of people with cerebral palsy suffer intellectual disabilities) may enjoy greater independence thanks to technology that promotes early child language development.
New developments in assistive technology will transform the lives of hundreds thousands of people with cerebral palsy. These inventions are changing the way people with disabilities live, as well as how our society thinks about disabilities. The European Commission (EC) has recognized the need for European law to adapt. To that end, the EC is funding RoboLaw, a large-scale research project to investigate the interplay between European law and emerging robotic technologies. This was a brief and narrow assessment, but it revealed that whether technology can successfully eliminate disabilities depends in part on the definition of disability in U.S. legal system. The U.S. should follow Europe’s lead and begin investigating the best way to restructure its laws as well.
Thoughts on Cerebral Palsy
I was four years old when my brother Steven was born. Steven was diagnosed with a developmental disability, which presented our family with unique and special experiences. Growing up with Steven allowed me to be involved with the special needs community. I have many fond memories of participating in Special Olympics basketball, golf, track and field, and swimming with Steven over the years. As a result of my experiences with Steven, I felt comfortable around others with disabilities. For example, when I was in the ninth grade I met Matt and Heidi. Matt was one of my teachers at school. Throughout high school I got to know their family well, including their then-eight-year-old daughter Sarah. Sarah has cerebral palsy.
When Heidi was pregnant with Sarah, it was considered a high-risk pregnancy from the beginning. At twenty-five weeks pregnant, Heidi started having contractions. She was admitted to the hospital so that medical staff could intervene and monitor her condition. After a week of bed rest and close monitoring, Sarah stopped moving. It was decided that an emergency C-section would be the best option. After Sarah was born, she was immediately taken to the Neonatal Intensive Care Unit. Because of some bleeding in the brain, she developed cerebral palsy and blindness in one eye.
After high school, I rented an apartment near this amazing family. I spent a lot of time hanging out with Sarah. I was never uncomfortable with Sarah’s CP. As a matter of fact, her disability could be credited for some of our more fun and memorable experiences. For example, we would take regular trips to the nearby Arby’s or Dairy Queen, where Sarah would laugh hysterically as I would attempt to interpret her adapted sign language for the cashier. Sometimes on our way home, I would let Sarah take the steering wheel of my car as we pulled into her driveway. This usually resulted in near misses of Heidi’s parked car. It was around this time that Sarah started calling me “my brother, my brother.” I really enjoyed that, as I grew up with three brothers and no sisters. Our brother-sister relationship continues to this day.
I always admired how Matt and Heidi took care of Sarah’s special needs. However, I also recognized the contribution of the many school and government programs and services. Growing up, I was familiarized with the various services for individuals with disabilities and their families. It was incredible to see all the support services, such as respite, attendant care, habilitation, physical therapy, occupational therapy, and music therapy. For Sarah, specially trained respite and habilitation providers visited her home several times each week to give Matt and Heidi a break from some of the stresses of raising a special needs child and to work with Sarah on her individualized goals. As a result, Sarah has been able to overcome many of the obstacles associated with her cerebral palsy. Today, Sarah is a very independent and industrious person.
Sarah continues to benefit from respite and habilitation services. Additionally, she is enrolled in a special performing arts school for individuals with disabilities. She recently gave a presentation to a large group of peers, parents, and community members, in which she dressed up as the historical figure Cleopatra. She entered her prepared speech into her iPad and, through the use of special assistive technology, was able to “talk” to the audience about her research. It was a very proud day for Sarah, Matt, and Heidi.
My experiences with Sarah, as well as my brother Steven, prompted me to seek employment after high school in the field of human services. Throughout my undergraduate years I worked in group homes and provided respite, attendant care, and habilitation services. After I graduated from Arizona State University, I went to work for Arizona’s Department of Economic Security in the Division of Developmental Disabilities. It was this work that led me to law school. As I near the end of my first year, I feel confident that my studies will lead me in the direction of health care law, where I can continue to provide service to individuals that have added a large measure of fulfillment to my life.
Sarah is now twenty-two years old. I am grateful for the continuing role that she plays in my life. She was the flower girl at my wedding. My children know her as “Aunt Sarah.” Even though we now live in different states, we still get to see each other several times a year. We like to watch Harry Potter movies and go out for Mexican food whenever we get together. I do not feel like CP is a burden. More importantly, as a result of all the great support, I don’t think Sarah does either.
Cerebral palsy can be a challenging condition, but individuals with CP have many treatment options available to them that can make their lives more enjoyable and productive. State governments and non-profit organizations often provide various forms of assistance. Additionally, parents and caregivers who suspect that a cerebral palsy injury may be due to medical malpractice might consider contacting a cerebral palsy lawyer. Cerebral palsy lawyers are happy to work with parents and caregivers to ensure that individuals with CP receive the best therapies and treatments available.