“It’s a personal decision”……or is it ?

This relates to the lack of a motorcycle helmet law in the great State of Florida. It was published in September of 2008.

Jessica Newman’s article [Helmet safety often ignored for convenience on campus, Gainesville Sun 9/20/08 1A] presents – in what is perhaps the best newspaper article format – the issue of safety and helmet use as a “one the one hand….on the other hand” topic. Eileen Muawad comments that to wear, or not, a helmet is a choice that is “up to the person” to make. Caring for the results of “on the other hand”, we see the issue slightly differently.

In the name of personal choice and personal responsibility, our legislature and former Governor Bush eliminated helmet laws for all motorcyclists, as long as they are over 21 years of age and have at least $ 10,000 in insurance [statute 316.211 Equipment for motorcycle and moped riders] in 2000. This rule alteration – as it was called – is about deregulation, rather than personal choice; it is about personal and state irresponsibility. Let us explain.

Newman’s article notes the increased numbers of motorcycle and bicycle accidents over a several year period. She is correct.

Since the legislative change in 2000, the numbers of un-indexed motorcycle deaths have increased – from 155 motorcycle deaths in 1999, the last year of the more aggressive helmet law, to 517 in 2007. When the data are more rigorously presented – indexed per 10,000 registered motorcycles – the numbers scream at us: the indexed motorcycle death rate has increased between 1999 and 2007 from 6.7 deaths per 10,000 registered motorcycles to 8.9.

Our legislature saw it appropriate, in this legal change allowing for “personal choice”, to ensure that all of the motorcyclists have at least $ 10,000 in insurance. This is beyond a cruel joke.

The cost of caring for a severely head injured motorcycle accident victim runs in the range of $ 150,000 to $ 200,000; and when they are out of the hospital, they will need thousands of dollars more in rehabilitation services and care to get back to a functional status.

The health care costs of a catastrophic injury – and a severe motorcycle accident with a head injury fits into this category – is one of the leading causes of personal bankruptcy. With more than 25% of Florida’s population uninsured, the legislatively mandated $ 10,000 in insurance ensures that these costs are borne by all of us.

The decision to use a helmet may be an individual one, but it has very serious repercussions throughout our state and our health system. It is not just a “personal decision”.

Allow us to be quite blunt: Wearing a helmet when you ride a motorcycle [or bicycle] significantly and measurably decreases your risk of death in the event of an accident. It is irresponsible to not do so. It was an abrogation of duty for our political leadership to do this; allowing this rule to continue in force is negligent.

So where do we go now ? The trauma surgeons, critical care physicians, and nurses are poised and ready to revisit motorcycle helmet protection for our state. The public cannot, and should not, be swayed by a group motorcycle enthusiasts who want to impose their biases on the entire group of motorcycle riders. Helmets are clearly a citizen safety issue, not a citizen rights issue.

Hopefully political champions will come forward in the legislative and executive branches to once again make Florida a safer state for all citizens.

A. Joseph Layon, MD, FACP
Professor of Anesthesiology, Surgery, and Medicine
Chief, Division of Critical Care Medicine

Lawrence Lottenberg, MD, FACS
Associate Professor of Surgery and Anesthesiology
Trauma Medical Director

University of Florida College of Medicine
Gainesville, Florida

About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the past approximately 10 years, until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director of Critical Care Medicine in PA. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". You are welcome to respond to him at ajlayon@gmail.com.
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