Citation

Pless IB. Inj. Prev. 2001; 7(3): 169-170.

Copyright

(Copyright © 2001, BMJ Publishing Group)

DOI

10.1136/ip.7.3.169

PMID

unavailable

Abstract

Vigilant readers will have noticed a BMJ editorial written by Ron Davis and me entitled "Banning accidents".1 The editorial announced that in future all BMJ publications would avoid the use of the word "accident". The main arguments in support of this move need not be spelled out for readers of Injury Prevention, but neither Davis nor I were prepared for the storm of criticism that followed, most of which appeared on bmj.com. (I urge readers to visit this site and follow the "Sturm und Drang".) When the dust finally settled, the score was about 25 against and 25 in favour. In spite of the draw, we felt obliged to offer a global reply. In summary, it reaffirmed our conviction that the "A" word is undesirable for many, many reasons beginning with the fact that it has so many meanings, especially with respect to preventability. We acknowledged that some injuries are not preventable, and, in fact, when the editorial was being drafted (and Davis deserves all the credit for initiating it), I was prepared to concede that the primary event could in some cases be appropriately called an "accident". On this point, however, Davis was more of a hardliner than I, and in the end we stuck to our guns. It was when the term was applied, as it so often is, to the subsequent injury, that we were equally and vigorously opposed. In our reply we also disagreed that there was a critical difference between injury predictability at the individual and population level but agreed that these could be two sides of the same coin. The argument that "most people understand that 'accidents' are preventable" was easily demolished; if they did, there would be no incentive to ban the term and the evidence, even from Girasek's study,2 supports this view. When accused of censorship, of being Orwellian, and totalitarian, we conceded that the use of the word "ban" may have been stronger than was intended and reminded readers that we had no intention of being draconian in its application. We also noted that language changes, and that although past attempts to change how English is spoken have failed, it does not diminish the need to challenge how it is written in a scientific context. Will banning the "A" word reduce injuries? There is no evidence it will, nor is there evidence it will cause harm. I, for one, still maintain that part of the reason governments have been so indifferent is their failure to view injuries as they do other diseases and that this is driven, in part, by the continued use of the word "accident".3

We strongly disagreed with one repeated criticism that in banning the use of the word "accident" we were blaming the victim. I have often stated that the victim can only be blamed when it is clear that society has done all that is possible to prevent injuries--a condition rarely fulfilled. Finally, and most surprisingly, there was concern that much editorial effort will be needed to find a suitable substitute. The best evidence to refute this lies in the pages of this journal--rarely have we been forced to use the term "accident" and we have never, ever had difficulty finding a suitable replacement --usually (surprise! surprise!)--the word "injury". (term-accident-vs-injury)

Language: en