IMPACT OF ROAD DEATH AND INJURY
RESEARCH INTO THE PRINCIPAL CAUSES OF THE DECLINE IN QUALITY OF LIFE & LIVING STANDARD SUFFERED BY ROAD CRASH VICTIMS AND VICTIM FAMILIES
PROPOSALS FOR IMPROVEMENTS
EXECUTIVE SUMMARY
Study undertaken in collaboration with the Commission of the European Union,
February 1995
1 ) PARTICIPATINGABSTRACT
A foregoing study by FEVR, the European Federation of Road Traffic Victims, established that families bereaved through road death, as well as disabled victims and their families, suffer a dramatic decline in their quality of life and standard of living.
The present study was designed to determine the causes of that decline and propose solutions for improvements. Sixteen organisations representing victims from 9 European countries undertook a survey of bereaved and injured victims and their relatives by means of a comprehensive questionnaire submitted to nearly 10,000 families.
The most significant findings of this latest research are:
- That information given to victims of road crashes about their legal rights and support organisations is totally inadequate.
- That most victims and affected families need considerable emotional, practical and legal support.
- That victims and their families declare widespread dissatisfaction with the criminal and civil justice systems.
- That there is no legal recognition of long-term impairment caused by head injury, which is frequent.
- That psychological suffering by the victims and their relatives is often extreme and long-lasting. This suffering often increases with time and is frequently the cause of serious illness which may even lead to death.
The victims and/or their families were asked to add their views and make their recommendations for improvements, which most did with incisive clarity, and these contributions substantiated the findings of the research. Practical solutions are proposed, as well as a list of legislative improvements, some of which are already in force in some European countries, for immediate and urgent implementation by all European governments.
2 ) OBJECTIVES OF THE ENQUIRY
A previous enquiry, Study of the physical, psychological and material secondary damage inflicted on the victims and their families by road crashes [1], showed that 90% of the families of dead victims and 85% of the families of disabled victims declared a significant, and in half the cases even dramatic, permanent decline in quality of life. Furthermore, about 50% of bereaved families and 60% of disabled victims and their families reported a long-lasting, substantial and even dramatic fall in standard of living.
These findings show the hitherto unimagined impact of road crashes on the families of both dead and disabled victims and confirm the severity of consequences for disabled victims. They also make apparent the enormous social cost and long-term financial impact on national resources inflicted by these individual tragedies.
The objective of the latest enquiry was to determine the causes of victim families' substantial drop in both quality of life and living standard and to propose administrative and legislative improvements.
The extreme suffering of victims and their families, already identified, warrants urgent attention and remedy. The enormity of the impact of road crashes must be recognised and acknowledged by society and the legal system. Victims need legal assistance and proceedings must reflect the severity of the offence and its effects. Civil procedures must also be simplified in order to achieve speedier settlements. The level of compensation to victims and their families must be increased to ensure that they are able to maintain their living standard.
The results of the latest enquiry will also be used to raise awareness nationally and across Europe of the largely preventable tragedies caused by road crashes, thus strengthening the consensus for reduction of road danger through education, law enforcement and all other possible measures.
3 ) METHODOLOGY
In order to determine the causes of victim families' reduced means and quality of life, they were asked to fill in an anonymous questionnaire consisting of 56 questions and divided into the following eight sections:
Preliminary questions
Sought to identify the category of victim, or the relative of the victim, by age, time of crash etc..
A. Initial support and information
These questions aimed to establish whether the victims, or their families, received adequate support and information from the various services with which they came into contact after the crash.
B. Criminal proceedings
The respondents were asked to say whether or not they felt criminal justice was done in their cases, how they were treated, and to suggest possible improvements.
C. Insurance - civil claims
The respondents were asked to describe their dealings with insurance companies, and give their views on the fairness of the compensation offered. If their cases came to court, they were asked to express their feelings on whether financial justice was done, to give the length of the civil proceedings and to suggest possible improvements.
D. Physical care given to the injured victim
These questions sought to ascertain the present physical condition of injured victims, and whether they were satisfied with their medical treatment and rehabilitation. Additional questions were asked in cases of head injuries.
E. Psychological and physiological impact on the victim or relatives
This section investigated secondary psychological and physiological effects on the health of respondents, thus excluding direct physical injury caused by the crash, in the case of injured victims. This secondary impact is generally ignored by courts and insurance companies, despite the often severe and long-lasting suffering involved.
F. Consequence on life
The respondents were asked to outline any changes that the incident had had on their way of life, their consumption of psychotropic drugs, their relationships within the family, with friends and colleagues, and their capacity to enjoy life.
G. Consequence on occupation
The respondents were asked to mention any changes which the crash had had on their occupations.
The questionnaire was intended to cover most of the possible circumstances which could affect quality of life and living standard of the families of dead or disabled victims. Therefore all participating organisations were asked to provide a list of questions under each heading.
Several hundred possible questions were gathered and thoroughly scrutinised. Their number was successively reduced and a draft questionnaire was returned to the various organisations for limited testing. Simple wording was chosen to ensure that the questions would be easily understood. The result was 56 questions considered to cover most situations. However, as each case is unique, and as a rigid pre-established formulation might have missed important issues, each section ended with a request for comments.
The final English version was then used as the basis for translations into French, German, Italian, Flemish, Dutch and Greek.
The questionnaires were sent by post to the victims and their families, together with an introductory letter prepared by the national organisation dealing with the enquiry. Care was taken to present the questionnaire in as neutral a manner as possible. An exact translation from English to the other languages was not easy because not all words have an equivalent meaning in another language, but this problem is inherent in any multilingual survey.
4 ) PARTICIPATING ORGANISATIONS
The following organisations, all members of the European Federation of Road Traffic Victims, took part in the research:
• Association de Parents pour la Protection des Enfants sur la Route [Belgium]
• Association de Parents pour la Protection des Enfants sur la Route, régions Wallonnes [Belgium]
These organisations are essentially associations of road traffic victims, their families, friends and interested persons. The objectives of these associations are:
a. to provide emotional, legal and practical help to victims,
b. and to contribute to the prevention of road crashes by campaigning against violence, negligence, excess alcohol and breaking of road traffic laws when driving.
The following organisations, which are not members of the Federation, also took part in the study:
- Centre of Research and Prevention of Injuries among the Young [Greece]
- Institute of Social and Preventive Medicine [Greece]
- L.O.S./A.N.W.B. [The Netherlands]
The first is a centre of research at the School of Medicine of the University of Athens. The last two provide assistance for victims. Unlike the members of the federation, these latter organisations are not associations of victims, therefore the kind of victims approached and their answers may differ. However, it can be seen below that in spite of the different sampling, their results are in line with the trends found elsewhere.
The sampling in relation to victims as a whole is open to question. This is because sampling was not randomly selected, as would be usual, but through members of the participating organisations, their friends and acquaintances.
The principal motivation for joining such an association is generally altruistic: victims and their families want to share with others the help they received or wished they had received and are particularly aware of road danger through personal experience, so want to participate in actions aimed at reducing that danger. The particular circumstances of their own tragedies, the intensity of their suffering or their difficulties with the legal system or insurance companies appear to be of secondary importance in their decision to join. Evidence of this is revealed by the type of membership of these associations, with many members uninjured, or only slightly injured, while many badly disabled victims or bereaved families are not members of any association. This gives reason to believe that drawing the samples from membership of these associations does not alter significantly the statistical validity. In the discussion of results, additional support is offered for this point. Furthermore, it has to be remembered that this was a fact-finding enquiry seeking qualitative understanding rather than exact measurements.
5 ) RESULTS
From the 1,364 answers, 59% came from relatives of dead victims and 41% from relatives of disabled victims or the disabled themselves. For these European results, the size of the samples implies a statistical error of ± 5%. In the following presentation distinction is made between dead and disabled victims where necessary.
A. Initial support and information
A large majority - 91% of the families of the dead, and 78% of those of disabled victims - complained of not being sufficiently informed of their legal rights such as the right to ask questions and be legally represented at inquests, the right to a second independent post-mortem, of time limits to appeal and so on. About 85% of families did not get any information about helping or victim organisations. (Graphic 5)
Although young people are the most frequent victims of road crashes, only 10% of their families were approached for organ donation, in spite of the often publicised shortage of donors.
(Graphic 6)
The help most needed by families is:
- To be informed of the death by someone specifically trained for this task.
- To have immediate access to the body of their loved one.
- Immediate and often long-term emotional, psychological, practical and legal support by professionals.
- Immediate information about their legal rights, legal and inquest proceedings, helping and victim organisations and the full circumstances of the crash.
- Legal advice.
B. Criminal proceedings
The greatest dissatisfaction was expressed with regard to criminal proceedings: 89% of the families of the dead and 68% of those of disabled victims considered that justice was not done in their case, 75% and 61% respectively considered that the charges were not fair [figures 7, 9, and 45]. Furthermore, nearly 70% felt that their cases were neither adequately, seriously, nor respectfully treated.
The most frequent wishes expressed by families were:
- For compulsory blood samples from drivers who caused the crash, to test for alcohol or drugs.
- For a quality of investigation and prosecution similar to that in murder cases.
- For suspension from driving of those who have killed or injured, at least until the case comes to court.
- For involvement of victim families in the proceedings.
- For respect during proceedings.
- For tougher sentences, appropriate prison terms and/or alternative punishment in cases of serious offences which cause death or injury [fig 10,11].
- For lifetime driving bans for persistent offenders.
C. Insurance and civil claims
Widespread dissatisfaction with insurance companies also emerged. Nearly 80% of families are not satisfied with either their dealings with insurance companies, or with the compensation offered to them [figures 12, 15, 16 and 53]. Nearly 60% complained about the compulsory medical examination required by companies.
A staggering majority of 95% of families consider it desirable to appoint a lawyer responsible for the civil interests (Graphic 18) of victims or their families immediately after the incident [figure 17].
The most frequently expressed requests were:
- For immediate advance payments by insurance companies to cover costs such as funeral expenses, loss of income and medical treatment, to prevent the victims and/or their relatives from suffering unacceptable financial hardship.
- For urgent improvements to insurance companies' tariffs and payment policies.
D. Physical care given to the injured victim
About half of the disabled victims considered that their physical condition became stable within 3 years, for the other half this did not happen until much later, if at all. The percentage of physical invalidity agreed by insurance companies is considered unfair by about 60% of the victims. Nearly 40% declared dissatisfaction with medical treatment and rehabilitation.
Only 37% of the victims who had suffered head injuries considered that they had fully recovered within the first 3 years and only a further 19% recovered after that period. The other 44% suffer from permanent neurological or brain damage. This is particularly striking as head injuries represent about half of all road crash injuries. About 40% of the victims are dissatisfied with neurological treatment and rehabilitation.
During the first 3 years head injured victims suffer from the following neurological disorders: loss of memory and inability to concentrate - 78%, inability to perform normal tasks - 70%, language disorder - 59%. After this period these figures fall to 61%, 52% and 29% respectively.
This enquiry provides very important evidence that:
- Physical and mental impairment through road traffic injury can have long-term effects which deny victims the ability to maintain their standard of living.
- The effects of head injury are often not recognised because they are not always apparent, yet they may cost victims their jobs or educational qualifications, with serious economic consequences for society as a whole.
E. Psychological and physiological impact on victims or their relatives
The victims also suffer the following physiological symptoms: sleeping problems - 49%, headaches - 55%, distressing nightmares - 41%, general health problems - 58%. No significant decrease occurs after 3 years, indicating long-lasting, if not permanent, psychological suffering (Graphic 25).
A large proportion of the relatives of dead and disabled victims, as well as the disabled themselves, suffer psychological disorders (Graphic 26). The worst situation is that of the relatives of the dead. During the first 3 years, 72% lose interest in everyday activities such as professional work, housework, cooking or studies, 70% suffer loss of drive, 49% loss of self-confidence, 46% have anxiety attacks, 37% experience suicidal feelings, 64% suffer from depression, 27% phobias, 35% eating disorders, 78% anger and 71% resentment. After 3 years, these figures, on average, decrease by only about 10 percentage points, indicating long term and in certain cases even permanent suffering. In particular, suicidal feelings decrease only from 37% to 26%, leaving an enormous proportion of relatives in extreme distress.
With the exception of suicidal feelings, the relatives of disabled victims present a similar pattern to that of the relatives of dead victims. Surprisingly, with their frequent neurological and other disorders, the disabled declare themselves slightly better off psychologically than their relatives, particularly as regards anxiety attacks, phobias, eating disorders, anger and resentment.
The bereaved are again the worst affected - 70% - by relationship problems, communication difficulties and sexual problems. The figure for relatives of disabled victims is 40%, and for the disabled themselves 50%. After 3 years these problems do not decrease as one would expect, but worsen for each category by about 5 points [figure 27].
Psychological help to relatives of dead victims was provided by the following during the first 3 years: family 87%, friends 86%, doctors 40%, professional counsellors 23%, religious group 22%, employers 9% and group therapy 5%. The pattern is similar for the relatives of the disabled, and the disabled themselves, although they rely more heavily than the bereaved on the help of family and doctors, probably because they need to be in much closer contact with them. After this 3-year period, the need for help increases by a few points. (Graphic 29)
F. Consequence on life
About 50% of the relatives of victims, and the victims themselves, state that for extended periods they consume more psychotropic products like tranquillisers, sleeping tablets, tobacco, alcohol and drugs than before the incident (Graphic 31). If the consumption of these products is associated with driving, they would be more likely to cause a crash, thus creating a vicious circle.
It is sometimes believed that due to the tragedy, the relationship of the respondents with their normal social partners deteriorates. This enquiry shows that this is not always the case. For the relatives of the dead, 36% declared no change in their relationship with friends, and 20% and 23% respectively declared better and worse relations. With their family, 42% declared no change, and 21% and 23% better and worse respectively. With their spouse, 34% declared no change, 16% and 21% better and worse. With their colleagues, 45% declared no change, 6% and 16% better and worse. For the majority of the relatives of the disabled, and the disabled themselves, their social relationships are also unchanged. However, in the last two categories, although the proportion of changed and unchanged remains the same, when a change occurs, it is usually for the worse rather than the better.
After the tragedy 49% of the families of dead victims, and 47% of those of the disabled were subject to changes of household. Families of dead victims suffered separation - 6% and divorce - 5%, 28% had children leaving home, 33% moved house, and 3% remarried. For the disabled and their families, separation and divorce are much higher.
Making plans for the future seems impossible for 68% of the relatives of dead victims during the first 3 years. After this period, 59% remain in this state. For the relatives of the disabled the prospects are a little better. As elsewhere, the disabled themselves are less pessimistic [figure 35].
The capacity to enjoy life as before the crash tragically disappears for 91% of the relatives of dead victims for the first 3 years. After this period, the loss persists for long periods for 84% of them. For many this loss will be permanent. The prospects for the first 3 years are not so bleak for the relatives of disabled victims, at 68%, and the disabled themselves, at 69%. Some time after this period there is no change for the relatives, but 15% recovery for the disabled themselves [figure 36].
G. Consequence on occupation
About 60% of the relatives of dead victims, 80% of the relatives of disabled victims and 70% of the disabled themselves who changed occupation, did so because they were forced to by the circumstances. Among those who lost their jobs about 65%, 33% and 33% respectively did so for psychological reasons, the others for physical reasons.
6 ) CONCLUSIONS
The suffering made evident through this research reveals an ever growing proportion of devastated lives in our societies as a result of road violence. What is hardly recognised by those in authority, and this includes the legal system, is that those bereaved or injured through road crashes are often permanently harmed, as are the families of other victims of violence and manslaughter. And yet there is almost no help, nor proper compensation for road violence victims and victim families.
The purpose of the present study is to point out the most urgent needs of victims and/or their families, and to propose adequate measures to alleviate their suffering, prevent discrimination and injustice and limit the decline in their quality of life and standard of living.
The following needs and solutions were identified:
There is an immediate need for access to information about the circumstances of the crash, legal rights, legal procedures, including inquests, on how to deal with insurance companies, about civil claims, helping and victim organisations, and counselling.
Such information should be contained in pamphlets handed to the victims by police without fail, and freely available from emergency services, hospitals, courts etc. Some victim organisations already distribute such information on a limited scale. However, the printing and distribution costs should be funded by the appropriate government departments, which should also fund a programme of education for all agencies which come into contact with victims of road violence. Police should inform the victims/victim families of the details and the progress of their cases on a regular basis.
There is an urgent need for emotional, practical and legal support.
It is suggested that free ASSISTANCE CENTRES for victims be created, where victims would receive assistance/advice in the fields of law, medicine and psychology. Voluntary victim organisations should receive government funding for their work of supporting victims. In the case of death or serious injuries a lawyer, responsible for the civil interests of the victim or/and the relatives, should be appointed immediately after the incident.
Charges following driving offences which cause death and injury must treat the death and injury as a central issue. If necessary laws must be changed to ensure that death/injury is addressed. Sentences must be sufficiently severe to provide a deterrent. Alternative punishment should be considered as a acknowledgement of death/injury.
Equality must be introduced into the criminal justice system - which at present favours the defendant - by taking into account the concerns and needs of victims of road violence. They should also no longer be excluded from criminal proceedings but be fully acknowledged as properly interested parties to those proceedings. Full participation and information would also prevent the many difficulties with civil proceedings suffered by a great many victims.
- Claims against Insurance Companies / Civil Proceedings
There is widespread dissatisfaction over dealings with insurance companies and with the amount of compensation offered, especially in cases of serious injury or death.
Victims and victim families are adversely affected by lengthy proceedings and the apparent insensitivity of insurance companies.
Civil court proceedings are often seen or suggested as a substitute for criminal proceedings.
Insurance companies should be obliged to make immediate payments to cover expenses such as funeral costs. Advance payment should also be made to those victim families who have suffered loss of income. The level of compensation must relate to the effects suffered and regular revision should take place to ensure that this is the case.
Civil procedures should be simplified and speeded up. Secondary harm must be taken into account. Civil proceedings should not be seen or suggested as a substitute for criminal proceedings.
All steps must be taken to recognise head injury in victims and to provide adequate settlements which enable them to maintain as normal a life as possible.
- Psychological and physiological impact on victims and their relatives
The sudden violent death of a close family member has a profound effect on the lives of the other members. In many cases the bereaved lose interest in life, experience suicidal feelings and some do commit suicide. The shock and ongoing stress damage the immune system, resulting in illness and even death. With the exception of suicidal feelings, the injured victims and their families suffer similarly.
These problems show the desperate need for long-term emotional and psychological support for the families of the victims. Such help, which is presently mainly provided by friends and family, should be supplemented by the Assistance Centres already described. These afflictions are the main causes of the decrease in quality of life. As they are considered secondary effects, they are presently not acknowledged legally.
7 ) LEGISLATIVE PROPOSALS
Below is a list of important points which should, in our opinion, be included in future legislation to favour the victims of road crashes. Numbers in brackets refer to countries which have already adopted specific points.
1. Create public centres for free help and advice in the areas of medicine, psychology, sociology and law, as well as sponsor voluntary organisations already providing such help [5,6].
2. Make provision for victims or their families to be represented and accompanied through every procedure following death or injury by a person they trust, in order to feel supported and be aware and assured of their rights [7,8].
3. Improve and regularly review the level of compensation to ensure realistic damages.
4. Ensure realistic compensation for all victims by, for instance, ensuring efficient operation of a guarantee fund.
5. Extend indemnity for physical injury to frequently occurring brain damage, which can range from recurrent mental impairment to permanent mental handicap.
6. Require insurance companies to provide immediate advance payments (interim) to victims and/or to their families, to cover expenses such as funeral costs, loss of earning or medical treatments [7].
7. Include victims and victim families in criminal proceedings, ensure informed, speedy settlements of civil claims as well as encourage the pursuit of claims by all those entitled to them [5,7].
8. Re-balance the justice system, which nowadays centres excessively on the accused, in order to ensure equality of rights for the victims, thereby answering the needs of victims and their families as well as the families of the guilty [5].
9. Give consideration to having part of the compensation paid by the defendant. Thus, a judge should be able to confiscate a part of the property or income of the guilty in order to give direct help to the victim. Furthermore, the guilty could be charged for the legal and medical expenses of their victim/s [5,7,8].
10. Treat certain violations committed due to gross negligence or disregard of fundamental road traffic rules as premeditated criminal offences. These would include exceeding the speed limit, disregarding red traffic lights, and driving with excess alcohol.
11. Provide a fast and efficient network of Help Centres, equipped with ambulances and helicopters co-ordinated by radio, as well as a free emergency helpline number for road traffic victims.
12. Extend to all European countries the European Convention concerning the compensation of victims of violent offences [9].
8 ) BILIOGRAPHY
[1] Study of the physical, psychological and material secondary damage inflicted on the victims and their families by road crashes. Published by the FEDERATION OF EUROPEAN ROAD TRAFFIC VICTIMS, Case Postale 2080, CH-1211 Genève 2, Suisse (1993).
[2] Rapport d'un groupe d'experts de haut niveau pour une politique Européenne de sécurité routière. DGVII, Commission des Communautés Européennes, Bruxelles, Belgique (1991).
[3] La sécurité routière. Stratégie et mesures pour les années 90. Département Fédéral de Justice et Police, Berne, Suisse (1993).
[4] Coût socio-économique des accidents de la route. COST 313, EUR 15464, DG XIII, Commission des Communautés Européennes, Bruxelles, Belgique (1994).
[5] Loi fédérale sur l'assistance aux victimes d'infractions (LAVI) approuvée par l'assemblée fédérale le 4 octobre 1991, Berne, Suisse (1991).
[6] Support for the families of road death victims. Report of an independent working party convened by Victim Support. Published by Victim Support, Cranmer House, 39 Brixton Road, London SW9 6DZ, United Kingdom (1994).
[7] Loi 85-677 du 5 juillet 1985 tendant à l'amélioration de la situation des victimes d'accidents de la circulation et à l'accélération des procédures d'indemnisation. “Dite loi Badinter” Paris, France (1985).
[8] Recommandation Nº R (85) 11 du Comité des Ministres aux Etats membres, sur la position de la victime dans le cadre du droit pénal et de la procédure pénale. Adopted by the Council of European Ministers, Strasbourg, 28 June, 1985.
[9] Convention européenne relative au dédommagement des victimes d'infractions violentes. Approved by the Council of Europe, Strasbourg, 24 November, 1983.
Authors : Marcel Haegi, Brigitte Chaudhry.
This Executive Summary, as well as the full version are available at the address of the Federation given below.
© FEVR
Case Postale 2080
CH-1211 Genève 2 Dépôt, Suisse
E-mail : fevr@worldcom.ch
Last update :
28/07/00
