05 January 2012

The drive towards safety

There is a revolutionary cure in the works for an affliction that kills over 42,000 Americans annually and injures many more. It is the 9th-leading cause of death in our country.

The affliction is the "motor-vehicle traffic accident." And the solution nearing market is the self-driving car. Google, in conjunction with a Stanford research team, has already built an autonomous car. They have driven it for over 175,000 miles on California and Nevada roads, accident-free (see a video of a reporter going for a ride on a busy Bay Area freeway in the Google car). Nevada has legalized texting while driving so long as the car is a self-driving car. It surprises me that people are paying so little attention to the advent of the autonomous car, and especially the medical community.

I took a class in college on transportation system optimization, and the field is absolutely fascinating. Traffic systems require careful planning and thought to make everything work harmoniously. I firmly believe three items: that the self-driving car is inevitable and will be commercially available within a decade; that government policies could make the adoption of the self-driving car a rather good thing or a rather terrible thing; and that the self-driving car will absolutely revolutionize our lives and our identities of place.

Humans are not great at driving cars. We fall asleep, we drink, we text, and we can only look in one direction at a time. There is a delay between when we observe a car stopped ahead of us and when we slam on the brakes. Computers lack these flaws and already operate some of our modes of transportation: many subway systems are under computer control, and planes already fly on autopilot. Computers need not be perfect drivers, just to surpass humans.

The technology for the self-driving car already exists, as does most of the software. The question now is how cheaply the most expensive parts (such as the sensors) can be produced and how quickly the infrastructure can be constructed. Google is moving quickly to bring its car to market. Even if the first self-driving cars are expensive, I can't foresee it taking more than a few years for the first to be sold to the public. I foresee that at first the cars would only be allowed to run on freeways, eventually spreading to all roads.

There are a number of market incentives for self-driving cars. Some demographics that cannot drive (the young, the elderly, the infirm, the vision-impaired) would suddenly be able to. Reducing the number of car crashes would save in medical costs and insurance reimbursements. Self-driving cars could also reduce traffic congestion (it would be safer for cars to drive closer together), free up parking spaces (the cars could park themselves), and run off alternative fuels (the cars could drive to charging stations).

Like any new technology, many conflicts will arise now that the first policies governing self-driving cars are being enacted into law. Will law enforcement try to more closely monitor our movements by car? Will government restrict the movements of certain groups (felons, sex offenders)? Will the rich be able to travel at faster speeds than the poor in exchange for paying more (akin to toll roads)? This is largely uncharted territory, but then again, the automobile and the airplane are not so old.

The effect on our lives
The automobile profoundly altered our way of life. It allowed the development of suburbs and exurbs and altered our social structure. What will the self-driving car do? Will cars look more like RVs, mobile homes where people travel from place to place while asleep?

Car crashes very much impact our lives. World history would be quite different if some crashes had been avoided. Some well-known people killed in car crashes include: author, philosopher, and Nobel Laureate Albert Camus; heir to the Syrian presidency Bassel al-Assad; Princess Diana; jazz trumpeter Clifford Brown; and artist Jackson Pollock. Also, car crashes are more likely to affect the young than some leading causes of death, such as cancer and heart disease.

What should we conclude?
Car crashes are a leading cause of death and injury in our country. The self-driving car already exists and it is a question of how long it will take before you and I can buy one for ourselves. The introduction of the self-driving car would be a massive public-health win, akin to the development of a successful vaccine to a deadly disease. Yet we must tread carefully. The self-driving car will disrupt our current way of life, and whether this change is for better or for worse will hinge upon the wisdom of our policies.

The health potential of the self-driving car underscores why the medical community ought to have an open mind about what it pays attention to. We are responsible for improving people's lives and preventing disease, and the self-driving car strikes me as one of the most promising medical therapies in years.