Pathogen | Treponema pallidum - spirochete | Kinetic energy |
Source-mode of transmission | Person-to-person, sexual contact or placental transmission | Vehicle-person impact, first, second and third collision |
Exposure voluntary-involuntary | Voluntary - sexual intercourse | Involuntary: most victims passively exposed |
Addictive effects from exposure | No | Yes |
Forewarning/prior consent to exposure to pathogen | Probably not | Sometimes yes, mostly no |
Ethical issue | Withholding effective treatment and total cure from sick victims | Reduction of severity of exposure to population already at excess risk for death and injury from road crashes |
Public health impact | Slow progression of disease in all victims; PYL <10 y (non-stochastic) | Stochastic for event: all or nothing: increase in risk in entire population |
Degree of compulsion/power relationships | One powerless, voiceless subgroup: Black, poor, southern in 1950s, passive acquiesence of uninformed black community | Many powerless subgroups at excess risk: occupants of motor vehicles struck by trucks; pedestrians (aged, children, infirm); children in fast vehicles; soldiers; truck drivers working under incentive premiums |
Role of “establishment”, “power elites” (mandarins, consultants, academics, senior scientists) | Initiated “experiment”; no known falsification of data within study; withholding information from powerless subgroup | Encouraged and endorsed “experiment”; misinformation to entire society; repression of information on adverse effects, including high-risk subgroups |
Scope | Restricted to one group; experiment terminated | Entire population; experiment expanded |
Motivations | “Science”, “knowledge”, fame, prestige, bureaucratic inertia | “Cost-benefit”, “rational policy”, “EEC”; consultant contracts, new highways |
Adequacy of current standards for best practice | Penicillin: good to excellent | “Best” standards: outcome criteria not explicitly defined |
Attitude of public | Approval in early years; instant repudiation following exposure in 1970s | Polls: majority supports 100 kph; majority opposes when told it causes increased death and injury |
Institutional safeguards | None at time (1945–1970) | None at time (1993–1999) |