The current COVID-19 crisis has focused many people’s attention on the question of risk and how governments go about ensuring public safety. I have no epidemiological experience that enables me to comment knowledgably upon the UK government’s strategies, and if I did claim to have any I am sure there would be someone out there who would choose to dismiss such claims as ‘uncheckable credentialism’. Nevertheless, I do know a thing or two about how the UK government persuaded itself that a particular road transport system would be sufficiently safe in operation – namely the UK’s Smart Motorways System. Having such experience provides me with some insight regarding how government agencies handle the ethics of setting public safety targets.

I have previously published on the subject of Smart Motorways in a specialist newsletter produced by the SCSC, a long-standing society set up for the benefit of professional safety engineers wishing to exchange best practice in the field of safety-related systems engineering. Inspired by news reports, I recently chose to publish once again on the same subject (Safety Systems vol. 28-2). I enclose below the second SCSC article in full. However, for those who prefer not to waste their valuable lockdown time wading through the detail, I also offer the following synopsis:

Synopsis of the SCSC Article

The government believes that if it takes a stretch of motorway and implements an upgrade to its infrastructure, then it will be morally and legally in the clear if the resulting rate of killed and seriously injured is no greater after the upgrade than it was before.

In the case of the Smart Motorways upgrades, two adjustments to the infrastructure were entailed. The first was expected to reduce the accident rate. The second (which is contingent upon the first adjustment being made) was expected to increase the accident rate but not by so much that it would overturn the benefits from the first.

The government had the option of only introducing the first adjustment, thereby maximising road safety. They chose not to take this option, arguing that they have no legal obligation to make the roads safer than they already are but only to ensure that through their actions they do not make them less safe.

The first adjustment I refer to is known as Controlled Motorways and its effect is to ‘calm’ traffic flow. The second adjustment I refer to is the removal of the hard shoulder as a breakdown zone in preference for its use as an extra lane for live traffic running.

The UK government knew that opening the hard shoulder up as a live lane would be unsafe but they expected the extra deaths and serious injury to be hidden by the road traffic safety statistics because of the benefits of traffic calming.

I have always argued that this approach is ethically dubious and potentially illegal. Smart Motorways have since gained a reputation in the public eye as death traps and Grant Shapps is now desperately backtracking on their further deployment. At least one grieving family is now planning to sue the UK government for a failure in its duty of care.

And the moral of the story is that governments are quite willing to cause death if it can be hidden within a statistic that accompanies a presupposed greater good. However, they often fail to appreciate the human story behind the statistics and just what this can sometimes mean in terms of political fall-out.

And Now the SCSC Article In Full (How Smart Are Our Motorways?)

In view of recent adverse publicity [1] surrounding the UK government’s Smart Motorways, I thought it might be useful to draw attention to two articles posted in this newsletter back in 2010. The first [2], an article written by myself, discussed ethical issues that may arise when setting safety targets. Particular reference was made to Active Traffic Management (ATM), a pilot for Smart Motorways hard-shoulder running. The second [3], an article written by David Boulton of Arthur D. Little’s Risk Practice, sought to outline the approach taken by the Highways Agency (HA) in the setting of safety targets and addressed some of the issues I had raised. To summarise, I had concerns that the HA’s adoption of the Globally At Least Equivalent (GALE) principle could lead to ethical difficulties, particularly if this were to entail the abandonment of the principle of reducing safety risk As Low As Reasonably Practicable (ALARP). A main purpose of [3] was to point out that the application of GALE did not preclude the aspiration to reduce risk further in a manner akin to ALARP—though I believe I would be correct in saying that any such endeavour on the HA’s behalf would still not be as a result of a perceived legal imperative.

I shall not seek to review in detail the two articles referenced above. However, since I believe recent events have vindicated the concerns I had raised back in 2010, I shall expand upon those concerns below. As was the case with my initial article, I trust there will be those amongst the readership of this newsletter who will be in a position to correct any errors made and, indeed, redress any imbalance or misrepresentation of which I may be guilty.

The Safety Argument as I Understand It

In order to understand how the Highways Agency could arrive at the conclusion that Smart Motorways with live hard-shoulder running would be acceptably safe, one has to appreciate the following:

Regarding the setting of safety targets for the Smart Motorway system (and indeed for its ATM predecessor), the HA maintained that the Health and Safety At Work etc. Act 1974 (HSAWA) did not apply. Consequently, they felt under no legal obligation to reduce safety risks to a level in accordance with the ALARP principle. This position is clarified in [4].

Instead of using ALARP to set safety targets, the HA looked towards the GALE principle, in which safety risks associated with a system should be Globally At Least Equivalent to the risks encountered prior to the introduction of the system (or upgrade thereof). This idea was taken from the UK rail industry (which, in turn, obtained the idea from the French railway’s concept of Globalement Au Moins Equivalent (GAME)). When assessing whether Smart Motorways were likely to comply with the GALE principle, the HA took into account that Smart Motorway schemes require the simultaneous introduction of a previously developed technology known as Controlled Motorways, in which variable speed limits are used to achieve a ‘calming’ effect on traffic flow. Since previous Controlled Motorway systems had been demonstrated to reduce levels of speed-related deaths and serious injury, this could be taken into account when making a GALE calculation. Accordingly, an increase in the rate of death and serious injury resulting from the removal of the hard shoulder safety zone could be offset by a presupposed equivalent reduction in the level of speed-related death and serious injury on the main carriageway.

The safety dividend resulting from the introduction of a Controlled Motorway scheme can be estimated based upon the accident statistics of previously operated Controlled Motorway systems (e.g. the M25’s scheme, incorporating Motorway Incident Detection and Automatic Signalling System (MIDAS) queue protection). On the other hand, the estimation of the safety penalty resulting from the removal of a hard shoulder safety zone would have to be based upon a theoretical safety model. Such a model-based risk assessment was conducted, and the HA concluded that the projected increase in deaths and serious injury due to the removal of the hard shoulder safety zone was no greater than the reduction that employing Controlled Motorway traffic calming could be expected to bestow.

The system was therefore predicted to meet the GALE target, i.e. a Smart Motorway operation (necessarily entailing Controlled Motorway traffic calming) would be at least as safe as a stretch of motorway lacking any traffic management system (to be accurate, I should point out that an adjustment was factored into the GALE calculation, which I believe provided for a proposed 10% safety improvement).

In all of the above, it should be appreciated that a fully functional Smart Motorway scheme is not feasible without the installation of Controlled Motorway technology (traffic calming is a necessary precursor for the opening of the hard-shoulder to traffic). However, a Controlled Motorway system is itself perfectly feasible as a stand-alone traffic management scheme (e.g. as previously operated on the M25).

The Concerns

I had always thought that the Highways Agency’s approach towards the setting of the Smart Motorway safety targets was problematic.

Firstly, it is ethically dubious to allow for an increase in deaths and serious injuries due to taking one action just because one can expect a compensating decrease in deaths and serious injuries due to taking another. For example, a car manufacturer that introduces air bags into the design of one of its vehicles could not use such a safety upgrade as an excuse for removing an engine fire management system from the same vehicle. By the same token, the removal of the hard shoulder as a safety zone for breakdowns cannot be justified by referencing the posited lives saved as a result of the simultaneous introduction of Controlled Motorway traffic calming. The fact that Smart Motorways require Controlled Motorway traffic calming is circumstantial and covers up the fact that key aspects of Smart Motorway operation are inherently dangerous.

Admittedly, GALE is supposed to apply to system installation and upgrades rather than to dynamic transitions from one mode of operation to another. Nevertheless, there is an argument that the GALE baseline for a Smart Motorway system, with live traffic running on the hard shoulder, should be a Controlled Motorway with the hard shoulder closed to traffic, since the latter provides the context in which hard-shoulder running is dynamically introduced. For its GALE baseline, the HA used a conventional stretch of motorway prior to the installation of any traffic management system. However, in those circumstances where an upgrade had actually been from a Controlled Motorway system to a full functionality Smart Motorway system, would the HA still insist on using the conventional motorway as the baseline for its GALE calculation?

Secondly, it is politically naïve to assume that the families of victims killed as a result of the removal of the hard shoulder safety zone would be satisfied with the argument that such deaths can be condoned simply because it may be presupposed that speed-related deaths on the main carriageway of the same stretch of motorway will have been avoided as a result of separate measures taken (i.e. Controlled Motorway traffic calming). In the eyes of the public, the perception of safety for a given action will be established by considering those deaths and serious injuries that have occurred as a result of that action; there will be no allowance made for the hypothetical deaths or serious injuries that may have been avoided by taking any separate, albeit attendant, actions. Such statistical arguments carry no weight with the bereaved, and the public mood is always going to be established by the factual and not the counterfactual.

Finally, the Highways Agency’s assertion that the HSAWA does not apply when deciding upon acceptable levels of safety for safety-related systems installed on the motorway was always questionable. Certainly, such legislation would apply to the designers, suppliers and installers of such systems. Accordingly, all such parties would be expected, under law, to reduce safety risks As Low As Reasonably Practicable. However, the Highways Agency (now Highways England) was the design authority for all traffic management schemes installed on England’s motorway network and, as such, they stipulated the safety requirements. If a system supplier’s customer (the government) is not applying ALARP when stipulating the system safety requirements, the possibility then arises that an accident resulting from system failure could place the supplier on the wrong side of the law, if the safety integrity of the system had been engineered only to meet the government’s own safety targets. Furthermore, as the ultimate design authority for traffic management schemes, the HA would surely have a duty of care to ensure that whenever two GALE compliant alternatives are reasonably available, then the lower risk alternative is taken. A motorway subjected only to Controlled Motorway traffic calming provides a lower safety risk alternative to full functionality Smart Motorways, so the Highways Agency had it as a GALE and ALARP compliant alternative. Denying the legal applicability of ALARP enabled the HA to justify not taking that option. A more germane justification may be that Controlled Motorways technology on its own (whilst alleviating congestion) would not enable the HA to meet its motorway network capacity targets. To meet those targets required the adoption of the less safe system.

Some Implications

Any suggestion that the deaths and injuries caused as a direct result of the removal of the hard shoulder as a safety zone could not have been foreseen is unsupportable. They were not only foreseen by the HA, they were analysed and quantified as part of the GALE calculations.

The GALE calculation alluded to above was based upon an assumed separation of 500m between Emergency Refuge Areas (ERAs). Having calculated that a Smart Motorways scheme employing ERAs spaced at 500m meter intervals would just meet the GALE safety target, it is inconceivable that GALE compliance could be assumed for a system employing ERAs every 1.5 miles (even working with a GALE-10% tolerance). The spacing of the ERAs was a critical factor in the risk model used by the HA’s safety consultants (as, indeed was the installation of technologies to detect hard shoulder breakdowns). I have no knowledge of whether the safety case was reviewed when Smart Motorways was rolled out with increased ERA spacing and, if so, what the logic would have been for concluding that the safety case could still be made.

Current statements from politicians, along the lines of ‘one death is one too many’ or ‘we need the motorways to be as safe as possible’ are inconsistent with the safety policies that had been adopted by the HA throughout the specification, development and operational phases of Smart Motorways. These are political sound-bites aimed at an electorate; they have not previously informed the safety management process and it would be naïve to believe that they will do so in the future.

The HA’s insistence that they had no legal requirement to apply the ALARP principle when deciding upon safety targets is now likely to be challenged in the courts. I understand that at least one bereaved family plans to charge Highways England with corporate manslaughter for failing in its duty of care [5]. This duty is premised in law upon the application of ALARP, therefore I assume that adherence to the GALE principle would not be a sufficient defence (notwithstanding a 10% margin). Even if my concerns regarding the HA’s approach to GALE calculations should be ruled as immaterial, it is difficult to see how extending the spacing between ERAs could be seen as an ALARP approach to safety risk management. Highways England may still be able to make a case based upon an improvement in risk efficiency (i.e. the number of deaths for a given traffic volume) but I have no idea where this would stand legally.

References

[1] See, for example, https://www.bbc.co.uk/news/uk-51236375

[2] J. Ridgway, “The Bogeyman – Fact or Fiction” Safety Systems, Vol 19, Number 2, 2010, https://scsc.uk/r111.2:1

[3] D. Boulton, “GALE or ALARP: Which to Choose” Safety Systems, Vol 20, Number 1, 2010, https://scsc.uk/r114.1:1

[4] M. Halbert, S. Tucker, “Risk Assessment for M42 Active Traffic Management, Developments in Risk-based Approaches to Safety”, Springer, London, 2006, https://scsc.uk/r6/2:1

[5] https://www.transport-network.co.uk/Widow-to-sue-Highways-England-over-smart-motorway-safety/16123

John Ridgway is a retired traffic systems consultant who led the software development team responsible for the M25 MIDAS computer control system. Subsequently, he undertook a functional safety management role whilst working for a contractor commissioned to provide a computer control system for the Highways Agency’s M42 Active Traffic Management system. All opinions expressed in this article are entirely his own and do not reflect the views of any previous employers.

The author retains copyright of this article.

32 Comments

  1. Avoid the hard shoulder altogether on ‘smart’ motorways. What are the chances of being pulled over by the police – there’s nowhere to go.

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  2. When did it ever be acceptable to change road systems such that some components are literally designed to increase the likelihood of increased deaths? And to justify this offense by somehow offsetting the extra deaths by improvements elsewhere beggars belief. And are you implying that government policies might be following similar strategies, as say in dealing with the Covid virus? This is heavy duty stuff.

    Liked by 1 person

  3. “And the moral of the story is that governments are quite willing to cause death if it can be hidden within a statistic that accompanies a presupposed greater good.”

    Yep. We’ve seen this with smart motorways. We’re seeing it with ‘climate change’ and net zero. We’re seeing it clearly with Covid-19 lockdown policies. Deaths will result/have resulted from the imposition of all three madcap policies. Deaths from net zero will remain effectively hidden for years, but reliance upon scare stories generated by computer models and uncertain science to formulate government policy will hopefully come into sharp focus in the coming months as the death toll from lockdown becomes more obvious.

    Liked by 1 person

  4. Alan,

    When I hear tales of a government planning for herd immunity or sending infected patients back to care homes to protect the NHS, I have to say it has a ring of truth. The British government has a long history of brutal objectivity when it comes to such matters. I first became aware of this when I read about the UK’s cold war civil defence plans.

    Liked by 1 person

  5. Jaime,

    The question of deaths caused by lockdown is no doubt relevant here. However, it’s not clear to me whether these have been modelled. I know that question has been asked at the press conferences but has a satisfactory answer ever been given? Is this information in the public domain?

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  6. The current COVID-19 crisis has focused many people’s attention on the question of risk

    Sadly not.

    It has focused many people’s attention on bogus “safety”, and almost no-one is talking about risk.

    So Seb Coe says “We have to ensure that athletes are able to enter competitions in a safe and secure manner, which doesn’t increase the risk of spreading the infection.” He wants athletics to be safe. Risk, in his eyes, is purely about danger, not about how we might balance it against other concerns.

    If we were all talking about balancing risks, then the lockdowns would have ended long ago.

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  7. Chester Draws, exactly right. The public now no longer understand the concept of risk, i.e. the vital fact that risk is always relative, if it is to be meaningul, not absolute. The hysterical left wing media, the government and scientists themselves have encouraged the fixation of the public consciousness upon individual risks in isolation and have furthermore ladled on the emotional syrup in relation to any particular risk to ensure the public abandon all objectivity. ‘Safety’ in the form of singular risk avoidance has been drummed into us throughout this ‘crisis’ to such an extent that a huge proportion of the populace have now become brain-washed by propaganda.

    John, I don’t think deaths from lockdown have ever been modeled – not at least by the establishment scientific ‘commoonity’. This would be in accordance with what I said above; the obsessive focus on one risk only.

    Matt Ridley has an article in the Telegraph on the scientific establishment’s damaging obsession with modeling:

    “If you tell the models there is thus a correlation between susceptibility and infectiousness you get much lower forecasts of cases and deaths. Add that we now know that cross-immunity from common colds probably allows 40-60pc of the population to resist Covid-19, and the result is – as the work of Gabriela Gomes at the Liverpool School of Tropical Medicine indicates — that herd immunity is probably reached when as little as 15pc of the population is infected, rather than the 50-60pc implied by Imperial’s model. Hence the epidemic is petering out in London despite crowded streets.

    Sweden, with no lockdown, did no worse than Britain and far better than the models predicted. By now the models say it should have had up to 40,000 deaths with a lockdown; it has had under 5,000 without. Had Sweden managed to keep the virus out of care homes and hospitals, as Germany partly did, it would have done much better than us despite no lockdown.

    Reversing these mistakes will not be easy. Britain needs to get out of lockdown quickly, ditching the stable-door-locking policies like 2-metre distancing and travel quarantine before damage to the economy becomes terminal. And science needs to rethink its affair with models rather than data.”

    https://www.telegraph.co.uk/news/2020/06/06/has-british-scientific-establishment-made-biggest-error-history/

    Liked by 1 person

  8. Chester,

    Indeed. When I say that minds are focused upon risk, I don’t wish to imply that the focus is well-informed. Risk is one of those subjects that we all think is intuitively simple but, as you clearly understand, it is not.

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  9. Jaime,

    The interesting thing is that the scientists have always insisted that they have not been obsessing over the deaths caused directly by COVID-19. There was a time when Chris Whitty would be at pains to point out at every press conference that there are four causes of death to consider: COVID-19, the effect of exceeding NHS capacity, death due to denial of NHS services, and economic factors. However, when asked how these were being quantified in order to inform the risk-based decision-making, and whether or not the public will be allowed to see these calculations, no meaningful answers were forthcoming. This is no surprise really. They were struggling to reliably quantify the direct COVID-19 deaths, so they had no chance with quantifying the broader picture. This has not been governmental risk management’s finest hour.

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  10. http://www.theguardian.com/society/2020/jun/07/more-than-half-of-englands-coronavirus-related-deaths-will-be-people-from-care-homes?

    “Figures released by NHS England show 25,060 patients were moved from hospitals to care homes between 17 March and mid-April, when guidance was formally changed to ensure testing took place.

    William Laing, the author of the new analysis on excess deaths among care home residents, said their treatment was “a scandal which is just emerging”. He said he believed a series of failings were behind the high number of excess deaths.

    “At the peak of the crisis, there were widespread reports of normal medical support simply being removed from care homes,” he said. “Ambulances would not turn up to take emergencies to hospital, since capacity had to be kept clear for Covid cases.”

    https://www.researchgate.net/publication/341832637_All-cause_mortality_during_COVID-19_No_plague_and_a_likely_signature_of_mass_homicide_by_government_response/link/5ed6b0b992851c9c5e748b1f/download

    His basic thesis is that Covid peaks happened as a result of government reaction, for example, in Italy, UK and NYC, transferring patients from hospitals to care homes. There is also interesting info on infectivity and immune response.

    Liked by 1 person

  11. Dennis,

    One of the mantras that the politicians have been eager to maintain when announcing death tolls is that behind every number lies a grieving family. Whilst I have no reason to doubt the sincerity of a dewy-eyed Hancock as he looks directly into the camera, the point of my article is that government policy-making is all about numbers and nothing to do with personal grief. And one of the things that becomes much easier to do when such issues reduce to number-crunching is risk transfer between stakeholders. So, scandals such as those described in your comment become all the more achievable.

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  12. With respect to risk, there’s a new dynamic on display in current street protests. It’s explained in a twitter thread by NYT columnist Bari Weiss:

    Bari Weiss Twitter Thread

    The civil war inside The New York Times between the (mostly young) wokes the (mostly 40+) liberals is the same one raging inside other publications and companies across the country. The dynamic is always the same. (Thread.)

    The Old Guard lives by a set of principles we can broadly call civil libertarianism. They assumed they shared that worldview with the young people they hired who called themselves liberals and progressives. But it was an incorrect assumption.

    The New Guard has a different worldview, one articulated best by @JonHaidt and @glukianoff. They call it “safetyism,” in which the right of people to feel emotionally and psychologically safe trumps what were previously considered core liberal values, like free speech.

    Perhaps the cleanest example of this dynamic was in 2018, when David Remnick, under tremendous public pressure from his staffers, disinvited Steve Bannon from appearing on stage at the New Yorker Ideas Festival. But there are dozens and dozens of examples.

    I’ve been mocked by many people over the past few years for writing about the campus culture wars. They told me it was a sideshow. But this was always why it mattered: The people who graduated from those campuses would rise to power inside key institutions and transform them.

    I’m in no way surprised by what has now exploded into public view. In a way, it’s oddly comforting: I feel less alone and less crazy trying to explain the dynamic to people. What I am shocked by is the speed. I thought it would take a few years, not a few weeks.

    Here’s one way to think about what’s at stake: The New York Times motto is “all the news that’s fit to print.” One group emphasizes the word “all.” The other, the word “fit.”

    W/r/t Tom Cotton’s oped and the choice to run it: I agree with our critics that it’s a dodge to say “we want a totally open marketplace of ideas!” There are limits. Obviously. The question is: does his view fall outside those limits? Maybe the answer is yes.

    If the answer is yes, it means that the view of more than half of Americans are unacceptable. And perhaps they are. https://theweek.com/speedreads/917760/plurality-democrats-support-calling-military-aid-police-during-protests-poll-shows

    A plurality of Democrats would support calling in the U.S. military to aid police during protests,…
    President Trump on Monday threatened to call in the United States military in an effort to curtail protests across the United States, and it turns out most Americans — even some of those who think…

    My Comment: So this is what happened to the “Fifth Estate.”

    Liked by 2 people

  13. The writing on the wall for establishments like the NYT has been evident for a long time in the ever increasing levels of hypocrisy ie from hiring people with a history of racist views because they’re against acceptable targets or a steady stream of articles in the vein of “Dear White People” from 2014 to an increasingly outlandish defense of acts they have criticized in the past which can be summed up as “rules for thee but not for me”. They’ve been feeding a growing and highly malignant position of moral tyranny, and they’re not alone.

    Liked by 2 people

  14. Since this article touches upon the ethical and political dilemmas that authorities can encounter when setting safety policies, I thought it might provide a suitable forum for discussing the controversy caused this weekend by Lord Sumption’s remarks regarding value of life. These were made in the context of a debate regarding lockdown strategies, and they have caused a predictable wave of moral outrage. For example, there is this:

    “Human rights barrister Adam Wagner said: ‘This is the figurehead of anti-lockdown movement – comes across as inhumane, almost grotesque’.

    Employment and personal injury barrister David Green said he would ‘swap every brain-cell in my head to avoid being as horrible as [Sumption] evidently is’.

    Meanwhile, NHS mental health doctor Benjamin Janaway labelled the comments ‘abhorrent’, ‘thoughtless’ and ‘devoid of empathy’.”

    https://www.independent.co.uk/news/uk/home-news/lord-sumption-bbc-cancer-patient-lockdown-b1788690.html

    The concept of value of life plays a key role in the setting of safety policy, so as a former safety analyst I might be expected to have some informed opinions on this subject. If anyone wishes to express their own opinions here, I would be glad to hear them. I only ask that the debate not get too personal. Contrary to popular opinion, there is nothing going on here worthy of the labels ‘inhumane’ or ‘grotesque’.

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  15. I’ve watched the video now and it very much looks like Sumption was set up. He was calmly talking about Quality Adjusted Life Years, which is a standard statistical measure. Then this woman comes on and accuses him of placing a greater intrinsic value upon some lives as opposed to others. His response was less than optimum and lefties and lockdown supporters immediately jumped on the moral outrage bandwagon. So predictable. Sumption strikes me as one of the most humane of human beings, also one of the most rational and genuinely compassionate, who has been utterly consistent throughout this crisis. Of course the hysterical mob had to find a way to take him down. Don’t the Left just love their impeachment trials. As a former Supreme Court judge, he should have expected it. Here he is, defending his comments on Talk Radio:

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  16. John. The reactions to Lord Sumption’s comments are to be expected. Our societies work in part on an assumption that everyone is equal under the law, but clearly in most other respects this is blatantly untrue. Our judgements also vary according to whether the persons being judged are close or distant from us – of course save my grandmother but not necessarily someone else’s. I also suspect our judgements change as we age. I don’t feel particularly old, yet only 10 years ago I felt very differently about other people who were as old as I presently am. The old also commonly believe they “have paid their dues” and have an expectation of being looked after by the State, not put at additional risk, nor given a lower life expectation to favour the young. On the other side, the youthful, should have their life before them. It’s a Gordian knot.

    I am also reminded of judgements made in lifeboats.

    Liked by 1 person

  17. That woman had cancer. Where was the moral indignation from her at the government’s decision to place a much greater value on preventing the death of Covid sufferers in comparison to cancer sufferers?

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  18. Jaime,

    Thank you for sharing your views.

    I agree, Lord Vader – sorry – Lord Sumption appeared to walk into an ambush, but I wonder how much he should blame himself for that. Why did he think he could introduce such a technically nuanced concept as value of life into a TV debate and get away with it? He was on Good Morning Britain earlier today trying to explain himself to jungle VIP, Piers Morgan. Now that really did look like an ambush, as Lord Vader claimed that he had been told he had been invited onto the programme to discuss something quite different. Again, the word ‘naïve’ springs to mind.

    For those who may be wondering what all the fuss is about, I heartily recommend that they read what Wikipedia has to say regarding Value of Life calculations:

    https://en.wikipedia.org/wiki/Value_of_life

    As well as quality adjusted life-years, there is also the concept of the value of a statistical life (VSL) to consider. The VSL is very much the economist’s perspective. I guess there were no economists in the audience. Tough gig.

    Liked by 2 people

  19. Alan,

    >”I am also reminded of judgements made in lifeboats.”

    Spot on. This is not an ‘all lives matter’ thing. This is about what to do when life-saving resources are finite and deficient.

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  20. John. Of course the converse of lifeboat discussions are the heroic actions of individuals like Lawrence Oates who voluntarily shorten their lives for others, or countless mothers who starve to give their children food. Profoundly different approaches to shortages.

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  21. Alan,

    Your contribution to this discussion highlights an important point.

    I mentioned earlier the value of a statistical life (VSL). This is an important metric in deciding how much society is prepared to pay to save a life, but it cannot be used to discriminate between different candidate groups. The reason is because the number is calculated by asking individuals how much they would be prepared to pay to reduce the risk to their mortality by a particular amount. If, for example, 100,000 people replied that they would be prepared to pay £100 to reduce the risk by 1 in 100,000, this would equate to total outlay of £10 million pounds to save one (statistical) life. However, if you broke that analysis down by age group, you would probably find little difference in the amount each group was prepared to pay (we tend to value our lives right to the bitter end). Hence the VSL would be the same regardless of age (if anything the younger age groups would provide a lower figure, suggesting they have yet to learn the true value of life and the risks they are exposed to). This innate sense of the universal value of life lies behind much of the moral outrage that Lord Sumption experienced

    Now repeat the calculation, but ask the elderly how much they would be prepared to pay to reduce the risk to which their offspring, or even a stranger’s child, should be exposed and quite a different picture would emerge. The VSL calculated on behalf of the young might very well exceed that calculated by the young for themselves. It would certainly exceed that calculated by the elderly for their own generation. It seems to be human nature that we can instinctively recognise the importance of quality-adjusted life years when thinking of the general case but we can’t bring ourselves to apply it in our own case. Lord Sumption provoked outrage because he could, and he did so publicly.

    There are very few mothers who would not sacrifice themselves for their offspring when push comes to shove. No one would suggest that their position is morally abhorrent. But when an aging justice of the peace expresses the same sentiment with respect to his own grandchildren, all hell breaks loose.

    As for cancer patients, we can thank our lucky stars that others are paid to make the ethical judgements. Here’s a nice article explaining how it’s done. I’ll rephrase that. Here’s an article explaining how NICE does it:

    *ttps://www.nice.org.uk/Media/Default/guidance/LGB10-Briefing-20150126.pdf

    To save you reading it, I’ll summarise it for you: They do cost benefit analyses using figures that are broadly numberwang (the ethical edition).

    Liked by 1 person

  22. Purely by coincidence, the following appeared in the Guardian a couple of hours ago: “Smart motorways present ongoing risk of death, says coroner”:

    https://www.theguardian.com/world/2021/jan/18/smart-motorways-present-ongoing-risk-of-death-says-coroner

    Apparently:

    “Max Brown, the head of road design for Highways England, told the inquest that data showed smart motorways had reduced casualty rates by 18% by one measure and 23% by another. Brown accepted that the removal of the hard shoulder was an added hazard but said this was “offset” by a range of other safety measures.”

    When you think about lockdowns and the statistics of death tolls, you should keep in mind that this is how government officials think.

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  23. The Daily Mail seems to be in no doubts today:

    “Smart M-ways condemned as death traps”

    You have to wonder how something that has saved lives since its introduction can earn such a reputation. It may have something to do with the fact that the government saw the opportunity to kill people but bury this in good news. Unfortunately for them, coroners have noticed.

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  24. Now the South Yorkshire Police and Crime Commissioner, Dr Alan Billings, has joined in the clamour condemning the safety of Smart Motorways:

    “The relevant test for us is whether someone who breaks down on this stretch of the motorway, where there is no hard shoulder, would have had a better chance of escaping death or injury had there still been a hard shoulder – and the coroner’s verdict makes it clear that the answer to that question is – Yes.”

    https://www.bbc.co.uk/news/uk-england-south-yorkshire-55782301

    In response to Dr Billings’ open letter, the Department for Transport said:

    “The stocktake [of smart motorways] showed that in most ways smart motorways are as safe as, or safer than, the conventional ones.”

    So, even now, the Department for Transport sees this as a debate that can be settled by stocktaking. And that is the point about this article. Governments will always see matters of public safety as a stocktaking exercise.

    I wonder how the Covid-19 stocktaking is going. Not so well the last time I looked.

    Like

  25. If all else fails, let’s have an enquiry:

    “MPs have launched an investigation into the safety of smart motorways, after a coroner said they created an ‘ongoing risk’ of death.”

    The interesting thing here is that the Government still seems to think it is the public and the coroners who have got this wrong, and that an enquiry will help sort this misunderstanding out:

    “Launching the Transport Committee investigation, chairman Huw Merriman said: ‘The Department for Transport says smart motorways help us cope with a 23% rise in traffic since 2000, helping congestion.’

    The Conservative MP added that the department’s own ‘stocktake’ found ‘lower fatal casualty rates for smart motorways without a permanent hard shoulder than on motorways with a hard shoulder’.

    ‘This message isn’t reaching the public, whose confidence in smart motorways has been dented by increasing fatalities on these roads,’ Mr Merriman continued.”

    Whenever you hear a government representative say “The message isn’t reaching the public”, you should always look for the lie behind the message. In this case, the lie resides in the false comparison being made when they do the ‘stocktake’. The correct comparison would be between a motorway with calmed traffic and a permanent hard shoulder, and the same motorway without the hard shoulder. I’ve been pointing this out to the government officials concerned but the message isn’t reaching them. Huw Merriman’s statement goes beyond self-confusion and enters the territory of deliberate deceit.

    I wonder if a bunch of MPs gathering in a room will be smart enough to work this out. I doubt it.

    https://www.bbc.co.uk/news/uk-politics-56198979

    Liked by 1 person

  26. John

    At the risk of stirring up again an acrimonious debate, and maybe on the wrong thread, it’s possible (I put it no higher than that) that something similar might be true of Covid-deaths:

    https://www.dailymail.co.uk/news/article-9305405/Grieving-relatives-demand-inquiry-loved-ones-wrongly-certified-virus-victims.html

    The suggestion (a suspicion which I share) is that many deaths have been put down as Covid-deaths, when they weren’t. I don’t doubt that there have been many thousands of deaths due to coronavirus, but the old debate about how many deaths were “of” Covid compared to “with” Covid rumbles on. It surely gives the Government a dilemma. While they no doubt aren’t happy at being labelled as the Government which has presided over one of the highest per-capita death rates from Covid anywhere in the world, they equally can’t be happy at the prospect of the numbers being revised drastically downwards, as that might seriously undermine their justification for lockdowns, and all the collateral damage that the lockdowns have caused.

    Like

  27. If, like me, you use Adblocker, and can’t access the Daily Mail story, there’s an extensive excerpt at Lockdown Sceptics:

    “Grieving families last night said deaths had been wrongly certified as COVID-19.

    Demanding an inquiry, top medical experts and MPs also insisted they were “certain” that too many fatalities were being blamed on the virus.

    One funeral director said it was “a national scandal”. The claims are part of a Daily Mail investigation that raises serious questions over the spiralling death toll.

    More than 100 readers wrote heartbreaking letters following a moving article by Bel Mooney last Saturday. She revealed the death of her 99-year-old father, who suffered from dementia and chronic obstructive pulmonary disease, was recorded as coronavirus.

    Dozens expressed similar frustrations that the causes of death of elderly and already-unwell relatives had been wrongly attributed. Eight of the families who wrote to the Daily Mail have successfully urged doctors to change causes of death previously recorded as COVID-19.

    Layla Moran, the Liberal Democrat MP who chairs the all-party parliamentary group on coronavirus, said: “The Government should call a public inquiry into the handling of the pandemic immediately with an interim investigation into all Covid deaths that should report as soon as possible.”

    Tory MP Paul Bristow, a member of the Commons health committee, said: “It’s almost certain that a number of deaths have been wrongly attributed to COVID-19.

    “Not only has this skewed figures when data has been so important in deciding how we respond to the pandemic, it has caused distress and anxiety for relatives.

    “Whether we have received the most appropriate figures should definitely be considered in any future inquiry.”

    A funeral director in the North West told the Mail: “The way Covid has been recorded and reported is a national scandal and a thorough enquiry should be opened immediately.”

    Medical experts have cited pressure on doctors to include COVID-19 as a cause of death because it was last year ruled a ‘notifiable disease’, meaning any case needs to be reported officially.

    Professor Clare Gerada, former chairman of the Royal College of GPs, said: “When this all comes out in the wash, we will find out we have over-recorded COVID-19 as a cause of death.”

    Richard Vautrey, who chairs the British Medical Association’s GP committee, said the toll may have been overstated at the beginning of the pandemic when testing was not widely available and “cause of death would have been based on best judgement of clinical symptoms”.

    A Department of Health spokesman said: “We are confident the death statistics are robust and provide an accurate picture of those who have sadly died from the virus. The guidance to doctors completing a medical certificate of cause of death explains they are expected to state cause of death to the best of their medical knowledge and belief.””

    Like

  28. Mark,

    I think a more suitable thread for this discussion may be the one under my article ‘A Brief Primer on Causation’. The question of cause of death, in relation to Covid-19, is similar to the question as to whether extreme weather events are caused by global warming. There are actually two questions to ask:

    a) Given that a patient has died with Covid, what is the probability the patient wouldn’t have died if they hadn’t had Covid?
    b) Given that the patient did not get Covid and did not die, what would be the probability that they would have died if they did get Covid?

    These amount to asking what the probability of necessity (PN) is and what the probability of sufficiency (PS) is. These questions are problematic since they are considerations of counterfactuals, but I’m afraid that is what is involved in any matter of causation. However, in practice, no-one records cause of death by referencing PN and PS. Instead, medical professionals make do with a simplistic ‘cause of death’ statement that rarely captures the complexity of the situation. Even before controversial or politically motivated factors are taken into account, the situation is fraught with difficulty. Indeed, reading what Wikipedia has to say about cause of death, it seems the problem of false recording is not a new one or particularly limited to pandemics:

    “A study published in ‘Preventing Chronic Disease’ found that only one-third of New York City resident physicians reported believing that the present system of documentation was accurate. Half reported the inability to record ‘what they felt to be the correct cause of death’, citing reasons such as technical limitation and instruction to ‘put something else’. Nearly four-fifths reported being unaware that determinations of ‘probable’, ‘presumed’, or ‘undetermined’ could be made, and fewer than three percent reported ever updating a death certificate when conflicting lab results or other new information became available, and cardiovascular disease was indicated as ‘the most frequent diagnosis inaccurately reported’.”

    I say good luck to anyone who wants to hold an enquiry on this one.

    Like

  29. @ Mark I have replied re: covid on a recent-ish covid thread to preserve the order of things.

    Technical note: if you use Firefox then you can get an add-on called NoScript, which as you might expect, blocks websites from running code. Often if you block the code of news sites, you can read the text of articles, although pictures etc are often not visible. (Sometimes the text also disappears, and then you have to start relaxing controls, but this is often accompanied by a demand to disable the ad blocker.) NoScript displays a list of all the sites it is blocking, which is quite an eye-opener at times.

    @ John I have been incensed by the lack of honesty in Gov’t over “smart” motorways. Everyone knows that a motorway with no hard shoulder is more dangerous than a motorway with a hard shoulder. For officials to blatantly sidestep this obvious fact by comparing “vanilla” motorways with motorways with a variable speed limit is just disgraceful and I have found myself shouting pointlessly at the TV on the occasions when this lie is aired.

    Like

  30. Jit,

    This controversy goes back a long way for me. Many years ago I was attending a safety engineering conference at which two gentlemen were presenting a paper on Smart Motorways. They were a senior civil servant, who had been tasked with ensuring safety of the project, and a consultant with whom he had worked in developing the safety analysis. After they had presented their paper, I stood up and asked why they were not applying the ALARP principle. They replied quite adamantly that, as a government agency, they were under no legal obligation to do so. I was quite taken aback by that response and wondered whether their judgment would come back to haunt them. Now that people are talking about taking Highways England to court for corporate manslaughter, I suspect it will. At the very least, the political folly of not applying ALARP is now clear for all to see. Even now, the government is seeking to hide behind the statistics, claiming that it is the public that isn’t getting the message.

    Liked by 1 person

  31. Grant Shapps has made an announcement in parliament to the effect that ‘additional safety measures’ are to be applied for all new Smart Motorway schemes, i.e. radar detection of stationary vehicles.

    Firstly, these would not be ‘additional’ measures since they were proposed as necessary safety measures when the initial safety assessment was performed. The requirement was overruled by the government because they anticipated that the number of people killed by such cost cutting could be hidden as long as one uses an invalid comparison (i.e. Smart motorways against conventional motorways rather than Smart Motorways against Controlled Motorways). They are backtracking, not improving.

    Secondly, nothing is being said about building extra Emergency Refuge Areas so that the number meets the requirement laid down in the original safety assessment (another cost cutting exercise).

    Thirdly, if Shapps is being truthful when he says “We are determined to do all we can to help drivers feel safer and be safer on our roads – all our roads”, then why were these cost-cutting and inherently dangerous measures applied in the first place, and why did it take so many subsequent deaths before they were only now, partially, rescinded?

    I just wonder, if the government can lie to the public over this, what other death-causing mistakes are they also lying about? Since when has “we promise not to kill anyone else with our cost cutting” been a story of ongoing benevolence?

    Liked by 2 people

  32. On Saturday I had the misfortune to drive on a section of the 6 that is now “smart” motorway, after years of travelling it and suffering endless delays while the road works went on for years and years. I was rather shocked to see that there is no hard shoulder, the safety refuges are few and far between, and after a few miles (I was in the second lane at the time) I was forced suddenly to swerve into the third lane (forcing the car there to swerve suddenly into the 4th lane) as a result of a lorry in the inside lane realising at the last moment that there was a car broken down in the inside lane and swerving into my lane.

    Who on earth in a position of authority thought it was a good idea to spend years making life misery for motorists (involved in endless traffic jams and delays) while hugely expensive and intrusive works took place to turn it in to a “smart” motorway? And what I witnessed on Saturday is the outcome…

    Liked by 2 people

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