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Re: [IP] Diabetic mistaken for drunk



At 08:42 AM 6/22/98 , John Neale wrote:
>I won't comment on police brutality, but I'll state my position clearly:
>the guy shouldn't have been driving while hypo. 

There have been a number of messages, now, saying that someone should not
be driving while hypo. I cannot imagine anything more obvious or less
controversial, yet IP members are writing it as if by saying this they were
disagreeing with what I wrote. Major non sequitur.

I write about the legal and social thought that led me to my statement,
below; since this is long, here is a summary: 

We are not in disagreement about the responsibility of diabetics for their
behavior while hypoglcyemic; however, we have a profoundly different degree
of understanding of the legal institutions that impact how we behave, in
society, as diabetics, and how other people treat us as impaired diabetics.
Note that a lawsuit can be brought against a diabetic who is irresponsible,
just as it can be brought against a police department ("to serve and
protect"??!!) that substitutes brutality for competence.

I strongly agree that diabetics need to be especially careful to test bg's
before driving, and that it is horribly irresponsible to drive while
impaired. I will not go so far as to say that it is equivalent to driving
drunk, and I think the testimonies of many of the people on this list will
demonstrate why; but as I said: it is horribly irresponsible to drive while
impaired.

If one gets behind the wheel of a car, one is responsible for one's own
life and all of one's actions while behind the wheel, including the
consequences of one's actions. Now it's *I* who am saying the obvious and
non-controversial.

>Here driving is in not a RIGHT. You have to PROVE that you are fit to

I pity that you are a subject of a fascistic state; but moreso, I pity the
slave who believes slavery is proper. 

Even in the U.S., people believe that it is the proper role of the state to
"own" the roadways and thus to determine driving regulations. In an ethical
society, a "driver's license" would be issued by an insurance agency, and
the insurance agencies would be responsible for the integrity of those
licenses. One's vehicle and one's license would be required to operate on
all major roadways, and the corporations, partnerships, non-profits or
individuals who owned the roadways, besides having a tremendous need to
keep their roads in excellent condition and safe, would need to audit the
insurance agencies or rely on third-party auditors. It is highly probable
that many people who currently drive would be judged unfit to drive in such
an ethical society. It is possible that *I* would not be allowed to drive
because of my history of hypos, in spite of my brief stint of training as
an emergency staff car driver in the military and the fact that I've driven
coast-to-coast in less than 45 hours (yes, without sleeping) six times.


However, I don't think the numbers would work out as you assert they ought
to (i.e. proving that you are fit to drive). The "proof of fitness" might
include riding a bicycle in the city; operating any heavy machinery
whatever; participating in most sports and recreational activities; etc.
Are others potentially at risk if you lose certain faculties, which are
known possibly to be lost in a state of hypoglycemia? And is it known that
hypoglycemia can occur, even if only a small portion of the time, without
the awareness or the ability of the diabetic to identify that he is
hypoglycemic and act to correct it? Well, then, diabetics *as such* should
not be allowed the privelege of engaging in those activities. The
paternalistic state should protect us by so legislating. (I realize that
nobody has argued this; but the legal methodology suggested is equivalent.)

It is a different legal approach, altogether, to attend to the consequences
of responsibility through litigation; this approach is the common law
tradition. It is far superior.

I am writing most of this simply to point out that the legal reasoning
behind the hypothetical lawsuit is NOT SIMPLE. Sorting out the pros and
cons, the secondary and tertiary and extended consequences of such
lawsuits, the legal system which enables such lawsuits, etc, is a
complicated task. It is also a science which I have been priveleged to
practice beyond the cutting edge; the advances in this legal reasoning will
not be felt in our society, nor will most judges, justices and legal
practitioners be aware of these advances, for some decades. 

Great Britain pioneered the common law tradition, and it is perhaps one of
Britain's greatest gifts to the world -- among many great gifts. 


It was wrong for the police to brutalize a man who appeared to be drunk; it
is characteristic of police, however, to be poorly trained and incompetent.
They substitute the use of nightsticks, dogs and other extreme measures for
competence, good judgment and efficiency. This happens regularly; it is an
*institutionalized* practice. It is much less common for a nurse or doctor
in a private practice to be so incompetent, and to substitute extreme
measures for competence, judgment and efficiency. One of the reasons for
this is the *precedent of litigation*.

Consider the case of McDonald's and the too-hot coffee. We laugh at the
lawsuit -- the stupid woman shouldn't have been putting hot coffee in her
lap!!! -- but when we do this, we are failing to analyze the situation. The
coffee was 180 degrees F, and this was an *institutionalized* practice (not
a solitary, exceptional instance). That is dangerous. The woman sued and
won a couple hundred million. The size and success of the lawsuit put it on
the front pages everywhere. The *very next day*, all businesses in America
were aware of the danger of serving coffee that was dangerously hot -- and
the instititionalized practice was changed *overnight*. 

If such litigation could effect the police departments, it would be a good
thing -- institutioinally substituting more judgment in place of more use
of nightsticks. That was the point of my comment, and what I have written
here is a very, very small sample of the reasoning behind it; insufficient,
I am certain, to really make most of us understand the issue -- but the
encyclopedic volumes I could write on the subject are more appropriate
elsewhere.

>I'm not perfect, and I do have mild hypos while driving. 

My diabetes is far from perfect, and I experience a great many swings
including a period of two years during which I went hypo about 10 times a
week, several of which induced grand mal seizures. But I have only been
hypo behind the wheel of a car once. One of the fascinating -- more
appropriately, horrifying -- things about a hypo is that the brain is
usually what gets struck first. This means that in some percentage of
hypos, for me it is about 15%, one of the faculties that gets impaired is
the ability to judge that one is hypoglycemic. During hypos I have walked
around for a couple hours, knowing that *something* is wrong but unable to
figure out, for the life of me, *what* is wrong. Instead I beat myself up
over not being able to get on with my day efficiently, and wonder what is
wrong with me that I am acting strangely AND I can't figure out why.

Summary: we are not in disagreement about the responsibility of diabetics
for their behavior while hypoglcyemic; however, we have a profoundly
different degree of understanding of the legal institutions that impact how
we behave, in society, as diabetics, and how other people treat us as
impaired diabetics. Note that a lawsuit can be brought against a diabetic
who is irresponsible, just as it can be brought against a police department
("to serve and protect"??!!) that substitutes brutality for competence.

Kirez
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