People Die Because of Recklessness!

 Dr. James Manos (MD)

July12, 2021

Many people die because of their recklessness!

20 common causes of death

Image (free to use): Head-on collision. Source for the image: Image created by Petiatil. Source: Wikipedia. Link: https://en.wikipedia.org/wiki/File:Head_On_Collision.jpg

You may watch my relevant YouTube playlist, Shocking Accidents Caused by Recklessness! 

(with the warning that some videos are shocking, although I tried to avoid videos with appalling scenes) 

"Only two things are infinite, the universe and human stupidity, and I'm not sure about the former!" (Albert Einstein) It is better to lose one minute in life than to lose life in a minute!

Abstract

Unfortunately, most people ignore the dogma of emergency medicine that ‘safety comes first.’ today, medical facilities are available to everyone. However, many people die from preventable causes. Their recklessness costs their life! In this article are described 15 examples that people neglecting their health or doing risky things without ensuring their own or their family's safety. 

Twenty typical causes of death related to recklessness

1. When safety is NOT a priority!

''Safety comes first,'' something that all First Aid courses stress. But for many, it does not come! An example was in June 2018 when a football coach in Thailand decided to take 12 kids to explore a cave in which they were trapped because of the heavy rain that blocked the entrance. International and local divers rescued the kids. However, the captain of the marine seals died trying to save the kids. Often, such as with climbers, people considered experts and well-trained are more likely to be killed in accidents than inexperienced individuals, as the former overestimate their capabilities, while the latter are more prudent about making risky decisions. Often in wildfires, people do not leave immediately when the fire comes close but remain at their house to save it, risking their and their family's lives. Noteworthy, some residents, during a wildfire, upload videos on their social media instead of running away. Often wildfires are caused by an idiot who recklessly burns garbage outdoors! 

The same scene repeated in California in November 2018 when wildfires left 87 dead and 475 people unaccounted for. Apparently, the evacuation procedures were insufficient, or many people ignored them. Many civilians uploaded shocking videos of themselves leaving with their families at the last moment their home and trying to escape with their vehicle among flames! I think it would be more prudent to leave in time and not on time! Every year in California, as in Australia, wildfires burn everything because there are no precautionary measures to prevent them or specific actions during the fire. The fact that wildfires in California and Australia burn for several days or weeks shows that the State cannot extinguish them promptly. Another case of recklessness was in New Zealand in December 2019 when several tourists who visited a volcano were killed by its sudden eruption. They were not warned about the explosion, and the NZ state found it unsafe to send rescuers immediately to the scene.

Another example that shows that safety is not a priority is the case of the US patrol police. It is unbelievable, but many police cruisers have a single driver as a crew, as they do not mind having a couple of officers who will protect each other in case someone attacks them! Another fact of recklessness in the US police is that officers often do not wear the necessary protective bulletproof vest.

2. Accidents, trauma, dangerous sports, and stupid ‘stunts.’ 

Trauma (injuries) is the main reason that people of an early age die. The reason is that many people neglect taking simple safety measures or adopt risky behavior. For instance, driving under the influence (DUI), meaning under the influence of drugs and alcohol, is dangerous for the individual and others! But a universal reason many die in car accidents is that they neglect to fasten their seat belts when they start driving. Many drivers have stupidly killed because they held their smartphones to speak, text, or visit the web while driving, so this destruction caused an accident. 

Many motorbike drivers or cyclists drive without wearing a protective helmet. Some who wear one have purchased a cheap brand that may break in case of a crash. Others wear a helmet without jaw protection. People driving a motorbike or a bicycle without a helmet expose their heads to fatal injuries. We should all consider that the head of a motorist, when unprotected in an accident, may break like a watermelon! Remarkably, a helmet may protect the head but does not protect the neck, where a severe injury may cause paralysis or even death. Additionally, helmets for cyclists and horse riders do not safeguard the jaw! There is appropriate protective gear for motorbikes that most riders do not mind wearing. 

Some people drive aggressively, often under the influence of alcohol or illicit drugs, ignoring traffic rules without paying attention to other cars or pedestrians and causing accidents. Unfortunately, many people, especially young men, choose to buy a car that runs fast. They, instead, do not prefer an automobile with high safety standards, such as Mercedes, BMW, and Volvo. They do not mind how many airbags or passive security mechanisms their new car has, but only how fast it runs. Aggressive and impulsive people tend to become easy victims of accidents. An example is road traffic accidents caused by aggressive drivers who do not pay attention to any traffic rules, and they may drive.

Pedestrians often act recklessly, for example, when they cross a road when the traffic light is red or pass it from a point without traffic lights, not minding the passing cars! 

3. Abuse of alcohol & illicit drugs 

Western society is addicted to alcohol, while illegal drug abuse is also a significant problem. Many people, especially the younger ones, think they will feel better with some beers! In Muslim countries, alcohol is prohibited, but some say that illegal alcohol is an issue in some.

Alcohol 

Binge drinking is common in northern Europe, especially in the UK and Scandinavia. Alcohol and illicit drugs have been implicated with common causes of death, including car accidents, rapes, domestic abuse, quarrels, batteries, murders, accidents (such as traffic collisions, falls, and pool drowning), deaths from severe intoxication, etc. Alcoholics do live shorter than other people as they are susceptible to severe diseases such as fatal bleeding from esophageal varices, hepatic (related to the liver) coma, encephalopathy (brain disease), liver failure, Wernicke Korsakoff's encephalopathy and psychosis, thiamine (a vitamin) deficiency, malnutrition, peptic ulcers, laryngeal cancer, etc. 

Illicit drugs

Illegal drugs may cause death from pulmonary edema or apnea from respiratory depression (both common in heroin abuse), usually after an overdose or an adulterated drug. Junkies may kill to find money to buy their next dose, while its delay may cause withdrawal symptoms and even psychosis. By needle sharing, they are exposed to infectious diseases such as AIDS and hepatitis B and C. The recurrence rates are high, especially for opioid users (but perhaps these numbers are not reported officially, which may cause cuts in funds). Today, there are eponymous and anonymous treatment groups for illicit drug and alcohol addicts. However, it is up to the addict to admit their addiction and next to seek help.

4. Tobacco addiction

Smoking is another addiction that, even though it is hazardous, many people continue to smoke until their doctor consults them to cut smoking, usually after a heart attack, stroke, or even cancer (I guess then it is too late to give up)! However, many smoke tobacco despite severe medical conditions, including heart attacks. That is self-destructive. There are cases of patients with COPD (chronic obstructive pulmonary disease, usually smoking-related) who are so addicted to tobacco that they keep smoking at home, even with the oxygen cannula placed in their noses' nostrils. Many smokers smoke in front of their children, making them passive smokers, which has severe health consequences, including susceptibility to asthma! Passive smokers are exposed to the same problems as smokers. Many people think that smoking only causes cancers. 

However, most deaths from smoking are from coronary artery disease (CAD) and cerebrovascular disease (CVD) that may manifest with myocardial infarction (heart attack) or a stroke, respectively. Smoking tobacco may also cause diseases such as cancer (lungs, laryngeal, pancreatic, etc.), chronic obstructive pulmonary disease (COPD, a lung disease that involves most chronic smokers), Burger’s disease (with foot gangrene), osteoporosis, etc.

5. The recklessness of the young

Young people do foolish things, often under the influence of alcohol or illicit drugs, or because of attention-seeking behavior, trying to post a ''catchy'' video (of a jackass type) or selfie or do stupid ‘stunts.’ There are many cases in which young people have died trying to take a selfie, for example, on the roof of a building, a skyscraper, a bridge, or a cliff. Others have been killed trying an acrobatic, including parkour. Many young people are keen to risk their lives to show off, and unfortunately, attention-seeking today is a pandemic! But it may end up in injury or death. Plenty of uploaded videos of kids holding their breath or performing a choking maneuver on another guy. But this practice may be lethal as smothered and choked individuals may die from severe bradycardia, i.e., a slow heart rate that may degenerate to asystole where the heart stops beating! I think YouTube should not allow these videos despite the vague ''community standards.''. 

And all these deaths are related to a video that intends to impress. I remember a naive video of a teenager who drank a flammable drink and burned his throat (this may cause suffocation)! On the internet, you may find numerous stupid videos that young people upload to show off and win the 5 min of fame they deserve. However, often these ''stunts'' may turn lethal! A typical example is parkour (which consists of stupid acrobatics), a silly (in my opinion) sport that attracts young people, even children. Wikipedia has a biased article about parkour, like advertising this naive ''sport,'' where cases of people who died during parkour are not mentioned. 

Many young people enjoy risky extreme hobbies such as bungee jumping from mountains or bridges, skydiving, canoe-kayaking, or scuba diving. Unfortunately, many people do extreme sports without proper training from an expert. Moreover, many neither follow all the safety rules nor wear the appropriate safety outfit. For instance, many kids enjoy skateboarding and doing amazing ‘stunts’ but neglect wearing helmets and protective gear. Their parents neglect as well to impose safety rules and equipment. However, ironically, the supposedly more experienced people have more often accidents, perhaps because they overestimate themselves and what they are capable of.

6. Lack of safety at work 

In medicine, 'safety comes first.' in many jobs, safety rules are essential. A notable example is healthcare professionals. However, many doctors and nurses neglect safety. For instance, they don’t regularly wash their hands with antiseptic handwashing or handwashing with an alcohol sanitizer (and don’t clean their stethoscope with an alcohol swab) after the physical examination of each patient (so they transfer bugs in the hospital), they do not wear the necessary protective equipment (goggles, face mask or screen, head cover, plastic apron, gown, shoe covers) when indicated (e.g., on trauma or a contagious disease), etc. An example is the SARS virus (a coronavirus) pandemic in 2003 that started in a hospital in Hong Kong when an anesthetist intubated a patient with SARS without wearing a protective face mask (during intubation to see better the vocal cords, the doctor approached their face to the patient’s mouth closely!). 

Safety at work is apparent. However, it needs to be addressed. For example, construction workers should wear protective equipment. Their supervisors must impose safety rules. If ignored, this may be deadly in case of an accident.  

7. Lack of Healthcare Insurance 

Many people do not have healthcare insurance because they cannot afford or neglect to pay for a public or private insurance program, assuming they will never become ill. However, they may have money to buy the latest expensive smartphone (such as an iPhone) or a smart TV rather than paying their Medicare insurance. Health care insurance is essential in countries such as the US, where not all medical facilities are available to uninsured patients, contrary to Australia and Scandinavia, where everyone has free access to the health care system. This system is of vital importance not only for the treatment of maladies but also for their prevention. 

8. Neglecting regular medical checkups & seeking medical help for health problems

Many people neglect to regularly take a medical checkup and wait first for a disease, such as a heart attack, to make them visit a doctor. Others have devastating or recurrent symptoms for many weeks, months, or years and do not see a doctor or may see a doctor only when it is too late! I remember an older woman with a distended belly at a hospital as if she was pregnant, but it was from ovary cancer. She delayed seeking medical advice. Many people do not visit a doctor even in case of an emergency! For example, some people have died after head trauma (injury) that they initially considered minor. That is the ''talk (or walk) and die syndrome''!

Commonly, adults neglect essential vaccines such as annual flu shots and pneumonia vaccinations and risk developing and even dying from the disease if they ignore their vaccination! Often people with an illness do not follow their doctor’s advice. For example, they don’t take their medication as advised; they don’t visit their doctor in case of recurrence, etc. Another example of recklessness is when people who visit a hospital's emergency room (RM) are advised to be admitted for further tests but act stupidly by asking the doctor to give them a drug and let them go. Sometimes, when the ER doctor suggests admission for further examinations, they may leave the hospital without signing a refusal paper. Other patients are instructed to return to the hospital if their symptoms recur; however, they don’t! In the above two examples, patients may be so ungrateful that they may even press charges against the doctors for negligence, although they were the ones who neglected themselves. 

As a doctor, I am frustrated with the inappropriate use of the internet and the ''expert patients'' who debate everything and ignore their physician's advice. A widespread kind of recklessness is when people use the internet, usually non-medical sites, to search and self-medicate for a health problem rather than seek a doctor's advice. Even when some search reliable sources such as PubMed, they are not qualified to read and interpret a medical study, while most people (including many doctors) ignore that a Cochrane systematic review & metanalysis is more helpful than a single study that alone says nothing. 

9. Medical malpractice

Medical malpractice is another reason that some people die today. There are many reasons for this. Three common causes are a) Doctors who are not specialists but are less experienced; treat severe cases in the emergency department (ED) or the ward. b) The need for teamwork, especially in emergencies. c) Working overtime without breaks. Doctors' performance is reduced if they are working overtime and are exhausted. The EWTD (European Working Time Directive) in Europe tries to solve this problem.

10. Drugs (medications)

Medications are another common reason for death, perhaps the most common! People, especially the elderly, may have their medical condition deteriorate or even die from the adverse effects of one or more drugs they take. For example, diuretics may cause low or high potassium, called hypokalemia and hyperkalemia, respectively. Contraindications are also an issue, e.g., combining an antiplatelet drug, such as aspirin or an NSAID (nonsteroidal anti-inflammatory drug), with warfarin, a blood - thinner) may cause bleeding tendency. Interactions (for example, combining a beta-blocker with a calcium channel blocker may slow the heart rate dangerously) or from wrong indications (for example, taking a drug that is not needed). Many people, especially the elderly and those with mental incapability, may take the wrong dose. Also, many people die because, without asking a doctor first, they abruptly stop taking medication, including beta-blockers, diuretics, antihypertensive drugs, steroids, and psychotropic drugs. Moreover, many people act with negligence and do not visit a doctor to prescribe them medication but consult a neighbor, friend, or pharmacist! 

11. Heart attack, stroke & cardiovascular disease risk factors

Cardiovascular (heart attack) or cerebrovascular (stroke) disease are the leading causes of death after mid-age. However, most of the modifiable risk factors for these diseases are preventable. The modifiable cardiovascular disease (CVD) risk factors related to coronary artery disease (CAD) and stroke include: tobacco use (smoking), hypertension (high blood pressure), dyslipidemia (increased blood fats such as cholesterol and triglycerides), diabetes mellitus (elevated blood sugar), a diet rich in saturated fats and carbohydrates, being overweight or obese, heart failure and left ventricular dysfunction, specific behavior (being competitive or combative or feeling overly stressful, as most people do) and sedentary lifestyle (lack of physical activity as the youth whose only exercise is texting and posting on their social media), depression, increased blood fibrinogen (which is a factor of blood clotting), increased blood homocysteine (congenital with premature atheromatosis or from decreased intake of vitamin B12, B6, and folic acid).

Most people neglect to control the modifiable risk factors for cardiovascular disease that may lead to myocardial infarction (heart attack), cerebrovascular accident (stroke), and also on peripheral artery disease (PAD). Many people continue to eat junk food and do not mind if lipids (such as cholesterol) will obstruct their arteries, causing a heart attack. Most people never or rarely check their blood pressure, another risk factor for stroke and heart attack. Other hypertensive people (with high blood pressure) or dyslipidemia (high blood fats such as cholesterol & triglycerides) continue eating salt and junk food rich in ‘trans’ fat, respectively. Most people have a sedentary life and never or rarely exercise.

Unfortunately, many people do not mind at all modifying their risk factors such as cutting smoking, eating a healthy diet (deficient in fats, sugar, and salt), reducing their weight (if obese or overweight), regularly exercising (such as to go for jogging), control their blood pressure (the most important is to avoid salt) and blood sugar levels, etc. 

Many, if not most, people modify their risk factors only after a severe disease such as a heart attack. However, this severe disease (e.g., heart attack) may often present with sudden cardiac death (SCD)! But SCD could be prevented merely by controlling the modifiable risk factors such as high blood lipid levels (with a statin drug or a plant sterol if not so high) or high blood pressure (avoiding salt, losing weight if obese, and taking an antihypertensive drug if it remains high).

Hippocrates (c. 460 – c. 370 BC), the father of medicine, used to say that ‘prevention is better than treatment.’ Today, even though many sophisticated medical tests exist (lab or imaging tests), people neglect to modify their risk factors and prevent cardiovascular diseases. Many people do not even do regular medical blood checkups. 

12. Diabetes mellitus (high blood sugar)

Many patients with diabetes neglect losing weight and exercise regularly (brisk walking is an option for the elderly) exercise, ignoring that diabetes mellitus is an atherogenic disease (namely, it is a disease in which the accelerated building of plaque obstructs in the arteries causing a heart attack or stroke). Diabetes may also lead to early complications such as eye and renal (kidney) disease and foot vascular problems (that may even end up as gangrene). Sometimes patients with diabetes mellitus neglect taking their antidiabetic drugs or may neglect to attend regular checkups for their kidneys (e.g., urine microalbumin), eyes, and feet. Consequently, many die from renal insufficiency (renal failure).

13. Obesity

Many obese individuals ignore the fact that obesity decreases life expectancy. So, they do not try to lose weight following a healthy, low-calorie diet, doing regular exercise, or consulting a surgeon (in the case of morbid obesity). Obesity causes many diseases and is a modifiable risk factor for heart attack, diabetes, and hypertension. Obese people are also susceptible to respiratory failure after a medical condition, such as an infection (even flu), or after surgery. Generally, they are high-risk patients. This elevated risk also includes pregnancy. 

14. Cancer 

Cancer is often a preventable cause of death, and contrary to widespread belief, many types of cancer are sporadic without any apparent genetic predisposition. Many people expose themselves to carcinogens such as tobacco, alcohol, sunlight (or at least without a high SPF sunblock), etc. However, carcinogens in the environment, our food, and water are so widespread that it is often impossible to avoid them. But we may try to avoid the ones that can be prevented, e.g., avoid the above carcinogens; participate in screening medical programs, e.g., for breast, rectal, and vaginal cancer. Importantly, people diagnosed with cancer should always seek a second opinion from an oncologist, as many people seek an expert's opinion for minor issues. Still, they may neglect to do so for cancer or leukemia! A common misconception is that enrolling in an anticancer drug trial may be helpful. But it may not, as not only does the patient become a ''guinea pig'' exposed to potential (and potent) adverse and side effects of the drug, but it may also belong to the inactive substance's placebo group. 

15. Abuse 

Physical abuse is another cause of death. Many people who are verbally, physically, sexually, or psychologically, or economically abused (usually women, children, and the elderly) sustain for many years the abuse and are afraid to report it to the police or at least talk about it to a relative or a trusted friend. So violence is perpetuating. The main three reasons people don’t report abuse are a) The fear of the abuser’s revenge. b) The fact that they are financially dependent on the abuser. c) The fear that they will be stigmatized. Usually, abusers are family relatives or close neighbors! 

16. Unsafe sex

Everyone talks about it, but many do not follow the rules. People who do not mind safe sex are exposed to infectious venereal diseases such as AIDS, syphilis, infection from Chlamydia and Gonococcus, and hepatitis B and C. Their excuse is that they don’t want to reduce pleasure during sex! However, the partner is responsible for making love with a male who refuses to wear a condom. Not wearing condoms also increases the chance of unwanted pregnancies. 

Sexual education should be taught in schools. However, in most countries, it doesn’t. People who use the excuse that they did not know about safe sex practices are still responsible because not only did they not ask anyone (for example, a health care professional) about safe sex, but also, they did not search about it on the web or in books. 

17. Ignorance of how to deal with emergencies, including sudden cardiac arrest (SCA)

It is unacceptable that many people today do not know how to perform CPR (cardiopulmonary resuscitation) to resuscitate a victim with a cardiac arrest. Instead, they wait for the ambulance, which may delay. After all, in the case of a cardiac arrest without resuscitation, the deadline to avoid permanent brain damage is only 10 minutes from the arrest! Commonly ambulances may arrive on the scene in more than 10 min. Moreover, most people do not know how to perform the Heimlich maneuver to resuscitate a victim from choking. It is disappointing that contemporary people can use complicated devices (including their smartphones and tablets) but do not use CPR and know how to use an automated external defibrillator (AED) in the community to give a life-saving electric shock to someone in a cardiac arrest. But even if they knew this, there are not enough AEDs distributed in the community! But first, prices of AED need to be reduced (medical devices were always overcharged) so that every building has its own AED. We must consider that a cheap AED may cost about one thousand dollars, which is not so costly for someone who spends nearly the same amount on an iPhone smartphone! 

Every building should have its AED, and volunteers should be skilled in using it. In Italy, in a small city, volunteers use their cars to reach and resuscitate cardiac arrest victims with an AED and CPR. First aid lessons must be taught in high schools. These should include CPR on infants, children, and adults, using AED, and managing choking from a foreign body on infants and adults. It is unacceptable for students to learn mathematics, science, and other complicated lessons but not to learn how to perform CPR and use an AED. The government should distribute AEDs in the community in busy public places such as malls, schools, crowded beaches, airports, etc.

Additionally, all hospitals should use battery-powered cardiopulmonary resuscitation devices, such as LUCAS and AutoPulse, that perform cardiac compressions. These devices should also be in the community, public places, and AEDs (automated external defibrillators). These are important, as the central issue in cardiopulmonary resuscitation is the inferior quality of chest compressions in cardiac arrest.

Finally, volunteering is essential. Volunteers in the USA (such as retired paramedics or nurses) help in an emergency (some even have an ambulance). Moreover, in the US, firefighters may also help in medical emergencies, as fires do not occur all the time. Citizens trained in CPR and the use of AED should act as volunteers, and in the case of a cardiac arrest, they may arrive with their vehicle at the scene and offer first aid. 

18. Reckless and ignorant parents!

Many parents behave unacceptably by not allowing their child to be vaccinated based on the nonsense they read on the web by people who are not pediatricians. These non-experts, often lay people, prevent parents from vaccinating their child by describing adverse effects that are exceedingly rare or unproven (such as the relation of the MMR vaccine with autism), forgetting that every drug carries side effects risk. At the same time, the diseases that vaccines prevent are common and may be deadly!

It is also negligence when parents do not seek medical advice when their child suffers from a medical condition, and when they do so, it is too late, while others do not give their consent to life-saving medical interventions, including blood transfusion (such as in case the parents are Jehovah witnesses). However, many parents neglect non-emergency medical problems with obesity (often accompanied by diabetes and high blood fats) being a pandemic, often untreated, increasing the risk of future heart disease.

Imposing a vegan diet on a child is negligence and somatic abuse. It may cause iron deficiency anemia (children are prone to sideropenic anemia) and neurological problems (from the lack of vitamin B12; this also causes megaloblastic anemia), as meat sources of iron, vitamin B12, as well as proteins (for proteins, the gold standard is egg), are more absorbable than plant sources. 

A tragic case of neglect is when parents do not care about their child's health and smoke tobacco inside their house or car in front of their child, rendering it a passive smoker. Additionally, a rare but not uncommon cause of death on babies is when their parents throw them up high for fun, causing their death not from injury (as most parents hopefully are cautious to catch them before they fall on the ground) but from a severe brain injury from the sudden thrust! Significantly neglectful are the parents who leave an unattended child playing on the balcony without a safety net or let them swim alone in the pool.

Parents usually neglect to teach safety rules to their children, not only to fasten their seatbelts in the car but also, for instance, to never plunge into the sea (or a pool) of unknown depth and without knowing if there are rocks inside. Diving into the water with the head down (or somersault) in shallow water may cause a cervical (neck) fracture, leading to death or tetraplegia (paralysis of all limbs). Also, teenagers may die while swimming in the pool or the sea drunk and unattended.

Notably, a common cause of death worldwide is when parents have their child in the car's front seat, even with their seatbelt fastened, as in case of a crash, the kid is suffocated from the airbag! Commonly, children are sitting in the back seats without their belts fastened, or babies are not correctly placed in their rear-facing child safety seats!

Although not lethal, it should be mentioned that many parents are so ignorant that they neglect to take their teenager with acne, even severe, to a skin doctor. Therefore, they develop permanent facial scars, while many parents of kids with nearsightedness (myopia) buy their kids ugly large black glasses when someone can find them subtler. But the most important is not the aesthetic aspect, but the fact that most parents allow their kids to play games wearing their glasses or not wearing a protective face mask and is something familiar at ''Nerf battles'' that kids play and for which you may watch numerous videos on YouTube!

It should be noted that many parents allow their child to play dangerous ''stunts'' such as parkour, neglecting that a head injury may be proven lethal, while a cervical (neck) injury may cause, if not death, permanent paralysis. Backflips, front flips, and skating on a skateboard or roller skates without protective gear (helmet, knee, and elbow pads) may also cause severe injuries. A bicycle helmet does not protect you from cervical damage! It is unbelievable that people, including minors, die from these 'stunts' in their attention-seeking attempt to upload a video with their naive stunt on YouTube.

Parkour is a modern version of acrobatics that is extremely dangerous. Wikipedia editors have covered up fatal cases of this naive ''sport'' by making a biased article that advertises this stupid (in my opinion) game. These stunts should be done only by professional stuntmen who take the risk and are paid to do them for a movie. Many stunts have died or been injured on these stunts. But these should not be done by kids who risk their lives. 

Other instances of negligence worldwide are when parents drive with their motorbike having their kids sitting in front of them or when women sit in the front seat holding their babies, which in the case of a crash act as living airbags. Additionally, in rural areas worldwide, children may even be allowed to drive tractors! Another negligence case is when parents allow their baby to eat nuts; some are proud of this. However, this is the most common cause of choking in infants. Similarly, parents are unaware that babies put everything they see in their mouths and may choke. I recall a child ICU pediatrician who described a case of a baby who swallowed many pins that were recovered from the lung using a bronchoscope! Parents often neglect to place a safety net for children in case they live in an apartment with a balcony. 

A rare cause of sudden death in children is martial arts! For example, a blow to the chest of a child not wearing protective gear (chest protector) may cause ''commotio cordis'' in which the chest impact may trigger a severe arrhythmia (irregular heartbeat) that may cause death if not defibrillated (similarly, a severe arrhythmia may occur in a car accident when the driver’s chest crashes to the steering wheel). A blow to the neck may cause severe bradycardia (low heartbeat) that may end up in asystole (the heart stops beating), while a blow to an unprotected from a sparring helmet head may be lethal. So, karate and other martial arts are not entirely safe.

19. Lack of safety when exercising

Most people have a sedentary life and never or rarely exercise, increasing their cardiovascular risk. But even when they exercise, people defy safety rules, as I explain in my text Physical Exercise with Safety

20. Lack of safety in migration

In the recent European migration crisis, migrants or refugees who were parents risked their children's lives when they carried them on an inflatable boat or a wooden 'tub that easily sank when it reached the open sea. Many pregnant women and children died this way, even wearing a life jacket, as these were often cheap and defective. In some cases, when migrants met a Coast Guard ship, some fell into the water to make coastguards save them, while other times, for the same reason, they even stabbed with a knife their inflatable boat to sink so that the coastguard rescue them instead of pushing them back.

Remarkably, hundreds of Africans who tried to reach Europe by sea drowned when the ship on which they were piled capsized from their weight or when they all suddenly moved to one side of the boat when the coastguard approached. 

Epilogue

To sum up, many people today die from preventable causes neglecting their safety (for example, by not fastening the seat belt before start driving) or their children’s safety (for instance, leaving them unattended in the pool or with their seat belt unfastened in the car), neglecting regular medical checkups or modifying risk factors for diseases, ignoring to cut addictions (such as alcohol and tobacco), or having a high-risk behavior (such as aggressive driving, unsafe sex, extreme sports) may be proven a deadly choice! Many people ignore the motto that ‘safety comes first.’

Thanks for reading!