When is an accident not an accident? This apparently obtuse question is driven by a recent editorial in the British Medical Journal, which implied that accidents are not unpredictable. "An accident is often understood to be unpredictable - a chance occurrence or an 'act of God' - and therefore unavoidable. However, most injuries and their precipitating events are predictable and preventable."
The British Medical Journal is written for a primarily medical audience, for whom the word accident is in everyday use. Accident-and-emergency departments deal with road-traffic accidents, accidental drug overdoses and accidental poisoning. Doctors and hospitals cause medical accidents when they inadvertently injure patients.
But why the fuss? A change of name is not going to make "accidents" go away. Is the journal guilty of pedantic quibbling that is "Injury In Ireland", a report published this month, suggests it is a real issue. Researchers found that, over a 17-year period, more than 900,000 people were admitted to hospital and more than 25,000 died in the State as a result of unintentional injury.
"Unlike most other diseases, we can predict unintentional injuries. They are the major cause of death amongst young people. If measured by years of life lost, rather than absolute number of deaths, injuries are one of the most important of all causes of death. They are also the major cause of severe acquired disability in younger people," says the report.
The authors steer well clear of using "accident" in this context. They advocate a programme to prevent "unintentional injury". So, as far as health promotion and preventive health is concerned, there are advantages to be gained from a change in terminology. By highlighting the fact that injuries of all kinds - in homes, schools and workplaces - are avoidable, we can encourage a "preventive awareness" mindset.
Public-health specialists agree with a change in terminology, judging from the report's use of language. The researchers were led by Dr Anthony Staines of the department of public health medicine and epidemiology at University College Dublin.
Responding to the finding that there are about 1,500 deaths from unintentional injury in the Republic each year, with 45,000 hospital admissions, Staines called for an injury strategy to be put in place. "We have a cardiovascular strategy and a cancer strategy, why not an injury strategy?"
Falls, road-traffic accidents and poisonings are the main causes of preventable deaths, according to the report. What are its recommendations for change?
The authors urge tough new driving laws, including cutting the permissible blood-alcohol level by almost half, random breath-testing of drivers and the introduction of a penalty points system - a change already signalled by the Government.
They also want to see fall-prevention programmes for older people. The highest rate of falls admissions to hospital is among older women, and even fear of falling has a detrimental effect on the quality of life of many older people. Such programmes should be introduced widely as part of routine health care for older people, especially those in nursing homes, the report suggests.
In an attempt to prevent avoidable childhood injuries, the report recommends banning the distribution of poisonous materials without child-resistant caps or other protective packaging.
Although drowning is uncommon, a high proportion of drownings are fatal; the authors suggest swimming lessons as part of the school curriculum and advice for first-time parents on the hazards of bathtubs for babies and toddlers.
As well as pursuing their good work on highlighting injuries and their prevention, public-health specialists will have to give some thought to promoting the use of an alternative word to "accident".
The authors of the British Medical Journal editorial admit they are struggling to find a generic term that covers the range of events formerly known as accidents. They dismiss "mishaps", "misadventures", "calamities", "events" and "incidents" Perhaps it is time to coin a word to plug the lexicographical gap. "Injident" has been mooted. Any better suggestions?
You can e-mail Dr Muiris Houston, Medical Correspondent, at mhouston@irish-times.ie or leave a message on 01-6707711, ext 8511. He regrets he cannot reply to individual medical problems