Accidents are accidental, and they can accordingly be prevented.  Strong Towns notes, however, that contemporary road designs facilitate accidents.
Who is showing a conscious indifference to the safety of others? In other words, who is grossly negligent? Is it the driver who is following the speed limit, operating a vehicle well below the much higher design speed? Or is it whoever decided that 45+ mph traffic should be feet away from kids biking on the sidewalk, moms with strollers and children waiting to be picked up from daycare?

Is it the driver -- a mere mortal suffering a predictable, perhaps even understandable, moment of inattention or confusion while performing the monotony that we call driving -- or is it the person who took 70 mph highway standards and applied them to urban streets?

Is it the driver, whose path has been cleared of every foreseeable obstacle in a desperate effort to gain them seconds' worth of performance, or is it the person who apparently believes it is optimal to have no less than a quarter mile distance between each seven lane pedestrian crossing?
You get what the highway commissioner asks for. If the highway commissioner sees his responsibility as clearing foreseeable obstacles (apart from, in too many places, those mal-timed traffic lights that probably encourage speeding) from the paths of motorists, and charges the highway engineers accordingly, the end result is roads that are hazardous to pedestrians, bicyclists, and patrons of businesses just off the road.
The engineering profession -- with a growing number of notable exceptions -- employs a systematic approach to design prioritizing the fast and efficient (but not safe) movement of automobiles over everything else. As a general rule, engineers show a conscious indifference to pedestrians and cyclists, misunderstanding their needs where they are not disregarded completely. This is the very definition of gross negligence.

This system can't be changed by engineers alone, but they are the only ones that can credibly lead the charge.
In a representative republic, pedestrians, bicyclists, and shoppers have the responsibility to lean on the highway commissioner, or to ask the select-men to do so.

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