Medical Examiner

Should Drunk Drivers Be Forced to Visit Morgues?

Thailand is trying to deter intoxicated motorists by scaring them. But no one knows if it works.

morgue.
Do morgue visits actually help prevent drunk drivers from reoffending?

phildaintith/Thinkstock

Southern California’s Orange County takes drunk driving seriously, especially if you’re underage. On top of all the typical punishments—fines, jail time, loss of driving privileges and work opportunities—a judge can sentence an offender to visit a morgue for a visceral dose of reality.

The county’s Youth Drug and Alcohol Deterrence program was born in the late 1980s after a surge in youth drunk driving arrests. Local courts, hospitals, and morgues—“the ones who see the worst of it,” says Sarah Tuckerman-Cluff, director of the county’s court referral program—got together and decided that the best way to keep these kids from driving drunk again was to make them face the potential consequences of their actions up close.

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“Let’s let them stand over a dead body,” Tuckerman-Cluff said. “Let’s let them smell the formaldehyde. Let’s let them hold a few organs, and let’s hear the story about these people and how they were killed at the hands of a drunk driver.”

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Starting in the 1980s, hundreds of thousands of DUI offenders (and others with drug- and alcohol-related offenses) across the United States have visited morgues as part of their criminal sentencings. I began looking into programs like Orange County’s last week after Thailand became the first nation to federally mandate that drunk drivers work in morgues, to see if there’s any evidence that such programs help people.

What I found was a scattershot collection of programs offered by municipalities throughout the U.S. (states dictate the basic framework for drunk driving penalties, and many let judges assign jail time, fines, and community service at their discretion). The programs vary in length and intensity. Some take little more than an hour, with a walk through the morgue and conversation with a coroner. Others span several days and offer opportunities for reflection through discussion and writing. What all programs shared was the unabashed support from the coroners and administrators who run them. These people believe they work.

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The key word there is believe. Most supporters rely on a gut-level evaluation based on the immediate change they see in the teens and adults with whom they work—and the fact that they rarely perform autopsies on the people who participate in the program.

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“Very seldom do we get anybody coming through on a table that attended the class,” says Ed Winter, the assistant chief of the Los Angeles County Department of Medical Examiner-Coroner. “It’s been very successful.”

“Does it work? We would like to think so,” says Orlando Portillo, the chief deputy coroner for Lake County, Illinois. “We have yet to have any of them end up on our autopsy table.”

Yet few could provide objective, scientific evidence that the morgue visits actually deterred people from drunk driving again. While some programs keep internal records, no outside research has assessed whether the experience prevents further drunk driving or other drug- and alcohol-related offenses.

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One way to measure success is to look at recidivism rates, which describe the number of drunk drivers who, after punishment or rehabilitation, go on to drive drunk again. There is no great national data on drunk driving recidivism, but a 2014 study by the National Highway Traffic Safety Administration estimated that about 30 percent of drunk drivers in the United States are convicted a second time. 

In comparison, less than 2 percent of drunk drivers who visit the Orange County morgue reoffend within 18 months, says Tuckerman-Cluff. In Clark County, Nevada, the home of Las Vegas, around 12 percent of DUI morgue visitors are arrested again, says county coroner John Fudenberg. In Santa Clara, California, where a similar program ran from 1998–2008, less than 20 percent reoffended, says lawyer Ingo Brauer, who started the program. If these low recidivism rates hold up over the long term, they suggest that a visit to the morgue could be a relatively quick and effective way to prevent drunk driving.

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Of course, just because you are not convicted again does not mean you are not drunk driving again; similarly, just because you don’t end up dead does not mean you’re not reoffending. (It’s estimated that only 1 percent of the 112 million annual drunk driving trips end in arrest.) Critics also complain that parading people through morgues could distract coroners from their work, increase the risk of disease, or cause trauma in people viewing the bodies (program advisers point to safety regulations they follow to prevent these occurrences).

Others worry the practice is merely a means of terrifying offenders—a tactic that rarely results in behavioral change. Several compared morgue visits with Scared Straight programs, which bring delinquent youth to prisons to show them where they’ll end up if they keep behaving badly. Research shows that these programs are ineffective; they may even increase the odds that teenage participants will go on to commit crimes.

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But that comparison is “a matter of apples and oranges,” says Brauer. And that’s because, unlike Scared Straight programs, morgue tours don’t attempt to instill a fear of death—but rather a valuing of life. 

“The more you value life, the more your behavior follows suit. Being in our office and seeing unexpected death helps you value life more,” says Nevada coroner Fudenberg.

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I described the morgue visitation programs to Hy Malinek, a Beverly Hills, California, forensic psychologist who regularly testifies on the recovery of violent offenders. He was impressed by their self-reported recidivism rates, though he noted that participants should be followed for longer—perhaps 10 years—to demonstrate long-term behavior changes.

He also said morgue programs square with what we know about how offenders can recover. Behavior change typically requires two components. The first is a cognitive understanding that your actions caused real harm—“appreciating the loss of life, the damage that one’s conduct created,” Malinek says. The second is an emotional component, where you empathize with the victim and internalize his or her pain to an extent that you’ll remember it the next time you have an opportunity to drink.

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Drug and alcohol recovery programs like 12 steps operate on the same principle; the difference is that the emotional experience is administered slowly, through the gradual sharing and discussion of past traumatic experiences. Malinek suspects that morgue visits could force offenders to understand and internalize the consequences of their actions—if they’re ready to take them in. 

So the question is whether one visit is enough. Again, it’s hard to know.

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“It depends on the individual and their willingness to really take a look at all this—at a level of openness, interest, ability to take a look at the consequences and let it affect them,” says Malinek.

If an offender is ready, a visit could be transformative. People who experience near-death experiences or simply imagine their own deaths in concrete detail—as a drunk driver might when visiting a morgue—often undergo personality change. They learn to value their own lives, take responsibility for harms they’ve caused, and may even start to behave more altruistically. The transformative power of confronting death head-on is a relatively new avenue of research, but the findings mirror the kinds of changes coroners observe in DUI offenders who visit their morgues and may help explain the impressive short-term recidivism rates.

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There’s no telling if morgue visitation programs are as effective as the practitioners claim. But drunk driving killed nearly 10,000 people in 2014—around one-third of total traffic fatalities—and it’s clear the current system doesn’t stop the 40 percent of offenders research shows go on to get in another accident (even if they’re not arrested).

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At New York magazine, Cari Romm writes that morgue visits are fear-based (like Scared Straight programs) and therefore don’t work. She argues that we should instead focus on the things we know reduce drunk driving—like enforcing existing laws and installing technology that prevents DUI offenders from driving unless they pass breathalyzer tests.

She has a point; technology especially offers great promise for reducing drunk driving, and in some places already has. But better law enforcement requires checkpoints for all drivers, which people resist, or more police, which budgets rarely allow.

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And more fundamentally, Romm gets morgue visits wrong. If designed thoughtfully, they aren’t a fear-based punishment. They can be rehabilitative—an opportunity to stop the problem at its source. Repeat offenders often suffer from psychiatric problems and abuse alcohol to self-medicate. The legal and social penalties that exist don’t stop them; what they need is help, not further punishment. Plus, if it proves to be an effective way of shocking people into facing their addictions, all the better—there’s no silver bullet for fixing that, either. Why wouldn’t we explore it as an option?

Given the preliminary evidence, it’s worth assessing whether morgue-based programs actually are different than failed Scared Straight programs. Seems like Thailand is a perfect place to start. I hope they collect good data.

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