Editors’ Note: 120 physicians and researchers from the University of Toronto are signatories to this letter to Doug Ford.
As physicians and researchers from the University of Toronto who practice in emergency medicine, trauma, surgery, anesthesiology, intensive care, rehabilitation, psychiatry, pediatrics and family medicine, we bear witness to the trauma inflicted on pedestrians, cyclists and the drivers of motor vehicles due to traffic-related injuries – the majority of which are preventable.
In Canada during 2022, 294 pedestrians, 46 cyclists, 258 motorcyclists, 316 passengers, and 952 drivers died in collisions. There were 8,851 serious injuries from collisions, including pedestrians (15 per cent), cyclists (5 per cent), motorcyclists (13 per cent), passengers (17 per cent) and drivers (47 per cent). As of Oct. 9 this year in Toronto, 16 pedestrians, six cyclists, three motorcyclists and 10 motorists have been killed by traffic-related trauma. Every fatality is the loss of a person, someone who loved and was loved.
Among survivors, the horrific consequences of motor vehicles hitting pedestrians, cyclists and people in other vehicles are difficult to imagine. Brain injuries that fundamentally change personalities, memories and cognition; torn spinal cords that commit people to lifelong ventilatory support; scars from surgeries; post-traumatic stress disorder from both the trauma and the care required to help people survive. These patients spend weeks and months in hospital, and often never return to work or school.
The victims are not just the patients who arrive in our hospitals’ trauma bay, but the families and caregivers who experience burnout and depression. Surviving drivers involved in fatal collisions are also haunted by their experience, many suffering from life-long regret and psychological torment (Maryann Gray spent her life advocating for people who accidentally killed others). Not only can these devastating injuries destroy lives, the costs for this care, and the opportunity-costs of lost productivity, are borne by society.
Most agonizing is that the vast majority of traffic-related fatalities – pedestrian and cyclist especially – are preventable. Research from many jurisdictions, including Toronto, shows that protected bicycle lanes reduce the risk of motor vehicle trauma for pedestrians and cyclists. A recent position statement from the Canadian Paediatric Society strongly endorses protected bike lanes as a way to protect children, the most vulnerable road users. Public health data can identify high-risk areas. Reductions in speed that result from changes to road design also improve safety for motorists. Bicycle lanes benefit all road users, and it is much preferable to prevent motor vehicle trauma than to try to treat it.
For this reason, we strongly oppose the recent proposed Ontario legislation, Bill 212, that limits the ability for municipalities and cities to make their roads safer for their citizens. The legislation requires that municipalities seek Ministry of Transportation approval before installing cycling lanes that reduce the number of lanes available for motor vehicles. The legislation states that the ministry will base its decision on whether to approve a bicycle lane on “whether it would unduly diminish the orderly movement of motor vehicle traffic”, without any mention of safety for road users.
The Ministry of Transportation is responsible for serving the people of Ontario, not its motor vehicles. We must address the root causes of traffic congestion and provide options for solutions, such as improved transit connectivity and reliability, incentives for choosing alternatives to motor vehicle travel, and support for complete streets that offer safe and efficient transportation options for all people.
Legislation proposing to guide road design decisions, such as Bill 212, should explicitly place a higher priority on road safety than motor vehicle travel times. We oppose the proposed legislation as currently written and remain available should the government seek broader input from stakeholders of road traffic trauma – us and others – who aim to help improve traffic safety for everyone in Ontario.
Signed (in alphabetical order),
- Dr. Neill Adhikari
- Dr. Najma Ahmed
- Dr. Maha Al Mandhari
- Dr. K. D. Alexopoulos
- Dr Kavita Algu
- Dr. Jillian Alston
- Dr Rufaro Asefa
- Dr. Imad Awad
- Dr Jillian Baker
- Dr. Iwona Baran
- Dr. Michaela Beder
- Dr. Jackie Bellaire
- Dr. Suzanne Beno
- Dr. Blair Bigham
- Dr. Gary Bloch
- Dr. Thomas Bodley
- Dr. Michael Bravo
- Dr. Corey Bricks
- Dr. Laurent Brochard
- Dr. Dylan Bould
- Dr. Nikki Bozinoff
- Dr. Natalie Butler
- Dr. Alice Cavanagh
- Dr. Eileen Cheung
- Dr. Arianne Cohen
- Dr. Eleanore Colledge
- Dr. Christopher J Coutinho
- Dr. Matthew Cruickshank
- Dr. Adrienne Davis
- Dr. Deric Diep
- Dr. Michael Dinsmore
- Dr. Katie Dorman
- Dr. Naheed Dosani
- Dr. Dallas Duncan
- Dr. Gina Eom
- Dr. Joseph Fiorellino
- Dr. Rob Fowler
- Dr. Gabrielle Freire
- Dr. Amy Gajaria
- Dr. Ritika Goel
- Dr. Samantha Green
- Dr. Sahil Gupta
- Dr. Barbara Haas
- Dr. Mona Haider
- Dr. Mika Hamilton
- Dr. Gregory Harvey
- Dr. Kate Hayman
- Dr. Margaret Herridge
- Dr. Christopher Hicks
- Dr. Paige Homme
- Dr. Alex Huang
- Dr. Jennifer Hulme
- Dr. Emma Jeavons
- Dr. Daisy T Joo
- Dr. Chris Kandel
- Dr. Neha Kanga
- Dr. Liana Kaufman
- Dr. Michael Kahn
- Dr. Jonathan Kong
- Dr. Karim Ladha
- Dr. Kevin Lam
- Dr. Kate Lazier
- Dr. KitShan Lee
- Dr. Michael Lee
- Dr. Mark Levine
- Dr. Sean Leung
- Dr. Sarah Levitt
- Dr. Winny Li
- Dr. Ken Lin
- Dr. Martin Ma
- Dr. Kristin Malcolm
- Dr. Selene Martinez
- Dr. Azad Mashari
- Dr. Lianne McLean
- Dr. Marc McVey
- Dr. John Mikhaeil
- Dr. David Ng
- Dr. Jessica Nguyen
- Dr. Ahtsham Niazi
- Dr. Valerie Palda
- Dr. Judith Peranson
- Dr. Ian Randall
- Dr. Danyaal Raza
- Dr. Vanessa Redditt
- Dr. Joao Rezende Neto
- Dr. Andrea Rigamonti
- Dr. Genevieve Rochon-Terry
- Dr. Luciana Rodriguez Guerineau
- Dr. Claire Rollans
- Dr. Daniel Rosenfield
- Dr. Daniel Rosenbaum
- Dr. Peter Sakuls
- Dr. Ashwin Sankar
- Dr. Annia Schreiber
- Dr. Saadia Sediqzadah
- Dr. Rami Shoucri
- Dr. Suzanne Shoush
- Dr. Isaac Siemens
- Dr. GL Silverman
- Dr. Jordan Silverman
- Dr. Marietjie Slabber
- Dr. Mayson Sousa
- Dr. Tomislav Svoboda
- Dr. Michael Szpejda
- Brandy Tanenbaum
- Dr. Irene Telias
- Dr. Mark Tessaro
- Dr. Bourke Tillmann
- Dr. M. Tylee
- Dr. Zoe Von Aesch
- Dr. Joshua Wales
- Dr. Marcin Wasowicz
- Dr. Nena Watson
- Dr. Edward Xie
- Dr. Roland Xu
- Dr. Michael H. Yang
- Dr. Christopher Yao
- Dr. Christopher Yarnell
- Dr. Eric You-Ten
- Dr. Eric Yung

Thank you for your letter re Bill 212 above! I would like to add the following point to the list of reasons Bill 212 must be rescinded.
The City of Toronto’s carbon emissions by sector website, states that unless (1) 30% of cars are electric and (2) 75% of local trips (within 5km) are made by means other than driving – by walking, cycling or transit – the City will not meet it’s 2030 carbon emissions reduction target! Removal of the bicycle lanes ear marked by the Premier will not only reduce the safety of citizens attempting to comply with this critically important City of Toronto initiative but will most certainly dissuade other citizens from participating. I offer as evidence the recent killing of a young female cyclist by a large construction vehicle when she was forced out of the current bike lane on Bloor at Avenue Road. Further to these specific locations Bill 212 indicates that all bicycle infrastructure existing or proposed that restrict lanes for vehicular traffic will be subject to provincial censure. It would seem clear that the Province places little importance on the issue of carbon emissions and by meddling with the City of Toronto’s business is imposing its self serving agenda on the City’s ability to meet these critical targets! All other provincial municipalities should take note! I’m left to believe that the Conservative Government of Ontario under Premier Doug Ford doesn’t believe in or care about Climate Change and it’s impact. This is a shocking rupture in the trust citizens must have with their elected government!
We need to rethink cycling in congested downtown traffic and during peak hours. I suggest cyclists who are using certain routes between certain hours of the day be required to display a small licence plate, and pass “drivers” test, as is required for motorists. (e.g. 7 AM to 7 PM on downtown routes) Fair us fair. There needs to be accountability by cyclists for dangerous habits, insufficient safety equipment, and poor examples ruining the experience for all. Esr=tablish rules for cyclists using routes without cycle lanes.
Some of my experiences:
1)I have been hit by a cyclist while crossing the street at the light and Queen and Spadina. Yes, I was following the traffick signals, the cyclist was not. She did not apologize, even though my shin was bleeding, but looked at me with the most angry agressive look, got on her bike and sped off without a word. My injury could have been worse, but I was literally caught in mid-fall by another pedestrian crossing at the same time. There were many pedestrians and she just proceeded to drive into the group of people.
2) while driving on Queen West, a cyclist doing tricks (wheelies) on the sidewalk showing off to a group of friends, wen flying in the air-hits my car damaging not only the windshield but 3 panels of the car body, making it irreperable, and a total loss according to insurance. Due to slamming in the breaks, I have had to have physiotherapy etc, for bruised ribs (seatbelt injury) , injured hands, neck, foot, leg etc. The cyclist was not at all held accountable, even though a police officer happened to witness the event, being present to monitor streetcar track construction. This happened 4 days before my sons wedding-I could barely have one dance with my son, plus no car. The cyclist was not at all held responsible.
Shall I go on?
So…..My thoughts: Drivers test, licence plates mandatory for cyclists at certain times and routes- violations enforcible by traffic ticket issuance by police &/or reported by other cyclists, car drivers and pedestrians.
Just wondering who would be responsible if an accident occurred at a spot where a safety barrier was taken out?
Great post. But that being said, where I worked in the past some highly educated people PhDs for pete sakes making very excellent money, were riding their bikes 20 km to work each day, in the winter with bad road conditons and one had a bad accident as such affecting his mobility for life. So while legislation is important, common sense is equally important. Stupidity is stupidity, PhD or elementary school student.
I question your assumptions in the above. 1) Only poor people ride bikes. 2) Riding bikes 20 km to work is somehow crazy. 3) Riding in the winter is inherently unsafe. Riding a bike is a transportation choice, not always dictated by dollars. Some are motivated by convenience, health and/or environmental concerns. 2) Riding 20 km to work is odd. Why? It takes less than an hour, less than many people spend in a car. Why is this questionable? 3)Winter roads are inherently dangerous for cyclists. The Danish population would disagree. Cycling in winter could be safe if we chose to make it safe. Provide separated bike lanes, keep them clear. A bicycle tipping over should not collide with a car. Winter roads are unsafe for motor vehicles too, let’s not forget. My mother in law was killed on a blizzardy winter road, in a car. I have spun out on an icy highway, in a car. If I spin out on my bike, I won’t kill anyone else and probably won’t die.
I think many more physicians and researchers would want to add their name to this. How can they do so?
All perfectly said – any way to add more signatures to this (as an academic researcher?)
All well but if the main road on the campus of UofT has a pedestrian crossing that asks pedestrians to wait for brake in traffic than things are not well.
Information that the Ontario Government needs to hear and hopefully takes seriously.