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With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention.

I have delineated the important public health implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design.

The broad expertise, ethical principles, and values of public health should be brought to bear on a wide range of issues pertaining to autonomous vehicles. (Am J Public Health. 2017;107:532-537. doi:10.2105/ AJPH.2016.303628)

The public's health has been dramatically affected by improvements in automotive design, such as seatbelts and automatic airbags, yet nothing portends a more significant reduction in morbidity and mortality rates from motor vehicle accidents than autonomous vehicles, sometimes known as "driverless, "robotic," or "selfdriving" cars.1,2 Motor vehicle safety ranks among one of the past decade's "ten great public health achievements"3 in the United States, right up there with tobacco control, prevention and control of infectious disease, and occupational safety.4 Autonomous vehicles, which could reduce traffic fatalities by up to 90% by eliminating accidents caused by human error-estimated to be 94% of fatalities-could save more than 29 000 lives peryearin the United States alone.5,6 Around the world, autonomous cars could save 10 million lives per decade, creating one of the most important public health advances of the 21st century.7,8

Although crash avoidance or mitigation of harm caused by motor vehicle accidents are specifically public safety issues, for simplicity I have included public safety issues under the intellectual umbrella of public health. From the vantage point of public health, the overarching goal is to transform the current approach to automotive safety from reducing injuries after collisions to complete collision prevention. Although the feasibility of creating an autonomous vehicle that never crashes is debatable and, by some analyses, impossible to achieve-considering the burst of enthusiasm, investment, and effort in autonomous vehicle technology-it is time to reflect on the many public health issues that have not yet been adequately analyzed or discussed.9,10

Vehicles equipped with automated driving systems are described in the literature as "autonomous," "driverless," "robotic," or "self-driving," yet it is important to clarify distinctions and use terms consistently. SAE International...

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