Eighteen-year-old Wayne Jowett died on 2 February this year because an inexperienced doctor injected the wrong drug into his spine. We all make mistakes, especially when we are tired and under stress, and for junior doctors the stress is intensified by having to follow complex procedures. When you read about the lethal element in all of this – the drugs themselves – you realise that this is one area that clear typography has never been allowed to enter.
Jowett needed Cytosine in his spine and Vincristine in his vein. The glass phials that contain these drugs are identical, the manufacturer is identical, the typeface is identical, the names are very similar. If the labels had carried the destination of the drug as well as its brand name – SPINE printed above Cytosine and VEIN above Vincristine – Jowett might still be alive today.
The Department of Health has begun an “urgent review” of drug labelling, and the figures that show the scale of the problem are staggering. It estimates that doctors administer two million drugs every single day, that is 730 million a year. One study estimates that there are three instances when the wrong drugs are administered in every 100 cases, or 60 every day, which is a horrifying 21 900 wrongly administered treatments a year.
The Association for the British Pharmaceutical Industry, the trade body of the companies that make the drugs, is predictably defensive. It says that “there is no evidence that unclear packaging or labelling” is responsible for errors, but it would say that wouldn’t it. It can only see the financial horror of the huge cost in re-labelling thousands of drugs, and obviously could not care less about the pressure its unhelpful and over-technical packaging puts on medical staff.
The initial target for Department of Health is damning: its clinical experts believe that improved labelling on drugs could immediately reduce errors by 40 per cent. This is another way of saying that nearly 9000 people a year are suffering unnecessarily, even dying, at least in part as a result of thoughtless typography.
What about the 30 000 people who die on our roads every year? How can design save some of them? Over 15 000 people die because they meander or dash into the road without using a crossing. Can barricades, better signs, clearer crossings and better advertising reduce these numbers? The two biggest killers after heart disease, which has complex causes, are smoking and alcohol, which could do with far more disturbing warnings to balance their allure. One of the best pieces in Bruce Mau’s recent self-promotional book is his prospective design for a cigarette pack with half its surface given over to a colour picture of cancer eating away a man’s jaw. My father died of alcoholism in a really horrible way. I wonder if he might have been able to arrest it if vodka bottles were compelled to carry graphics showing the awful consequences of over-indulgence.
Once you see design used well as helping to address these shared problems, the list of work to do grows ever longer. A young graphic designer at the Royal College of Art, Frank Philippin, is working on a project that shows the benefits of clearer typography for household drugs such as headache pills – less text in much larger sizes – for ease of use by the 40 per cent of the population who have less than perfect eyesight. Britain’s road sign scheme, designed by Jock Kinneir and Margaret Calvert, once gloriously fresh and modern, is now 40 years old, and car use has increased and changed immeasurably in that time. When will that venerable system be reviewed? I bet Al Gore is wishing the bureaucrats in Florida had asked a better typographer to layout the voting forms.
Much has been made in design criticism recently about design going down the same road as art. This is a context in which design is seen and used as a specific and individual language, concentrating on satisfying the needs of each designer to express themselves. This vision has design becoming ever finer in its variety and complexity, inevitably – like art – being used in an increasingly irrational and personally-justified way.
But as well as broadening its range in articulating inner, personal worlds, it seems as though design still has some good old-fashioned problems to solve. These are problems that call on design to be what the pioneers of the later Bauhaus believed it could and should be, a clarifying and rational way of thinking that can improve and save lives.
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