More than a million people are killed on the world's roads annually. Injuries vastly outnumber deaths. The victims are overwhelmingly young and healthy prior to their crashes. This harm flows from many decisions made at many levels, from the individual road user to top government and industry leaders. While the decisions are steeped in a host of ethical questions, the ethical questions are almost universally ignored. This paper raises ethical issues relating to drivers, industry, and government. Increased professional and public focus on the ethical issues surrounding death and injury in traffic has the potential to generate enormous reductions in harm, far larger than those from ongoing safety programs.