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There are harms done to others when a person doesn't wear a seatbelt. As mentioned, it's very possible that others will have to contribute to expensive medical care, and perhaps long-term disability maintenance. Also, at the time of the accident, you can lose control of the vehicle due to not being restrained in the driving position, which could lead to a further collision that injures others.
It's all a matter of what the government is requiring citizens to do, and what sanctions are threatened. in this case, if someone is too stupid or defiant to wear a seatbelt, I'm not going to feel much outrage over a minor-misdemeanor level of sanction.
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