What the punishment in this case should be is indeed a very difficult call, but I think there's got to be significant jail time involved. And getting caught using one behind the wheel at all should be a big fine and mandatory license suspension. Hand-held electronics are becoming more and more ubiquitous. A whole lot of young people have them, and more and more will in the future. They need to know that using them behind the wheel will get you into BIG trouble, whether or not you hurt or kill someone.

A lot of people believe that using a hands-free device like a Bluetooth is safer than talking on a hand-held cell phone, and there's even been legislation passed based on this assumption, but there's no evidence to support that, and those laws are nothing more than "feel-good legislation." In fact, all the evidence suggests that your ability to drive is just as impaired as if you were on a hand-held. It's not the act of holding the phone up to your ear that's distracting, it's listening to the person on the other end of the line.
http://www.latimes.com/features/heal...,3192911.story

I use a Bluetooth, but still, I generally don't answer my phone when I'm driving, and if I do, I keep it real short. I've never had anybody get mad at me when I told them, "Hey, I"m driving. Mind if I call you back in a few minutes?"