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08/03/2012 // INFO Leave a comment

Medical ethics paper argues for right to choose on helmet wearing



Helmet compulsion is a subject that always divides cyclists. Everyone has their own view on whether cycle helmets significantly protect adults against serious head injury.

Indeed, it is an issue that splits the British Medical Association (BMA), the governing body of medic and doctors in the UK.

This is laid bare by a medical ethics paper recently published by two researchers via the BMA’s journal’s wing, the BMJ. The paper discusses mandatory cycle helmet wearing and argues that any law to make the wearing of cycle helmets mandatory in the UK should only apply only to children and not adults. The researchers argue that it is a matter of principle that people should be allowed to take risks with their health, if they choose to do so.

The ethics paper, which is called Liberty or death; don’t tread on me, was published in Journal of Medical Ethics today.

Evidence on compulsion not “clear cut”

The two authors, Dr Carwyn Hooper of St George’s, University of London and John Spicer of the London Deanery, state that evidence that cycle helmets significantly protect adults against serious head injury is uncertain and questionable, arguing that the evidence for adults is “not as clear cut as many advocates of cycle helmet legislation seem to think”.

Australian research shows that most (80%) cyclists killed or seriously injured were wearing helmets at the time of the incident. And the overall risk is small, irrespective of whether a helmet is worn, the authors state in their paper.

“There were 17064 reported cycling casualties in 2008 in the UK, yet the number of fatalities(104) and the number of serious injuries (2606) were not large—especially when one considers the number of ‘road miles’ covered by cyclists in the UK every year.”

This compares with over 35,000 deaths from lung cancer alone in 2008—”a figure that dwarfs the deaths from cycling,” the research paper emphasises.

They also argue that cycle helmets do not provide the same level of protection as motor bike helmets, which recent research shows cut the risk of head injury by 69% and that of death by 42%.

Motorcycle helmets are made of heavier material than cycle helmets and are not a viable option for cyclists. They also argue that while helmets work well for those who fall off their bike, it is less clear whether they provide much protection against the many cycling injuries sustained during a collision with another vehicle.

Deterrent to cycling

While the evidence from countries where cycle helmets are mandatory indicates a fall in head injuries, other evidence suggests this might be because helmet legislation deters people from cycling.

The BMA has in the past refused to support legislation that would make the wearing of cycle helmets compulsory (in 1998/9 and 2003/4). However, more recently, the BMA has supported compulsion on helmet wearing for adults.

With the Northern Ireland Assembly having voted in favour of a bill to make cycle helmets compulsory but just failed to get it into the statute book because of a lack of parliamentary time, the authors suggest that similar legislation in Britain is just around the corner.

This is a position they disagree with and they state that instead of legislation, governments should continue to provide public health information to their citizens about the potential benefits of wearing cycle helmets and leave it up to them to decide for themselves

“If competent adults wish to cycle with their hair (or their shiny pates) exposed to the wind, rain, and sky, then they ought to be able to do so without interference from the government or anyone else.”

The full paper published in the Journal of Medical Ethics can be found here.

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See also

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Integrated cycle rail travel gets a boost with £30m funding

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