There are strong reasons for promoting the use of pedal cycles in Britain, including that it is ‘beneficial to health’ and is one of the most ‘ecologically friendly’ modes of transport. But is it safe? In the June issue of the Journal of the Royal Society of Medicine, Professor Aziz Sheikh at the University of Edinburgh and colleagues discuss the public’s risk of head injury and the ethics behind legislation making helmets mandatory for all cyclists.
Are cycle helmets effective?
The question of whether cycle helmets offer protection against serious head injury has been ‘hotly debated.’ Studies have ‘indicated that helmets offer substantial protection’ and reveal ‘a strong association between increasing helmet use and declining rates of injury.’ Although critics have suggested that helmets may give cyclists a ‘false sense of security,’ there is no evidence to support this claim.
The ethical debate: individual autonomy versus ‘collective benefits’
Professor Sheikh argues that although a law requiring helmets to be worn by all cyclists is a ‘moderate inconvenience,’ there are benefits for individuals and society. Legislation, as opposed to voluntary use programmes, have proven the most ‘effective way of realising the benefits of cycle helmets’ in some Canadian provinces, US states, Australia and New Zealand. Not only do more people wear helmets, but more importantly the overall number of head injuries is reduced. The possibility that cycling will decrease in popularity as a result, or that legislation will infringe on the cyclist’s autonomy or civil liberties has been considered. The author claims, ‘In principle, legislative intervention should be efficient in achieving the aim of protecting cyclists while not adversely affecting patterns of cycle usage.’ He also stresses that the law would need to be enforced in a fair and ‘equitable’ way and must give individuals enough time to comply.
Legislation for young cyclists only
One proposed option for legislation is a law that ensures only children are required to wear helmets. ‘This case has some merit,’ the authors say. ‘The autonomy considerations are weaker,’ Professor Sheikh writes, ‘and we have a general obligation to promote the welfare of children.’ However, although adults may comply to support their children’s use of helmets, responsible adults may be penalised and this could cause ‘much resentment and dispute.’ Additionally, if the law applies only to children it may encourage a ‘rite of passage effect’ whereby older children ‘abandon helmets to signify maturity.’ This situation is likely to undermine the secondary policy aim to make helmets compulsory for children by trying to enforce helmets on adults without challenging their ‘legal liberty and moral autonomy.’
Due for a second reading in the House of Commons on 18 June, a Protective Headgear for Young Cyclists Bill has been introduced to Parliament this year. Professor Sheikh responds, ‘Whilst I welcome the new legislation with respect to children on the grounds that it is likely to reduce the risk of serious head injuries, I would like to see it extended to adults as they also stand to benefit from the use of protective headgear when cycling.’Read the full article