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Public Health

Oxford Debates – The NHS should not treat self-inflicted illness (Moderator’s Introduction)

Moderator: Dr Paula Boddington

Should the NHS treat self-inflicted illness? This question raises a plethora of different issues, about science, society, social policy, as well as philosophical questions about human nature and individual freedom.

The best use of health care resources will always be debated. How much money should be spent on health? How efficiently can it be spent? How should it be divided within the healthcare system? These can never simply be questions of economics but also raise vitally important questions about values. This debate about what treatments the NHS should offer is taking place in an economic climate where there is a call to curtail public spending. Would refusing to treat self-inflicted illnesses be a fair place to start to save money?

But money is only one aspect of this debate.

Read More »Oxford Debates – The NHS should not treat self-inflicted illness (Moderator’s Introduction)

More on drugs…

In a recent
entry on this weblog, Roger Crisp discusses the recent and controversial
“Release” advertising campaign on drugs (and its slogan “Nice People Take
Drugs”),
and rightly highlights the need for serious and widespread debate on drug
legislation. My home country, Switzerland, precisely had a debate on this issue
a few months ago, when we were called to vote on a popular initiative
purporting to decriminalize the use, purchase, consumption and possession of
cannabis (not of other drugs) – which would have meant placing the consumption
of this drug on a similar plane with that of tobacco or alcohol. This measure
was supposed to be accompanied by others, notably destined to protect young
people. On the 30th of November 2008, however, the Swiss people
rejected the initiative by quite a large majority.

Read More »More on drugs…

Nice People Take Drugs (Too)

The drug and human rights charity *Release* recently launched an advertising campaign in which the slogan ‘Nice People Take Drugs’ was displayed on the sides of London buses. Their aim was to encourage society to face up to the reality that a huge proportion of the population does at least experiment with drugs and to combat the popular assumption, which underlies a good deal of political rhetoric and media coverage, that since drugs are simply ‘evil’ there is no point in seriously debating drug policy. Those ads are now being withdrawn by the company that booked the space, after advice from the Committee of Advertising Practice: http://www.guardian.co.uk/media/2009/jun/09/nice-people-drugs-ads-pulled

Apparently, Release has been told that their strap-line would be more acceptable if it included the word ‘too’. This suggests that the CAP may have felt that the public would read the original claim as equivalent to ‘All those who take drugs are nice people’. But even adding the word ‘too’ may not be enough. For the new sentence might be read as: ‘All nice people take drugs, along with other things (such as holidays when they can, advice when they need it, offence when people are rude to them, etc.).’ Of course, no one would have understood either the new or the old sentence in these ways. But in fact, though it should be up to Release how they word their strap-line (the censorship charge they have made doesn’t seem far-fetched), adding ‘too’ does bring out more clearly what they want to say: that we should stop demonizing drug-takers and have an open, impartial, and well-informed debate.

Read More »Nice People Take Drugs (Too)

The flu paradox: is the WHO focusing too little on flu?

The WHO is in the news these days thanks to the H1N1 epidemic (alias the swine flu, or the Colbert flu), and it is doing an admirable job coordinating various national agencies in fighting a pandemic. Historically it has been at the forefront of fighting epidemic disease, whether tuberculosis or AIDS. However, since Gro Harlem Brundtland's director-generalship 1998-2003 there has been an increased emphasis on public health, in particular fighting alcohol and tobacco use but also traffic accidents. Has the WHO aimed at the right or wrong problems?

Read More »The flu paradox: is the WHO focusing too little on flu?

Be mindful of results, not the method

David King warns that we should modify society, not childrens' brains. This is a response to a recent Radio 4 documentary on "the criminal mind", which discussed recent evidence for biological underpinnings of some forms of antisocial behaviour and the possibility of reducing it using vitamins, drugs or early interventions. Dr King quite rightly points out that the image given by the program tends to oversimplify things and promote a reductionistic view of the causes of crime. But he also appears to contend that complex social problems cannot be solved through biological interventions. In this he is likely wrong.

Read More »Be mindful of results, not the method

Educating children on matters of food

As evidenced by recent declarations by the Children’s Secretary (see here and here),
the British government is determined to fight childhood obesity and to initiate
nothing less than a “lifestyle revolution”, resulting in more children leading
a healthy and active life. With this aim in view, a free cookbook was recently distributed to 11
year-olds by the Department for Children, Schools and Families. In
addition to that, from 2011
cookery lessons will be compulsory in England's secondary schools for children
aged 11 to 14, and £3.3 million will be invested in order to
recruit and train people capable of teaching cooking skills to children.
Parents are also urged to teach their children how to prepare meals from
scratch.

These are certainly sensible steps to take. With nine out of 10 British adults
and two-thirds of children expected to be overweight or obese by the year 2050
unless action is taken (http://www.guardian.co.uk/society/2008/jul/30/obesity),
we are clearly dealing with an important public health issue. And given the
significance of the link between excess weight and an unhealthy diet (lack of
exercise being another major contributing factor), it seems clear that we should
teach children what a healthy diet consists in and equip them not to be dependent on
the local fast-food chain when the time of the next meal comes. We can hope
that the government’s scheme will help to achieve this, and that parents will
follow the lead – though it is also necessary that the meals provided in school
canteens be in keeping with those aims. However, I would like to suggest that
these steps should form part of a wider project meant to educate children on
matters of food. We want our children to be healthy, but we should also want
them to become autonomous and ethically responsible eaters (and, more
generally, consumers).

Read More »Educating children on matters of food

Travelling for Treatment

A BBC report today suggests that “many” UK couples are going overseas to choose the sex of their children. What seems most odd about this is that in some cases they go to places where sex selection is illegal.

What is interesting here is the fascination with what people do when they go overseas or why they go overseas. There are a whole range of stories about Britons going overseas to get things that they cannot get in the UK – or cannot get in the UK as cheaply. The obvious examples are sex selection, assisted suicide or treatments not available on the NHS.

Read More »Travelling for Treatment

Knowledge may be power, but is it healing?

The
explosion of medical information on the internet is a good thing,
right?  Patients worried that their condition
is not being taken seriously, those who want a second opinion but are worried
about upsetting their GP by asking for it, and those with symptoms too trifling
or embarrassing to take to a doctor—all these people who, fifteen years ago, may
have felt at a dead end with the medical profession can now use
the internet to research their conditions from the comfort of their own homes.

Read More »Knowledge may be power, but is it healing?