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J R Soc Med. 2004 December; 97(12): 612.
PMCID: PMC1079693

Compulsory helmets for cyclists

Professor Sheikh and colleagues (June 2004 JRSM1) favoured legislation that would compel cyclists to wear helmets. They conceded that the ethical argument was somewhat stronger for children than for adults. Subsequent correspondents questioned the evidence on helmet efficacy and argued that legislation would have negative effects by discouraging the healthful activity of bicycling. When analysing the cost–benefit ratio of legislation we should factor in the full effects which flow from traumatic brain injury, not only to the patient but also to the patient's family and carers.2,3 These involve many levels ranging from the formally quantifiable health costs, through changes in quality and quantity of life, to the less measurable personal, family and social losses. Wearing seat belts in motor vehicles now seems common sense and has reduced the neurological burden imposed by accidents. Wearing helmets by all cyclists should also seem common sense. Combined with public health campaigns on the long-term benefits of exercise, any potential negative impact of mandatory helmet-wearing should disappear. We have already accepted the impositions on our freedom of movement (e.g. airports and elsewhere) brought about by the global terrorist threat. In many countries the risk of traumatic brain injury following a cycle accident may be much greater than a terrorist threat.


1. Sheikh A, Cook A, Ashcroft R. Making cycle helmets compulsory: ethical arguments for legislation. J R Soc Med 2004;97: 262-5 [PMC free article] [PubMed]
2. Hendrie D, Legge M, Rosman D, Kirov C. An economic evaluation of the mandatory helmet legislation. University of Western Australia Public Health Department. []
3. Kneafsey R, Gawthorpe D. Head injury: long-term consequences for patients and families and implications for nurses. J Clin Nurs 2004;13: 601-8 [PubMed]

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