Monday 18 October, 7.00pm until 8.30pm, Royal Society of Medicine, 1 Wimpole Street, London W1G 0AE
Venue: Royal Society of Medicine, 1 Wimpole Street, London W1G 0AE
Tickets: Free, tickets are available from the Institute of Ideas website.
In the Green Paper A Healthier Nation, Prime minister David Cameron declared ‘many of our most severe health problems are caused…by wrong personal choices’. From the national smoking ban in public places, to local authorities designating certain streets and parks booze-free zones, the urge to legislate against ‘wrong personal choices’ has grown ever stronger in recent years. While some saw such Nanny State-ism as peculiar to New Labour, the new coalition has announced that it too will encourage the public ‘to make the right choices about what they eat, drink and do in their leisure time’. Despite the language of right and wrong, we are reassured that this is not moralism. Policy-makers are simply responding to what the latest research shows. But the type of evidence cited, and the conclusions drawn, reflect a broader change in the role of public health. Where once it was about society-wide schemes such as mass vaccinations or sanitation, now its focus is on micro-managing individuals’ lifestyle choices. As primary health care has shifted away from diagnosis and treatment towards managing patients’ behaviour to prevent future illnesses, GPs are often on the front line of delivering endless evidence-based ‘advice’ as to how patients should live.
Critics object that in this context, medical evidence has become politicised. Indeed, Richard Smith, former editor of the British Medical Journal, and one of the experts responsible for government recommendations on how many ‘units’ of alcohol we should drink, has admitted the figures were ‘plucked out of the air’. When research published in April showed the much-vaunted ‘five a day’ (portions of fruit and vegetables) confers only marginal health benefits, campaigners insisted the advice should be promoted anyway, to drum home a wider message about obesity and junk foods. And while politicians have embraced ‘evidence-based policy’, when government advisor David Nutt went off-message on drugs policy, he was punished for overstepping his jurisdiction.
How far can evidence go in deciding what is a ‘right’ or ‘wrong’ choice? The consensus seems to be that healthy means good, regardless of anything else. Healthy, clean-living restraint may appeal to some, but others may feel more sympathy for Clement Freud’s famous quip that in giving up life’s irresponsible pleasures, ‘You don’t actually live longer; it just seems longer’. Do preventative health initiatives risk becoming moralism in disguise, or are they simply a responsible way of stopping people harming themselves? Are politicians offloading responsibility and avoiding debate over contentious policies by variously citing and blaming scientific evidence? With advances in medical technology, might we find cures and treatments for conditions caused by ‘unhealthy living’, saving us the trouble of changing our behaviour? What role should the latest evidence play in forming public health policy?
The session will be introduced by Claire Fox, director of the Institute of Ideas.
journalist and writer; co-writer and performer, BrainSex, Humans V Nature: Engineering FTW! and Your Days Are Numbered: the maths of death
director, Straight Statistics; columnist, British Medical Journal; former health editor, The Times
|Dr Amanda Killoran|
public health analyst, National Institute for Health and Clinical Excellence; co-editor, Evidence-based Public Health: effectiveness and efficiency
|Dr Jon Rohrer|
member, Royal Society of Medicine Council; neuroscience researcher; neurology trainee
executive director and member of executive committee, Centre for Science and Policy, University of Cambridge
associate fellow, Institute of Ideas
'Is it in a peer-reviewed journal?' journalists are meant to ask themselves before launching into another story about rice pudding causing cancer, or chocolate prolonging life. The truth is that peer review is largely hokum.Nigel Hawkes, Independent, 22 August 2010
Cardiologists propose putting pills beside salt and ketchup to balance heart disease riskDenis Campbell, Guardian, 12 August 2010
But even where the science is clear cut, how far should we go to cut our life according to its (potential) optimum length? Is it not a matter of personal choice whether we choose to risk our life and health by indulging in pies, whisky and cigarettes (or, for that matter, canoeing, ecstasy and hang gliding)?Timandra Harkness, Prospect, 9 August 2010
The spat over how officialdom should refer to plump people overlooks the fact that it should be none of its business how much we weigh.Rob Lyons, spiked, 6 August 2010
Could financial incentives that encourage fat people to lose weight solve the obesity crisis?Liz Hollis, Prospect, 22 July 2010
Government health advisers urge doctors to monitor patients' drinking habits as a matter of routineDenis Campbell, Guardian, 3 June 2010