The years of magical thinkingBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4678 (Published 11 November 2009) Cite this as: BMJ 2009;339:b4678
All rapid responses
Delamothe’s (1) cogent and pithy essay is the second article (2) to
appear in the BMJ commenting on the triumph of ideology over evidence in
UK health policy in the wake of the sacking of Prof David Nutt. Neither
article has however mentioned the area in which this is most apparent in
virtually all current policy– namely sexual health.
To take just two examples:-
1) The vast majority of studies show that in those US states which
have introduced laws making parental notification (not consent) mandatory
before abortions are performed in underage girls, there are significant
decreases in overall conception rates(3), in underage abortion rates (4),
and in rates of teenage STIs(5).
This evidence however is totally ignored by UK government who are
determined to promote children’s rights over parental responsibility in
the education and healthcare of underage young people for sexual behavour.
2) The gross failings of the chamydia screeing programme in UK were
recently highlighted (6) including the waste of £17m and poor uptake
rates. Even with adequate uptake however, the 3 month reinfection rate
after treatment is 30% in those who don’t use condoms consistently and 15%
in those who do (7). Without primary prevention programmes, all efforts
being channeled into screening for chlamydia are destined to remain
fruitless in reducing the incidence of the disease.
With the latest UK figues showing an increase of a third in underage
teenage abortions (8) and continuing rises in underage STIs, there is
surely much more evidence to call for the sacking of the head of the
incompetent Advisory Group on Sexual Health than for the sacking of the
unfortunate Professor Nutt.
1.Delamothe T 2009 The years of magical thinking BMJ 339 1117
2.Colquhoun D 2009 The highs and lows of policy based evidence BMJ
3.Levine P 2003 Parental involvement laws and fertility behavior.
Journal of Health Economics 22 861-78
4.Joyce T et al 2006 Changes in abortions and births and the Texas
Parental Notification Law. New EnglandJournal of Medicine 354 10 1031-38
5.Klick J, Stratmann T 2008 Abortion access and risky sex among
teens: parental involvement laws and sexually transmitted diseases.
Journal of Law, Economics and Organization 24 2-21
6.Mayor S 2009 Chlamydia screening in young people fails to reduce
prevalence BMJ 339 b4736
7.Paz-Bailey G, Koumans EH, Sternberg M et al 2005 The effect or
correct and consistent condom use on chlamydial and gonoccocal infection
among urban adolescents Arch Ped and Adol Med 159 536-542
8.Institute for Family Policies 2009 Evolution of the Family in
Competing interests: No competing interests