Human cloning laws, human dignity and the poverty of the policy making dialogue

BACKGROUND: The regulation of human cloning continues to be a significant national and international policy issue. Despite years of intense academic and public debate, there is little clarity as to the philosophical foundations for many of the emerging policy choices. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity. DISCUSSION: The author critiques one of the most commonly used ethical justifications for cloning laws – the idea that reproductive cloning necessarily infringes notions of human dignity. He points out that there is, in fact, little consensus on point and that the counter arguments are rarely reflected in formal policy. Rarely do domestic or international instruments provide an operational definition of human dignity and there is rarely an explanation of how, exactly, dignity is infringed in the context reproductive cloning. SUMMARY: It is the author's position that the lack of thoughtful analysis of the role of human dignity hurts the broader public debate about reproductive cloning, trivializes the value of human dignity as a normative principle and makes it nearly impossible to critique the actual justifications behind many of the proposed policies

Evidence for physical activity guidelines as a public health intervention: efficacy, effectiveness and harm – a critical policy sciences approach.

BACKGROUND: Evidence for the efficacy of physical activity in conferring health benefits is unequivocal, and this has led national governments to produce guideline recommendations for physical activity levels in their populations. AIM: To evaluate how far evidence for the efficacy, effectiveness and comparative effectiveness of current physical activity guideline recommendations as a public health intervention is considered in developing guideline recommendations, including a consideration of the extent to which, in comparison to alternatives, they may result in harm. METHODS: Utilising a critical policy sciences approach, national physical activity guideline recommendations in Australia, the UK and the USA, and those of the World Health Organisation, are examined, along with their stated underlying evidence bases, to analyse what evidence has been considered, how it has been interpreted, for what purpose, and with what outcomes. RESULTS: All current guidelines recommend 150 minutes moderate physical activity per week. However, efficacy evidence shows 60 minutes is sufficient to provide some health benefits. None of the guidelines consider effectiveness evidence nor potential effectiveness. No evidence could be found for the effectiveness of a recommendation of 150 minutes in improving population health, and none of the guidelines consider whether a recommendation at a lower but still sufficient level of efficacy (e.g. 60 minutes) would be a more effective public health intervention. CONCLUSIONS: Evidence considered in drawing up physical activity guidelines relates only to the efficacy of physical activity in conferring health benefits. The lack of effectiveness evidence, the failure to consider potential effectiveness, and related un-evidenced value judgements call into question the claim that the guidelines are evidence-based. Because neither effectiveness nor comparative effectiveness is considered, it is possible that current guidelines of 150 minutes may result in net harm to population health in comparison to the opportunity cost of recommendations at alternative levels

Public, private and personal: Qualitative research on policymakers' opinions on smokefree interventions to protect children in 'private' spaces

<p>Abstract</p> <p>Background</p> <p>Governments use law to constrain aspects of private activities for purposes of protecting health and social wellbeing. Policymakers have a range of perceptions and beliefs about what is public or private. An understanding of the possible drivers of policymaker decisions about where government can or should intervene for health is important, as one way to better guide appropriate policy formation. Our aim was to identify obstacles to, and opportunities for, government smokefree regulation of private and public spaces to protect children. In particular, to seek policymaker opinions on the regulation of smoking in homes, cars and public parks and playgrounds in a country with incomplete smokefree laws (New Zealand).</p> <p>Methods</p> <p>Case study, using structured interviews to ask policymakers (62 politicians and senior officials) about their opinions on new smokefree legislation for public and private places. Supplementary data was obtained from the Factiva media database, on the views of New Zealand local authority councillors about policies for smokefree outdoor public places.</p> <p>Results</p> <p>Overall, interviewees thought that government regulation of smoking in private places was impractical and unwise. However, there were some differences on what <it>was </it>defined as 'private', particularly for cars. Even in public parks, smoking was seen by some as a 'personal' decision, and unlikely to be amenable to regulation. Most participants believed that educative, supportive and community-based measures were better and more practical means of reducing smoking in private places, compared to regulation.</p> <p>Conclusions</p> <p>The constrained view of the role of regulation of smoking in public and private domains may be in keeping with current political discourse in New Zealand and similar Anglo-American countries. Policy and advocacy options to promote additional smokefree measures include providing a better voice for childrens' views, increasing information to policymakers about the harms to children from secondhand smoke and the example of adult smoking, and changing the culture for smoking around children.</p