Dear Editor

Whilst I agree with much of this response to the recent government proposal of violence against the UK’s disabled population, I am yet again disappointed that carers are erased from the discourse. Especially distressing and frustrating that this is coming from a significant representative of the medical community.

According to carersuk.org 60% of carers have a long term health condition or disability, and “the rate of poverty amongst unpaid carers is 50% higher in comparison to those who do not provide unpaid care”. These cuts will push families such as mine (a disabled lone parent caring for disabled adult children) into crisis. I don’t have a choice but to provide care and support, they are my children. The lack of consideration for the subsequent impact on carers health and wellbeing is always shocking to me. We plug the gaps poor health care leaves, which often detrimentally impacts our own health. Unpaid carers are subject to the same poor health care provision as the people we care for. Currently we’re already impacted by benefit cuts given Carers Allowance is effectively taken from our universal credit each month, pound for pound, and replaced with a UC premium around half its value.
Any discourse around systemic failures in health and social care and the benefits system MUST include unpaid carers. It’s our labour that plugs the gap. Literally our bodies. Until a consideration of unpaid carers is made at foundational levels of the medical community you’re failing service users and carers, and failing to move towards a healthier nation.

Give solid consideration to my response before replying.

Regards
Abby

Dear Editor,

We share the conclusions of this article but want to add our concerns. The recent decision by the Trump administration to identify the words they don’t like to be used in official communication by civil servants or scientists, are no less than a kind of peekaboo, but this time, a decision with dramatic consequences. Flagging certain words like "racism", “health equity” or “injustice" raises significant issues. While the Trump administration is playing peekaboo, the reality is that injustice or inequities in health care and beyond still do exist. The problem is no one is allowed to denounce it or link certain politics to unfair allocation of means, chances or capabilities. These situations are damaging and hurt, especially “people in vulnerable situations”. Today in the US, conducting research on that, making reports of it and taking action to improve the situation in the field, is no longer possible, at least doing it openly. It sets a huge burden, not only for science and health care in the US but also abroad and for people worldwide collaborating with American scientists and healthcare professionals. Some institutions already change the names of their departments or units to escape censorship. Understandably, this means that the identity and scientific scope of these institutes is likely to disappear or induce a 'culture of double speak'.

Flagging words is an ideological gesture the Trump administration pretended to fight, shouting out loud how, in their view, “wokism” had put us in a situation where people were cancelled because they used certain vocabulary. While wokism had for sure certain radical outbursts, it had the merit of pointing us to existing discrimination of people, at an individual or systemic level. Playing peekaboo does not have this merit. It only puts us in a situation of censorship and denial of reality.

Using a list of flagged words is a symptom of what French philosopher Michel Foucault called the representation of a shift in the “episteme” of a certain era. As the shift in our era restricts the language available to scientists and healthcare workers, thereby limiting their ability to address and communicate about inequities and injustices in health care, we are worried about the repercussions for the future of science and health care in the US and globally. We are worried because if we are no longer able to address inequities and injustices effectively, the consequences will be dramatic. The potential negative impact on patient care and outcomes is huge. Next to that, censoring existing unfairness can reduce public awareness and understanding of critical social issues and therefore also the support of the public for policy making to reduce inequity and injustice, leading to more sickness, poorer quality of life and a higher mortality rate within society.

By raising our voices and keeping on telling the world the narratives which represent the ongoing reality behind the peekaboo, we want to challenge the atrocities of the Trump policies that undermine the ability to address health disparities and promote social justice. Foremost, we don’t do this because of certain political ideas. We simply want to safeguard the principles of equity, solidarity, justice, and integrity for patients in our healthcare systems since they are a matter of democracy and basic rights, which should be evident in our era. Unfortunately, they are not.

We therefore call scientists, scientific journals, health care professionals and policy makers to spread the word - pun intended - and withstand the evolution sketched above. We need to stand up against the censorship by engaging ourselves to fight against injustice and inequity, in health care and in society in general.

Dear Editor

After banning corporal punishment, what else do we need to do?

Every child deserves to grow up in safety, but how can the law truly be their shield? A recent opinion article called for an amendment to the bill to ban corporal punishment of children in England altogether (1). This is undoubtedly a big step forward, but after reading the article, I felt a little uneasy: If the law is passed, then what?

The core logic of the article is clear and powerful—to remove the "reasonable punishment" defense and free children from violence just as much as adults (2). The authors support this with positive data from other countries that have banned corporal punishment, such as Finland and Sweden, where rates of corporal punishment have declined. This is compelling, but the problem is that these countries did not succeed solely on the basis of a ban. There is a whole support system behind them, from rental education to changing social attitudes. The article says almost nothing about it.

Will a law banning corporal punishment end violence?
The authors' assumption that changes to the law will automatically lead to behavioral change may be too optimistic. Imagine that a parent who is used to beating and scolding is suddenly told that "this is illegal, but there are no alternative methods; the result may be twofold: either fear of the law to suppress emotions, accumulating greater family conflicts, or going "underground" and hiding the violence. The real challenge is not the legislation itself, but getting it on the ground.

More important than a ban is teaching people "how not to use corporal punishment."
Corporal punishment often stems from a sense of powerlessness—when parents or teachers don't know how to respond to a child's behavior, violence becomes the quickest "solution." After the prohibition of corporal punishment, society needs to provide more specific tools. Schools have added emotional management courses to help teachers deal with classroom conflict. The cost, resource allocation, and policy coherence of these measures are not covered in the article. Without support, laws can become castles in the air and even add to educators' frustration.

Beyond the law, a 'gentle revolution' is needed.
The deeper problem is that the legitimacy of corporal punishment has long been rooted in the cultural notion of "spare the rod, spoil the rod." Laws can be changed overnight, but it takes time to change hearts. The article, on the other hand, only focuses on the parliamentary vote but ignores the importance of mass mobilization and cultural reconstruction. Without public support, the new law may face enforcement resistance and even be stigmatized as "government interference in parenting."

Conclusion: Give the law a pair of walking shoes.
A ban on corporal punishment is necessary, but the law cannot go it alone. What is needed is not just a ban but a one-two punch: from a family education resource pack to a community support network to a reshaping of public awareness. Only in this way can the law be transformed from justice on paper into a smile on the face of a child. Otherwise, the perfect article may stumble in reality—and the price will eventually be borne by the child.

References
1. Rowland A G, Hastie G. Amend the Children’s Wellbeing and Schools Bill to protect children from assault BMJ 2025; 388 :r566 doi:10.1136/bmj.r566.
2. Smith, Anne B. "The state of research on the effects of physical punishment." Social Policy Journal of New Zealand 27 (2006): 114.

Dear Editor,

I thank Professor Yong Wu for highlighting key points from our recent article advocating the shift from "non-pharmaceutical interventions" (NPIs) to the more descriptive and inclusive term "public health and social measures" (PHSMs).

As Professor Wu emphasises, the Covid-19 pandemic has underscored the critical role that comprehensive public health strategies play. China's "dynamic zero-Covid" strategy aimed to integrate traditional public health approaches with innovative solutions such as rapid contact tracing, big data analytics, and active community participation. I agree with Professor Wu that categorising such nuanced strategies merely as NPIs inadequately conveys their complexity and importance.

I also appreciate Professor Wu’s recognition of the risks associated with prematurely relaxing these measures, as shown by the spike in global cases following the emergence of the Omicron variant. This illustrates the continued necessity and effectiveness of PHSMs, even in a context where vaccines and other pharmaceutical interventions are available.

Professor Wu’s point regarding the potential negative implications of overly restrictive or prolonged measures is also important. It reinforces the need for balanced and nuanced communication to ensure that public health measures are proportionate, equitable, and sensitive to their economic and social impacts. The shift in terminology from NPIs to PHSMs is indeed intended to facilitate clearer public understanding, promote interdisciplinary collaboration, and emphasise the social dimensions integral to the success of these interventions.

I appreciate Professor Wu’s support for this terminological shift and echo the call for a continued evolution in our language and practices in public health. Such changes not only improve clarity and consensus but also support more effective, equitable and sustainable public health strategies moving forward.