I've never posted on this topic before, but I've witnessed how heated it gets - I'll try to be careful!
Personally: I generally wear one. Sometimes forget to pick it up, and don't always bother on quiet routes. I generally find it really annoying.
My opinion:
1. I think it seems quite likely that helmets will help reduce some injuries and deaths*** (the nuances of impact speeds, cyclist confidence, etc all seem a little pointless).
2. Getting the bus or car instead of cycling is harmful (less exercise, more dangerous for the remaining cyclists through more traffic and no 'group' effect).
3. Making helmets mandatory is very likely to reduce the number of people cycling - I can't imagine you'll ever head towards Amsterdam-numbers if helmets were mandatory*.
So putting those together, for the individual** rating the courses of action (excluding things like how annoying carrying a helmet around is, how sweaty it can make your head, etc):
First: Ride a bike wearing a helmet (best option).
Second: Ride a bike not wearing a helmet (probably not quite as safe).
Third: Don't ride a bike at all (very dangerous, far more likely to have a variety of illnesses associated with lack of exercise).
For society, the best option is to have as many people cycling as possible (regardless of helmet use) - ideally I guess everyone would have helmets on, although if you improved infrastructure sufficiently they would be unnecessary. The worst option would be to have few people cycling (with or without helmets).
In summary: In my opinion the health benefits of cycling without a helmet still outweigh the associated dangers.
And so: Individuals should be encouraged to, but making it mandatory would harm more people (through no exercise, pollution, traffic, etc) than it would protect.
Regarding Uberuce's point about the NHS etc. The path of excluding people who do an "avoidable risk", or at least tax them sufficiently is dangerous. Poor diet has already been cited. Would those who don't do enough exercise be barred from the NHS if they get a related disease? Would people who have hurt themselves while doing exercise also be excluded?**** Basically most illnesses/injuries can be avoided to an extent, and none of us are perfect. I imagine very few people would be permitted treatment under the imagined system.
At the end of the day: Treating everyone (however stupid they've been - and people can do really stupid things) seems like the best policy :)
Thanks all!
Mike
* There are some bits of evidence from countries that did enforce helmets - although I guess this is confounded by other factors too. But anecdotally, things like the London bike hire scheme would completely fail. My office mate when asked said she'd not ride a bike because of helmet hair! Also it makes cycling look dangerous, etc.
** I'm excluding that people might not wear helmets because they feel it gives cycling a poor image, and are willing to take the small risk to encourage the 'normalisation' of cycling.
*** If you cycle sufficiently slowly (as many people appear to) helmets are probably even less important (especially if it's off road etc).
**** Another example is pedestrians not wearing helmets - 100s of pedestrians die each year from avoidable head injuries...
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