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Try out PMC Labs and tell us what you think. Learn More. Decriminalisation could restore public health priorities and human rights. This has provoked an overdue debate, but the same stereotyping, prejudices, myths, and a failure to appreciate the complexity and diversity of sex work and its social contexts persist.

Sex workers around the world continue to be murdered, including about six each year in the United Kingdom. Death and violence are but part of a spectrum of physical and emotional morbidity endured. At issue are human rights and repressive legislation in the UK, thus inviting comparisons with how other countries protect sex workers. Governments and health and social services have a duty of care without discrimination. The UK government was warned of the consequences of its actions from many quarters, but persisted.

The moral debate on sex work is deeply divisive, often denying both a voice and the ability to make choices to the women at its centre. The liberal viewpoint recognises the inevitability and legitimacy of sex work and that choices, even when constrained, are still legitimate. Ethical analysis of prostitution is further obscured by links 4 with other issues including people trafficking, underage sexuality, substance misuse, sexually transmitted disease, and organised crime.

These issues must be uncoupled. Even if these claims of related social harm can be verified and many are disputed 4 9 , prostitution does not cause these; it is prohibition that turns social issues into criminal ones. The harm then is to the sex workers themselves.

John Stuart Mill, who campaigned for repeal of the UK's prostitution laws during the 19th century, stated that demonstration of harm the harm principle should be the basis of defining crime, and therefore the basis of law. The use of antisocial behaviour orders by the Home Office to control prostitution has also forced women into more dangerous locations and isolated them from support services. Comparisons have been made with the Netherlands and Germany, but we should be cautious before transposing models between social systems.

These approaches have not eradicated harm to workers, but merely shifted its focus. The Swedish model, based on abolition, which criminalises men who purchase sex rather than women who provide it, has influenced the UK government's philosophy, but this model is not grounded in reduction of harm to women, 14 16 ignores the welfare of sex workers, and drives markets into more dangerous areas, as in Ipswich.

Surprisingly absent from most proposals is discussion of New Zealand's decriminalised model. In New Zealand and parts of Australia sex work is an occupation with its own health and safety standards. Public health measures must be built on evidence based best practices.

Health and social services have an ethical obligation to ensure universality of access to care, to minimise harm to all, and to be advocates for those they provide care for. Criminalisation of prostitution limits access to health and social care and contravenes United Nations' guidelines on human rights. The status quo in the UK is unacceptable moral cowardice.

The prime minister has opposed reform w8 and stalled demands for the protection of women; he must show leadership and restore human rights by decriminalising all aspects of sex work now. Remedies for social issues surrounding prostitution lie not in legislative measures but in social determinants that limit women's choices, such as wage disparities, access to welfare, and domestic violence.

Gemma, Tania, Anneli, Paula, and Annette were each some mother's daughter w7 and some were mothers. Their deaths were almost inevitable. National Center for Biotechnology Information , U. Journal List BMJ v. Author information Copyright and information Disclaimer. Michael D E Goodyear: ac. This article has been cited by other articles in PMC. References 1. Harcourt C, Donovan B.

The many faces of sex work. Sex Transm Infect ; 81 Peate I. Paying the price: health care and prostitution. Br J Nurs ; 15 Prostitutes are people too. Lancet ; Cusick L, Berney L. Prioritising punitive responses over public health: commentary on the Home Office consultation document. Paying the price.

Crit Social Policy ; 2 Prostitution laws: health risks and hypocrisy. CMAJ ; , Living and working in areas of sex work. London: Joseph Rowntree Foundation, Hepburn M. Prostitution: would legalisation help? BMJ ; Boynton P, Cusick L. Sex workers to pay the price. Home Office. A coordinated prostitution strategy and summary of responses to paying the price.

Roberts MJD. Feminism and the state in later Victorian England. The Historical Journal ; 38 Pivot Legal Society. Beyond decriminalization: sex-work, human rights and a new framework for law reform. Vancouver: Wolfenden J. Crime and sin. BMJ ; 2 Rekert ML. Sex-work harm reduction. Mill JS. On liberty In: Robson JM, ed. Collected works of John Stuart Mill. Toronto: University of Toronto Press, Sex work and the law. Sex Health. Lord Lofthouse of Pontefract.

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A Heated Debate: Theoretical Perspectives of Sexual Exploitation and Sex Work