Political Theory, Values and Public Health

Abstract

This article offers some general criticisms of the idea that any political theory can legitimate public health interventions, and then some particular criticisms of Civic Republicanism as a political theory for public health. Civic Republicanism, I argue, legitimizes liberty-infringing public health interventions by demanding high levels of civic engagement in framing and reviewing them; to demand such engagement in pursuit of such a baseline value as health will leave insufficient civic energy for the pursuit of higher values.

Civic republican medical ethics

“…Discussing republican public health ethics, Stephen Latham tell us that, ‘Non-domination, as Oscar Wilde might have said, will take a lot of evenings’ 31. He believes that the provision of health is best left to competent governments who we are able to replace if necessary.…”

“…Furthermore, he notes that the sheer willingness of citizens to hold those with power to account can often be an effective constraint—exercising a ‘virtual influence’ on healthcare policy. Nevertheless, Latham asks: Might it not be better for a government simply (and paternalistically) to give the people the health—and the security, and the peace—they need, without demanding their legitimising engagement in that project, in a way that leaves them free to engage their attentions and cultivate their virtues in pursuit of higher, weaker values?32…”

“…Might it not be better for a government simply (and paternalistically) to give the people the health—and the security, and the peace—they need, without demanding their legitimising engagement in that project, in a way that leaves them free to engage their attentions and cultivate their virtues in pursuit of higher, weaker values?32…”

Republicanism and the Paradox of Public Health Preconditions Comments on Steve Latham

“…Proponents of the role of republican ideas in public health ethics, law and policy, such as Bruce Jennings (2007), argue republican thinking has the necessary resources to legitimate public health interventions. Latham disagrees, however, because 'Civic Republicanism's concern with non-dominance will lead any Civic Republic to expend all its citizens' energies merely in maintaining themselves as free' (Latham, 2016). On the republican view, the pursuit of health requires a constant intensive engagement of each citizen in political life, leaving little or no time to employ their healthy body to further their respective life plans.…”

“…Latham substantiates his argument with the assistance of Nicolai Hartmann's (2003) hierarchical theory of value. In particular, Latham is interested in 'Hartmann's distinction between "high" values and "strong" values, and his claim that height and strength of values are in inverse proportion to one another' (Latham, 2016). Following Hartman's theory, a value is 'high' if its achievement confers great merit, and a value is 'strong' if being deprived of it is considered a great wrong.…”