Public Health Ethics and Liberalism

Abstract

This paper defends a distinctly liberal approach to public health ethics and replies to possible objections. In particular, I look at a set of recent proposals aiming to revise and expand liberalism in light of public health's rationale and epidemiological findings. I argue that they fail to provide a sociologically informed version of liberalism. Instead, they rest on an implicit normative premise about the value of health, which I show to be invalid. I then make explicit the unobvious, republican background of these proposals. Finally, I expand on the liberal understanding of freedom as non-interference and show its advantages over the republican alternative of freedom as non-domination within the context of public health. The views of freedom I discuss in the paper do not overlap with the classical distinction between negative and positive freedom. In addition, my account differentiates the concepts of freedom and autonomy and does not rule out substantive accounts of the latter. Nor does it confine political liberalism to an essentially procedural form.

Adolescents’ Perspectives on Personal and Societal Responsibility for Childhood Obesity — The Study of Beliefs through ‘Serious’ Game (PlayDecide)

“…If the nutritional value of food does not drive food choices, and if food holds multiple meanings for young people, imposing policies based on nutritional choice and weight control as the indicator of personal causal responsibility can be a route to authoritarian health governance. Daniels () has argued that health is a normative concept and a considerable debate is emerging about whether lifestyle‐related health should be treated as a moral compass for adjudging individual responsibility (Barnhill and others, ; Nielsen and Andersen, ; Radoilska, ). World Health Organization () campaign for the ‘whole society’ approach to tackling the issue of childhood obesity and rightly identify the need to develop life‐course approaches that speak to the everyday experiences of the young.…”

Preventing Unintentional Injuries: Ethical Considerations in Public Health

“…Injury prevention strategies that limit individual choice are often seen as paternalistic. Those who place a higher value upon free choice than upon welfare find paternalistic policies objectionable, because, in legislating behaviors, the state tells individuals what to do, as though they are unable to make such decisions for themselves (Radoilska, 2009). Thus, not only is individual choice limited, but individuals are perceived to be treated disrespectfully by paternalist lawmakers.…”

Can Republicanism Tame Public Health?

“…It might however be more difficult to cleave to this ethic in the case of public health than in other policy domains. Many who have questioned the troubled relationship between public health and liberalism have noted that the practice of public health officials sometimes offends against the fact that people's conceptions of the good tend to be pluralistic in character, recognizing the importance, but not the supremacy, of health among the various goods that are fitting objects of human aspiration (Radoilska, 2009). The claim is that public health practice often seems to be premised on the view that health is the most important of all goods.…”