A broader liberty: J.S. Mill, paternalism and the public's health

L. O. Gostin, K. G. Gostin

Research output: Contribution to journalArticle

Abstract

Is the 'harm principle', famously propounded by J.S. Mill and widely adopted in bioethics, an appropriate principle to guide public health regulation? The harm principle limits liberty-limiting interventions to those instances where the person poses a significant risk of harm to others. However, much of public health regulation is not primarily directed to avert risk to others, but to safeguard the health and safety of the individual him- or herself. Regulations regarding seatbelts, motorcycle helmets and the fluoridation of water are examples of pervasive public health regulations that are primarily intended to safeguard the individual's own health or safety. Even laws designed to reduce smoking are justified, at least in substantial part, by the reduction of risk to the smoker. Certainly, scholars argue that there are 'other-regarding' aspects to these types of laws, but there is little doubt that there are strong paternalistic features to these, and many other public health laws, such as bans on trans fat in foods. This article directly and forcefully questions the Millian principle, making the case for hard paternalism. When seen from a population-based perspective that counts the number of lives saved, paternalism becomes a plausible justification for interventions that do not pose a truly significant burden on individual liberty, but go a long way towards safeguarding the health and well-being of the populace.

Original languageEnglish (US)
Pages (from-to)214-221
Number of pages8
JournalPublic Health
Volume123
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

Fingerprint

Paternalism
Public Health
Health
Motorcycles
Fluoridation
Safety
Head Protective Devices
Bioethics
Risk Reduction Behavior
Smoking
Fats
Food
Population

Keywords

  • Harm principle
  • J.S. Mill
  • Paternalism
  • Public health
  • Regulation
  • Risk

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

A broader liberty : J.S. Mill, paternalism and the public's health. / Gostin, L. O.; Gostin, K. G.

In: Public Health, Vol. 123, No. 3, 03.2009, p. 214-221.

Research output: Contribution to journalArticle

Gostin, L. O. ; Gostin, K. G. / A broader liberty : J.S. Mill, paternalism and the public's health. In: Public Health. 2009 ; Vol. 123, No. 3. pp. 214-221.
@article{e7fea4f352fc4e98a1c0d10a0119197f,
title = "A broader liberty: J.S. Mill, paternalism and the public's health",
abstract = "Is the 'harm principle', famously propounded by J.S. Mill and widely adopted in bioethics, an appropriate principle to guide public health regulation? The harm principle limits liberty-limiting interventions to those instances where the person poses a significant risk of harm to others. However, much of public health regulation is not primarily directed to avert risk to others, but to safeguard the health and safety of the individual him- or herself. Regulations regarding seatbelts, motorcycle helmets and the fluoridation of water are examples of pervasive public health regulations that are primarily intended to safeguard the individual's own health or safety. Even laws designed to reduce smoking are justified, at least in substantial part, by the reduction of risk to the smoker. Certainly, scholars argue that there are 'other-regarding' aspects to these types of laws, but there is little doubt that there are strong paternalistic features to these, and many other public health laws, such as bans on trans fat in foods. This article directly and forcefully questions the Millian principle, making the case for hard paternalism. When seen from a population-based perspective that counts the number of lives saved, paternalism becomes a plausible justification for interventions that do not pose a truly significant burden on individual liberty, but go a long way towards safeguarding the health and well-being of the populace.",
keywords = "Harm principle, J.S. Mill, Paternalism, Public health, Regulation, Risk",
author = "Gostin, {L. O.} and Gostin, {K. G.}",
year = "2009",
month = "3",
doi = "10.1016/j.puhe.2008.12.024",
language = "English (US)",
volume = "123",
pages = "214--221",
journal = "Public Health",
issn = "0033-3506",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - A broader liberty

T2 - J.S. Mill, paternalism and the public's health

AU - Gostin, L. O.

AU - Gostin, K. G.

PY - 2009/3

Y1 - 2009/3

N2 - Is the 'harm principle', famously propounded by J.S. Mill and widely adopted in bioethics, an appropriate principle to guide public health regulation? The harm principle limits liberty-limiting interventions to those instances where the person poses a significant risk of harm to others. However, much of public health regulation is not primarily directed to avert risk to others, but to safeguard the health and safety of the individual him- or herself. Regulations regarding seatbelts, motorcycle helmets and the fluoridation of water are examples of pervasive public health regulations that are primarily intended to safeguard the individual's own health or safety. Even laws designed to reduce smoking are justified, at least in substantial part, by the reduction of risk to the smoker. Certainly, scholars argue that there are 'other-regarding' aspects to these types of laws, but there is little doubt that there are strong paternalistic features to these, and many other public health laws, such as bans on trans fat in foods. This article directly and forcefully questions the Millian principle, making the case for hard paternalism. When seen from a population-based perspective that counts the number of lives saved, paternalism becomes a plausible justification for interventions that do not pose a truly significant burden on individual liberty, but go a long way towards safeguarding the health and well-being of the populace.

AB - Is the 'harm principle', famously propounded by J.S. Mill and widely adopted in bioethics, an appropriate principle to guide public health regulation? The harm principle limits liberty-limiting interventions to those instances where the person poses a significant risk of harm to others. However, much of public health regulation is not primarily directed to avert risk to others, but to safeguard the health and safety of the individual him- or herself. Regulations regarding seatbelts, motorcycle helmets and the fluoridation of water are examples of pervasive public health regulations that are primarily intended to safeguard the individual's own health or safety. Even laws designed to reduce smoking are justified, at least in substantial part, by the reduction of risk to the smoker. Certainly, scholars argue that there are 'other-regarding' aspects to these types of laws, but there is little doubt that there are strong paternalistic features to these, and many other public health laws, such as bans on trans fat in foods. This article directly and forcefully questions the Millian principle, making the case for hard paternalism. When seen from a population-based perspective that counts the number of lives saved, paternalism becomes a plausible justification for interventions that do not pose a truly significant burden on individual liberty, but go a long way towards safeguarding the health and well-being of the populace.

KW - Harm principle

KW - J.S. Mill

KW - Paternalism

KW - Public health

KW - Regulation

KW - Risk

UR - http://www.scopus.com/inward/record.url?scp=61849095287&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61849095287&partnerID=8YFLogxK

U2 - 10.1016/j.puhe.2008.12.024

DO - 10.1016/j.puhe.2008.12.024

M3 - Article

C2 - 19249800

AN - SCOPUS:61849095287

VL - 123

SP - 214

EP - 221

JO - Public Health

JF - Public Health

SN - 0033-3506

IS - 3

ER -