Abstract
In this article, I argue that public health regulations are a necessary component of changing the culture of health in the US. After considering libertarian critiques of public health interventions, I maintain that many of the interventions critiqued are not in fact coercive. Looking forward, I do not envision an either/or between the nanny state vs. a libertarian polity. Instead, a middle ground will emerge that respects individual choice and personal responsibility while accepting that government has a legitimate interest in securing the population’s health. Better health helps people make better choices and enjoy freedom; being free from poor health status is as important to liberty as free choice.
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Notes
For a good discussion of the trans-fat ban, see the articles collected in Volume 10, No. 3 (2010), of the American Journal of Bioethics. It is worth noting that what might inconvenience some may be liberating for others. For example, tobacco control laws have enabled many people to enjoy bars and restaurants without exposure to second hand smoke.
In any event, if the governmental Leviathan is alive and well, a far more important reason is legislation like the Patriot Act that imposes no limits on governmental intrusion into our private lives.
Economic studies demonstrate that restaurateurs and bar owners have not suffered economic losses as a result of smoking bans (though there are certainly distributional consequences) (Loomis et al. 2013).
To add insult to injury, comedian Jon Stewart said in 2012 that, “It combines the Draconian government overreach people love with the probable lack of results they expect.”
Wendy Parmet notes that there are many other examples of public health advocates adopting a civil liberties/libertarian approach. In the early decades of the HIV/AIDS epidemic, advocates argued forcefully for a human rights/civil liberties approach to stopping the spread of HIV/AIDS (personal communication, 31 December 2013).
It is beyond the scope of this essay to elaborate on how that might be implemented in practice.
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Jacobson, P.D. Changing the Culture of Health: One Public Health Misstep at a Time. Soc 51, 221–228 (2014). https://doi.org/10.1007/s12115-014-9768-z
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DOI: https://doi.org/10.1007/s12115-014-9768-z