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Why It ’ s Time to Stop Worrying About Paternalism in Public Health Policy

Public health policies which involve active intervention to improve the health of the population are often criticised as paternalistic. This paper argues that it is a mistake to frame our discussions of public health policies in terms of paternalism. First, it is deeply problematic to pick out which policies should count as paternalistic; at best we can talk about paternalistic justifications for policies. Second, two of the elements that make paternalism problematic at an individual level – interference with liberty and lack of individual consent – are endemic to public policy contexts in general and so cannot be used to support the claim that paternalism in particular is wrong. Instead of debating whether a given policy is paternalistic, we should ask whether the infringements of liberty it contains are justifiable, without placing any weight on whether or not those infringements of liberty are paternalistic. Once we do so, it becomes apparent that a wide range of interventionist public health policies are justifiable.