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

Steve Latham’s paper in this special issue raises an important criticism against the political theory of civic republicanism as applied to public health. 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. High and strong values are both important, but they nevertheless stand in a particular hierarchical relation, with strong values being the conditions upon which to exercise the high values (Latham, 2016). Latham applies the distinction between high and strong values directly to public health. ‘Life and health are, for most of us, quintessential strong values. One who deprives another of his life, or who injures his health, has greatly wronged that other. But no person deserves much praise merely for being alive and healthy. Being alive and healthy is merely the baseline from which a person can hope to build toward higher achievements’ (Latham, 2016). The distinction between high and strong values suggests a division of labour between personal and social responsibility. Where individuals take responsibility for pursuing the ‘merit goods’ embodied in the high values, the state is charged with securing the foundation of strong values that allow individuals to devote their time and energy in pursuit of their life plans. Here, Latham argues, Civic Republicanism gets into trouble. Non-domination, like life and health, is best regarded as a strong value, a condition of being free to pursue one’s life free from alien control, as Philip Pettit has it (Pettit 2012). The state plays a key role in securing the condition of freedom from domination for all its citizens, but state agency itself can rapidly turn into domination in its own right. The republican solution against state-based domination (or imperium) is the constant active vigilance of its citizenry. The problem for Latham is that this suggests that citizens’ virtue is entirely dispensed by securing a strong value (non-domination), leaving no time or energy to private pursuits of high virtues. The same conclusion applies with respect to the achievement of the value of public health. ‘Health is too basic a goal to demand citizen’s time. Citizens should be engaged in the pursuit of higher values’ (Latham, 2016). Latham runs the arguments against republican theory and public health in tandem, but it remains unclear how they interact. One key question PUBLIC HEALTH ETHICS VOLUME 9 NUMBER 2 2016 150–152 150