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Public Health

Cross-post: Fairness and Freedom in Public Health Policy – On the need for a Humanities-based approach to public health policy

by Alberto Giubilini

Originally posted on the Oxford Medical Humanities website

 

This conference explored two distinct but related issues in public health. One is the extent to which individual freedom could be restricted in the pursuit of public health goals. The other is whose freedom could be restricted. That is, freedom and fairness in public health policy.

The tension between freedom and public goods pervades our lives. Public goods such as functioning healthcare systems or environmental resources depend on actions we collectively take. Collective actions raise issues about whether and how each of us ought to contribute to them by giving up some of our own personal interests. Pandemic policies simply made that tension more salient. However, our living together is a constant negotiation of the boundaries between us as individuals and us as members of communities, often (but not necessarily) through the mediation of Governmental restrictions.

Public goods cost freedom or, if you prefer, freedoms can erode public goods.Read More »Cross-post: Fairness and Freedom in Public Health Policy – On the need for a Humanities-based approach to public health policy

The Language of Freedom in Public Health: the Case of the Smoking Ban

Alberto Giubilini

 

Enough manipulation of the definition of man, and freedom can be made to mean whatever the manipulator wishes

(Isaiah Berlin, Two Concepts of Liberty, 1958)

 

The UK Prime Minister has announced his plan to ban the sale of tobacco products to young generations in England. Smoking will be phased out by progressively increasing the legal age for buying tobacco every year. Assuming the plan is effective and does not simply open the door to a black market, young generations in England will be prevented from starting to smoke. According to the Prime Minister, “this measure will be the single biggest intervention in public health in a generation.”

It is hardly necessary to provide figures about the risks of smoking. Lighting up that first cigarette is one of the most unhealthy choices one could ever make. In fact, it is a decision many regret later in life. The question is: to what extent is a government justified in preventing competent individuals from making unhealthy decisions for themselves?

Read More »The Language of Freedom in Public Health: the Case of the Smoking Ban

Banning Cigarettes, Paternalism, Liberty and Harm: Clearing the Smoke

Media headlines in the UK are widely reporting Rishi Sunak’s announcement of a proposal to ban smoking for younger generations. Under the proposal, the legal age of smoking would increase by one year every year so that, eventually, no-one would be able to buy tobacco.

The proposal has proved to be controversial, and it has prompted a number of different arguments. This is unsurprising; the proposal represents a classic conflict between individual well-being, liberty, and third-party interests. As the BBC reports, some commentators have also highlighted an apparent inconsistency in Sunak’s own position, since he recently pushed back part of the government’s anti-obesity strategy, because of “people’s right to choose”. Again, the BBC reports that Sunak’s own response to this consistency argument has been that there is an important difference between the two policy positions, because ‘there is no healthy level of smoking’, whilst one can enjoy unhealthy foods as part of a healthy diet.

However, the claim that there is ‘no healthy level of smoking’ can be used to respond to this consistency argument and support the proposed smoking ban in quite different ways. Whether we support or oppose the proposal, it is crucial to be clear about the precise moral arguments that both supporters and opponents are making.

One useful way to begin is by thinking about whether or not the proposed ban is paternalistic.

Read More »Banning Cigarettes, Paternalism, Liberty and Harm: Clearing the Smoke

Well-being at Work

The University of Oxford, partly as a result of the pandemic, has recently begun to develop a new strategy and programme to support staff well-being. Last term, Frances Parkes, the Wellbeing Programme Manager, gave a fascinating presentation at the Oxford Uehiro Centre on well-being at work, and the resources available to staff to assist in various areas of their lives – not only work itself, but also, for example, finance and health.Read More »Well-being at Work

Honesty and Public Health Communication: Part 2

Written by Rebecca Brown

This post is based on two recently accepted articles: Brown and de Barra ‘A Taxonomy of Non-Honesty in Public Health Communication’, and de Barra and Brown ‘Public Health Communication Should be More Transparent’.

In a previous post, I discussed some of the requirements for public health institutions to count as ‘honest’. I now want to follow that up to discuss some of the ways in which public health communication seems to fall short of honesty.Read More »Honesty and Public Health Communication: Part 2

Healthcare Ethics Has a Gap…

By Ben Davies

Last month, the UK’s Guardian newspaper reported on a healthcare crisis in the country. If you live in the UK, you may have already had an inkling of this crisis from personal experience. But if you don’t live here, and particularly if you are professionally involved in philosophical ethics, see if you can guess: what is the latest crisis to engulf the publicly funded National Health Service (NHS)?

Read More »Healthcare Ethics Has a Gap…

Video Interview: Is Vaccine Nationalism Justified?

High income countries have been criticised for hoarding covid-19 vaccines: they have been accused of ‘vaccine nationalism’. But what exactly is vaccine nationalism? Is it really wrong to prioritise one’s own citizens, and, if so, why? How can we do better when the next pandemic strikes? In this Thinking Out Loud interview, philosopher Dr Jonathan… Read More »Video Interview: Is Vaccine Nationalism Justified?

Exercise, Population Health and Paternalism

Written by Rebecca Brown

 

The NHS is emphatic in its confidence that exercise is highly beneficial for health. From their page on the “Benefits of exercise” come statements like:

“Step right up! It’s the miracle cure we’ve all been waiting for”

“This is no snake oil. Whatever your age, there’s strong scientific evidence that being physically active can help you lead a healthier and happier life”

“Given the overwhelming evidence, it seems obvious that we should all be physically active. It’s essential if you want to live a healthy and fulfilling life into old age”.

Setting aside any queries about the causal direction of the relationship between exercise and good health, or the precise effect size of the benefits exercise offers, it at least seems that the NHS is convinced that it is a remarkably potent health promotion tool.Read More »Exercise, Population Health and Paternalism

Video Interview: Julian Savulescu on the Selective Restriction of Liberty During the Pandemic

Many people accept that, to protect public health, it is sometimes acceptable, or morally obligatory, to restrict people’s liberties. But there’s a lot of disagreement about how far these restrictions should go, and whom they should apply to: everyone, or certain groups of people only? In this Thinking out Loud interview, Professor Julian Savulescu (Uehiro… Read More »Video Interview: Julian Savulescu on the Selective Restriction of Liberty During the Pandemic

Video Interview: Should We Vaccinate Young Children Against COVID?

Many who had no doubts whatsoever about having themselves vaccinated against COVID, are much more hesitant when it comes to vaccinating their young children. Is such hesitancy justified?  In this Thinking Out Loud interview, Katrien Devolder talks to Dominic Wilkinson, Consultant Neonatologist and Professor of Medical Ethics at the University of Oxford about the ethical… Read More »Video Interview: Should We Vaccinate Young Children Against COVID?