Nouvelles des membres du Réseau Can Republicanism Tame Public Health?


Liberalism and Public Health have always had a difficult relationship, because of the former's emphasis on the illegitimacy in all cases of unconsented-to interferences. Republicanism, with its emphasis on freedom as non-domination, has the potential to give rise to a more nuanced view of the relationship between public health interventions and a robust defence of liberty. This article argues that public health interventions not justified by the Millian harm principle can be justified on republican grounds if, though paternalistic, they aim to promote the autonomous decision-making of agents on matters to do with their health, and with the place of health within their overall conceptions of the good life.

The practice of public health has always been difficult for political philosophers of broadly liberal sympathies to justify (Holland, 2015: 48–62). After all, most liberals are moral individualists, in that they believe that only individuals are legitimate sources of moral claims. They are wary of communitarian claims, according to which groups might be taken to be possessed of irreducible moral worth. But public health takes populations rather than individuals as the targets of their policies. They are concerned with population-level patterns of disease. This leads to a second source of apparent incompatibility between liberalism and public health: public health policies nudge, and sometimes coerce individuals, to achieve community-level goals of health promotion and disease reduction. They engage in health surveillance, which is difficult to square with the liberal value of individual privacy (Fairchild et al., 2008). They sometimes recommend mandatory vaccination and banning super-sized sodas, thus on the face of it violating the liberal belief in the supremacy of the value of individual liberty.1