An ethical framework for public health Professor Tom Baldwin Professor of Philosophy, University of York

The state and the citizen: ethical theories Libertarian Perspective Intermediate positions (Liberal State) Collectivist Perspective (Utilitarian and Social Contract approaches)

How to resolve the conflict between promotion of public health and protection of individual freedoms? The harm principle: “That the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant”

An initial framework Goals for public health: reduce health risks from environment and actions of others provide information and advice, with special attention to children Constraints: avoid coercive attempts to make people lead healthy lives and minimise interventions in important areas of personal life

Further issues important in public health Individual consent Health inequalities Changing habits Community

Also consider… Paternalism The ‘nanny' state The Stewardship Model

The revised framework Goals: reduce the risks of ill health people impose on each other environmental conditions to sustain good health special attention to the vulnerable access to medical care reduce inequalities Constraints: minimise intrusion / coerciveness consent / alternative procedures

Role of third parties Medical institutions, schools, charities Businesses: food, drink, tobacco and pharmaceutical companies, shops, pubs and restaurants Corporate social responsibility function But, intervention by the state to protect important goods is acceptable