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Public health: do we need more state interference?

Mon, 12 November 2007

How and when the state should intervene in our lives for our own good has been a hotly debated topic since the beginning of organised society. To shed more light on the issues, the Nuffield Council on Bioethics has published a report, Public health: ethical issues, which considers the responsibilities of governments, individuals and other parties, such as the food and drink industry, in achieving a healthy society.

Public health measures are designed to improve health across the population. In the past, they have included vaccination schemes, the provision of clean water, and banning smoking in public places. Some measures are more restrictive than others.

Measures that target health problems caused by alcohol, smoking and obesity tend to restrict personal behaviour. Although restrictions on smoking have been a recent government priority, the Council recommends that more coercive strategies to manage alcohol consumption could be implemented in the UK. For example, increasing taxes on alcoholic drinks has been shown to be an effective strategy for reducing consumption. With regards to obesity, the Council recommends that if the food industry does not adopt the most effective food labeling scheme voluntarily, the government should step in with legislative enforcement.

Public health measures for infectious diseases illustrate the difficulty of introducing interventions without the consent of those affected. Compulsory quarantine and isolation are considered to be among the most intrusive public health measures. The Council suggests that these might be acceptable where the costs, such as imposing such restrictions without consent, are outweighed by the prevention of significant harm to others.

Both adding and not adding fluoride to the water supply could disadvantage some groups of people, either through limiting personal choice or through preventing possible health benefits. The need for fluoridation varies from region to region, and the Council recommends that the most appropriate way of deciding whether fluoride should be added to water supplies is through democratic decision-making procedures. More ....

Last Updated Mon, 12 November 2007