Free to Consume? Anti-Paternalism and the Politics of New York City’s Soda Cap Saga

New in Public Health Ethics – “Free to Consume? Anti-Paternalism and the Politics of New York City’s Soda Cap Saga.”

In 2012, New York City Mayor Michael Bloomberg proposed capping the size of sugary beverages that could be sold in the city’s restaurants, sporting and entertainment facilities and food carts. After a lawsuit and multiple appeals, the proposal died in June 2014, deemed an unconstitutional overreach.

In dissecting the saga of the proposed soda cap, the authors highlight both the political perils of certain anti-obesity efforts and, more broadly, the challenges to public health when issues of consumer choice and the threat of paternalism are involved.

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Free to Consume? Anti-Paternalism and the Politics of New York City’s Soda Cap Saga

California Prop. 86 Raises Tobacco Taxes $2.00

Yesterday, California voters approved Proposition 56, increasing taxes on a pack of cigarette from 87 cents to $2.87.  This will slow use and save lives.  “Every 10 percent increase in the price of cigarettes brings about a 7 percent decrease in use by youth and a 4 percent decrease overall.”

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California Prop. 86 Raises Tobacco Taxes $2.00

Respect for Autonomy: Deciding What Is Good for Oneself

University of Utah psychiatrist Brent M. Kious has a new article in the Journal of Medical u0763085Ethics: “Respect for Autonomy: Deciding What Is Good for Oneself.”

“Paternalistic interference in autonomous decisions is typically impermissible. This has several explanations, among which is a view I call the agent-constitution of the good: that the autonomous agent not only knows what is best for herself, but determines what is best for herself through her desires, goals and so on (her aims). For instance, it might seem that if an autonomous person does choose not to take insulin for her diabetes, then not only is it inappropriate to force treatment upon her, it is also not in her best interest to take insulin.”

“Here I argue that agent-constitution, though appealing, is false. In fact, autonomous agents can be mistaken about their good, even when it seems to depend only upon their aims. Agent-constitution appears true only because we typically fail to notice constraints on a person’s good in private, self-regarding decisions where paternalism might be considered.”

Respect for Autonomy: Deciding What Is Good for Oneself

Stay Out of the Sunbed! Paternalistic Reasons for Restricting the Use of Sunbeds

Two Danish political science professors have just published “Stay Out of the Sunbed! zzzPaternalistic Reasons for Restricting the Use of Sunbeds” in Public Health Ethics.  Here is their abstract:

“The use of tanning beds has been identified as being among the most significant causes of melanoma and non- melanoma skin cancer. Accordingly, the activity is properly seen as one that involves profound harm to self. The article examines paternalistic reasons for restricting sunbed usage. We argue that both so-called soft and hard paternalistic arguments support prohibiting the use of sunbeds.”

“We make the following three arguments: (i) an argument from oppressive patterns of socialization suggesting that the autonomous nature of the conduct in question is questionable; (ii) an argument from so-called evaluative delusions in which individuals attach incorrect weights to some of their values; (iii) a strictly hard paternalistic argument appealing to the harm in itself (as opposed to failures of rationality or agency) pertaining to the use of sunbeds.”

It is a refreshing surprise to see authors make a hard paternalistic justification for limiting liberty.

Stay Out of the Sunbed! Paternalistic Reasons for Restricting the Use of Sunbeds

Public Health Ethics: Individualism, Republicanism, Paternalism

A new special issue of Public Health Ethics is organized around a key question: should republicans care about health?  Republicanism is the political doctrine 2.coverthat holds that society should be ordered on the basis of principles that prioritize the value of individual freedom. Republicans’ focus on individual freedom is shared with many variants of Liberalism, but they contrast with the latter by virtue of adopting a distinctive conception of freedom as non-domination.  For republicans, you are free insofar as you are robustly protected from even the mere possibility of someone arbitrarily interfering with your choices.

Republicanism Special Symposium
Jurgen De Wispelaere and John Coggon
Introduction: Towards a Republic of Health?

Daniel Weinstock
Can Republicanism Tame Public Health?

Paul Scott
Democracy, Law and Relationships of Domination—A Response to ‘Can Republicanism Tame Public Health?’

A. M. Viens
Public Health and Political Theory: The Importance of Taming Individualism

Stephen R. Latham
Political Theory, Values and Public Health

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

Karen Yeung
Public Health Interventions as Regulatory Governance: The Place of Political Theory

Morten Ebbe Juul Nielsen and Xavier Landes
Fighting Status Inequalities: Non-domination vs Non-interference

Stephen John
The Moral Physiology of Inequality: Response to ‘Fighting Status Inequalities: Non-domination vs Non-interference’

Cillian McBride
Commentary on Nielsen and Landes, ‘Fighting Status Inequalities: Non-domination and Non-interference’

Bruce Jennings
Right Relation and Right Recognition in Public Health Ethics: Thinking Through the Republic of Health

David Owen
Right, Well-being and the Republic of Health: A Response to Jennings

Keith Syrett
Comment on Jennings, ‘Right Relation and Right Recognition in Public Health Ethics: Thinking through the Republic of Health’

Public Health Ethics: Individualism, Republicanism, Paternalism

Public Health and Political Theory: The Importance of Taming Individualism

The Oxford journal Public Health Ethics continues to be a great source of scholarship on the conflict between public health and individual liberty.  One of the newest is Adrian Viens (Southhampton Law), “Public Health and Political Theory: The Importance of Taming Individualism.”

“Daniel Weinstock (2016) notes two significant problems with applying liberalism to public health: (i) liberals tend to be individualists, while public health is predominantly focused on populations and (ii) many public health measures involve interventions that can be seen as being in tension with liberal values such as autonomy, liberty and privacy. He examines whether civic republicanism can provide a more promising means of reconciling these concerns.”

“Despite Weinstock’s proposed solution to the problem of potential domination with its institutional and ethical solutions, I suggest the individualism at the core of liberalism and civic republicanism means both political theories will continue to have conceptual and normative problems with public health’s population-level perspective.”

Public Health and Political Theory: The Importance of Taming Individualism

Mini-Symposium: Regulating smoking

The May 2016 issue of the Journal of Medical Ethics includes a mini-symposiumF1.medium on “Regulating Smoking.”

Paper: Ethics of tobacco harm reduction from a liberal perspective
Yvette van der Eijk

The ethics of a smoking licence
Daniel Halliday

Commentary: Daniel Halliday, ‘The Ethics of a Smoking License’
David Shein

Commentary: What’s the point of tobacco control? Comment on Dan Halliday, ‘The ethics of a smoking licence’
Kristin Voigt

Commentary: Halliday’s ‘The ethics of a smoking licence’
Simon Chapman

Commentary: Replies to Shein, Voigt and Chapman
Daniel Halliday

Commentary: The case for banning cigarettes
Sarah Conly

The case for banning cigarettes
Kalle Grill, Kristin Voigt

Commentary: Tobacco bans and smokers’ autonomy
Daniel Halliday

Commentary: Double standards and arguments for tobacco regulation
Jessica Flanigan

Mini-Symposium: Regulating smoking