Community: The Neglected Tradition of Public Health

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Abstract
What are the limits of government in protecting the health and safety of the public? As more and more states regulate personal behavior to protect the public health and safety, this question again becomes central. Can there be good reasons for public health paternalism in a democracy? Are health and safety individual interests, or also common and shared ends? ... In one version of democratic theory, the state has no legitimate role in restricting personal conduct that is substantially voluntary and that has little or no direct consequence for anyone other than the individual. This strong antipaternalist position is associated with John Stuart Mill. In his essay “On Liberty,” which has deeply influenced American and British thought for over 100 years, Mill wrote: “[t]he only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harms to others.” Mill restricts paternal ism to children and minors. In this view the common good consists in maximizing the freedom of each individual to pursue his or her own interests, subject to a like freedom for every other individual. In the words of Blackstone, “The public good is essentially interested [in] ... the protection of every individual’s private rights.” In a second version, health and safety remain private interests, but some paternal ism is accepted, albeit reluctantly. As Joel Feinberg argues, common sense makes us reject a thoroughgoing antipaternalism.

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