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A Broader Liberty: J.S. Mill, Paternalism, and the Public's Health


Lawrence O. Gostin


Georgetown University - Law Center - O'Neill Institute for National and Global Health Law

Kieran G. Gostin


Harvard Law School


Public Health (J. Royal Society of Public Health), Vol. 123, No. 3, p. 214, 2009
Georgetown Public Law Research Paper No. 1364388

Abstract:     
Is the 'harm principle', famously propounded by J.S. Mill and widely adopted in bioethics, an appropriate principle to guide public health regulation? The harm principle limits liberty-limiting interventions to only those instances where the person poses a significant risk of harm to others. However, much of public health regulation is not primarily directed to avert risk to others, but to safeguard the health and safety of the individual him or herself. Think about regulations regarding seatbelts, motorcycle helmets, or the fluoridation of water as illustrations of pervasive public health regulations that are primarily intended to safeguard the individual's own health or safety. Even laws designed to reduce smoking are justified, at least in substantial part, by the reduction of risk to the smoker. Certainly, scholars argue that there are 'other-regarding' aspects to these kinds of laws, but there is little doubt that there are strong paternalistic features to these, and many other, public health laws, such as bans on trans fat in foods. This article directly and forcefully questions the Millian principle, making the case for hard paternalism. When seen from a population-based perspective that counts the number of lives saved, paternalism becomes a plausible justification for interventions that do not pose a truly significant burden on individual liberty, but go along way toward safeguarding the health and wellbeing of the populace.

Number of Pages in PDF File: 10

Keywords: JS Mill, public health, harm principle

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Date posted: March 19, 2009  

Suggested Citation

Gostin, Lawrence O. and Gostin, Kieran G., A Broader Liberty: J.S. Mill, Paternalism, and the Public's Health. Public Health (J. Royal Society of Public Health), Vol. 123, No. 3, p. 214, 2009; Georgetown Public Law Research Paper No. 1364388. Available at SSRN: http://ssrn.com/abstract=1364388

Contact Information

Lawrence O. Gostin (Contact Author)
Georgetown University - Law Center - O'Neill Institute for National and Global Health Law ( email )
600 New Jersey Avenue, NW
Washington, DC 20001
United States
202-662-9038 (Phone)
202-662-9055 (Fax)
Kieran G. Gostin
Harvard Law School ( email )
1575 Massachusetts
Hauser 406
Cambridge, MA 02138
United States
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