Public Health Ethics Advance Access originally published online on June 16, 2009
Public Health Ethics 2009 2(2):146-157; doi:10.1093/phe/php014
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Liberalism, Altruism and Group Consent
Department of Philosophy and the History of Technology, Royal Institute of Technology
* Corresponding author: Teknikringen 78b, SE-100 44 Stockholm, Sweden. Tel.: +46 8 790 9528; Fax: +46 8 790 9517; Email: kgrill{at}kth.se.
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Abstract |
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This article first describes a dilemma for liberalism: On the one hand restricting their own options is an important means for groups of people to shape their lives. On the other hand, group members are typically divided over whether or not to accept option-restricting solutions or policies. Should we restrict the options of all members of a group even though some consent and some do not? This dilemma is particularly relevant to public health policy, which typically target groups of people with no possibility for individuals to opt out. The article then goes on to propose and discuss a series of aggregation rules for individual into group consent. Consideration of a number of scenarios shows that such rules cannot be formulated only in terms of fractions of consenters and non-consenters, but must incorporate their motives and how much they stand to win or lose. This raises further questions, including what is the appropriate impact of altruistic consenters and non-consenters, what should be the impact of costs and benefits and whether these should be understood as gross or net. All these issues are dealt with in a liberal, anti-paternalistic spirit, in order to explore whether group consent can contribute to the justification of option-restricting public health policy.