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Chapter 2
Why Is Public Health
Controversial?

Social Jus/ce vs. Market Jus/ce

The common good

Individual responsibility
Ques/ons about the scope of public health
Importance of economic factors for health
poli/cally controversial

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Sources of Controversy

Economic impact
Individual liberty
Moral and religious concerns
Poli/cs vs. science

Economic Impact
Businesses oIen resist public health measures
because they aect prots
Those who must pay may not be the ones who
benet
Costs may be short-term, while benets may
be long-term
Costs easier to calculate than benets

Tragedy of the Commons

Exemplied in many environmental laws
Freedom to pollute

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When Can Government Restrict

Individual Freedom?
To prevent harm to others generally
acceptable
Paternalism acceptable for children
To protect individuals from their own ac/ons?
(opposed by libertarians)
For the common good lots of room for
controversy

Moral and Religious Concerns

Sex and reproduc/on
Alcohol and drugs
Assisted suicide and other end-of-life
decisions

Poli/cs vs. Science

There is always the possibility of tension
Conserva/ve control of federal government
intensies the conict
Cri/cism of Bush administra/on for going too
far in misrepresen/ng science to support its
policies
Eorts by the Obama administra/on to inform
policy decisions based on honest science

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Discussion Ques/on 1
Do you agree that the philosophy of social
jus/ce is preferable to the philosophy of
market jus/ce?
Which is likely to lead to greater
improvements in public health?

Discussion Ques/on 2
Give an example of a measure that would
benet public health but might be expensive
to implement.
Who would benet?
Who would pay the cost?

Discussion Ques/on 3
Give an example of a measure that would
improve public health but might limit some
peoples freedom.
Who would benet?
Whose freedom would be limited?

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Discussion Ques/on 4
How far do you believe government should go
in advoca/ng and/or enforcing moral
behavior?