General justifications for public health regulation

Convention holds that government intervention designed to promote population health and well-being is an unmitigated good. However, government should justify interventions because, almost invariably, they intrude on individual rights and interests and incur economic costs. This paper presents three general justifications for government intervention: (1) risk to others; (2) protection of incompetent people; and (3) risk to self. The first justification is the standard, well-accepted idea that government may intervene to prevent harm to others or punish individuals for inflicting harm. The second justification supports government action to protect the health and safety of those who are incapable of safeguarding their own interests. The third justification, and by far the most controversial, is paternalism; the protection of the health or safety of competent individuals irrespective of their own expressed wants or desires. This paper argues that the government gains the greatest legitimacy when regulating for the protection of harms to others, but even paternalism can support state action when health risks are socially embedded and harmful to the public.