Ethics and public health promotion

As a goal, promotion of public health is quite uncontroversial. But attempts to modify people's lifestyles and life conditions in order to realize this goal bring up a number of ethical conflicts. One such conflict concerns the balance between autonomy and paternalism in the process of changing human behaviour. In this paper a model for analysis of such conflicts is presented and applied to assess anti-smoking policies. The model consists of two dimensions: the first specifies the relevant ethical principles, the second specifies the persons involved in or affected by such policies. My conclusion is that anti-smoking policies cannot be justified by reference to the good of the person whose right to selfdetermination is limited, but only by reference to the need to protect others from that person, i.e. prevent them from being exposed to tobacco smoke.