Reconceiving the role of the state in public health policy
Over the past few decades there have been numerous examples of public health measures that have been designed to influence the choices that people make about their behaviour in ways that can lead to health. These include, but are certainly not limited to, the UK government’s tax on sugar sweetened beverages (https://www.bbc.co.uk/news/health-43659124) and the failed initiative in New York City to limit the size of “big sodas” (https://www.nytimes.com/2014/06/27/nyregion/city-loses-final-appeal-on-limiting-sales-of-large-sodas.html).
For the most part, ethical and philosophical debates about the acceptability of these interventions have centred on considerations of the health, welfare and cost benefits both to individuals and to the population as a whole as they are traded against the value of individual liberty and choice. This focus is reiterated in the public health discourse and policy debates.
This project will examine alternatives to this framing of the debate (very broadly, one of overall health benefits versus individual liberties) by bringing more contemporary debates in political philosophy to bear directly on this applied public health set of problems.
At least two potential lines of inquiry suggest themselves:
- There have been various articulations and defences of the idea of political perfectionism whereby the state’s role is to play a role in promoting a range of conceptions of the good to the exclusion of others (e.g. Raz 1986). Such an account of state power may be useful in underpinning public health measures like those mentioned above.
- Policies such as the sugary drinks tax might be understood as ‘expressive’ of the values of a society in various ways and so might be taken not to represent as much of an intervention for good or benefit but a statement or symbol of the values of the state or the society.
RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING
This project will be largely desk-based research incorporating ethical and philosophical theorising alongside detailed case-based analysis of the health economic, public health data and potentially, some analysis of media/public discourse. The precise proportion of focus on a particular policy example as compared to the theoretical will depend on the individual candidate but the project does rest heavily on the consideration of ethical and political theory in practice.
This project is best suited to individuals with a background in philosophy, bioethics or political theory and an interest in policy application or with a public health or health economic background and an interest in philosophical political theory.