Should public health experts stop us from consuming products?
It is clear that the problem of unhealthy consumption and the associated health consequences are societal problems that require a societal approach, Dr Ken Harvey, from La Trobe University, Melbourne, argues in the latest edition of the Medical Journal of Australia.
“In theory, allowing people to make their own choices about purchasing products, unfettered by a ‘nanny state’, sounds fine. However, this assumes that consumers can make informed, rational choices about the cost, risks and benefits of a given product, and that their decisions have no impact on others,” Dr Harvey said.
“In practice, humans are far from rational. We have problems controlling consumption and behaviour, such as how much we eat, drink, or smoke, and how much we spend on poker machines.
“Furthermore, many of our individual decisions do affect others: smoking in enclosed shared spaces and drink-driving cause, harm, injury and death to others; and gambling addiction destroys families.
“Such individual actions have societal costs – premature death, hospitalisation and the need for remedial services.
“The public has a right to better health. Evidence-based public health strategies, appropriately implemented, are vital to this effort.
“This may entail impinging on individual freedoms. However, when informed of the benefits, people are prepared to accept the sensible curtailment of choice for a better life for themselves and the community as a whole.”
But in an opposing view, Dr Michael Keane, from Swinburne and Monash Universities, Melbourne, uses the example of a prominent billboard, which exclaims ‘Alcohol does not cause violence. Blame and punish the individual’ and argues that this simple message articulates a far more comprehensive understanding of the complete body of relevant knowledge than many public health academics who advocate reactionary, prohibition-like controls on the voluntary consumption of ever more products.
Dr Keane said that public health traditionally focused on the health consequences of unwanted phenomena. However, today it increasingly focuses on restricting the active and the deliberate consumption of desired products and services, thus imposing government lifestyle mandates (GLM) on the population.
“The long-established principle of autonomy acknowledges that only the individual can apportion the appropriate weighting to each of the myriad factors in any harm-benefit calculation,” Dr Keane said.
“GLMs are health interventions, and, like any intervention, need to be consistent with contemporary medical ethics.
“Sensationalist studies of harm are inadequate to justify enforcing health interventions against peoples’ will.”
Dr Keane said that crucially, the “disease” model, which is used to justify many public health interventions, is promoting a society-damaging, malignant lack of personal responsibility
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACT: Dr Ken Harvey 0419 181 910
Mr Mark Pearce 03 9479 5246
Media and Communications Manager, La Trobe University Media Unit
Dr Michael Keane 0403 780 935/ 03 8768 1200
