Conflict between public health interventions and individual rights

Public health interventions may lead to conflicts between individual rights and community action. An understanding of how acceptable such interventions are is part of establishing common values across  the public health workforce.

A major feature of public health practice is to achieve positive health outcomes at population levels through consultation processes (including democratic decision making) while at the same time minimising the effects on people’s freedoms.

Individual consent is not always relevant where an intervention is not very intrusive or if significant health dangers are posed to a population at large. Immunisation programmes and smoke-free workplaces and public places are community interventions where wider community benefits may override the rights of individuals. Public health interventions have to be proportionate and based on evidence. The benefits and risks of public health policy should not be based on incomplete and ambiguous evidence that may exacerbate conflicts between individual rights and community action. The public health workforce will need to be able to understand and negotiate such complex ideas in decision-making processes.

Sources or references

• Buchanan, D. R (2008) Autonomy, Paternalism, and Justice: Ethical Priorities in Public Health, American Journal of Public Health January 2008, Vol 98, No. 1
• Nuffield Council of Bioethics Ladder of Intervention
• “Ethical analysis in public health”, the Lancet (2002) - download (The large number of citations of this article, and the numerous directions in which the arguments are being taken, suggest strongly that the ethics of PH are rising up the agenda.)

Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.