You Must Be Healthy: For British health officials, liberty doesn't count

(From Theodore Dalrymple)

The place of liberty among political desiderata is a matter of philosophical dispute. No doubt, we must occasionally curtail liberty in pursuit of other ends; but I nevertheless find alarming the creeping authoritarianism of the medical journals, which seldom recognize liberty as an end worthy of the slightest consideration in the making of public policy.

The British government is proposing to ban smoking in all pubs that serve food but not in those that don't. You might think this a sensible compromise, allowing for separate public places for smokers and non-smokers. But a recent paper in the British Medical Journal attacks the proposals, on the grounds that they might well increase the differential in the life expectancy between the rich and poor, which has stubbornly refused to yield to 60 years (so far) of profound social engineering.

The reason the proposals, if implemented, might increase the differential is that there are more pubs that don't serve food in poor areas than in rich, so the poor would be subjected to more passive smoking in pubs than the rich. The authors therefore propose a total rather than a partial ban of smoking in pubs. For them, a widening of the differential would be undesirable, even when everyone's life expectancy was rising.

Now clearly there exist threats to public health so severe that we must curtail liberty to meet them, as with quarantines. Whether passive smoking is such a threat that it justifies such curtailment is a matter of opinion and not yet susceptible to definitive answer supported by a knockdown argument. But the authors of the article in the British Medical Journal do not even recognize the need to justify their proposal to curtail liberty, because they do not value liberty.

Perhaps it is only natural that considerations of public health should seem all-important to public health doctors (the authors), such that anything that will lengthen the public's life span appears to them justified without further argument. But I still find it disturbing that they should be unaware of other desirable ends other than health and a prolonged life span that is equal between all social classes. Monomania is never good.

Besides, in practice not every activity that threatens the public health leads to a call by public health doctors for prohibition. The British Medical Journal once published a news item stating that 17 million sports injuries occurred in Britain every year-17 million! They ranged from the trivial to the fatal, of course; but no public health doctor called for the prohibition of sport to protect human life and to avoid the waste of medical resources on what were essentially self-inflicted injuries.

This is because they regard sport as morally good, while smoking is the nearest people can come these days to sin. I hasten to add that I have no shares in tobacco companies, and I abhor tobacco smoke.