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Beauchamp advocates for public health to function as a part of social justice, where the “value and priority of human life” is asserted over all else. He believes that this is preferably to the current system, one that he calls “market justice”. Market justice, in his mind, “emphasizes individual responsibility” with “minimal obligation to the common good”. He also states that it market justice contains the “fundamental freedom to all individuals to be left alone”. (Schneider, 2018, p.18) I would argue that, in a perfect world, social justice is preferable.
On a public health level, social justice advocates for the absolute value of all human life, and the obligation of society to protect those lives. To go beyond just public health, social justice advocates for a “fair distribution of the burdens and benefits of society”. (Schneider, 2018, p.18)
It would be hard to argue that this is not a great concept. However, in practice, it raises concerns. Staying in the public health realm, there has to be a line in placing human life as a supreme goal.
Is abortion allowed as a medical necessity? Who’s life takes on more value, the living mother, or the unborn fetus? What about in cases of persistent vegetative states? Should they be allowed to die to save other lives via organ donation? Can they be allowed to die simply because there is nothing left to do for them? It is great to limit death as much as possible, but there is only so much that can be done for people; the rest needs to be done by people.
Social justice contends that all life should be treated equally, but all aspects of health depend on individual input. We cannot ban everything that is bad for us; people need to be accountable for their actions. If a person chooses to smoke, or drink to excess, or eat nothing but cheese curds, they have to hold some responsibility for their actions.
That is what market justice states, and due to human nature, that is what we need. The government has the power to protect the people through the use of police powers, which are critical to public health. (Schneider, 2018, p.32) We see their use in things such as seatbelt laws, laws against drinking and driving, and many more. It is impossible to deny that these laws benefit the public, just as much as it is impossible to deny that these laws restrict individual liberty. The majority of people would probably be unaffected by other legal restrictions that could improve the overall health of the population, but that doesn’t mean that they won’t meet widespread resistance. As our text points out, “Americans reflexively oppose being told what to do and resist the idea of government restrictions on their behavior”. (Schneider, 2018, p.19)
I think that limiting restrictions, such as age limits on tobacco and alcohol, are a more tolerable and preferable method of limiting their use that outright bans, which have been shown to be ineffective time and time again. It is easy to restrict actions that have an impact on others, such as drunk driving. It is much more controversial to restrict actions that have limited impact on those not involved, such as the use of tobacco in one’s home. Living in a society focused on the voice of the people requires that people’s voices be heard. If the population clamors for limits, then they should be explored, but outright limits in the name of the “public good” is ripe for manipulation. It is supremely vulnerable to being co-opted by minority groups with extreme views, attempting to force their views on the public as a whole.
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