Public Health 129 (8):1092--1098 (2015)

Authors
Paul Edmund Griffiths
University of Sydney
Caroline West
University of Sydney
Abstract
The widely cited Nuffield Council on Bioethics ‘Intervention Ladder’ structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme ‘negative liberty’ view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided ‘Balanced Intervention Ladder,’ where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill’s classic version of negative liberty puts some interventions on the positive side of the ladder
Keywords Category C1 - Refereed Journal articles   Intervention ladder   John Stuart Mill   Nanny state   Nuffield council on bioethics   Public health ethics
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