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Effective public health measures are coercive

By Peter Baume - posted Tuesday, 24 August 2021

Sonia Bowditch is wrong. Her article in On Line Opinion of 23rd August is wrong. The intentions are good, she is a worried mother with cause to be worried, she is right about what she says about the negative effects of the lockdown, but she is wrong to say that personal autonomy should rule.

A Victorian Englishman named John Stuart Mill enunciated his famous "harm principle" about 150 years ago. It says that the only reason that government is entitled to interfere with the liberty of individuals is to prevent harm to innocent third parties.

So, we must obey traffic signals – we limit personal autonomy to cross intersections against lights to prevent avoidable injury to ourselves and to others. We are not allowed to ride bicycles in certain area – we limit personal autonomy to prevent injury to third parties. We must wear seat belts in cars – this rule limits personal freedom but is done because it stops people being unable to access hospitals because beds are occupied by those who did not wear seat belts. Similarly, we mandate that people must not be affected by alcohol or other drugs when they drive. Again, we are limiting personal freedom to drink and drive, or to take other drugs and drive. It is innocent third parties that are being protected. In some places we enrich flour with iodide, thereby forcing everyone, whether they like eating enriched flour or not, to eat the medicated flour.


The rule is that effective public health measures are often coercive. They limit personal autonomy but protect third parties. The justification for what is done rests on the ethical principle of consequentialism.

We have mandated that everyone in Sydney will drink fluoridated water. This has limited personal autonomy to make a choice on this matter, but a generation has grown up with no dental caries.

So, can we invoke Mill's harm principle in the current situation? What is the danger of the Coronavirus virus, and particularly the delta variant to others? First, the delta variant of the virus is very infectious. By the way, in developing that variant, the virus is only doing what viruses do, and it is almost certain that other variants will emerge. We will need an annual booster – just as we do for influenza. Second, infections can be severe and can kill and put people into hospital. Third, those infected are infecting others, sometimes those they are close to and love, who are then in danger of getting sick and dying. Fourth, the public demonstrations against lockdown are perfect super-spreader opportunities.

Our health care workers are at risk whenever someone is infected. Doctors and nurses, cleaners, wardspeople, food deliverers, deserve to live too and not to get the disease. Entire families are at risk from any family member who is infected, especially if there is overcrowding.

Yes – lockdowns are hard. Yes – there is great economic hardship. Yes – many families need the money that comes from their jobs. But most effective public health measures have been coercive, and what is happening now is just one more example of a necessary and proper coercive intervention.

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About the Author

Professor Peter Baume is a former Australian politician. Baume was Professor of Community Medicine at the University of New South Wales (UNSW) from 1991 to 2000 and studied euthanasia, drug policy and evaluation. Since 2000, he has been an honorary research associate with the Social Policy Research Centre at UNSW. He was Chancellor of the Australian National University from 1994 to 2006. He has also been Commissioner of the Australian Law Reform Commission, Deputy Chair of the Australian National Council on AIDS and Foundation Chair of the Australian Sports Drug Agency. He was appointed a director of Sydney Water in 1998. Baume was appointed an Officer of the Order of Australia in January 1992 in recognition of service to the Australian Parliament and upgraded to Companion in the 2008 Queen's Birthday Honours List. He received an honorary doctorate from the Australian National University in December 2004. He is also patron of The National Forum, publisher of On Line Opinion.

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