A Personal Perspective: When the freedom to be healthy curtails other freedoms.

Part of the aim of these essays is to engage with topics that may be challenging, reflecting the importance of having difficult conversations that advance progress. If we find that nothing we say causes us to feel a bit uncomfortable, it is hard to think we are truly having the conversations that make us better at holding a mirror up to ourselves toward a more effective pursuit of health.

This suggests questions: What is “the right amount” of paternalism? How do we define how much is necessary and how much is too much? How do we practically apply this definition to ensure our actions are no more or less paternalistic than needed?clearly that the risk of serious injury in a motor vehicle accident is so high for those not wearing a helmet that we have come as a society to largely accept the paternalism inherent in requiring helmet-wearing, even if a rider may prefer to feel the...

Now, we can imagine the inclination some may have to dismiss this example. “It is all well and good,” one might say, “to talk about helmet-wearing. But helmet-wearing is so obviously safer, so well-established as beneficial, that to compare its benefits to the relatively minor pleasure of feeling the wind in one’s hair is to put forward a straw man representation of what causes people to resist paternalism and when we might reasonably decide to overrule this resistance.

Paternalism should be considered skeptically, as should any constraint on individual autonomy and dignity. We should make this consideration, however, with the understanding that the effect of refraining from a measure of paternalism can be arguably worse than the thoughtful, balanced use of paternalism as a tool to support health. At the end of the day, we are trying to balance freedoms, and some constraint on negative liberty is well worth it to maximize positive liberty .

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