The question ‘are nanny states healthier states?’ is designed to imply that if they are healthier their policies and interventions are justified. This is not necessarily a valid conclusion, however. It could be that a course of action which is very effective by some parameters is counterproductive or harmful by other measures.
A better question would be: are nanny states ethically justifiable? Policies or systems cannot be justified by their outcome alone; there are always other considerations. These might be a little more abstract: justice, respect for human dignity, compassion etc. But they are no less important. Indeed, they are perhaps more so. It is never the outcome alone which settles a matter, but also how human beings relate to one another, and what sort of action is appropriate in view of this. Efficiency should not be allowed overrule propriety. So where does the ‘nanny state’ fit into this?
Since genes are largely beyond the reach of the state, it remains for public health interventions to change the environment to modify behaviour. Changing people's’ environment can be beneficial and relatively non-invasive (e.g. reducing air pollution). Many different things can be tried generate the desired outcome, from taxation to education.
It is often assumed that changing the environment necessarily changes conduct, since humans are a function of their genes and their environment. This is perhaps the greatest fallacy of some public health initiatives. The fact is that behaviour does not often change in proportion to changes in environment. Behaviour can and does change, but, at bottom, and though it might seem trite to say so, public health initiatives cannot touch the root of conduct, which is human nature. Failing to reckon with this leaves public health initiatives without a reasonable endpoint, and gives them permission to cross ethical boundaries in the name of efficiency and beneficence. This is the shadowy side of the ‘nanny state’ which we should be anxious to avoid.
Competing interests:
No competing interests
09 December 2016
Toni Saad
Medical Student
Cochrane Medical Education Centre Heath Park Cardiff CF14 4YU
Rapid Response:
When nudge comes to shove
The question ‘are nanny states healthier states?’ is designed to imply that if they are healthier their policies and interventions are justified. This is not necessarily a valid conclusion, however. It could be that a course of action which is very effective by some parameters is counterproductive or harmful by other measures.
A better question would be: are nanny states ethically justifiable? Policies or systems cannot be justified by their outcome alone; there are always other considerations. These might be a little more abstract: justice, respect for human dignity, compassion etc. But they are no less important. Indeed, they are perhaps more so. It is never the outcome alone which settles a matter, but also how human beings relate to one another, and what sort of action is appropriate in view of this. Efficiency should not be allowed overrule propriety. So where does the ‘nanny state’ fit into this?
Since genes are largely beyond the reach of the state, it remains for public health interventions to change the environment to modify behaviour. Changing people's’ environment can be beneficial and relatively non-invasive (e.g. reducing air pollution). Many different things can be tried generate the desired outcome, from taxation to education.
It is often assumed that changing the environment necessarily changes conduct, since humans are a function of their genes and their environment. This is perhaps the greatest fallacy of some public health initiatives. The fact is that behaviour does not often change in proportion to changes in environment. Behaviour can and does change, but, at bottom, and though it might seem trite to say so, public health initiatives cannot touch the root of conduct, which is human nature. Failing to reckon with this leaves public health initiatives without a reasonable endpoint, and gives them permission to cross ethical boundaries in the name of efficiency and beneficence. This is the shadowy side of the ‘nanny state’ which we should be anxious to avoid.
Competing interests: No competing interests