Liberty, Public Health Ethics, and Policy Responses to COVID-19

Abstract

This paper presents, defends and applies a conception of public health ethics as focused on liberty-limiting public health action.  This approach has been persistently criticised, but the criticism is ambiguous between two challenges: that the focus on liberty makes an objectionable presumption in favour of liberal values and that the focus on liberty fails to address institutionalised social injustice.  Part One of the paper addresses both challenges to show they can be met by a nuanced account of a liberty-oriented public health ethics.  Part Two establishes that debates about policy responses to the current Covid-19 pandemic illustrate and vindicate this conception of public health ethics as focused on liberty-limiting public health action.  The discussion then turns to the methodological question as to how public health policies are to be evaluated, focusing particular on the role of normative theory in such evaluations.  The methodology of ‘wide reflective equilibrium’ is described and endorsed; the paper ends with a case study to illustrate this evaluative methodology, focused on the ethics of COVID-19 immunity passports.