Rethinking autonomy in a field that serves populations
This piece was co-written by Dr Salma Abdalla and is also cross-posted here.
Public health is concerned with health at the population level. Most of the time our work as public health scientists and practitioners, expands rather than restricts what people can do with their lives. Clean water, safe food, and the countless quieter interventions that constitute public health have given people more years, more options, and more freedom to live the lives they wish to live. But sometimes, the pursuit of public health requires that individuals accept constraints on their choices for the sake of the population’s health.
There is nothing particularly new about this restricting feature of public health. But this feature was brought to the fore in an unprecedently visible way during the Covid-19 pandemic. Vaccine mandates, mask requirements, and restrictions on movement and gathering all surfaced a national conversation about the role of public health: when is it right for the field to infringe on an individual’s autonomy in the name of the population’s health, and when is it not? The debate has not settled since. If anything, it has widened, as the field faces questions about harm reduction, policies to tackle obesity, and many other issues where the line between protecting populations and respecting individuals is less clear than we sometimes think.
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