Ramiro Avilés Miguel A, Lobo Félix
Instituto de Derechos Humanos Bartolomé de las Casas, Universidad Carlos III, Madrid, España.
Gac Sanit. 2010 Dec;24 Suppl 1:120-7. doi: 10.1016/j.gaceta.2010.09.011. Epub 2010 Nov 20.
In recent times, various voices in Spain have questioned public health policies as an assault to personal freedom. The present article aims to respond to these voices with ethical and economic arguments.
The scope and characteristics of this current of opinion are described. Then, starting with John Stuart Mill, the ethical principles of non-maleficence, beneficence, personal autonomy and justice, as well as related concepts taken from economic efficiency, such as externalities, monopoly, incomplete and asymmetric information, agency relationship, public goods and adverse selection, are discussed. A short mention is made of equity in economics, the welfare state and public health systems. The justification for paternalist actions by the state, as well as limits to these actions, are briefly discussed.
Respect for individual freedom does not exclude the implementation of public health actions but rather demands the adoption of such policies. If these actions comply with certain conditions, they do not limit individual freedom but rather serve to protect it.
近来，西班牙的各种声音质疑公共卫生政策是对个人自由的侵犯。本文旨在从伦理和经济角度回应这些声音。
描述了这种舆论潮流的范围和特点。然后，从约翰·斯图尔特·密尔开始，讨论了不伤害、行善、个人自主和正义等伦理原则，以及从经济效率中提取的相关概念，如外部性、垄断、不完全和不对称信息、代理关系、公共物品和逆向选择。简要提及了经济学中的公平、福利国家和公共卫生系统。简要讨论了国家家长式行为的正当理由及其限制。
尊重个人自由并不排除实施公共卫生行动，反而要求采取此类政策。如果这些行动符合某些条件，它们不会限制个人自由，而是有助于保护个人自由。
