Wageningen Universiteit en Researchcentrum, Wageningen, Netherlands.
Bioethics. 2019 May;33(4):511-521. doi: 10.1111/bioe.12548. Epub 2019 Jan 18.
Within healthcare ethics and public health ethics, it has been the custom that medical and public health interventions should adhere to the principle of the least restrictive means. This principle holds that public health measures should interfere with the autonomous freedom of individuals to the least possible or necessary extent. This paper contributes to the discussion on how best to conceptualize what counts as the least restrictive means. I argue that we should adopt a novel, qualitative interpretation of what counts as the least restrictive means. Based on the multidimensional framework of the capability approach, the qualitative interpretation holds that the least restrictive means should be measured in terms of whether it restricts certain normatively valuable freedoms. I contrast this interpretation with quantitative interpretations that measure how much, or the extent to which, a public health measure interferes with the freedom of individuals.
在医疗保健伦理和公共卫生伦理中,医疗和公共卫生干预措施应遵循限制最小原则已成为惯例。这一原则认为,公共卫生措施应以尽可能最小或必要的程度干扰个人的自主自由。本文为如何最好地概念化何为限制最小原则的讨论做出了贡献。我认为,我们应该对何为限制最小原则采用一种新颖的定性解释。基于能力方法的多维框架,定性解释认为,限制最小原则应该根据它是否限制了某些规范性有价值的自由来衡量。我将这种解释与衡量公共卫生措施对个人自由的干扰程度或范围的定量解释进行了对比。