Should we punish responsible drinkers? Prevention, paternalism and categorization in public health

Abstract

Many public debates over policies aimed at curbing alcohol consumption start from an assumption that policies should not affect 'responsible' drinkers. In this article, I examine this normative claim, which I call prudentialism. In the first part of the article, I argue that prudentialism is both a demanding and distinctive doctrine, which philosophers should consider seriously. In the middle sections, I examine the relationship between prudentialism and two familiar topics in public health ethics: the prevention paradox and the relationship between responsibility and solidarity. I argue that standard positions in these debates do not necessarily undermine prudentialism. In the final part of the article, I outline an alternative, more successful, argument against prudentialism: that the categories of 'responsible' and 'irresponsible' drinking behaviour are not 'apt' for use in policy. I show how this objection relates to Elizabeth Anderson's arguments against the more familiar doctrine of 'luck egalitarianism'.