Prevention vs. Treatment

A substantial book review of an anthology to which I contributed was just published by Notre Dame Philosophical Reviews.  Here is the introduction and conclusion:  

Prevention vs. Treatment: What's the Right Balance? is a collection of 15 essays on various aspects of the perennial tension in health policy between treatment and prevention. There is also a substantial introduction by the two editors, one of whom (Faust) is a preventive medicine physician and President-elect of the American College of Preventive Medicine; the other (Menzel) is a philosopher who has made important and influential contributions to bioethics, health policy, and health economics. . . .  Prevention vs. Treatment is an exceptionally wide-ranging and provocative collection. It is valuable not only for its new contributions but also as an orienting guide to a wider literature. Political philosophy and health policy alike would be well served if there were more volumes like it.

Here is the review of my chapter:  

The next essay in Part Two is Thaddeus Pope's "The Slow Transition of U.S. Law toward a Greater Emphasis on Prevention." Pope gives an excellent overview of the development of public health law in America, highlighting the transition from a focus on communicable diseases to the current focus on unhealthy lifestyles and personal behaviors. He then explores whether the normative frameworks of communitarianism and liberalism can justify limiting individuals' liberty in order to prevent sickness and death. Pope worries that communitarianism "masks hard paternalism" by "restricting the liberty of a particular individual or group for the good of just that same individual or group" (236, italics added). However, the explicitly stated concern of public health communitarians is the overall "good of the community," not the good of the individuals it contains. Still, I think he is absolutely right that "more justification is needed before the mere invocation of 'community' justifies limiting liberty" (237). I wish only that Pope had ventured to offer a viable alternative to communitarianism. He expresses hope that "a new 'collective harm' liberty-limiting principle" can be added to classical liberalism, but this is not yet much different from the hope that a rights-respecting communitarianism can be salvaged. One theme highlighted by Pope's focus on lifestyle risks (but not explored by him) is that prevention is very often within people's own grasp. So one reason to prioritize treatment might be that prevention often helps those who can easily help themselves but who are too weak-willed or irresponsible to do so. Of course, this reason could only be used to prioritize treatments for individuals who are sick or disabled through no fault of their own.