Harm and Helmets: How Harmful Social Costs Fail to Justify Paternalistic Health and Safety Regulations

AuthorDevin J. Christensen
Published date01 December 2022
Date01 December 2022
Subject MatterArticles
Political Research Quarterly
2022, Vol. 75(4) 12711283
© The Author(s) 2021
Article reuse guidelines:
DOI: 10.1177/10659129211070351
Harm and Helmets: How Harmful Social
Costs Fail to Justify Paternalistic Health
and Safety Regulations
Devin J. Christensen
Mills harm principle and the f‌inancial externalities of risky behavior are routinely invoked to justify health and safety
regulation. However, this approach fares poorly when subjected to theoretical scrutiny. First, it is false: individuals
engaging in risky behavior do not harm others. Second, even if risky behavior were har mful to others, the argument from
harmful externalities does not imply safety-enhancing policy interventions, at least not without additional appeals to
paternalism. Third, focusing on the economic impacts of accidents invites perverse victim-blaming attitudes toward
accident victims that undermine democratic values and justice. To improve our moral understanding of health and safety
regulation, I sketch a theory of public policy justif‌ication grounded in the controversies which attract our attention to
paternalistic polices in the f‌irst place. On this account, justif‌icatory arguments are plausible if they identify goods that
individuals genuinely aff‌irm on their own terms, are sensitive to causal responsibility and imbalances between restraint
and protection, and comparatively engage with possible policy alternatives. Illustrating the shortcomings of one dominant
approach to public policy justif‌ication and reorienting us toward the controversies that policy justif‌ications need to
confront ref‌lect two ways that political theory can help enhance justice in public polic y design and articulation.
justif‌ication, public policy, social costs, harm, paternalism, motorcycle helmet
Health and safety regulations are a thorny issue for liberals
because they pit the moral goals of protecting life and
protecting freedom against one another. On the one hand,
regulatory interventions save thousands of lives every
year (Cook et al. 2009;Mayrose 2008;Wobrock et al.
2003), and repealing them would lead thousands of in-
dividuals who otherwise would have lived to die (Carter
et al. 2017;Preusser, Hedlund and Ulmer 2000). This is
cause for alarm on any defensible moral platform. On the
other hand, safety regulations are rightly criticized for
being paternalistic because they restrict individuals
freedom in the name of delivering what the state estimates
is in those individualsbest interests. The puzzle for
liberals who support regulatory intervention, then, is to
somehow reconcile liberal commitments with basic moral
intuitions concerning the value of human life.
To navigate this puzzle, policymakers and citizen
commentators routinely invoke Mills harm principle
(Biegler and Johnson 2013;Mello and Studdert 2014;
Claassen 2016;Diekema 2004;Eastridge et al. 2006;
Gostin and Gostin 2009;Ferguson 2011). It is generally
accepted that the state may intervene in order to protect us
from other people, which creates the possibility for non-
paternalistic justif‌ications for health and safety regulations
that prevent individuals engaging in risky behavior from
harming third-party others (Huster 2015;Anomaly 2009;
Le Grand and New 2015). In the case of health and safety
regulations, defenders of intervention point to external
f‌inancial costs as relevant harms the state should intervene
to prevent, thereby vindicating regulatory intervention
without directly confronting paternalism (Biegler and
Johnson 2015;Mello and Studdert 2014;Winokur
2007;Claassen 2016;Purdy and Seigel 2012;Le
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Corresponding Author:
Devin J. Christensen, University of North Carolina at Chapel Hill, 361
Hamilton Hall CB 3265, Chapel Hill, NC, USA.
Email: djc2020@live.unc.edu

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