Is It Legitimate for Society to Intervene in the Way Citizens Live Their Lives When the Cost of Health Care Has to Be Borne by the General Public?-General Considerations and Special Implications During the Covid-19 Pandemic.

Christoph Edlinger,Dominic Klein,Michael Lichtenauer

doi:10.3389/fpubh.2021.653923

Abstract

Over the last few decades, the perception of disease has changed significantly. In the concept of the sick person's role it should be the aim of every person to keep health at a good level for as long as possible. Several examples can be found where, however, a disease can be caused or worsened by a person. Examples include unhealthy diet, alcohol consumption leading to atherosclerosis and diabetes, or smoking, leading to lung cancer and COPD. There are also other appropriate examples where there is a potential for conflict between the autonomy of the individual and health. Improving public health should be the main objective of any health system. However, the more the impact is on personal freedom (and there is no extraneous danger), the more an attempt should be made to achieve this through the motivation of each individual to support the desire for a healthy lifestyle, rather than through legal prohibitions or penalties. The situation is even more complex in the case of the Covid-19 pandemic. In this context too, personal freedom is restricted in many areas and some people feel, for example, that compulsory masks or the prohibition of large crowds are serious encroachment on their autonomy. However, even in this case, the risk of possible external threats from the spread of the virus outweighs the right to personal choice and freedom. To sum up, it is necessary to balance the two principles - autonomy and interference in them in the interests of public health.

Highlights

The health system of several European countries is based on a social security system and is financed by compulsory insurance for all citizens
The central theme of this essay is to present the conflict question “Since the costs of health care must be borne by the general public, is it legitimate for society to intervene in the lifestyle of the citizen?”
When we look at the points of conflict between autonomy and public health, a red line can be drawn where the autonomy of the individual restricts the freedom or rights of others or the general population

Summary

INTRODUCTION

The health system of several European countries is based on a social security system and is financed by compulsory insurance for all citizens. There are deductibles in some areas, such as the prescription fee for medication or dental treatment The aim of this system is to create a social balance and to ensure that all sections of the population receive the same high quality health care. Even as a counter-example, a study by Chalfont and Kurtz in 1971, which looked at alcohol addiction, showed that people with alcohol addiction are seen by society as responsible for their illness and stigmatized, or that alcohol addiction is sometimes not seen as a disease at all (5) Examples like these do not fit into the model postulated by Parsons. Decades of research and frequent media coverage of the most common risks, such as poor nutrition and lack of exercise, have led to the conclusion that every person should be aware of the lifestyle that leads to these diseases, a substantial part of the population refuses to accept these insights. This is partly due to traditional lifestyles and habits and certainly to a certain amount of neglect of the risks of disease

SMOKING AND LUNG DISEASE

ALCOHOL CONSUMPTION

DISCUSSION