The Mount Sinai Journal of Medicine - Mount Sinai School of Medicine

Volume 73 Number 4 July 2006	back to contents

Medical Police and the Nanny State: Public Health versus Private Autonomy	708-715
Jeremy Hugh Baron, D.M., F.R.C.P., F.R.C.S., F.R.C.P.G.

From the Dr. Henry D. Janowitz Division of Gastroenterology, Mount Sinai School of Medicine, New York, NY.

Address correspondence to Dr. J.H. Baron, Division of Gastroenterology, Box 1069, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029-6574.

Presented at the Mount Sinai-Oxford-London Consortium on Bioethics and Social Responsibility at Mount Sinai School of Medicine, New York, NY, on April 13, 2005.

Accepted for publication July 2005.

Abstract

Rome tried to increase both the numbers of its people and their well-being, and hence their wealth, but it was not until the 16th century that European rulers were urged to achieve these aims by the power of the state to enforce public health. By the 17th century, absolutist states such as France, Austria and especially Germany had created an administrative profession of enlightened despotism, with medical police to encourage healthy and thus wealth-producing citizens. Johann Peter Frank (1745–1821) was the profession's exemplar with his 6,262 page System einer vollständigen medischiner Polizey, leading to comprehensive public health legislation in German-speaking states, followed by more libertarian countries such as Britain and the United States. However, controversy continues on the role of government in trying to save its citizens, and especially their children, from harming themselves and/or others by their actions and omissions.

Key Words

Public health, Europe, US, Johann Peter Frank, immunization, alcohol, autonomy.

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