Article Text

Download PDFPDF
Epistemic paternalism in public health
  1. K Grill,
  2. S O Hansson
  1. Philosophy Unit, Royal Institute of Technology, Stockholm, Sweden
  1. Correspondence to:
 K Grill
 Philosophy Unit, Royal Institute of Technology, Teknikringen 78B, 100 44 Stockholm, Sweden;,


Receiving information about threats to one’s health can contribute to anxiety and depression. In contemporary medical ethics there is considerable consensus that patient autonomy, or the patient’s right to know, in most cases outweighs these negative effects of information. Worry about the detrimental effects of information has, however, been voiced in relation to public health more generally. In particular, information about uncertain threats to public health, from—for example, chemicals—are said to entail social costs that have not been given due consideration. This criticism implies a consequentialist argument for withholding such information from the public in their own best interest. In evaluating the argument for this kind of epistemic paternalism, the consequences of making information available must be compared to the consequences of withholding it. Consequences that should be considered include epistemic effects, psychological effects, effects on private decisions, and effects on political decisions. After giving due consideration to the possible uses of uncertain information and rebutting the claims that uncertainties imply small risks and that they are especially prone to entail misunderstandings and anxiety, it is concluded that there is a strong case against withholding of information about uncertain threats to public health.

  • MCS, multiple chemical sensitivity
  • REACH, Registration, Evaluation, and Authorisation of Chemicals
  • epistemic paternalism
  • public health
  • withholding of information
  • uncertain information

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • i The term “epistemic paternalism” is borrowed from Goldman. He first introduces the term as referring exclusively to withholding of information in the subject’s best epistemic interest (Goldman,1 pp 118–19), but later includes extra-epistemic reasons for withholding under the same concept (Goldman,1 p 127).

Other content recommended for you