Subsidiarity, Human Dignity, and Public Health Policies

The principle of subsidiarity points a way forward out of the political impasse regarding health inequities. Based on human dignity and the preferential option for the poor, subsidiarity offers a flexible middle way between utilitarianism and libertarianism. My normative framework focuses on the social or relational dimension of human dignity and a non-ideal approach, i.e., an approach that allows for incremental improvements. Some non-pharmaceutical interventions by public authorities against the COVID-19 pandemic, especially general lockdowns, have had a negative impact on the relational dimension of both human dignity and health equity. I identify leaving patients to die alone, even though there was no compelling virological reason for this, as a core-case violation of human dignity. Extremes would have been avoidable with the more flexible approach of subsidiarity. The vast public expenditure for public health with relatively poor health outcomes calls for reflection on how to improve health equity through a more flexible approach closer to the problem.