{"id":1666,"date":"2012-03-26T15:07:48","date_gmt":"2012-03-26T14:07:48","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=1666"},"modified":"2012-03-26T15:07:48","modified_gmt":"2012-03-26T14:07:48","slug":"raised-glasses-to-raised-prices","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/","title":{"rendered":"Raised Glasses to Raised Prices?"},"content":{"rendered":"

The proposal that there should be a minimum 40p\/ unit price for alcohol, announced last week, has been broadly welcomed. \u00a0Not universally, but broadly. \u00a0There has been some dissent – but, by and large, it doesn’t seem to have been particularly vocal.<\/p>\n

From a ethicist’s perspective, the objection that we might expect to hear articulated most has to do with paternalism: if the move is designed to coerce people into a certain kind of behaviour, and the motivation for this is a concern with people’s own good, then that might be presented as undue interference. \u00a0However, the response to this is simply to deny that paternalism of this sort is always a bad thing. \u00a0“Respect for autonomy” has become something of a dogma among many people working in bioethicists, but it’s not beyond question – and it’s certainly not enough simply to stamp your foot and say, “Yes, but AUTONOMY<\/em>” to defeat a proposal. \u00a0At the very least, the idea that governments should not intervene to prevent self-harming behaviour needs argumentative backing. \u00a0(I know that this is a particular bugbear of Angus Dawson and a number of other people working in public health ethics. \u00a0I don’t agree with the suggestion in some quarters that\u00a0the “rules” of PHE are different from the “rules” of the rest of bioethics, such that autonomy is not as important in PHE as it is in those other areas – I think that ethics is ethics is ethics; but this simply means that unquestioning deference to autonomy and liberty is philosophically bogus right across the board.)<\/p>\n

But, actually, the minimum-pricing policy doesn’t have to be defended on public health grounds. \u00a0It could also be defended on the grounds that not having a minimum price is simply ignoring the true cost of alcohol. \u00a0That cost would be counted in terms of strain on the NHS, lost work days, public order, and so on. \u00a0Alcohol consumption – at least in large quantities – generates all kinds of externality that the price at the till simply doesn’t reflect. \u00a0It’s therefore legitimate – the argument would go – for the government to intervene and set a minimum unit price as a way to correct this failure in the market. \u00a0Arguing in this way would mean that we don’t have to engage in endless debates about liberty and paternalism – we’d simply be able to say that people can do what they want, as long as they pay the “true” cost. \u00a0It’s hard to insist that that’s an infringement of anyone’s rights.<\/p>\n

The problem is that minimal pricing is regressive: it means the price of the cheapest booze will rise, while the price of the stuff that’s already more expensive will not; and this means that the impact will be felt by those most likely to buy the cheaper alcohol – the poorest – and not by those more likely to buy more expensive alcohol – the better off. \u00a0(Eric Joyce, for example, has claimed that the price rise is directed at the poorest<\/a>. \u00a0That isn’t true – but it is the poorest who’ll bear the brunt of the rise.)<\/p>\n

Should we worry about this? \u00a0Probably not too much. \u00a0Many things are priced, if not regressively, then at least non-progressively, but without that being a problem. \u00a0For example, near my office in Manchester there’s a garage that sells Jaguars, Maseratis, Ferraris and suchlike. \u00a0These things are, obviously, unaffordable to most people. \u00a0(I’m assuming that there’s passing trade from the higher levels of the non-academic staff, consultants from the medical school, and so on, tee hee.) \u00a0But that’s not a problem, because though there’s a right not to be prevented from buying a car like this, there’s no actual right to buy.<\/p>\n

Alcohol, as far as I can see, might be like this. \u00a0It’s not a basic good – notwithstanding what a rather perplexing recent ruling in Lithuania<\/a> might imply (and – gee whizz – I suspect that that might have had more to do with union-busting than any genuine belief that brewing is an essential service, though I’d love to read the ruling – preferably in English, my Lithuanian being a little rusty…). \u00a0There’s therefore little in the way of a positive moral right to access it. \u00a0At the same time, the social cost of alcohol is demographically blind: a wrecked liver is a wrecked liver, and I’m not convinced that the propensity to smash bus-stops is particularly strongly associated with any one class. \u00a0On this basis, everyone paying the same price is not self-evidently unjust.<\/p>\n

There is a small caveat<\/em>, which is that, though the social cost is class-insenstitive, it doesn’t follow that it’s constant. \u00a0To see why, imagine the difference between two drinkers, Smith and Jones. \u00a0Smith buys a crate of cheap strong cider in order to get drunk. \u00a0Jones buys a crate of the same cider because he’s invited some friends around for a barbecue, would like to be able to offer them a drink, but can’t afford to buy the more expensive stuff. \u00a0In Smith’s case, it’s likely that the social cost will be higher: he’s more likely to become ill, to injure himself, to get into a fight, and all the rest of it. \u00a0Jones and his friends, by contrast, will consume a couple of units each, and so their risks will not be significantly elevated all else being equal – and so the social cost will not be elevated either. \u00a0So there does seem to be at least a slight disparity of treatment.<\/p>\n

Is this enough to matter? \u00a0I doubt it. \u00a0Cheers!<\/p>\n","protected":false},"excerpt":{"rendered":"

The proposal that there should be a minimum 40p\/ unit price for alcohol, announced last week, has been broadly welcomed. \u00a0Not universally, but broadly. \u00a0There has been some dissent – but, by and large, it doesn’t seem to have been particularly vocal. From a ethicist’s perspective, the objection that we might expect to hear articulated […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,475],"tags":[304],"class_list":["post-1666","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-politics","tag-public-health"],"yoast_head":"\nRaised Glasses to Raised Prices? - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Raised Glasses to Raised Prices? - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"The proposal that there should be a minimum 40p\/ unit price for alcohol, announced last week, has been broadly welcomed. \u00a0Not universally, but broadly. \u00a0There has been some dissent – but, by and large, it doesn’t seem to have been particularly vocal. From a ethicist’s perspective, the objection that we might expect to hear articulated [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2012-03-26T14:07:48+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Raised Glasses to Raised Prices?\",\"datePublished\":\"2012-03-26T14:07:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/\"},\"wordCount\":967,\"commentCount\":12,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"keywords\":[\"Public Health\"],\"articleSection\":[\"In the News\",\"Politics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/\",\"name\":\"Raised Glasses to Raised Prices? - Journal of Medical Ethics blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\"},\"datePublished\":\"2012-03-26T14:07:48+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2012\\\/03\\\/26\\\/raised-glasses-to-raised-prices\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Raised Glasses to Raised Prices?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"name\":\"Journal of Medical Ethics blog\",\"description\":\"A blog to discuss the ethics of medicine in its many guises and formats.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\",\"name\":\"Journal of Medical Ethics blog\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"width\":200,\"height\":50,\"caption\":\"Journal of Medical Ethics blog\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Raised Glasses to Raised Prices? - Journal of Medical Ethics blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/","og_locale":"en_US","og_type":"article","og_title":"Raised Glasses to Raised Prices? - Journal of Medical Ethics blog","og_description":"The proposal that there should be a minimum 40p\/ unit price for alcohol, announced last week, has been broadly welcomed. \u00a0Not universally, but broadly. \u00a0There has been some dissent – but, by and large, it doesn’t seem to have been particularly vocal. From a ethicist’s perspective, the objection that we might expect to hear articulated [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/","og_site_name":"Journal of Medical Ethics blog","article_published_time":"2012-03-26T14:07:48+00:00","author":"BMJ","twitter_card":"summary_large_image","twitter_misc":{"Written by":"BMJ","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"Raised Glasses to Raised Prices?","datePublished":"2012-03-26T14:07:48+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/"},"wordCount":967,"commentCount":12,"publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"keywords":["Public Health"],"articleSection":["In the News","Politics"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/","name":"Raised Glasses to Raised Prices? - Journal of Medical Ethics blog","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website"},"datePublished":"2012-03-26T14:07:48+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/26\/raised-glasses-to-raised-prices\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/medical-ethics\/"},{"@type":"ListItem","position":2,"name":"Raised Glasses to Raised Prices?"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","name":"Journal of Medical Ethics blog","description":"A blog to discuss the ethics of medicine in its many guises and formats.","publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/medical-ethics\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization","name":"Journal of Medical Ethics blog","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","contentUrl":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","width":200,"height":50,"caption":"Journal of Medical Ethics blog"},"image":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/medical-ethics\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/1666","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/comments?post=1666"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/1666\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/media?parent=1666"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/categories?post=1666"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/tags?post=1666"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}