Forget about the hypothetical risks of a human bird flu epidemic or terror attacks on cinemas. The scariest thing I saw this week was the demand from the Nuffield Council on Bioethics for more “coercive” public health policies to protect “vulnerable people”.

The influential Nuffield experts propose the sort of measures once considered the preserve of “health fascists”: even higher taxes on alcohol, shorter licensing hours, a ban on smoking in your home, denying or delaying health treatment for unrepentant smokers and drinkers, compulsory food labelling, even anti-obesity architecture. Their report confirms that public health policy now means not just providing clean air or water, but policing personal behaviour.

Worse, they justify this as the “liberal” approach - a word that, like the “public” in public health, now seems to mean its opposite. The Nuffield report rejects the old “nanny state” label and champions a “stewardship model”.

The job of the steward State should be to “reduce the risks of ill-health that people might impose on each other”, and “pay special attention to the health of children and other vulnerable people”.

Unless you really are a health fascist - and bioethicists are no Nazis - there are limits to what you can make people do “for their own good”.

Thus the report concedes that the State should “not attempt to coerce adults to lead healthy lives”. But the trick is that, by adopting the stewardship model, it can coerce us not to lead lives that are deemed risky to the health of others.

The illiberal liberals even wheel on J.S.Mill to support coercion. The summary claims that Mill's “classic harm principle” (I thought his classic principle was liberty, but still), backs state intervention “where an individual's actions affect others”. It is hard to think of any non-hermit who does not “affect others”. In fact, what Mill said in On Liberty - quoted in the full report - was that to justify compulsion, an individual's conduct “must be calculated to produce evil to someone else”. It seems that the definition of calculated evil is now to smoke in your living room, feed your family burgers or drink more than a couple of glasses of wine.

And who are the vulnerable people that the steward State must protect? More to the point, who aren't they? Those labelled “vulnerable groups” now include children, women, the elderly, ethnic minorities, disabled people — in short, most people. So, we supposedly live in a society where almost everybody is vulnerable, and millions are harming the health of others. No matter that we are actually living longer and healthier lives than ever before.

As a man of the libertarian Left who believes that autonomy and freedom from coercion are the basis of a healthy society, I recall how that passage in Mill's On Liberty ends: “Over himself, over his own body and mind, the individual is sovereign.”

Bioethicist, steward thyself.

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