Qualitative and quantitative interpretations of the least restrictive means

Abstract

Within healthcare ethics and public health ethics, it has been the custom that medical and public health interventions should adhere to the principle of the least restrictive means. This principle holds that public health measures should interfere with the autonomous freedom of individuals to the least possible or necessary extent. This paper contributes to the discussion on how best to conceptualize what counts as the least restrictive means. I argue that we should adopt a novel, qualitative interpretation of what counts as the least restrictive means. Based on the multidimensional framework of the capability approach, the qualitative interpretation holds that the least restrictive means should be measured in terms of whether it restricts certain normatively valuable freedoms. I contrast this interpretation with quantitative interpretations that measure how much, or the extent to which, a public health measure interferes with the freedom of individuals.

Keywords: capability approach; principle of the least restrictive means; public health ethics; qualitative freedom; quantitative freedom.