Public Health Interference in Individual Behavior: The Islamic and the Secular Ethical Discourses through Tobacco as an Applied Example

Public health policy today subsumes individual behavior within its scope of interference. This conflation of the public and private creates tension between the limitations that individual freedom imposes on the state’s coercive power on the one hand, and the state’s obligation to promote public interest that can conflict with individual freedoms on the other. This thesis examines the ethics of such interference in the Islamic discourse in comparison to the secular discourse through taking tobacco use as an applied example. In terms of ends, the secular public health discourse justifies interference on grounds of the pursuit of physical health of discrete individuals or the pursuit of social wellbeing. Tobacco control as public health practice is largely driven by physical health as an end, translates that into an end of controlling prevalence, and thus focuses its ethical deliberations on the means of such control. Unfortunately, the contemporary Islamic discourse falls short of critically deliberating the ends of interference, where the existing attempts are mostly led by health authorities and thus adopt physical health as a justification without delving into the underlying Islamic conceptualization of humans. The few exceptions, undertaken by philosophers and Islamic scholars, attempt to examine the human nature but fail to develop a theory on public interference. Accordingly, with respect to tobacco control, the contemporary Islamic discourse uncritically adopts physical health and prevalence control as ends, and as a blanket justification for the enterprise. This renders any deliberation more of a religious endorsement of the enterprise and its strategies rather than an attempt to establish a position informed by the Islamic worldview. Fortunately, the works of earlier scholars from the times of introducing tobacco into the Muslim world provide insight that can inform a reformed approach to examining health as a value and as public interest, and thus better define the potential and limits for state interference. This engagement should extend beyond a fiqhī ruling on behaviors, to tap into virtue ethics and moral refinement, and into political treatment through siyāsah sharʿiyyah. With tobacco being an applied example, this reform may be extrapolated to other forms of behavior provided the unique attributes of tobacco use, such as addiction, are recognized.