Rose’s Prevention Paradox

Abstract

Geoffrey Rose's ‘prevention paradox’ occurs when a population‐based preventative health measure that brings large benefits to the community – such as compulsory seatbelts, a ‘fat tax’, or mass immunisation – offers little to each participating individual. Although the prevention paradox is not obviously a paradox in the sense in which philosophers understand the term, it does raise important normative questions. In particular, should we implement population‐based preventative health measures when the typical individual is not expected to gain from them? After canvassing other attempts to address the paradox, I argue that what is significant about the prevention paradox is that it involves intra‐personal trade‐offs; the costs and benefits of the choice to implement or not implement a preventative health measure fall on the same individuals. The intra‐personal nature of these trade‐offs has two implications. First, the solutions to the paradox proposed by other authors are deficient. Second, the policy choice to not implement some preventative health measures can be normatively justified.