Smokers' rights to health care: why the 'restoration argument' is a moralising wolf in a liberal sheep's clothing

J Appl Philos. 1999;16(3):255-69. doi: 10.1111/1468-5930.00128.


Do people who cause themselves to be ill (e.g. by smoking) forfeit some of their rights to healthcare? This paper examines one argument for the view that they do, the restoration argument. It goes as follows. Smokers need more health-resources than non-smokers. Given limited budgets, we must choose between treating everyone equally (according to need) or reducing smokers' entitlements. This paper criticises the restoration argument on the following grounds. In order to avoid generating unpalatable conclusions elsewhere, it must be combined with a principle according to which activities which are sufficiently 'socially valuable' (e.g. parenting) are immune from restoration claims. This however means that what was supposed to be one of the argument's most attractive features, its compatibility with 'liberal neutrality' with respect to the values of different lifestyles, doesn't really exist. Hence, the restoration argument is nowhere near as attractive as it first appears to be.

MeSH terms

  • Delivery of Health Care / economics
  • Delivery of Health Care / ethics*
  • Ethical Analysis*
  • Health Care Costs
  • Human Rights*
  • Humans
  • Life Style*
  • Morals
  • Patient Selection / ethics
  • Resource Allocation / ethics*
  • Smoking*
  • Social Justice*
  • Social Values