PAINFUL PROHIBITION

John Stuart Mill wrote On Liberty to defend the principle that the only justification for restricting liberty is to prevent harm to others.

- Peter Singer

Were Mill alive today, he would have been pleased to see how many jurisdictions have repealed laws criminalizing acts widely thought immoral despite harming no one directly: suicide – including medically assisted dying –is one prominent example. Same-sex relations between consenting adults are another.

In contrast, laws that criminalize potentially self-harming behavior, like traveling in a car without wearing a seatbelt or riding a motorcycle without a helmet, have proliferated. If Mill had been updated with information about how often we fail to give proper weight to low risks of catastrophic outcomes, he might have accepted those laws, while still arguing for exemptions for people who have a serious reason not to wear a seatbelt or a helmet.

This brings me to the issue that has prompted these “What would Mill do?” thoughts: the overwhelming case for exemptions to laws prohibiting certain drugs. Consider cluster headache, possibly the most painful condition known to medicine. It consists of recurring headaches that come in clusters and cause pain behind the eye so severe that they are also known as “suicide headaches.” The intense pain leads many sufferers to contemplate suicide, and some of them carry it out. Worldwide, about four million people suffer from this condition in any given year.