Why the prevention paradox is a paradox, and why we should solve it: a philosophical view.

Abstract

This paper provides some philosophical comments on Rose's prevention paradox, suggesting why that paradox seems so difficult, and why policy-makers should care about solving it. The assumptions underlying the paradox section sets out two ways of understanding the notion of "benefit" in public health programmes, and shows how the prevention paradox arises from combining both understandings. Thinking through the paradox section argues that if we find the second understanding of benefit appealing, then we should rethink how we typically assess preventive public health measures. The implications section shows how these theoretical arguments imply that public health practitioners should care about solving the prevention paradox, rather than simply denying the legitimacy of one of the two views from which it arises.