Kamilla Zita Hajdu, LLB International and European Law Research Master Philosophy, University of Groningen, k.z.hajdu student.rug.nl

How the principle of autonomy is relevant to alcohol policy

Alcohol regulation is a contentious matter. On one hand, in a large part of the world, alcohol consumption is deeply woven into cultural and social life. Certain wines or spirits have strong cultural ties to a specific country or region, and therefore to their people’s cultural identities. Sharing a bottle of wine or grabbing a beer gives frame to many social interactions and is considered as exercising some basic personal freedoms: deciding what we do with our money, time and body.

On the other hand, alcohol consumption has strong downsides. Alcohol is connected to a myriad of health risks: from addiction to reduced rational decision making, to injuries and diseases diminishing quality of life.[1] Additionally, alcohol related injuries are often suffered by third parties. These negative consequences also put strain on the country’s healthcare system.[2] It is an increasingly common argument that individuals can only exercise full autonomy collectively, so in a harmonious relationship with a healthy environment.[3] Consequently, the risks and negative consequences of alcohol consumption can also be seen as a risk to autonomy.

For these reasons, reducing alcohol consumption is a rational policy goal, but one that quickly becomes complicated. Imposing regulation on alcohol might restrict individual freedoms in the strict sense. At the same time, failing to impose regulation may lead to an environment in which these freedoms cannot be fully realised in the first place. At the heart of the dilemma is the principle of autonomy: a value often invoked both in defending and restricting our freedom to drink, yet rarely examined in depth.

Autonomy under the UN instruments

International human rights law frames autonomy largely through the right to privacy,[4] found in Article 17 of the International Covenant on Civil and Political Rights (ICCPR).[5] This protection extends to personal decision-making, including private consumption choices. However, privacy is not absolute: states may lawfully and proportionately restrict it, particularly to protect public health. What counts as “arbitrary” or “unreasonable” interference leaves room for interpretation.[6]

The International Covenant on Economic, Social and Cultural Rights (ICESCR) elaborates on possible restrictions by recognising the right to “the highest attainable standard of health.”[7] States must foster conditions in which people can make informed, healthy choices.[8] Alcohol regulation can help achieve this, even if the precise scope of state responsibility is unclear.

The Convention on the Rights of the Child (CRC) goes even further in explicitly emphasising specific actions to protect children from the harmful uses of alcohol.[9] This also makes sense from an autonomy perspective: as children’s rationality and agency are still developing, stronger paternalistic measures are permissible. So, it might be clear why we are justified in preventing children from drinking. Additionally, harm to children can also arise indirectly, such as when adult drinking contributes to neglect or abuse.[10] Therefore, under the CRC, restricting adults in their alcohol consumption may be required to protect children and their developing autonomy.

Autonomy under the European Convention of Human Rights

Under the European Convention on Human Rights (ECHR), similarly to the ICCPR, there is no explicit right to personal autonomy; it is, however, encompassed by Article 8, concerning the right to private and family life.[11] The European Court of Human Rights (ECtHR) has confirmed that autonomy is a core interpretive principle (Pretty v UK)[12] and, at times, an enforceable right under Article 8 (Evans v UK, Tysiac v Poland)[13], though this is applied inconsistently. In some cases, the Court has treated autonomy as a right that must be balanced against other Convention rights, including health (Laskey, Jaggard and Brown v UK).[14] In sum, while autonomy’s status as a right or principle is not entirely clear, it is an integral enough part of the right to private life to be legally enforceable.

However, autonomy under the ECHR is not absolute.[15] Article 8(2) permits restrictions to protect health, morals, or the rights of others, provided they are proportionate.[16] The Court grants states a wide “margin of appreciation” in health policy, especially on contested issues of moral significance.[17] Without an international consensus on alcohol regulation, states have significant discretion.

In practice, the ECHR requires that personal autonomy be considered when crafting alcohol policy,[18] but health protection can justify a wide range of restrictions, as long as the balance struck is proportionate.

Autonomy’s internal contradictions

The difficulty with the balancing exercise that international legal frameworks rely on is that autonomy itself is full of internal contradictions. Generally, we can understand personal autonomy to mean self-determination, the ability to make independent decisions in line with one’s goals and values, free from coercion.[19] However, this definition causes some issues.

We can think of autonomy as encompassing two fundamental, interconnected components: sovereignty and non-alienation.[20]  Sovereignty is the ability to act without outside interference, and non-alienation is acting in accordance with one’s deep inner values. If I take the bottle out of somebody’s hand or impose regulation which makes it impossible or disproportionately difficult for them to choose to drink, I violate their sovereignty. On the other hand, when they drink and harm their health or make decisions while intoxicated, people are likely acting against their fundamental values. Several studies have found that even moderate alcohol consumption alters decision-making and even moral attitudes.[21] In this way, imposing alcohol policy may impede on citizens’ sovereignty while strengthening their non-alienation. Of course, the inverse causes an issue too: failure to regulate alcohol consumption may guarantee sovereignty at the expense of non-alienation. But an agent is never fully autonomous with only one of the elements present.[22]

A normative debate on the meaning of the principle of autonomy as part of the policy response to alcohol

A thorough philosophical examination of autonomy is essential to guide lawmakers in drafting a coherent response to the challenges posed by alcohol consumption. The role of autonomy in alcohol regulation is far from clear, and, as the analysis of international and European legal instruments shows, it has ambiguous legal interpretations. Without a comprehensive understanding of the principle of autonomy, we cannot know how to apply it in the context of alcohol regulation either.

[1] World Health Organization, ‘Alcohol’ (World Health Organization, 2023) <https://www.who.int/news

room/fact-sheets/detail/alcohol> accessed 24 February 2025.

[2] Robin Room and others, ‘The Drinker’s Effect on the Social Environment: A Conceptual Framework for

Studying Alcohol’s Harm to Others’ [2010] Int. J. Environ. Res. Public Health 1855 [1858]

[3] Philipp Hacker, ‘Nudging and autonomy: a philosophical and legal appraisal’ in Hans W Micklitz, Anne-Lise Sibony and Fabrizio Ernesto (eds), Research methods in consumer law: a handbook (Edward Elgar 2018) 115.

[4] Jill Marshall, Personal freedom through human rights law?: autonomy, identity and integrity under the European Convention on Human Rights (Martinus Nijhoff Publishers, 2009) 30-31.

[5] International Covenant on Civil and Political Rights (adopted 16 December 1966, entered into force 23 March 1976) 999 UNTS 171 (ICCPR), Article 17.

[6] See also Oliver Diggelman and Maria Nicole Cleis ‘How the Right to Privacy Became a Human Right’ [2014] Human Rights Law Review 441[451].

[7] International Covenant on Economic, Social and Cultural Rights (adopted 16 December 1966, entered into force 3 January 1976) 993 UNTS 3 (ICESCR), Article 12.

[8] UN Committee on Economic, Social and Cultural Rights, General Comment No. 14: The Right to the Highest Attainable Standard of Health (Article 12, ICESCR), UN Doc E/C.12/2000/4 (11 August 2000) para 37.

[9] Committee on the Rights of the Child, General Comment No 15 on the Right of the Child to the Enjoyment of the Highest Attainable Standard of Health (Art 24) (2013) UN Doc CRC/C/GC/15.

[10] Anne-Marie Laslett, ‘Alcohol’s involvement in recurrent child abuse and neglect cases’ [2012] Addiction 1786 [1789].

[11] Convention for the Protection of Human Rights and Fundamental Freedoms (European Convention on Human Rights, as amended) (adopted 4 November 1950, entered into force 3 September 1953) 213 UNTS 221, art 8.

[12] Pretty v. United Kingdom App no 2346/02 (ECHR, 29 April 2002), para. 61.

[13] Evans v. the United Kingdom App no 6339/05 (ECHR, 7 March 2006) para. 107 and Tysiac v Poland App no 5410/03 (ECHR, 20 March 2007) para. 109.

[14] Laskey, Jaggard and Brown v. the United Kingdom App nos 21627/93, 21826/93 and 21974/93 (ECHR, 19 February 1997) para 44.

[15] ECHR Article 8(2).

[16] ibid.

[17] Hristozov and Others v. Bulgaria App nos 47039/11 and 358/12 (ECHR, 13 November 2012) para 118 and Vavřička and Others v. the Czech Republic App no. 47621/13 (ECHR, 8 April 2021) paras 274, 275.

[18] Marshall (n 4) 69-70.

[19] Sarah Buss and Andrea Westlund, "Personal Autonomy", The Stanford Encyclopedia of Philosophy (Spring 2018 Edition), Edward N. Zalta (ed.), <https://plato.stanford.edu/archives/spr2018/entries/personal-autonomy/>.

[20] David Enoch, ‘How Nudging Upsets Autonomy’ [2024] The Journal of Philosophy 658 [664-665], or for another formulation of the same idea, see Marshall (n 4) 15-20.

[21] See, for example, Hanna Karlsson and others, ‘Acute effects of alcohol on social and personal decision making’ [2022] Neuropsychopharmacology 824 and S. George and others, ‘The acute effect of alcohol on decision making in social drinkers’ [2005] 160.

[22] For a similar interpretation of how autonomy’s different components are considered in a legal context, see Marshall (n 4) 65-68.