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Public health is in a bind. The goal of the discipline is to protect and improve the public’s overall health so that populations remain as healthy as possible. Public health considers decisions from a Malthusian perspective: what is good for the overall population and often sidesteps the issue of personal choice, and the extent to which that choice is informed or not. What should public health do about individuals who, informed or otherwise, act in ways that threaten their health or that of others, for instance, by smoking, declining screening and refusing vaccinations?