This basic idea—the promising nature of the neo-republican idea of freedom as non-domination, applied to inequalities in health and status relative to liberal freedom as non-interference—is explored in this article. However, the article also serves to examine some of the finer nuances and differences in neo-republican and liberal views, and contributes to the application of neo-republican ideas to the field of health and public health ethics. On another level of abstraction, we believe that our argument implies that freedom as non-domination cannot be isolated. It must go hand in hand with a «classical» negative conception of freedom as non-interference. In light of pluralism, we should not expect a consensus on which forms of exercise of power should be considered arbitrary. Therefore, we cannot expect consensus on which forms of exercise of power are to be understood as domination. At this stage, at least some forms of fundamental freedoms, protected by rights shaped by non-interference rather than non-domination, seem definitely necessary. The objections raised in the preceding sections relate mainly to the problems of letting non-domination alone serve as a value or guiding principle. None of the objections we raise militate against the inclusion of non-domination in the fundamental values or principles that should form the basis of political thinking and action. We have already found that non-interference seems insufficient to address status inequalities, at least to the extent that some of these inequalities are not imposed by force. Here, non-domination is a better candidate. The humble conclusion to be drawn here is that both concepts of freedom should be part of our core values in order to adequately address the problem of unequal status.
Neo-Republican concerns about dominance should play an important, but not exclusive, role in public health ethics regarding inequalities in health and status. However, this was quickly influenced by the onset of the Cold War, which increased the number and intensity of domestic interventions in many developing countries under the pretext of a «world socialist revolution» or the «containment» of such a revolution. The adoption of such pretexts and the idea that such interventions were aimed at preventing a threat to «international peace and security» made it possible to intervene under Chapter VII of the Charter of the United Nations. Moreover, the power of the United Nations to regulate such interventions was hampered during the Cold War, as both the United States and the USSR had veto power in the United Nations Security Council. The usual liberal concept of freedom is often called non-interference. Basically, you are free as long as no one interferes in your decisions. The (neo-)republican conception, on the other hand, presents freedom as a non-rule. Generally speaking, non-domination is the lack of ability of other agents to arbitrarily intervene in one`s life. One is free to the extent that others cannot dominate and submit to their unjustified orders. In this article, we examine how these alternative conceptions of freedom relate to the problem of health inequalities and, in particular, to health inequalities arising from status inequalities. These reflections lead us to link the question of status to a current debate in political philosophy between neo-republicanism and liberalism applied to public health issues. Given a somewhat broader use of the term «domination» and given the desire to pursue egalitarian goals related to the adverse health effects of status hierarchies for those at the bottom of the hierarchy, it seems that neo-republican freedom is non-domination—an essentially relational concept, since it is defined by the ability of a particular agent to arbitrarily invade the life of another agent (Pettit, 1997: 113-117) – is more promising than a liberal conception of freedom than actual non-interference, because the latter would require real interference by someone, whether the interference is legitimate or not, while the former considers all hierarchies, including status asymmetries, as sources of morally legitimate concerns, at least prima facie.
A recurring theme in the debate is whether or not there is an important practical difference between non-dominance and non-interference (Goodin & Jackson, 2007). Without commenting conclusively on this question, let`s continue with the hypothesis that exists. In international law, the principle of non-interference includes, inter alia, the prohibition of the threat or use of force against the territorial integrity or political independence of a State (Article 2(4) of the Charter). The principle of non-interference in the internal affairs of States also means that a State should not interfere dictatorially in the internal affairs of other States. In the Nicaragua case, the International Court of Justice referred to «the element of coercion which defines prohibited interference and is in fact the very essence of prohibited intervention» (ICJ Reports 1986, p. 108, para. 205). As Oppenheim`s international law states, «the interference must be coercive, dictatorial or otherwise coerced, thus depriving the intervening State of control over the matter in question. Pure and simple interference is not intervention» (Vol. I, 9th ed., 1992, p.
432). However, the extent to which acts other than the use of force are or should be prohibited is uncertain. Intervention (including military intervention) with the appropriate consent of a state government is not excluded. The most common term is «non-intervention», although «non-intervention» also appears in the texts. The latter may indicate a broader prohibition, although the two terms appear to be interchangeable in most contexts. This is based on the justification that a state should not interfere in the internal politics of another state as well as in the principles of state sovereignty and self-determination. A similar phrase is «strategic independence.»  In summary, it seems strange to point out the wickedness of the domination exercised by a tyrant, master or powerful faction in society, while at least being at some extent frivolous about the rule exercised by majorities. It is simply impossible to say that majority rule—no matter how (by «consideration») feelings are shaped and how benevolent their dispositions are—is less dominant.
And here we can repeat the point from the previous section: the enjoyment of true non-domination seems to require a very large part of the good old liberal rights of non-interference. Perhaps this is acceptable to (some) liberals and (some) neo-Republicans – it may even be the best available idea of political rights. Nevertheless, it undermines confidence in the specificity or independence of the neo-republican political program, at least to a significant degree. We allow the possibility of formulating neo-republican (genuine) rights or a (genuine) neo-republican conception of freedom that is distinct from liberal non-interference and can solve the problems raised above. However, it seems unlikely that such rights, or such a conception of freedom, can resolve these questions without absorbing something at least indistinguishable from the guarantees created by standard liberal rights. For example, unfettered democracy (understood as unchecked majority rule) can be as arbitrary as any tyrant (a point raised by Pettit: Pettit, 1997: 62; Lovett and Pettit, 2009: 13(f). The correct definition is essential to assess the appeal of neo-republicanism. At first glance, non-predominance, especially if the term is allowed to be extended to systemic and structural issues, seems more promising than non-interference: to the extent that some individuals are arbitrarily dominated because of their lower status – they suffer from poorer life prospects in terms of health, freedoms and autonomy, recognition and inclusion for arbitrary reasons, So there is a neo-republican reason, namely the hierarchy of statuses to address directly, or at least to try to mitigate the negative effects of the hierarchy. The promising aspect of neo-republicanism in terms of inequalities of status also stems from the moral vocabulary used (domination, arbitrary interference). Neo-republican grammar seems to presuppose an asymmetry of power or capacity that seems to be reflected in the very idea of social status.
On the one hand, domination can only be exercised if there is a certain asymmetry between two agents.