Preprints are early versions of research articles that have not been peer reviewed. They should not be regarded as conclusive and should not be reported in news media as established information.

sorry, we can't preview this file

...but you can still download Ladders and Stairs.docx
Ladders and Stairs.docx (90.08 kB)

Ladders and Stairs: How the Intervention Ladder Focuses Blame on Individuals and Obscures Systemic Failings and Interventions

Download (90.08 kB)
posted on 2023-08-24, 13:49 authored by Tyler PaetkauTyler Paetkau

Introduced in 2007 by the Nuffield Council on Bioethics, the intervention ladder has become a widely used tool in bioethics and public health policy. By ordering potential interventions from least to most intrusive, the intervention ladder seeks to balance efficacy of interventions with the cost to individual liberty. While the ladder serves as a useful tool for evaluating potential interventions, it also has unintended side-effects. In particular, by orienting itself around how interventions impact individual liberty, the ladder obscures potential interventions that operate on a systemic rather than individual level. As such, I argue that the ladder needs to be broadened into stairs. That is, the ladder needs to be broadened to accommodate multiple parties simultaneously. Whereas a ladder can only accommodate one party at a time, stairs allow for multiple parties to exist at the same level and to pass each other freely.  


Declaration of conflicts of interest


Corresponding author email

Lead author country

  • Canada

Lead author job role

  • Postgraduate Student

Lead author institution

McGill University

Human Participants

  • No

Terms agreed

  • Yes, I agree to Advance terms


Log in to write your comment here...

Usage metrics

    Advance: Social Sciences & Humanities