Promoting Healthy Behavior: How Much Freedom? Whose Responsibility?

by Daniel Callahan (Editor), Beverly Ovrebo (Contribution by), Helen H Schauffler (Contribution by), E. Haavi Morreim (Contribution by), Ann Robertson (Contribution by)

Overview

The government, the media, HMOs, and individual Americans have all embraced programs to promote disease prevention. Yet obesity is up, exercise is down, teenagers continue to smoke, and sexually transmitted disease is rampant. Why? These intriguing essays examine the ethical and social problems that create subtle obstacles to changing Americans' unhealthy behavior.

The contributors raise profound questions about the role of the state or employers in trying to change health-related behavior, about the actual health and economic benefits of even trying, and about the freedom and responsibility of those of us who, as citizens, will be the target of such efforts. They ask, for instance, whether we are all equally free to live healthy lives or whether social and economic conditions make a difference. Do disease prevention programs actually save money, as is commonly argued? What is the moral legitimacy of using economic and other incentives to change people's behavior, especially when (as with HMOs) the goal is to control costs?

One key issue explored throughout the book is the fundamental ambivalence of traditionally libertarian Americans about health promotion programs: we like the idea of good health, but we do not want government or others posing threats to our personal lifestyle choices. The contributors argue that such programs will continue to prove less than wholly successful without a fuller examination of their place in our national values.

Product Details

ISBN-13:	9780878408535
Publisher:	Georgetown University Press
Publication date:	06/18/2001
Series:	Hastings Center Studies in Ethics series
Edition description:	New Edition
Pages:	192
Product dimensions:	6.00(w) x 9.00(h) x 9.00(d)
Age Range:	18 Years

About the Author

The co-founder and former president of the Hastings Center, Daniel Callahan is currently the director of international programs for the Hastings Center and author of The Troubled Dream of Life: In Search of a Peaceful Death, Setting Limits: Medical Goals in an Aging Society, and What Kind of Life?: The Limits of Medical Progress(Georgetown University Press).

Table of Contents

Preface

Introduction
Daniel Callahan

Personal Responsibility for Health: Contexts and Controversies
Meredith Minkler

Health Promotion and Civil Liberties: The Price of Freedoms and the Price of Health
Beverly Ovrebo

The Credibility of Claims for the Economic Benefits of Health Promotion
Helen Halpin Shauffler

Sticks and Carrots and Baseball Bats: Economic and Other Incentives to Modify Health Behavior
E. Haavi Morreim

Health Promotion and the Common Good: Reflections on the Politics of Need
Ann Robertson

Health Promotion and the Common Good: Toward a Politics of Practice
Ronald Labonte

The Promise of Molecular Medicine in Preventing Disease: Examining the Burden of Genetic Risk
Barbara Koenig and Alan Stockdale

Freedom, Healthism, and Health Promotion: Rinding the Right Balance
Daniel Callahan

Promoting Health and Preventing Disease: Ethical Demands and Social Challenges
Daniel Callahan, Barbara Koenig, and Meredith Minkler

Contributors

Index

Editorial Reviews

Insightful . . . provide[s] fascinating analyses. . . . A must-read for all involved with health promotion and disease prevention programs and concerned about their social and ethical implications.

Choice

A scintillating collection of essays

Revue Canadienne de Sante Publique

"Insightful . . . provide[s] fascinating analyses....A must-read for all involved with health promotion and disease prevention programs and concerned about their social and ethical implications."—Choice

"A scintillating collection of essays"—Revue Canadienne de Sante Publique

From the Publisher

This collection of original essays arose from a two-year collaborative research project on the ethical and social dilemmas of health promotion and disease prevention. The contributors, a diverse group of ethicists and health policy professionals, seek to "examine the ethical and social problems that create subtle obstacles to changing Americans' unhealthy behavior." Social scientists and philosophy of medicine researchers are the intended audience. The essays are useful in bridging abstract discussions of healthcare justice with case studies of the effectiveness and costs of particular efforts at health promotion. Most contributors apply moral or political analysis to empirical findings about the success or failure of health promotion and disease prevention initiatives. Among the topics addressed: the threat posed to civil liberties and to the physician-patient relationship by health promotion initiatives; the ways in which managed care companies, employers, and governments incentivize healthy behavior in individuals; the sociological and political limitations of purely behavioral approaches to health promotion that emphasize personal responsibility; the often contradictory values pursued in public health; and the implications that our rapidly increasingly knowledge of genetics will have for debates about who is responsible for individuals' health. There are two main drawbacks in this publication. First, the collection would have benefited from greater pluralism -- nearly all of the contributors reject libertarian or market-oriented approaches to promoting healthy behavior in favor of more interventionist, 'communitarian' alternatives that focus on collective responsibility. Thedangers of this latter alternative are hardly addressed. Second, those seeking hard-headed moral argument may well be disappointed; opposing positions are brushed off too easily and the contributors' own views are presented rather programmatically. Nonetheless, these essays should prove useful to humanists, social scientists, and public health professionals in search of novel insights into the ethical perils and practical deficiencies of current efforts to encourage healthy behavior.

Michael J. Cholbi

North American scholars of health and ethics raise questions about the role of the state and employers in trying to change health related behavior, such as diet, exercise, and safe sexual practices, and whether or not these efforts are either beneficial (for health or economic reasons), or ethical. Throughout the book the idea of the ambivalence of Americans regarding public health programs is discussed. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews

Reviewer: Michael J. Cholbi, PhD (Brooklyn College (CUNY))
Description: This collection of original essays arose from a two-year collaborative research project on the ethical and social dilemmas of health promotion and disease prevention.
Purpose: The contributors, a diverse group of ethicists and health policy professionals, seek to "examine the ethical and social problems that create subtle obstacles to changing Americans' unhealthy behavior."
Audience: Social scientists and philosophy of medicine researchers are the intended audience.
Features: The essays are useful in bridging abstract discussions of healthcare justice with case studies of the effectiveness and costs of particular efforts at health promotion. Most contributors apply moral or political analysis to empirical findings about the success or failure of health promotion and disease prevention initiatives. Among the topics addressed: the threat posed to civil liberties and to the physician-patient relationship by health promotion initiatives; the ways in which managed care companies, employers, and governments incentivize healthy behavior in individuals; the sociological and political limitations of purely behavioral approaches to health promotion that emphasize personal responsibility; the often contradictory values pursued in public health; and the implications that our rapidly increasingly knowledge of genetics will have for debates about who is responsible for individuals' health.
Assessment: There are two main drawbacks in this publication. First, the collection would have benefited from greater pluralism — nearly all of the contributors reject libertarian or market-oriented approaches to promoting healthy behavior in favor of more interventionist, "communitarian" alternatives that focus on collective responsibility. The dangers of this latter alternative are hardly addressed. Second, those seeking hard-headed moral argument may well be disappointed; opposing positions are brushed off too easily and the contributors' own views are presented rather programmatically. Nonetheless, these essays should prove useful to humanists, social scientists, and public health professionals in search of novel insights into the ethical perils and practical deficiencies of current efforts to encourage healthy behavior.

Doody's Review Service