Appeal to fear in health care: appropriate or inappropriate?

Abstract

AimThis paper examines appeal to fear in general: its perceived positive aspects, its negative characteristics, its appropriate as well as its fallacious use.BackgroundAppeal to fear is a commonly used marketing method that attempts to change behaviour by creating anxiety in those receiving a fearful message. It is regularly used in public health initiatives such as anti-smoking, anti-drunk driving campaigns as well as in hypertension awareness campaigns. Some chiropractors appear to use appeal to fear to promote subluxation awareness and thereby encourage the use of chiropractic treatment.Research supporting its use is equivocal; nevertheless, when used judiciously, appeal to fear probably has sufficient strengths to warrant its continued conditional use. When used to promote care for which there is no supporting evidence, its use is fallacious.DiscussionAppeal to fear has been used in health promotion campaigns for sixty years or more with the intent of modifying behaviours. While there is evidence to suggest that appeal to fear may motivate some individuals to modify offending behaviour or adopt recommended behaviour there is growing resistance to the use of appeal to fear on ethical and psychological grounds. Using appeal to fear as a tool of persuasion can be valid or fallacious depending on the truth of the premises within the argument.When used to raise awareness about genuine health concerns such as smoking, drunk driving and hypertension appeal to fear is considered to be a valid approach with certain caveats. However, when appeal to fear, not based on evidence or reason, is used as motivator to get others to accept unnecessary interventions for unproven disorders, the use of appeal to fear is fallacious.ConclusionIn spite of the evidence against its use, it seems likely that appeal to fear will continue to be used in conjunction with other public awareness initiatives to modify recognized detrimental behaviours such as smoking and drunk driving as well as silent killers such as hypertension. However, when used to promote a treatment that has no evidentiary basis such as subluxation based practice in chiropractic the appeal to fear is a fallacy and must be stopped.

Words Matter: Political and gender analysis of speeches made by heads of government during the COVID-19 pandemic

“…We have seen in previous disease outbreaks, and during the COVID-19 pandemic, how a fearbased or nonchalant narrative can be disastrous for an effective response. [46][47][48][49] This highlights the critical role that communication plays in public health. 50 There is more to learn about how the discourse around COVID-19 influences the pandemic response, however the impacts of this pandemic are far-reaching and far from over.…”

The Manchurian candidate: chiropractors as propagators of neoliberalism in health care

“…For example, spondylosis is understood to be a naturally occurring phenomenon, is highly prevalent, and has poor evidence to suggest causality of back pain [9]. "Vertebral subluxation" is inconsistently and poorly defined, lacks substantiated evidential support, [10][11][12] and is deficient in longstanding or widespread agreement within the chiropractic field [13]. Back pain is highly prevalent and is recurrent and long-lasting [14].…”

“…Certain chiropractic communication and marketing practices may elevate chiropractors' financial self-interests over best patient care practices. Chiropractic has embraced marketing and entrepreneurialism with financial achievement seen as a gauge of success [12]. Marketing and communication practices that focus on appealing to fear, such as for health risks of "vertebral subluxation" may drive the patient to seek ongoing care.…”

“…Marketing and communication practices that focus on appealing to fear, such as for health risks of "vertebral subluxation" may drive the patient to seek ongoing care. These practices may be unethical, [12] however, and impact an individual's pain and potential for related disability [20].…”

Informed consent, duty of disclosure and chiropractic: where are we?

“…They breach fiduciary duties, professional conduct codes, and consumer laws. Such conduct is likely to appeal to fear and lead health care consumers into potentially dangerous decisions [ 19 , 20 ].…”