Means, ends and the ethics of fear-based public health campaigns

Abstract

Controversy has swirled over the past three decades about the ethics of fear-based public health campaigns. The HIV/AIDS epidemic provided a context in which advocacy groups were almost uniformly hostile to any use of fear, arguing that it was inherently stigmatising and always backfired. Although this argument was often accepted within public health circles, surprisingly, the bioethicists who first grappled with this issue in terms of autonomy and coercion in the 1980s were not single-minded: fear could be autonomy-enhancing. But by the turn of the 21st century, as opponents of fear-based appeals linked them to stigmatisation, ethicists typically rejected fear as inherently unethical. The evidence has increasingly suggested that fear-based campaigns 'work.' Emotionally charged public health messages have, as a consequence, become more commonplace. We conclude that an ethics of public health, which prioritises population well-being, as contrasted with the contemporary focus of bioethics on autonomy, provides a moral warrant for ensuring that populations understand health risk 'in their guts.' This, we argue, does not relieve public health authorities from considering the burdens their efforts may impose on vulnerable populations.

Association of the LiveLighter mass media campaign with consumption of sugar‐sweetened beverages: Cohort study

“…Messages about the negative health consequences of lifestyle behaviours have been shown to provide motivation for positive change in other public health campaigns. 10,34,35 Given the observed increase in knowledge reflects the campaign message about the health effects of drinking too many SSBs, this provides support for the campaign as a driver of the increase. These findings also support the benefits of a specific, actionable health-message in public health communication.…”

“…As a mechanism to provide motivation for lifestyle change, the campaign aimed to increase awareness and understanding of the health consequences of SSB consumption. Messages about the negative health consequences of lifestyle behaviours have been shown to provide motivation for positive change in other public health campaigns . Given the observed increase in knowledge reflects the campaign message about the health effects of drinking too many SSBs, this provides support for the campaign as a driver of the increase.…”

Barriers to accessing methamphetamine treatment: A systematic review and meta-analysis

“…Stigma could be attributed to: extremely poor health (Lecomte et al, 2013); social issues, such as violence (McKetin et al, 2014); and media campaigns sensationalising the deleterious health, social and justice outcomes associated with methamphetamine use in a way likely to stigmatise, rather than assist methamphetamine users (Australian Government, 2016; Meth Project Foundation, 2016; Multnomah County Sherrif's Office, 2016)(Australian Federation of Aids Organisations, 2015; Kiejda, 2015). Prior literature suggests that campaigns that utilise shock or fear with the aim of changing behaviours, must also emphasise the treatment options available in order to be effective (Bayer and Fairchild, 2016;Soames Job, 1988).…”

No to circumcision: The road to effective social marketing campaigns in Egypt

“…For example, Durkin, Biener, and Wakefield (2009) found that fear-based appeals increased smoking cessation rates. Similarly, Bayer and Fairchild (2016) argue that although fear-based public health campaigns may be controversial, a growing body of evidence suggests that they are successful in changing norms. In contrast, our findings suggest that negative associations and the use of fear may limit the effectiveness of FGM/C abandonment initiatives.…”