Saying something interesting about responsibility for health

Abstract

The concept of responsibility for health is a significant feature of health discourse and public health policy, but application of the concept is poorly understood. This paper offers an analysis of the concept in two ways. Following an examination of the use of the word 'responsibility' in the nursing and wider health literature using three examples, the concept of 'responsibility for health' as fulfilling a social function is discussed with reference to policy documents from the United Kingdom. The philosophical literature on moral responsibility is introduced, and in considering two versions, reactive attitudes and accountability, it is argued that in application both can be regarded, though with different emphasis, as being constituted in three parts: (i) a responsible agent (ii) having obligations (responsibilities) and (iii) being susceptible to being held responsible (that is blamed) if he fails to meet them. The three stage model is consistent with the examples of the word responsibility in use, but application to the social function model causes a number of problems for healthcare practice, especially for the reactive attitudes account. Apart from considerable problems in stating what exactly the obligations are and how they can be justified; and how blame might justly be apportioned and by whom, the very ideas of obligation and blame are in conflict with healthcare systems and professional nursing practice which have foundations deeply embedded in the notion of the supremacy of personal autonomy. It is concluded that current application of the concept of responsibility for health is conceptually incoherent, and if it is to retain its place in health policy and discourse, urgent remedy is required.

Nuorten terveysvalintoihin liittyvät oikeudet, velvollisuudet ja vastuu

“…Sen lisäksi, että nuorella on vastuu itsestä ja omista valinnoista, hänellä on myös osaltaan vastuu muista ihmisistä ja heidän hyvinvoinnistaan. (23) Vastuu muista tarkoittaa sitä, että nuori huomioi, ettei vahingoita muita ihmisiä omilla valinnoillaan (7, 18,23).…”

What's Wrong with Tombstoning and What Does This Tell Us About Responsibility for Health?

“…Despite its many ambiguities the concept personal responsibility for health forms part of the NHS constitution 10 , and is accepted by a large number of people (King's Fund 2004). There are three parts to responsibility for health (Snelling 2012): (1) a moral agent having (2) responsibilities and (3) liable to be held responsible in failing to meet them.…”

Challenging the Moral Status of Blood Donation

“…However, it would be surprising if there was a clear statement of a moral position in official documents because this is not their purpose, but also because there is a clear normative tension in UK healthcare practice between any notion of obligation and the predominant moral imperative to respect and promote personal autonomy (Snelling 2012). …”