Who can blame who for what and how in responsibility for health?

Abstract

This paper starts by introducing a tripartite conception of responsibility for health consisting of a moral agent having moral responsibilities and being held responsible, that is blamed, for failing to meet them and proceeds to a brief discussion of the nature of blame, noting difficulties in agency and obligation when the concept is applied to health threatening behaviours. Insights about the obligations that we hold people to and the extent of their moral agency are revealed by interrogating our blaming behaviour, and to facilitate this my own blaming attitudes and actions are analysed in respect of an imagined adult son who seeks thrills by jumping from a pier into the sea, an activity common around coastlines and intended to be analogous in varying degrees to a range of health-threatening behaviours. I consider my responses to this imagined act in relation to some features of moralism, the excess of morality, concluding that blame can be justified when it is proportionate and within interpersonal relationships. There is evidence that some nurses hold negative blaming attitudes towards groups of patients considered to have caused or contributed to their illness, but this is not justified, not only because of impaired agency, but because if there is responsibility for health, associated obligations are owed to those who share our lives, and it is those people who are entitled to hold individuals responsible. Nurses who hold negative blaming attitudes towards groups of patients are invited to identify the status of moral agency, the precise natures of their (failed) obligations and of the patient / nurse relationship. It is concluded that reflection on these matters, and the difference between justified blame and moralism demonstrates that blaming behaviour in the context of professional health care is built on nothing stronger than prejudice.

Nuorten terveysvalintoihin liittyvät oikeudet, velvollisuudet ja vastuu

“…Nuoren oikeudet ja velvollisuudet liittyvät vastuuseen (22). Vastuu tarkoittaa sitä, että nuori huolehtii terveydestään ja sen edistämisestä.…”

Responses to warnings about the impact of eating disorders on fertility: a qualitative study

“…As sociological work on risk has argued, constructions of risk invoke ideological narratives on causality, blame and responsibility, as seen explicitly in recent years with the neoliberal emphasis on ‘personal responsibility’ for health (Herrick, , McClean, ). But ideas of both personality responsibility and blame are beset by problems and inconsistencies (Snelling, ), not least because they depoliticise the social contexts of health, and thus the ways in which identities are structured and lived within relations of social power (McClean, ). Such debates about blame and individual responsibility have been particularly prevalent with respect to another area of body ‘management’: obesity (Snelling, ).…”

Developing a scale: Adolescents’ health choices related rights, duties and responsibilities

“…Adolescents have duties in relation to themselves and their own health, but they also have a duty to acknowledge others when making decisions 13,14 . Rights and duties about health choices are connected to responsibilities 9,15,16 . Responsibilities refer to adolescents taking care of their own health choices, including practical everyday tasks that relate to their health [17][18][19] .…”