Promoting Healthy Behavior: How Much Freedom? Whose Responsibility? by Daniel Callahan (Editor)

From the Publisher

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 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.

Michael J. Cholbi

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.

Doody Review Services

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 ofthe 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.

Booknews

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)

Rating

3 Stars from Doody

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Table of Contents