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How to Think about Health Promotion Ethics

Public Health Reviews volume 34, Article number: 9 (2012) Cite this article

Abstract

Health promotion ethics is moral deliberation about health promotion and its practice. Although academics and practitioners have been writing about ethics, and especially values, in health promotion for decades, health promotion ethics is now regaining attention within the broader literature on public health ethics. Health promotion is difficult to define, and this has implications for health promotion ethics. Health promotion can be approached in two complementary ways: as a normative ideal, and as a practice. We consider the normative ideal of health promotion to be that aspect of public health practice that is particularly concerned with the equity of social arrangements: it imagines that social arrangements can be altered to make things better for everyone, whatever their health risks, and seeks to achieve this in collaboration with citizens. This raises two main ethical questions. First: what is a good society? And then: what should health promotion contribute to a good society? The practice of health promotion varies widely. Discussion of its ethical implications has addressed four main issues: the potential for health promotion to limit or increase the freedom of individuals; health promotion as a source of collective benefit; the possibility that health promotion strategies might “blame the victim” or stigmatise those who are disabled, sick or at higher risk of disease; and the importance of distributing the benefits of health promotion fairly. Different people will make different moral evaluations on each of these issues in a way that is informed by, and informs, their vision of a good society and their understanding of the ends of health promotion. We conclude that future work in health promotion ethics will require thoughtfully connecting social and political philosophy with an applied, empirically informed ethics of practice.

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Authors and Affiliations

  1. Centre for Values, Ethics and the Law in Medicine, School of Public Health, The University of Sydney, NSW, 2006, Australia

    Stacy M. Carter BAppSci, MPH(Hons), PhD (NHMRC Career Development Fellow)

  2. Centre for Public Policy Research, King’s College, London, UK

    Alan Cribb BA, PhD (Professor of Bioethics and Education)

  3. Teachers College, Columbia University, USA

    John P. Allegrante BS, MS, PhD (Professor of Health Education and Deputy Provost, Adjunct Professor of Sociomedical Sciences in Public Health)

  4. Mailman School of Public Health, Columbia University, USA

    John P. Allegrante BS, MS, PhD (Professor of Health Education and Deputy Provost, Adjunct Professor of Sociomedical Sciences in Public Health)

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  1. Stacy M. Carter BAppSci, MPH(Hons), PhD
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  2. Alan Cribb BA, PhD
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  3. John P. Allegrante BS, MS, PhD
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Correspondence to Stacy M. Carter BAppSci, MPH(Hons), PhD.

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Carter, S.M., Cribb, A. & Allegrante, J.P. How to Think about Health Promotion Ethics. Public Health Rev 34, 9 (2012). https://doi.org/10.1007/BF03391661

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