Personal responsibility for health as a rationing criterion: why we don’t like it and why maybe we should

Buyx, Alena

doi:10.1136/jme.2007.024059

Cited by 103 publications

(102 citation statements)

References 31 publications

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“…Despite the growing research on the relation between solidarity and personal responsibility (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) few studies have directly and systematically explored this question for a broad range of unhealthy behaviours.…”

Section: Introductionmentioning

confidence: 99%

Should I pay for your risky behaviours? Evidence from London

Miraldo¹,

Galizzi²,

Merla³

et al. 2014

Preventive Medicine

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We investigate the extent to which respondents from a general population sample in London (JulyAugust 2011) agree or disagree with the NHS covering the healthcare costs related to five risky health behaviours: overeating, unhealthy diet, sedentary life, excess of alcohol, and smoking. For each behaviour, we also directly explore the main factors associated with the likelihood to agree or disagree. Half of the respondents (N=146) manifest agreement with the idea. Wider agreement exists for covering the costs associated to smoking, heavy drinking, and sedentary lives than to overeating, or poor diets. With the exception of alcohol drinking and sedentaray life, there is an almost one-to-one relationship between the agreement that the NHS should pay the healthcare costs associated to a specific behaviour, and the respondents' actual engagement in that behaviour. Those at higher risk of depending on publicly funded healthcare, are more likely to agree.

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Section: Introductionmentioning

confidence: 99%

Should I pay for your risky behaviours? Evidence from London

Miraldo¹,

Galizzi²,

Merla³

et al. 2014

Preventive Medicine

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“…When debating criteria for rationing within healthcare systems, personal responsibility seldom receives good press (Buyx, 2008). Holding individuals personally responsible has often been perceived as a way of 'blaming the victim,' which is contrary to the aims of contemporary medicine (Buyx, 2008).…”

Section: Introductionmentioning

confidence: 99%

Personal Health Responsibility: Blaming Victims or Empowering Nations?

Valela¹

2010

RISS-IJHS

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Abstract:The place for personal responsibility within healthcare has been highly contested within academic debate. Meanwhile, leading causes of death within the United States have shifted to chronic disease as a result of lifestyle behaviours suggesting the need for health promotion to take action. In this position paper, I will argue that the less punitive element of personal responsibility implied by health promotion is both ethically justifiable and beneficial as a means of empowering the individual, population and healthcare system as a whole. Several counter-arguments are presented and subsequently refuted: health responsibility unduly places blame upon vulnerable populations; administration of negative sanctions based on health responsibility is difficult; and actions detrimentally affecting health are not certain to be autonomously undertaken by the individual. Arguments in favour are then presented: a dependence of the population upon the healthcare system has been created; empowerment is effective as the central guiding principle of health promotion; and sensible care for oneself should be a duty of citizens, which they are required to fulfill as the healthcare system is not in a position to act as an unlimited resource. As such, health promotion must continue to emphasize the importance of sensible health behaviour as a means of empowering individuals through self responsibility.

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“…Foremost, individual responsibility for one's health is discussed in medical ethics as a matter of fairness. From the viewpoint of liberal egalitarian justice, it seems fair to apply a principle of individual responsibility as means for prioritysetting (Buyx 2005;Cappelen and Norheim 2006). Other ethicists such as Daniel Wikler (1987 dismiss the responsibility principle, not least because the extent of choice people actually have is difficult to measure, but also because lifestyles are said to depend rather on environmental factors and class position than on free choice.…”

Section: Introductionmentioning

confidence: 99%