Public Health Communications: Values and Ethical Dilemmas

This book represents a significant contribution to the “growing up” of the public health movement. It challenges the naïve assumption that health interventions and campaigns are inevitably and a priori a good thing, noble enterprises, run by modern day crusaders in the public interest.

The book reminds us that behind every health communication is a range of, usually unexpressed, assumptions and values. It questions how far we can and should go in attempting to change people’s behaviour and values, and suggests that some common outcomes of health communication, such as anxiety, guilt and social ostracization may not be ethically acceptable or compatible with attempts to develop a physically and mentally healthy society. It also points out that the Utopian vision of society, beloved of some health promoters, may be considered intrusive rather than well intentioned, imperialistic rather than benevolent, through the imposition of unfamiliar, class based norms and values. It suggests that some approaches can therefore be seen as morally dubious and tyrannical, run by “health vigilantes”, rather than those who are genuinely concerned with understanding and empowering people.

The message should not be seen as a denial of the importance of health communication. Rather it acts as an essential reminder of the importance of avoiding naïve preconceptions, and the need for a more sophisticated and critical awareness of assumptions and values. The book itself presents a range of very clear, practical and useful conceptual frameworks and constructs that help identify hidden values and justifications, and widen the criteria for programme evaluation and policy making.