Abstract
Aim
Discussions about who is responsible for public health problems such as obesity and smoking-related diseases are often heated. A central question concerns the extent to which individuals are responsible for the consequences of their health-impairing behaviour and whether the State and the food and tobacco industries can justifiably be said to be responsible, too. The controversy may be partly due to the two aims of responsibility ascriptions: that they should be morally justified and that they should be efficient. The primary aim of this article is to achieve more clarity in the analysis of this issue.
Method
The method used in the article is conceptual analysis in the tradition of moral philosophy.
Results
There are two major perspectives on responsibility ascriptions. First, there is the merit-based idea that responsibility should be ascribed to someone who deserves to be held accountable, e.g. because he or she voluntarily and knowingly brought about his or her own health impairment. Second, there is the consequentialist view that responsibility should be ascribed in ways that have as good effects as possible. There are two values at stake here: Responsibility ascriptions in public health should satisfy criteria of moral norms or fairness as well as of efficiency.
Conclusion
It is argued that both perspectives should be taken into account in public health policymaking. It is concluded that it is important to be aware of the two views of responsibility ascriptions in public health discussions and the policymaking process and to aim at striking a balance between the two.
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Notes
One theorist who wrote about the multicausality of social phenomena and the complex nature of social reality is Max Weber; see in particular The methodology of the social sciences [1903–1917 (1949)].
I would like to thank an anonymous reviewer for pointing out this important distinction.
As pointed out by a reviewer, there may be a difference between an American and a European perspective in terms of the goals and justification of public health efforts.
E.g., Habermas (1990), Moral consciousness and communicative action.
The NRW (North Rhine Westphalia) health conferences is an example of this.
References
Beaty D (1995) The naked pilot. The human factor in aircraft accidents. Airlife, Shrewsbury
Dekker S (2002) The field guide to human error investigations. Ashgate, Aldershot
Eshleman A (2004) Moral responsibility. The Stanford Encyclopedia of Philosophy (Fall 2004 Edition), Zalta EN (ed.), URL= http://plato.stanford.edu/archives/fall2004/entries/moral-responsibility/
Habermas J (1990) Moral consciousness and communicative action. Polity Press, Cambridge
Harlem Brundtland G (2005) Viewpoint. Eur J Public Health 15(1):3–5
Horner JS (2000) The virtuous public health physician. J Public Health 22:48–53
Nozick R (1974) Anarchy, state and utopia. Blackwell, Oxford
Vallgårda S (2001) Governing people's lives. Eur J Public Health 11:386–392
Weber M 1903–1917 (1949) The methodology of the social sciences. Shils EA, Finch HA (transl, eds) Free Press, New York
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Fahlquist, J.N. Responsibility ascriptions and public health problems. J Public Health 14, 15–19 (2006). https://doi.org/10.1007/s10389-005-0004-6
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DOI: https://doi.org/10.1007/s10389-005-0004-6