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抵制健康促进中的道德化

Resisting Moralisation in Health Promotion.

作者信息

Brown Rebecca C H

机构信息

Oxford Uehiro Centre for Practical Ethics, University of Oxford, Suite 8 Littlegate House, 16-17 St Ebbe's Street, Oxford, OX1 1PT UK.

出版信息

Ethical Theory Moral Pract. 2018;21(4):997-1011. doi: 10.1007/s10677-018-9941-3. Epub 2018 Nov 8.

Abstract

Health promotion efforts are commonly directed towards encouraging people to discard 'unhealthy' and adopt 'healthy' behaviours in order to tackle chronic disease. Typical targets for behaviour change interventions include diet, physical activity, smoking and alcohol consumption, sometimes described as 'lifestyle behaviours.' In this paper, I discuss how efforts to raise awareness of the impact of lifestyles on health, in seeking to communicate the (perceived) need for people to change their behaviour, can contribute to a climate of 'healthism' and promote the moralisation of people's lifestyles. I begin by summarising recent trends in health promotion and introducing the notion of healthism, as described by Robert Crawford in the 1980s. One aspect of healthism is moralisation, which I outline (alongside the related term moralism) and suggest is facilitated by efforts to promote health via information provision and educational strategies. I propose that perceived responsibility plays a role in mediating the tendency to moralise about health and behaviour. Since I argue that states ought to avoid direct and indirect moralisation of people's health-related behaviour, this suggests states must be cautious with regard to the use of responsibility-indicating interventions (including informational and educational campaigns) to promote health.

摘要

健康促进工作通常旨在鼓励人们摒弃“不健康”行为,采取“健康”行为,以应对慢性病。行为改变干预措施的典型目标包括饮食、体育活动、吸烟和饮酒,有时被称为“生活方式行为”。在本文中,我将讨论在试图传达人们改变行为的(感知到的)必要性时,提高对生活方式对健康影响的认识的努力如何会促成一种“健康主义”氛围,并促进人们生活方式的道德化。我首先总结健康促进的近期趋势,并引入20世纪80年代罗伯特·克劳福德所描述的健康主义概念。健康主义的一个方面是道德化,我将对此进行概述(连同相关术语道德主义),并指出通过提供信息和教育策略来促进健康的努力会助长这种道德化。我认为,感知到的责任在调节对健康和行为进行道德化的倾向方面发挥着作用。由于我认为国家应该避免对人们与健康相关的行为进行直接和间接的道德化,这意味着国家在使用表明责任的干预措施(包括信息和教育活动)来促进健康时必须谨慎。

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