Nir Eyal is with the Center for Population-Level Bioethics, Rutgers University, New Brunswick, NJ. Manne Sjöstrand is with the Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Am J Public Health. 2020 Apr;110(4):480-484. doi: 10.2105/AJPH.2019.305428. Epub 2020 Feb 20.
What is the ethics of setting unrealistic goals in public health-declared goals of population health campaigns that, when introduced, are already known to be impossible to accomplish? Over the past 2 decades, major public health campaigns have set unrealistic goals, such as "eliminating" or reaching "zero" on diseases and risk factors that are clearly ineliminable.We argue that unrealistic goals can sometimes motivate action, attract funding, and help educate the public and public health practitioners better than realistic goals. Although unrealistic goal setting faces ethical challenges, including the charge of deceit and that of undermining the field's credibility, we argue that these challenges can be met.The advantages of unrealistic goal setting while overcoming these challenges can be accomplished in 2 stages: (1) an initial declaration of the attractive but unrealistic goal educates and motivates; (2) realistic, precise, and actionable subgoals then expose its unrealistic nature and preempt ongoing deceit.
在公共卫生领域设定不切实际的目标是否合乎道德规范——即人口健康运动所宣布的目标，在提出时就已经知道不可能实现？在过去的 20 年里，许多重大的公共卫生运动都设定了不切实际的目标，例如“消除”或达到“零”疾病和风险因素，而这些显然是无法消除的。我们认为，不切实际的目标有时可以激发行动、吸引资金，并比现实目标更好地教育公众和公共卫生从业者。尽管不切实际的目标设定面临着伦理挑战，包括欺骗指控和破坏该领域可信度的指控，但我们认为这些挑战是可以克服的。在克服这些挑战的同时实现不切实际的目标设定的优势可以分两个阶段来完成：（1）最初宣布有吸引力但不切实际的目标可以起到教育和激励作用；（2）然后设定现实、精确和可操作的次级目标，揭示其不切实际的本质，并预先防止持续的欺骗行为。
