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英国癌症研究中心2018年和2019年的肥胖症宣传活动:是有效的健康促进还是延续对肥胖症的污名化?

Cancer Research UK'S obesity campaign in 2018 and 2019: effective health promotion or perpetuating the stigmatisation of obesity?

作者信息

Varshney Natasha

机构信息

Liverpool School of Medicine, University of Liverpool, Liverpool, UK

出版信息

J Med Ethics. 2020 Nov 25. doi: 10.1136/medethics-2020-106192.

Abstract

In 2018 and 2019 Cancer Research UK (CRUK) launched a controversial advertising campaign to inform the British public of obesity being a preventable cause of cancer. On each occasion the advertisements used were emotive and provoked frustration among the British public which was widely vocalised on social media. As well serving to educate the public of this association, the advertisements also had the secondary effect of acting as health promotion through social marketing, a form of advertising designed to influence behavioural changes. As CRUK delivered a public health message through its campaign, the advertisements should be held according to the ethical principles which underpin healthcare in the UK. This article evaluates whether the advertisements used by CRUK in 2018 and 2019 fulfilled the ethical principles of beneficence, autonomy, non-maleficence and justice. It is found that while providing an important message, the oversimplification of obesity as being the result of personal decisions ignored the complex aetiology and served to stigmatise the target demographic, potentially disengaging them from the message. Additionally, posting cancer as the consequence of obesity invokes feelings of fear due to its connotations of suffering and premature death. Based on available evidence, the use of fear in social marketing does not create sustained behavioural change. This essay recommends that CRUK discontinue its use of such strategies in its future social marketing endeavours.

摘要

2018年和2019年,英国癌症研究中心(CRUK)发起了一场颇具争议的广告宣传活动,告知英国公众肥胖是癌症的一个可预防病因。每次使用的广告都很情绪化,在英国公众中引发了不满,社交媒体上对此议论纷纷。这些广告在向公众宣传这种关联的同时,还通过社会营销起到了促进健康的次要作用,社会营销是一种旨在影响行为改变的广告形式。由于CRUK通过其活动传递了一条公共卫生信息,这些广告应依据支撑英国医疗保健的伦理原则来评判。本文评估了CRUK在2018年和2019年使用的广告是否符合 beneficence(有益)、autonomy(自主)、non-maleficence(不伤害)和justice(公正)的伦理原则。研究发现,虽然传达了一条重要信息,但将肥胖过度简化为个人决定的结果忽视了其复杂的病因,还对目标人群造成了污名化,可能使他们对该信息产生抵触。此外,将癌症描述为肥胖的后果,因其包含痛苦和过早死亡的含义,会引发恐惧情绪。根据现有证据,在社会营销中使用恐惧并不能带来持续的行为改变。本文建议CRUK在未来的社会营销活动中停止使用此类策略。

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