Responsibility Considerations and the Design of Health Care Policies: A Survey Study of the Norwegian Population

A scoping review of individual health responsibility: A context-base concept

BACKGROUND

Individual health responsibility plays an important role in maintaining and improving people's health. There are controversial opinions related to this concept. This study aimed to investigate controversial opinions related to individual health responsibility and familiarize researchers and policy makers with the available evidence and gap of knowledge in the recent years.

MATERIAL AND METHOD

This paper is a scoping review. The five-step approach of Arksey and O'Malley was used to review the relevant literature from the beginning of 2017 to the end of 2022. The search was done in the PubMed, Embase, Scopus, web of sciences, Cochrane databases, and Google Scholar search engine using the English keywords "health responsibility" AND "individual" OR "personal".

RESULTS

All articles and theses related to individual health responsibility, which were in English and had access to their full text, were included in the study. After a 2-stage screening for 1,412 articles and theses, 32 were included in the study. The findings indicated that most of the studies were conducted in developed European continent. The published articles included a wide range of quantitative, qualitative, and mixed research, and acute and chronic diseases have been considered in this field.

CONCLUSION

Individual health responsibility is a multidimensional concept that is influenced by individual, social, and cultural factors, and emphasizing it can have both positive and negative effects on people's health. To the concept be effective in health promotion, it is important to pay attention to individual and social context, health status, and community and health policy makers views about individual health responsibility.

Discrimination Based on Personal Responsibility: Luck Egalitarianism and Healthcare Priority Setting

Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding harm, it is very plausible to consider the policies harmful but much less reasonable to consider those responsible for their health disadvantages a socially salient group. Drawing on the disrespect literature, where social salience is typically not required for something to be discrimination, the policies are a form of discrimination. They are, however, not disrespectful. The upshot of this first assessment of the discrimination objection to luck egalitarianism in health is, thus, that it fails.

Bioethics: An International, Morally Diverse, and Often Political Endeavor

Bioethicists often remind health care professionals to pay close attention to issues of diversity and inclusion. Approaches to ethics consultation, where the perspective of the bioethicist is taken to be more morally correct or necessarily authoritative, have been critiqued as inappropriately authoritarian. Despite such apparent recognition of the importance of respecting moral diversity and the inclusion of different viewpoints, authoritarianism is all too often the approach adopted, especially as bioethics has shifted evermore into concerns for public policy. Yet, secular values and philosophical principles are not morally neutral; nor are the private moral convictions of bioethicists. Such analysis is always grounded in particular understandings of the right and the good, the virtuous and the just. Critical examination of common treatments and new alternatives is essential for the careful scientific practice of medicine. The same is true with regard to bioethics. Stagnating in customary or accepted claims of a common secular morality or a standard set of bioethical principles out of an unwillingness to explore the real diversity of moral thought, including traditional religious and cultural worldviews, fails to tap the human capacity to find innovative solutions to the complex challenges facing medicine.