This week I taught a session Ethics in
health promotion practice, on our MSc Public Health – Health Promotion. Ethics, of course permeates the course –
ethics is at the heart of deciding what kind of society we want to create, and
health promotion is all about creating the kind of society in which health
justice is available for all. Previously, we have
considered ‘big picture’ ethics, with issues of inequity, justice and so on,
and also the practical issues facing health promoters in designing their
programmes, such as use of coercion, fear appeals, how to work ethically with communities
and so on. This session focused more on the processes of ethical reasoning. We
therefore started by considering the link between critical thinking and ethical
reasoning with a useful guide being:
We also took a look at the work of one of
the most prominent ethical thinkers, Peter Singer, who in this video ponders why
some people but not others feel that the level of wealth enjoyed by the super
rich is a moral outrage:
Most of the session though focused on the
work of Michael Sandel, whose series of public ethical debates are currently
being aired on BBC Radio 4:
He feels that the philosophy behind current
issues is not explicit, and he has tried to develop the lines of reasoning that
it would be useful to take to arrive at decisions.
The reason that this broadcast as useful
for us, apart from exposing the principles of ethical reasoning, was that it
took the issue of whether we should bribe people to be healthy. The discussion
started by considering whether people who are obese and overweight should be
given money to lose weight.
He used a variety of means – dialogue,
using evidence, listing objections and the case for, giving similar but
different cases and really defining terms – to arrive at a series of
principles. The discussion ranged over the fact that we do in effect use
incentives – e.g. taxing cigarettes – although giving people money to lose
weight is in effect rewarding previous ‘bad’ behavior. What about all the
people who do promote their own health without being given any inducements?
There was moral repugnance at paying female drug addicts if they agreed to be
sterilized, on the basis that they were not in a ‘proper place’ to make free
decisions. But opinion was divided about whether giving money to the overweight was ethicaly acceptable - for one in the audience, it had worked.
Some felt that a bribe was a more honest
word that an incentive, though one participant felt that a bribe is something
that goes against a moral code, whereas an incentive doesn’t.
Summing up, Sandel argued that paying
people implicitly goes against other values, such as freedom of choice, and
also crowds out other learning, such as the intrinsic value of carrying out an
activity.
The podcast is well worth listening to.
As it happens, this week our new external
examiner, Dr. Peter Duncan came to Leeds
Met for our exam board. He is also a leading writer on ethics in health
promotion, having published a lot with Alan Cribb. Peter works at King’s
College London:
His publications can be seen at:
Peter joins a distinguished list from the
epistemic health promotion community who have acted as external examiners in
the past. (For those unfamiliar with
higher education, an external examiner scrutinises the marking of student work,
and looks at student assignments to make sure they are of a similar standard to
that in other Universities). For the last five years, our external was Angela
Scriven, an academic working at Brunel University, and a prolific writer and
editor of key health promotion books:
Before that, Jane Wills occupied the post
of external examiner. She is perhaps most well known for her introductory book
on health promotion, written with Jennie Naidoo, but she has written many other
papers and books too. She works at the University of the South Bank in London:
This linking of academic health promotion
experts brings added dimensions to the course.
For the last five years I have acted as external at the University of
the West of England in Bristol and other colleagues play this role elsewhere.
It remains to be seen whether having a
particular person as external affects students’ reading. Maybe we will see more students reading
Peter’s work on ethics and health promotion!
No comments:
Post a Comment