Journal Article

Behavior Change or Empowerment: On the Ethics of Health-Promotion Strategies

Per-Anders Tengland

in Public Health Ethics

Volume 5, issue 2, pages 140-153
Published in print July 2012 | ISSN: 1754-9973
Published online September 2012 | e-ISSN: 1754-9981 | DOI: http://dx.doi.org/10.1093/phe/phs022
Behavior Change or Empowerment: On the Ethics of Health-Promotion Strategies

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There are several strategies to promote health in individuals and populations. Two general approaches to health promotion are behavior change and empowerment. The aim of this article is to present those two kinds of strategies, and show that the behavior-change approach has some moral problems, problems that the empowerment approach (on the whole) is better at handling. Two distinct ‘ideal types’ of these practices are presented and scrutinized. Behavior change interventions use various kinds of theories to target people’s behavior, which they do through information, persuasion, coercion and manipulation. Empowerment is a collaborative method where those ‘facilitated’ participate in the change process. Some ethical problems with the behavior-change model are that it does not sufficiently respect the right to autonomy of the individuals involved and risks reducing their ability for autonomy, and that it risks increasing health inequalities. Empowerment, on the other hand, respects the participant’s right to autonomy, tends to increase the ability for autonomy, as well as increasing other coping skills, and is likely to reduce inequalities. A drawback with this approach is that it often takes longer to realize.

Journal Article.  9552 words. 

Subjects: Philosophy of Science ; Philosophy of Biology ; Bioethics and Medical Ethics ; Medical Ethics ; Public Health

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