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Health Promotion and Autonomy-Based Ethical Concerns
Health promotion initiatives are associated with ethical concerns that affect their implementation and effectiveness. In particular, most health promotion activities could be perceived as limiting peoples rights to choose unhealthy behaviors over healthy ones. For example, although smoking has multiple negative effects on health, many people choose to continue smoking, and they have a right to do so. For healthcare professionals, resolving this ethical dilemma is a way of understanding health promotion principles and applying them to practice.
Gardner (2014) explains that, although health promotion is among the crucial steps in improving population health, it can be a controversial concept when viewed from an ethical perspective. The two main types of ethical concerns associated with health promotion initiatives are efficacy-based and autonomy-based (Gardner, 2014). Whereas efficacy-based concerns are usually specific to a certain intervention, autonomy-based concerns can be applied to health promotion efforts in general. Any type of health promotion initiative, whether it is focused on providing information, changing patients lifestyle, or improving community access to health, can affect the autonomy of patients. For example, if a health promotion initiative insists that, in order to avoid a health issue, it is crucial to maintain a certain lifestyle, it might be perceived as limiting the patients autonomy. In addition, if the patient has any autonomy-related concerns regarding an intervention, he or she might be less willing to follow the recommendations, which could affect the efficiency of the health promotion initiative. Thus, it is crucial for health professionals to find a way of resolving autonomy-based ethical concerns.
Health promotion initiatives are generally considered from a utilitarianism perspective. Utilitarianism is an ethical theory where the morality of actions is judged based on their consequences (Bonde & Firenze, 2013). Thus, healthy lifestyle changes and other prevention or treatment schemes promoted by health professionals are considered beneficial not just to a single individual but entire communities due to their consequences. Duty-based ethical theories, on the other hand, view moral actions as an obligation, and thus they can limit the persons autonomy (Bonde & Firenze, 2013).
One way to resolve autonomy-based ethical concerns is thus to focus on providing information about the positive consequences of the promoted change. Such approach would allow the patient to exercise the necessary degree of autonomy in decision-making. In addition, it would also help health professionals to improve health promotion efforts by increasing customer satisfaction. If a person does not feel that the initiative is restricting his or her personal rights, he or she would be more likely to follow the recommendations and experience higher satisfaction with the service provided. Maintaining customer focus and working to achieve better customer satisfaction is among the key ethical principles noted in the NAHQ Code of Ethics and Standards of Practice (NAHQ, 2012). Thus, approaching health promotion from the utilitarianism perspective could also improve the quality of practice.
On the whole, autonomy-based ethical concerns can have a serious influence on health promotion efforts and their efficiency, which is why it is essential for health professionals to address them. Based on utilitarianism, actions for health promotion are beneficial due to their consequences for the individual and the society. However, utilitarianism does not stipulate that these actions are mandatory, thus allowing patients to be autonomous in decision-making. Therefore, explaining health promotion initiatives from a utilitarianism perspective would allow health professionals to resolve the autonomy-based ethical concerns and achieve better outcomes in patients.
References
Bonde, S., & Firenze, P. (2013). Making choices: A framework for making ethical decisions. Web.
Gardner, J. (2014). Ethical issues in public health promotion. South African Journal of Bioethics and Law, 7(1), 30-33.
National Association for Healthcare Quality (NAHQ). (2012). NAHQ Code of Ethics and Standards of Practice.
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