Incentives in Health Promotion: The Ethics and Politics of Healthy Choices
Behaviour shaping through incentives plays a major role in health and health promotion, and governments are increasingly interested in incentive technologies to counter what they perceive as poor health outcomes.
On the one hand, poor health often results directly from people making “unhealthy choices” (smoking, no exercise, poor diet), and incentives to promote healthy choices are typically regarded as justified by their effect on health outcomes.
On the other hand, we also know that many external interventions impact on individual or population health, and here too aligning the incentives of the relevant individual (e.g., organ donors) or corporate (e.g., tobacco firms or food and drinks industry) actors with the goal of health promotion appears justified.
Nevertheless, considerable disagreement persists over both the appropriate range of incentives and the particular mechanisms or tools best suited for the task. Regarding the former, we must question whether there are areas or aspects that should remain off-limits to incentivizing interventions; a concern related to the oft-debated public/private distinction in ethics and politics.
Regarding the latter, recent controversies include the use of monetary incentives in an increasing range of health interventions, the debate between strict regulation and self-regulation (including the use of extreme penalties and even outrights bans), and most recently the importance of nudging technologies affecting the “choice architecture” of both individuals and health professionals.
These issues raise many normative questions of relevance to heath ethicists, political theorists, social scientists and policy analysts, including the role of legitimate paternalism, stigma, manipulation, coercion, exploitation, distributive fairness and equality of regard, and more generally trade-offs between freedom and objective good in a liberal society.
In this workshop we invite papers that address general issues related to incentives in health promotion or a more targeted discussion of a particular incentive mechanism or a specific area of application within the health field.
We welcome papers that take a philosophical stance but equally those that consider issues of policy application and governance. Those interested in participating in this workshop should send a title and short abstract (about 250 words) to either convener.
Richard Ashcroft (Queen Mary, University of London)
Jurgen De Wispelaere (McGill)