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Saying something interesting about responsibility for health
Author(s) -
Snelling Paul C.
Publication year - 2012
Publication title -
nursing philosophy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.367
H-Index - 35
eISSN - 1466-769X
pISSN - 1466-7681
DOI - 10.1111/j.1466-769x.2011.00531.x
Subject(s) - blame , obligation , social responsibility , moral responsibility , accountability , autonomy , function (biology) , health care , sociology , law and economics , public relations , epistemology , political science , psychology , law , social psychology , philosophy , evolutionary biology , biology
The concept of responsibility for health is a significant feature of health discourse and public health policy, but application of the concept is poorly understood. This paper offers an analysis of the concept in two ways. Following an examination of the use of the word ‘responsibility’ in the nursing and wider health literature using three examples, the concept of ‘responsibility for health’ as fulfilling a social function is discussed with reference to policy documents from the UK. The philosophical literature on moral responsibility is introduced, and in considering two versions, reactive attitudes and accountability, it is argued that in application both can be regarded, though with different emphasis, as being constituted in three parts: (i) a responsible agent; (ii) having obligations (responsibilities); and (iii) being susceptible to being held responsible (that is blamed) if he fails to meet them. The three‐stage model is consistent with the examples of the word responsibility in use, but application to the social function model causes a number of problems for healthcare practice, especially for the reactive attitudes account. Apart from considerable problems in stating what exactly the obligations are and how they can be justified; and how blame might justly be apportioned and by whom, the very ideas of obligation and blame are in conflict within healthcare systems and professional nursing practice which have foundations deeply embedded in the notion of the supremacy of personal autonomy. It is concluded that current application of the concept of responsibility for health is conceptually incoherent, and if it is to retain its place in health policy and discourse, urgent remedy is required.