An Ethic for Health Promotion

What are the goals of health promotion and the most apropriate means of achieving them? The prevailing view is that these goals are to prolong life and reduce mortality rates. Since the leading causes of morbidity and mortality are now largely attributable to lifestyle behaviors--smoking, diet, exercise, etc.--the means of achieving reductions in heart disease, cancer, strokes, diabetes and other chronic conditins are to identify more effective techniques for changing people's behavior. Virtually all health promotion research is currently directed towards accomplishing this objective. But at what cost? As researchers strive for more effective ways to change people's behavior, what are the implications for individual autonomy, integrity, and responsibility? Buchanan sets out to explain why a science of health promotion is neither imminent or estimable. He argues that health promotin is inescapably a moral and political endeavor and that goals more befitting the realization of human well-being are to promote self-knowledge, individual autonomy, integrity, and responsibility through putting into practice more democratic processes of self-direction and mutual support in civil society.

David R. Buchanan is at University of Massachusetts, School of Public Health and Health Sciences.