Bioethics Blogs

Personal responsibility within health policy: unethical and ineffective

Guest Post: Phoebe Friesen
Article: Personal Responsibility Within Health Policy: Unethical and Ineffective

If someone who has smoked two packs a day for thirty years and someone who has never smoked but is unfortunate enough to inherit a genetic condition are both in need of heart surgery, who should be given priority?

Should an alcoholic be placed on the liver transplant list, even if they continued to drink against their doctor’s advice?

Does someone who never works out and has poor eating habits have the same right to health care as someone who eats healthy and exercises every day?

Policy makers who are faced with the difficult task of distributing limited resources in health care need to determine which criteria are relevant, and questions related to ‘personal responsibility’ come up time and again. Within the field of medical ethics, many have argued that personal responsibility should be taken into account within health care policy. Advocates suggest that treatments will be more effective or provide longer-lasting solutions if illnesses are not self-caused, and argue that individuals who knowingly take health risks violate their obligation to take care of themselves and should therefore be treated differently. Others argue that there is no place for responsibility in health care policy, pointing out that there is no evidence for different treatment outcomes in individuals who did or did not contribute to their condition, and emphasizing the difficulty, if not impossibility, of determining how responsible someone is for a particular health problem.

In an extended essay in the Journal of Medical Ethics, I join those who argue against taking responsibility into account within health policy, by offering two arguments against such policies.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.