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Reconsidering the Moralization of Health: Practices Versus Concepts, and What We Can Learn from Evidence-based Research

Published online by Cambridge University Press:  22 May 2019

S. JOSHUA THOMAS
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Abstract:

This article aims to do two things. First, it argues that moralization of health occurs not only at the practical level of individual healthcare choices and health states, but also at the conceptual level of health itself. This is most evident in cases where the concept of health is presumed to possess the property of “overridingness” when compared to competing values and norms, that is, when it is treated as taking precedence over other values and norms it may come into conflict with. Second, the article makes a case for being critically skeptical of specific deployments of the concept of health when it has been moralized in this way. In such cases, what typically results is that some other personal value/norm, or set of values/norms, held by the individual is treated as intrinsically at odds with the concept of health, which is presumed, uncritically, to be superior, often because it is taken to be free-standing and self-justifying. Yet, a growing body of evidence-based research suggests that the role played by dimensions of personal meaningfulness in the quality of individuals’ overall health is quite underappreciated. It is useful to think of these dimensions of personal meaning and significance as representing the individual’s values. Thus, taking these data more seriously ought to lead to a reevaluation of the moralization of health at the conceptual level. In the first place, it is not obvious that if the concept of health runs afoul of other values/norms held by an individual, the latter should automatically yield. In the second place, they suggest that other values/norms held by an individual are not necessarily intrinsically opposed to the concept of health, but in fact may go a good distance in support of it.

Keywords

conceptual moralization of healthoverrdingnessmedical valuescultural valuesmoralization of healthresponsibilizationevidence-based medicine
Type
Special Section: Health, Morality, and Moralism
Information
Cambridge Quarterly of Healthcare Ethics , Volume 28 , Issue 2 , April 2019 , pp. 215 - 224
Copyright
Copyright © Cambridge University Press 2019 

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References

Notes

1. Rozin, P. The process of moralization. Psychological Science 1999;10(3):218–21. See also, note 3, Rozin 1997.CrossRefGoogle Scholar

2. See note 1, Rozin 1999.

3. Rozin, P, Markwith, M, Stoess, C. Moralization and becoming a vegetarian: The transformation of preferences into values and the recruitment of disgust. Psychological Science 1997;8(2):67–73.CrossRefGoogle Scholar

4. Wakefield, AJ, Murch, SH, Anthony, A, Linnell, J, Casson, DM, Malik, M, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998; 351:637–41. Retraction in: Lancet. 2010;375:445.CrossRefGoogle ScholarPubMed

5. Rao, TSS, Andrade, C. The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian Journal of Psychiatry 2011;53(2):95–6.Google ScholarPubMed

6. Kata, A. A postmodern Pandora’s box: Anti-vaccination information on the internet. Vaccine 2010;28:1709–16.CrossRefGoogle ScholarPubMed

7. Amin, AB, Bednarczyk, RA, Ray, CE, Melchiori, KJ, Graham, J, Huntsinger, JR, Omer, SB. Association of moral values with vaccine hesitancy. Nature Human Behavior 2017;1:873–80.CrossRefGoogle ScholarPubMed

8. Olpinski, M. Anti-vaccination movement and parental refusals of immunization of children in USA. Pediatria Polska 2012;87:381–5.CrossRefGoogle Scholar

9. Caplan, A, Hoke, D, Diamond, N, Karshenboyem, V. Free to choose, but liable for the consequences: Should non-vaccinators be penalized for the harm they do? The Journal of Law, Medicine, and Ethics 2012; 40(3):606–11.CrossRefGoogle Scholar

10. Roehling, MV. Weight-based discrimination in employment: Psychological and legal aspects. Personnel Psychology 1999;52(4):969–1016.CrossRefGoogle Scholar

11. Paul, RJ, Townsend, JB. She up or ship out? Employment discrimination against the overweight. Employee Responsibilities and Rights Journal 1995;8(2):133–45.CrossRefGoogle Scholar

12. Fikkan, J, Rothblum, ED. Weight bias in employment. In: Brownwell, KD, Puhl, RM, Schwartz, MB, Rudd, L, eds. Bias, Stigma, Discrimination, and Obesity, New York: Guilford Publications; 2005. p. 13–23.Google Scholar

13. Gert, J. Moral overridingness. In: Lafollette, H, ed. International Encyclopedia of Ethics, Vol 1; 2013;3764–3770.Google Scholar

14. Hurley, P. Two senses of moral verdict and moral overridingness. In: Timmons, M, ed. Oxford Studies in Normative Ethics, Vol. 6; 2016;215–240.CrossRefGoogle Scholar

15. See note 13, Gert 2013.

16. Portmore, DW. Are moral reasons morally overriding? Ethical Theory and Moral Practice 2008;11(4):369–88.CrossRefGoogle Scholar

17. Foot, P. Virtues and Vices. Los Angeles: The University of California Press; 1978.Google Scholar

18. See note 14, Hurley 2016.

19. Weis, J, Giesler, JM. Subjective dimensions of patient competence: Relationships with selected healthcare usage behaviors and general features of self-rated competence. Patient Education and Counseling 2008;73:511–18.CrossRefGoogle ScholarPubMed

20. Venetis, MK, Robinson, JD, Turkiewicz, KL, Allen, M. An evidence base for patient-centered care: A meta-analysis of studies of observed communication between cancer specialists and their patients. Patient Education Counseling 2009;77(3):379–83.CrossRefGoogle ScholarPubMed

21. Pollak, KI, Arnold, RM, Jeffreys, AS, Alexander, SC, Olsen, MK, Abernethy, AP, et al. Oncologist communication about emotion during visits with patients with advanced cancer. Journal of Clinical Oncology 2007;25(36):5748–52.CrossRefGoogle ScholarPubMed

22. Gawande, A. Letting go: What should medicine do when it can’t save your life? The New Yorker. 2 Aug 2010; available at https://www.newyorker.com/magazine/2010/08/02/letting-go-2 (last accessed 15 Oct 2017).Google Scholar

23. Hill, PL, Turiano, N. Purpose in life as a predictor of mortality across adulthood. Psychological Science 2014;25(7):1482–86.CrossRefGoogle ScholarPubMed

24. Mirowsky, J, Ross, CE. Creative work and health. Journal of Health and Social Behavior 2007; 48(4):385–403.CrossRefGoogle ScholarPubMed

25. Piliavin, JA, Siegel, E. Health benefits of volunteering in the Wisconsin longitudinal study. Journal of Health and Social Behavior 2007;28(4):450–64.CrossRefGoogle Scholar

26. Brown, SL, Nesse, RM, Vinokur, AD, Smith, DM. Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality. Psychological Science 2003;14(4):320–27.CrossRefGoogle ScholarPubMed