The ethical commitments of health promotion practitioners: an empirical study from New South Wales, Australia

Abstract

In this article, we provide a description of the good in health promotion. This description comes from an empirical study of health promotion practices in New South Wales, the most populous state in Australia. Through analysis of interviews and observations, we found that practitioners were unified by a vision of the good in health promotion that had substantive and procedural dimensions. Substantively, the good in health promotion was teleological: the good inhered in meliorism, an intention to promote health, which was understood holistically and situated in places and environments, a commitment to primary rather than secondary prevention, and engagement with communities more than individuals. Procedurally, the good in health promotion arose from qualities of practices: that they developed over time in respectful relationships, were flexible and responsive to communities, built capabilities in communities, and were sustainable. We discuss our findings with reference to Martha Nussbaum’s normative list of functional capabilities for a good human life, David Buchanan’s vision for health promotion ethics, and common concerns in health promotion ethics regarding the relationship between paternalism and freedom. Our thick, vague conception of the good in health promotion, founded in the values and practical reason of people engaged daily in health promotion work, makes an important contribution to the development of a more complete theory of health promotion ethics.