What is health promotion ethics?

Abstract

What does it mean to think about the ethics of health promotion? When most of us think ‘ethics’ we think of the Human Research Ethics Committee applications required for research projects. But I’m thinking of something quite different here: the ethics of health promotion practice. Health promotion ethics is an attempt to answer questions such as: Can we provide a moral justification for what we are doing in health promotion? or What is the right thing to do in health promotion, and how can we tell? As other authors have argued, sometimes these questions are ignored in health promotion in favour of scientific and technical questions about effectiveness. But there is increasing recognition that health promotion is a moral project, that health promotion can be practised in ways that are more or less ethical, and thus that considering ethics in health promotion is just as important as – and related to – considering the evidence about whether or not health promotion works. 1-5 The number of publications about health promotion ethics has been slowly increasing since the 1980s, including in this journal, where authors have particularly argued the importance of being explicit about values in health promotion. If something has value, it has worth or importance. 6 Authors in the HPJA have suggested that health promotion practitioners value: health and wellbeing as opposed to the mere absence of disease, justice, environmental sustainability, empowerment, respect for culture, and truth telling. 3, 7, 8 But concern has been expressed that although these things are valued in health promotion, this may not always influence the way that health promotion is implemented and evaluated.