Health promotion: ethical and social dilemmas of government policy.

Abstract

Prologue: Does government have the right to require its citizens to use seathelts and to place limits on alcohol and cigarette use? This question has been raised by those fearful of losing their personal autonomy as an increasing number of states pass seatbelt laws and tighter controls on smoking and alcohol use. In this article, authors Ronald Bayer and Jonathan Moreno assert that beyond economic incentives to encourage health promotion and discourage risky behavior, there are ethical reasons as well for government to take an active role in the health of the public. In addition, Bayer and Moreno offer a set of ethical guidelines for public policymakers in fashioning personal behavior and health regulations. This article is the result of a Hastings Center study funded by the National Center for Health Services Research which brought together scholars from the fields of law, economics, philosophy, and public health to examine the ethical issues in government health promotion. Bayer, who received his doctorate in political science from the University of Chicago, is an associate for policy studies at the Hastings Center in New York. He has been affiliated for the past eight years with Hastings, a think tank which focuses on a variety of ethical issues. Bayer is involved in issues of health policy such as access to health care and the ethical issues surrounding public health responses to AIDS (acquired immunodeficiency syndrome). Moreno is an associate professor of philosophy and health care sciences at George Washington University in Washington, D.C. He was involved with the Hastings Center report as an associate for social and behavioral studies during 1984-85, while on leave from George Washington University. He received his doctorate in philosophy from Washington University in St. Louis.