On Knowingly Setting Unrealistic Goals in Public Health

Abstract

What is the ethics of setting unrealistic goals in public health—declared goals of population health campaigns that, when introduced, are already known to be impossible to accomplish? Over the past 2 decades, major public health campaigns have set unrealistic goals, such as “eliminating” or reaching “zero” on diseases and risk factors that are clearly ineliminable. We argue that unrealistic goals can sometimes motivate action, attract funding, and help educate the public and public health practitioners better than realistic goals. Although unrealistic goal setting faces ethical challenges, including the charge of deceit and that of undermining the field’s credibility, we argue that these challenges can be met. The advantages of unrealistic goal setting while overcoming these challenges can be accomplished in 2 stages: (1) an initial declaration of the attractive but unrealistic goal educates and motivates; (2) realistic, precise, and actionable subgoals then expose its unrealistic nature and preempt ongoing deceit.