Who Should be Blamed for Being Sick?

Abstract

That individuals are responsible for staying healthy is becoming a truism of health promotion and health policy. However, it is unclear what the slogan means, whether it is true, and what the consequences would be or should be if it is. A careful examina tion of the contexts in which the notion of personal responsibility for health occurs re veals a number of distinct arguments for different policy ends, each relying in turn on key unstated assumptions whose validity is doubtful. There is no disputing the minimal claim that most of us would be healthier if we took better care of ourselves. However, assignment of responsibility for health to the individual is usually part of a more far- reaching reassessment of obligations and entitlements in health care and health policy. A assessment of the concept of personal responsibility for health should precede any attempt to draw broad conclusions on rights and duties in maintaining health.