• Ethics

This special issue is the result of a conference organised by Verina Wild and Anca Gheaus, at the Ludwig-Maximilians University of Munich in December 2014. The conference addressed normative issues raised by the use of incentive mechanisms to promote better health, and included papers by most contributors to this special issue. So far, the normative discussion on health incentives focussed on questions of autonomy, paternalism, motivation and responsibility. This resulting special issue responds to a need to expand the normative analysis of such measures to other issues of justice, which have so far been largely ignored.

Recent policies and programmes in health prevention tend to appeal to, and encourage, individual responsibility with respect to lifestyle choices. One way of advancing this goal is via schemes that provide individuals with incentives to live healthy lives. For example, individuals may be offered discounted health insurance rates if they adopt healthy lifestyles or be given vouchers to purchase healthy food or to use fitness centres. Such programmes often use so-called ‘nudging’ mechanisms, meant to motivate people without coercively interfering with their private choices and to improve health outcomes without overregulating the market for products that are detrimental to health. They also raise many normative questions.

Health incentive programmes put pressure on us to rethink how to balance reasons of freedom, solidarity and justice in the design of public health policies. Angus Dawson's article is a criticism to the …