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Social values and the corruption argument against financial incentives for healthy behaviour
  1. Rebecca C H Brown
  1. Correspondence to Dr Rebecca CH Brown, Health Services Research Unit, Third Floor Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; rebecca.brown{at}abdn.ac.uk

Abstract

Financial incentives may provide a way of reducing the burden of chronic diseases by motivating people to adopt healthy behaviours. While it is still uncertain how effective such incentives could be for promoting health, some argue that, even if effective, there are ethical objections that preclude their use. One such argument is made by Michael Sandel, who suggests that monetary transactions can have a corrupting effect on the norms and values that ordinarily regulate exchange and behaviour in previously non-monetised contexts. In this paper, I outline Sandel's corruption argument and consider its validity in the context of health incentives. I distinguish between two forms of corruption that are implied by Sandel's argument: efficiency corruption and value corruption. While Sandel's thought-provoking discussion provides a valuable contribution to debates about health policies generally and health incentives specifically, I suggest the force of his criticism of health incentives is limited: further empirical evidence and theoretical reasoning are required to support the suggestion that health incentives are an inappropriate tool for promoting health. While I do not find Sandel's corruption argument compelling, this only constitutes a partial defence of health incentives, since other criticisms relating to their use may prove more successful.

  • Behaviour Modification
  • Social Aspects
  • Health Promotion
  • Ethics
  • Public Health Ethics

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Funding This research was funded by the Centre for the Study of Incentives in Health, from a strategic award from the Wellcome Trust Biomedical Ethics Programme (PI Marteau: 086031/Z/08/Z).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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