• ethics

Rebecca Brown and Julian Savulescu argue in ‘Responsibility in Healthcare Across Time and Agents’ that if responsibility should play a crucial role in healthcare, then we need a concept of responsibility that reflects that an individual’s behaviour is sometimes, if not routinely, influenced by external factors in various ways. As Brown and Savulescu convincingly show, health-related behaviour in particular is often affected by other agents and typically involves multiple decisions on different occasions. Smoking and a poor diet are but two examples where these factors are salient. Since health-related behaviour is often influenced by others, and often spread out over time, a notion of responsibility that does not take these two factors into account will be inadequate.

In this comment to their paper I wish to raise an issue concerning Brown and Savulescu’s characterisation of individual responsibility for health-related behaviour that involves multiple choices by the same agent over a period of time. For simple acts—smoking a cigarette or eating some junk food for example—Brown and Savulescu assume two necessary conditions for responsibility: a ‘control condition’ and a ‘epistemic condition’. These conditions are intended to capture the plausible idea that …