Table 3

Results for the subthemes regarding the objections to personal health responsibility

Subthemes (i)Subthemes (ii)Identified objections to personal health responsibilityIllustrative quotes
Objections to responsibilityCausationEvaluation of factual (not only statistical) causal relationship‘(T)here ought to be a proven causal relationship between the patient's behaviour and lifestyle and the diagnosed illness or injury’ (p. 85).60
AvoidabilityEvaluation of earlier knowledge and possibilities‘Many among today’s smokers were smokers for decades before they could have known that smoking increased the risk for lung cancer and other diseases. The same could be said about the relationship between diet, lifestyle and cardiovascular diseases’ (p. 85).60
HarshnessReluctance to deny necessary treatment to those in need‘(N)ot even the drunken reckless driver who smashes his car and himself into the mountain wall is denied first aid or other necessary treatment and rehabilitation’ (p. 85).60
‘(…) the central political currents in Norway for the last hundred years have generally aimed at opposing to such principles (ie, desert-based) for the distribution of benefits. The principle of distribution according to desert seems to be stronger in its negative version: that someone is excluded from benefits because they have done something, or neglected to do something, implying that they do not deserve (those benefits). A key concept here is lifestyle-related diseases’ (p. 75).60
Intrusiveness
InequityRisk of reinforcing socioeconomic inequity in access to healthcare‘A negative criterion (ie, exclusion from benefits) can have an unfortunate systemic effect in the sense that the healthcare system reinforces inequality in socio-economic status’ (p. 57).62