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Responsibility for Health and Blaming Victims

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Abstract

If we are responsible for taking care of our health, are we blameworthy when we become sick because we failed to meet that responsibility? Or is it immoral to blame the victim of sickness? A moral perspective that is sensitive to therapeutic concerns will downplay blame, but banishing all blame is neither feasible nor desirable. We need to understand the ambiguities surrounding moral responsibility in four contexts: (1) preventing sickness, (2) assigning financial liabilities for health care costs, (3) giving meaning to human suffering, and (4) interacting with health care professionals. We also need to distinguish different kinds of blame, explore the interplay of justice and compassion in avoiding unjustified blaming of victims, and work toward a unified moral-therapeutic perspective that encourages individuals to accept responsibility while avoiding destructive forms of blaming.

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REFERENCES

  • Alexander, L. (1980). The double-bind between dialysis patients and their health practitioners. In L.Eisenberg & A. Kleinman (<nt>Eds.</nt>), The relevance of social science for medicine (pp. 307–329).Dordrecht, Holland: D. Reidel.

    Google Scholar 

  • Allegrante, J. P., & Green, L. W. (1981). When health policy becomes victim blaming. New England Journal of Medicine, 305, 1528–1529.

    Google Scholar 

  • Arras, J. (1997) Nice story, but so what?: Narrative and justification in ethics. In H. L. Nelson (<nt>Ed.</nt>), Stories and their limits: Narrative approaches to bioethics (pp. 65–90). New York: Routledge.

    Google Scholar 

  • Bellah, R., Madsen, R., Sullivan, W. M., Swidler, A., & Tipton, S. M. (1985). Habits of the heart: Individualism and commitment in American life. Berkeley: University of California Press.

    Google Scholar 

  • Broyard, A. (1992). Intoxicated by my illness. New York: Fawcett Columbine.

    Google Scholar 

  • Butler, J. (1964). Upon resentment. In W. R. Matthews (<nt>Eds.</nt>), Fifteen sermons (pp. 120–132). London: G. Bell.

    Google Scholar 

  • Butler, S. (1960). Erewhon. New York: New American Library.

    Google Scholar 

  • Callahan, D. (1998). False hopes: Why America's quest for perfect health is a recipe for failure. New York: Simon and Schuster.

    Google Scholar 

  • Card, C. (1996). The unnatural lottery: Character and moral luck. Philadelphia: Temple University Press.

    Google Scholar 

  • Cassell, E. J. (1991). The nature of suffering and the goals of medicine. New York: Oxford University.

    Google Scholar 

  • Crawford, R. (1997). Individual responsibility and health politics. In P. Conrad (<nt>Ed.</nt>), The sociology of health and illness: Critical perspectives (5th ed., pp. 393–401). New York: St. Martin's Press.

    Google Scholar 

  • Darwall, S. L. (1983). Impartial reason. Ithaca, NY: Cornell University Press.

  • Duff, K. (1993). The alchemy of illness. New York: Bell Tower.

    Google Scholar 

  • Dworkin, G. (1981). Taking risks, assessing responsibility. The Hastings Center Report, 11, 26–31.

    Google Scholar 

  • Fingarette, H. (1963). The self in transformation. New York: Basic Books.

    Google Scholar 

  • Fitzgibbons, R. (1998). Anger and the healing power of forgiveness: A psychiatrist's view. In R. D. Enright & J. North (<nt>Eds.</nt>), Exploring forgiveness (pp. 63–74). Madison, WI: University of Wisconsin Press.

    Google Scholar 

  • Frank, A. (1991). At the will of the body: Reflections on illness. New York: Houghton Mifflin.

    Google Scholar 

  • Frank, A. (1995). The wounded storyteller: Body, illness, and ethics. Chicago: University of Chicago.

    Google Scholar 

  • Frank, A. (1997). Enacting illness stories. In H. L. Nelson (<nt>Ed.</nt>), Stories and their limits: Narrative approaches to bioethics (pp. 31–49). New York: Routledge.

    Google Scholar 

  • Freud, S. (1961). Civilization and its discontents (J. Strachey, Trans.). New York: W. W. Norton.

    Google Scholar 

  • Gilligan, J. (1997). Violence: Reflections on a national epidemic. New York: Vintage.

    Google Scholar 

  • Gordon, L. (1997). Teenage pregnancy and out-of-wedlock birth: Morals, moralism, experts. In A. M. Brandt & P. Rozin (<nt>Eds.</nt>), Morality and health (pp. 251–271). New York: Routledge.

    Google Scholar 

  • Houston, B. (1992). In praise of blame. Hypatia, 7, 128–147.

    Google Scholar 

  • Jaeger, M. (1998). The power and reality of forgiveness: Forgiving the murderer of one's child. In R. D. Enright & J. North (<nt>Eds.</nt>), Exploring forgiveness (pp. 9–14). Madison, WI: University of Wisconsin Press.

    Google Scholar 

  • Janoff-Bulman, R. (1979). Characterological versus behavioral self-blame: Inquiries into depression and rape. Journal of Personality and Social Psychology, 37, 1798–1809.

    Google Scholar 

  • Kant, I. (1963). Lectures on ethics. (L. Infield, Trans.). New York: Harper and Row.

    Google Scholar 

  • Kass, L. R. (1975). Regarding the end of medicine and the pursuit of health. Public Interest, 40, 11–42.

    Google Scholar 

  • Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: BasicBooks.

    Google Scholar 

  • Knowles, J. H. (1977). The responsibility of the individual. Daedelus, 106, 57–80.

    Google Scholar 

  • Lamb, S. (1996). The trouble with blame: Victims, perpetrators, and responsibility. Cambridge, MA: Harvard University.

    Google Scholar 

  • Leichter, H.M. (1997). Lifestyle correctness and the new secular morality. In A.M. Brandt & P. Rozin (<nt>Eds.</nt>), Morality and health (pp. 359–378). New York: Routledge.

    Google Scholar 

  • Lorde, A. (1980). The cancer journals. San Francisco: Aunt Lute Books.

    Google Scholar 

  • Martin, M. W. (1999a). Alcoholism as sickness and wrongdoing. Journal for the Theory of Social Behaviour, 29, 109–131.

    Google Scholar 

  • Martin, M. W. (1999b). Good fortune obligates: Gratitude, philanthropy, and colonialism. Southern Journal of Philosophy, 37, 57–75.

    Google Scholar 

  • Martin, M.W. (2000a). Meaningful work: Rethinking professional ethics.NewYork: Oxford University Press.

    Google Scholar 

  • Martin, M. W. (2000b). Moral health: Responsibility in therapeutic culture. Journal of Value Inquiry, 34, 27–43.

    Google Scholar 

  • McCullough, M. E., Pargament, K. I., & Thoresen, C. E. (2000). Forgiveness: Theory, research, and practice. New York: The Guilford Press.

    Google Scholar 

  • McKegney, F. P., & Lange, P. (1971). The decision to no longer live on chronic hemodialysis. American Journal of Psychiatry, 128, 267–274.

    Google Scholar 

  • Morris, D. B. (1991). The culture of pain. Berkeley, CA: University of California.

    Google Scholar 

  • Moyers, B. (1993). Healing the mind. New York: Doubleday.

    Google Scholar 

  • Nietzsche, F. (1998). On the genealogy of morality, (M. Clark & A. J. Swensen, Trans.). Indianapolis, IN: Hackett Publishing.

    Google Scholar 

  • Parsons, T. (1979). Definitions of health and illness in the light of American values and social structure. In E. G. Jaco (<nt>ed.</nt>), Patients, physicians and illness (3rd ed., pp. 120–144). London: Free Press.

    Google Scholar 

  • Pellegrino, E. D., & Thomasma, D. C. (1993). The virtues of medical practice. New York: Oxford University Press.

    Google Scholar 

  • Pincoffs, E. L. (1986). Quandaries and virtues. Lawrence, KS: University Press of Kansas.

    Google Scholar 

  • Poirier, S. (1996). Expressing illness: Review essay of Arthur W. Frank, The wounded storyteller, Medical Humanities Review, 10, 74–79.

    Google Scholar 

  • Reiser, S. J. (1985). Responsibility for personal health: A historical perspective. Journal of Medicine and Philosophy, 10, 7–17.

    Google Scholar 

  • Ryan, W. (1976). Blaming the victim (<nt>Rev. ed.</nt>). New York: Vintage.

    Google Scholar 

  • Schoeman, F. (1991). Alcohol addiction and responsibility. In M. I. Bockover (<nt>Ed.</nt>), Rules, rituals, and responsibility (pp. 11–36). La Salle: Open Court.

    Google Scholar 

  • Shweder, R. A., Much, N. C., Mahapatra, M., & Park, L. (1997). The “big three” of morality (autonomy, community, divinity) and the “big three” explanations of suffering. In A. M. Brandt & P. Rozin (<nt>Eds.</nt>), Morality and health (pp. 119–169). New York: Routledge.

    Google Scholar 

  • Schweitzer, A. (1990). Out of my life and thought, (A.B. Lemke, Trans.). New York: Henry Holt.

    Google Scholar 

  • Sontag, S. (1990). Illness as metaphor and AIDS and its metaphors. New York: Doubleday.

    Google Scholar 

  • Strawson, P. (1962). Freedom and resentment. Proceedings of the British Academy, 48, 187–211.

    Google Scholar 

  • Thomas, K. (1997). Health and morality in early modern England. In A. M. Brandt & P. Rozin (<nt>Eds.</nt>), Morality and health (pp. 15–34). New York: Routledge.

    Google Scholar 

  • Veatch, R. M. (2000). The basics of bioethics. Upper Saddle River, NJ: Prentice-Hall.

    Google Scholar 

  • Wachtel, P. L. (1999). Race in the mind of America. New York: Routledge.

    Google Scholar 

  • Wikler, D. (1987). Who should be blamed for being sick? Health Education Quarterly, 14, 11–25.

    Google Scholar 

  • Williams, B. (1985). Ethics and the limits of philosophy. Cambridge, MA: Harvard University Press.

    Google Scholar 

Download references

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Martin, M.W. Responsibility for Health and Blaming Victims. Journal of Medical Humanities 22, 95–114 (2001). https://doi.org/10.1023/A:1009074811781

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