Responsibility and health: explanation-based perspectives

Abstract: There is a growing trend of holding people responsible for their lifestyle-based diseases. For example, policymakers as well as researchers have argued that medical conditions caused by smoking, overweight, or extreme sports should be given lower priority in publicly funded healthcare. This view on resource allocation is grounded in a common belief that people are responsible for these diseases and that it is fair to hold them responsible because of this. It is far from clear, however, that we are responsible for anything we do, never mind our ill health. A wide range of skeptical arguments seem to show that the notion of responsibility is misplaced. Though these arguments are controversial, they have by no means been successfully refuted. Furthermore, even if these skeptical arguments were shown to be invalid, there are additional, more mundane, excusing conditions that might relieve people of responsibility, such as those from nonculpable ignorance and addiction. Responsibility and Health: Explanation-Based Perspectives presents four papers that address this problem from a new angle. The first two papers show that the discussion about the conditions for responsibility should be reframed, and they provide new grounds for rejecting the skeptical arguments. The third paper discusses the validity of the skeptical arguments further and shows that even though healthcare personnel should reject the skeptical arguments, poli-cymakers should not. The fourth paper examines whether the obese are re-sponsible for being obese and finds that they are not. This, in conjunction with other arguments, gives us reason to prioritize overweight surgery. Taken together, the four papers offer new insights in the discussion about responsibility and health and a promising avenue for making progress in the responsibility debate.