How should you respond if your health promotion values conflict with a client’s values?

Assignment: Case Health Promotion Values

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Week 2 discussion Discussion 1 How should you respond if your health promotion values conflict with a client’s values? Discussion 2 What ethical issue have you recently encountered when teaching health promotion strategies to a patient? What ethical decision-making process did you use?

o examination of health promotion is possible without first considering what health is. The health of individuals is strongly influenced by their social and physical environments and it can never be fully considered outside the context of people’s everyday lives.

In 1948 the World Health Organization (WHO) defined health as ‘a complete state of physical, mental and social wellbeing, and not merely the absence of disease or infirmity’. This is probably the most often cited definition of health. It has been important for the role it has played in highlighting that health is about much more than the absence of disease, and that it is much more than a physical state.

Individual health is defined in different ways depending on who you are. Probably the main distinction between definitions of individual health is between those that define health as the absence of disease and those that define it more broadly as a sense of wellness.

In defining health, it is not sufficient to consider only the health of the individual. If health is defined only in individual terms, then issues of power and control, and the unequal access to life chances because of socioeconomic status, ethnicity and gender or environment, for example, are easily ignored.Two notable efforts to define health of individuals within a broader socio-environmental context have come from the Aboriginal health movement and theenvironmental movement, where concern for spiritual and cultural connectedness and ecological sustainability, respectively, have moved health definitions beyond the individual, and so, for example, Aboriginal health has been defined as:

Not just the physical wellbeing of the individual but the social, emotional, and cultural wellbeing of the whole community. This is a whole-of-life view and it also includes the cyclical concept of life-death-life.

(National Aboriginal Health Strategy Working Party 1989: x)

Similarly, Honari (1993: 23), attempting a similar approach, provides an environmental definition of health by defining health as ‘a sustainable state of wellbeing, within sustainable ecosystems, within a sustainable biosphere’.

How health is defined is very important because definitions determine what are regarded as health problems and therefore what will be regarded as appropriate health promotion. If we define health as merely the absence of disease, we see health promotion as disease prevention, and ignore the significance of positive wellbeing or the social determinants of health that may make people’s lives uncomfortable, but which are not medically classified as diseases. Ignoring those problems, such as chronic back pain, discrimination, social isolation or fear for safety, for example, may leave people suffering from conditions that limit their abilities or reduce their quality of life. It is quite possible that, if we address only medically defined problems, we could be ignoring issues that play an important role in disease causation, including mental illnesses. Furthermore, many environmental health issues are ignored on the grounds that there is no ‘evidence’ of a problem, when evidence may take 20 years to surface and people’s health may have already suffered greatly during this time.