The concept of responsibility for health is a significant feature of health discourse and public health policy, but application of the concept is poorly understood. This paper offers an analysis of the concept in two ways. Following an examination of the use of the word ‘responsibility’ in the nursing and wider health literature using three examples, the concept of ‘responsibility for health’ as fulfilling a social function is discussed with reference to policy documents from the UK. The philosophical literature on (...) moral responsibility is introduced, and in considering two versions, reactive attitudes and accountability, it is argued that in application both can be regarded, though with different emphasis, as being constituted in three parts: a responsible agent; having obligations ; and being susceptible to being held responsible if he fails to meet them. The three‐stage model is consistent with the examples of the word responsibility in use, but application to the social function model causes a number of problems for healthcare practice, especially for the reactive attitudes account. Apart from considerable problems in stating what exactly the obligations are and how they can be justified; and how blame might justly be apportioned and by whom, the very ideas of obligation and blame are in conflict within healthcare systems and professional nursing practice which have foundations deeply embedded in the notion of the supremacy of personal autonomy. It is concluded that current application of the concept of responsibility for health is conceptually incoherent, and if it is to retain its place in health policy and discourse, urgent remedy is required. (shrink)

Political philosophers often grapple with the issue of the legitimacy of state coercion. Aristotle, a perfectionist, opines that all men hold an objective account of the good life. As regards legitimacy, he entails that state policies are justified only when all its members comprehend the value that has been identified in accordance with the true notion of good. Aristotle argues that the state should facilitate the encouragement of objectively valuable notions of the good. Ronald Dworkin, a neutralist, proposes a specific (...) model of the good life so that one can live well. He holds that certain elements of the ethical conception lead to various notions of the good and, in matters of legitimacy, the state should be neutral towards the notion of good. This is so because A cannot make B’s life better by way of the coercive means of the state. This paper throws light on Aristotle’s and Dworkin’s dialogues on the moral foundations of legitimacy (conceived during their notion of the good life). Therefore, I argue that, in contrast to perfectionism, Dworkin justifies his liberal principle of legitimacy through the idea of state neutrality. But, eventually, Dworkin’s arguments overlook his ethical foundation or admissible towards perfectionism, which is emaciated enough to offer any justification for the principle of legitimacy. (shrink)