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Demonstrators taking part in a march protesting to end austerity policies.
70th Anniversary of the NHS March and Rally in London.

Ethical issues

Central to an ethical approach to health promotion are issues of control and power. For example, have you ever considered whether your health-promoting practice is ‘top down’ or ‘bottom up’?

Do you set the agenda and decide what health issue(s) to target and discuss with your patients and clients, or do you let them identify and decide the issues they perceive to be important? Might there be any possible tensions between these two approaches?

Ethical theory serves to highlight the dilemmas or tensions that may exist between promoting the health and well being of an individual and the health and well-being of a population. Consider, for example, whether an individual’s rights should be overridden to achieve a greater good for the population as a whole. In other words, to what extent is it ethical to place infringements on individual freedom in terms of lifestyle choices in order to justify state intervention? The sugar levy, introduced by a number of countries to combat the prevalence of obesity (ITV 2018), throws up such tensions.

Another issue for consideration concerns how you go about promoting health. Do you promote health in a health-promoting way? For example, does your approach emphasise values of professional knowledge and paternalism through instructing, passing on information and advising patients and clients on aspects of their health, perhaps in relation to eating fresh fruit and vegetables? This approach to individual health-related behaviour change is often characterised by persuasion or coercion to comply. Alternatively, is your health-promoting practice empowering?

It is also important to consider the extent to which you, as a nurse and health promoter, are a role model. Should you lead by example and take responsibility for the lifestyle you lead and the messages your lifestyle may convey to your patients, clients and others or is this unreasonable and not relevant?

Your task

When nurses live healthy lifestyles and look healthy, do they have more credibility as health promoters? Discuss and share your thoughts.


ITV (2018) ‘Sugar tax comes into effect in the UK’ ITV news [online] available from http://www.itv.com/news/2018-04-06/sugar-tax-comes-into-effect-in-the-uk/ [4th July 2018]

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This article is from the free online course:

Could You Be the Next Florence Nightingale?

Coventry University