Ladders and stairs: how the intervention ladder focuses blame on individuals and obscures systemic failings and interventions.
J Med Ethics
; 50(10): 684-689, 2024 Sep 20.
Article
en En
| MEDLINE
| ID: mdl-38408850
ABSTRACT
Introduced in 2007 by the Nuffield Council on Bioethics, the intervention ladder has become an influential tool in bioethics and public health policy for weighing the justification for interventions and for weighing considerations of intrusiveness and proportionality. However, while such considerations are critical, in its focus on these factors, the ladder overemphasises the role of personal responsibility and the importance of individual behaviour change in public health interventions. Through a study of vaccine hesitancy and vaccine mandates among healthcare workers, this paper investigates how the ladder obscures systemic factors such as the social determinants of health. In overlooking these factors, potentially effective interventions are left off the table and the intervention ladder serves to divert attention away from key issues in public health. This paper, therefore, proposes a replacement for the intervention ladder-the intervention stairway. By broadening the intervention ladder to include systemic factors, the stairway ensures relevant interventions are not neglected merely due to the framing of the issue. Moreover, it more accurately captures factors influencing individual health as well as allocations of responsibility for improving these factors.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_desigualdade_iniquidade
/
1_recursos_humanos_saude
Asunto principal:
Determinantes Sociales de la Salud
Límite:
Humans
Idioma:
En
Revista:
J Med Ethics
Año:
2024
Tipo del documento:
Article
País de afiliación:
Canadá