Helen Rance of the Health Promotion Forum in New Zealand attempted to send a
reply to Peta Sharrock's request regarding reviews of David Seedhouse's
writings, however she is not a Click4HP subscriber and her posting of a
review that she wrote was too long.  Click4HP listserv has a new policy of
limiting postings to 250 lines to help keep the discussion flowing and not
tie up email boxes of readers.

Below is a slightly abridged book review written in April 2001 and Published
in the Health Promotion Forum of NZ newsletter.  Helen Rance indicates that
the last paragraph is very important [to this discussion].

Book reviews

The ethical implications health promotion practice in Aotearoa-New Zealand
appears to be an issue for many of the workforce. The development of values
and ethical guidelines as part of the competency development process, muted
calls for a "code of ethics" indicate that the issue is on top for quite a
number of practitioners right now. Among this background of interest, two
books by philosopher and academic David Seedhouse have made a very timely
appearance. Both volumes complement each other. One presents a wider
perspective of ethics in health while the other looks at our individual
philosophy, values and prejudices which form the platform for ethical health
promotion practice.

Ethics The Heart of Health Care - Second edition 1998  David Seedhouse
While not specifically written for health promoters, in this edition
Seedhouse challenges us that as 'work for health' is inextricably involved
with people and interactions between them, it is a 'moral endeavour'
therefore 'creating health requires ethical commitment.'
So how do we make ethical decisions about our practice?  Critical reflection
of both the situation and our own values are necessary and this book
provides us firstly with theory and background then tools to assist us.  15
case stories present a range of health scenarios some of which may feel
familiar, including tobacco sponsorship, immunisation, coercion, drug
education. Thus the scene is set for following chapters that explore values
and morality and the implications for health work.
Working through dilemmas to systematically reach ethical decisions in
practice is not easy but Seedhouse offers us the ethical grid as a tool to
help.  Ethical practice is not a matter of rights and wrongs rather it is
about understanding, reasoning then justifying actions and interventions.
From the wider perspective of ethics in health I then moved to the book
written specifically for health promotion

Health Promotion Philosophy, Prejudice and Practice David Seedhouse 1997
Health promotion is values based and competent practice involves a
recognition that values underpin our practice. Seedhouse challenges us to
reflect on and understand these values in pursuit of ethical health
promotion practice.
Diane Grant a reporter for the Willesville Chronicle, wants to write an
article on health promotion. She meets with the Willesville District Health
Promotion Unit and after a session with staff, instead of being enabled with
information for her article, she is confused and bewildered about health
promotion.  What follows is a series of philosophical chapters, interspersed
with the case story of Diane who finally reaches an understanding of and
becomes an advocate for health promotion. Many of the scenarios in Diane's
story may reflect some health promoters own learning experiences.  This
approach makes light reading of some thought provoking theories that might
otherwise be very dry.

To help clarify learning and application of the theories, both books are
illustrated with stimulating exercises. As reflected in the reality of
practice most exercises do not have a right or wrong outcome but encourage
the reader to work through logical processes thus assisting reasoned
decisions, which is something Seedhouse clearly feels lacking in health
promotion.

I am left with a little disquiet about both books.  Although shifting
paradigms of health are mentioned strongly in 'Ethics' and the whole of the
second book is about 'Health Promotion' there is very little reference to
population health.  Well through the later book 'health of populations' is
mentioned but some health promoters have trouble with this terminology.
Social contexts and equity issues are mentioned only as background
conditions to the health of the individual.  However both books are thought
provoking and encourage critical reflection about the values and ethics of
health promotion practice.

If I can be of any further assistance please keep in touch

Helen Rance
Health Promotion Forum
Email: [log in to unmask]
http://www.hpforum.org.nz

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