ABSTRACT

Ethics is at the heart of health communication interventions. Invariably communication that aims to affect people’s views or health-related behavior raises a multitude of ethical concerns, especially since they deal with topics that are integral to deeply held personal preferences and social values.1 The following four propositions underscore why ethical issues should be considered in the design and implementation of health communication interventions: (a) any communication activity that constitutes a purposeful attempt to promote people’s health-even the most benevolent-is inundated with ethical issues; (b) ethical issues can be found in each component of the intervention, from conception of goals to assessment of outcomes; (c) ethical issues are often implicit and embedded in subtle decision-making processes and their delineation requires an assessment of unintended impacts; and (d) attending to ethical considerations may be not only a moral prerequisite but also has pragmatic significance. Whereas communication for health promotion is essentially a benevolent endeavor (Rogers, 1994), by definition it is a purposeful attempt to bring about certain changes in people’s lives. Thus, like any attempt to intervene or influence people to adopt health recommendations, health communication needs a moral justification. When closely scrutinized, most, if not all, decisions that relate to the goals, design, implementation, and evaluation of health communication interventions are associated with ethical issues (Burdine, McLeroy, & Gottlieb, 1987; Doxiadis, 1987, 1990). These include decisions regarding which health issues to tackle, which populations should

be targeted by the intervention, how to employ the most effective tactics, and according to which criteria to assess success (Hornik, 1990; Ratzan, 1994). In addition, because health communication interventions are increasingly carried out as an interdisciplinary enterprise, professional orientations and moral obligations may differ and may even place conflicting demands.2