Incentives For Treatment and Health Promotion

This mom has just given birth to her first child. She is surprised when the health visitor says that she will be given food vouchers if she tries to breastfeed her baby for 3 months. Her son has had schizophrenia for 15 years. His compliance with medication is variable. He is offered a chance to take part in a program whereby he will be paid for each injection of depot antipsychotic. A council-run weight loss program is offering reduced membership to the local gym for people who have a BMI of more than 35 and who commit to a weight loss and fitness program for 6 months. The sexual health consultant has the responsibility for a local hostel for women who are sex workers. A number of them do not use contraception effectively, which results in pregnancy and increased abortion rates. This consultant wants to encourage the women to come to a talk about depot contraception which he thinks would be an effective strategy to prevent pregnancy, in addition to using barrier methods. He offers lunch vouchers and toiletries to encourage their attendance at the talk. This patient is a heroin addict and is enrolled in a drug rehabilitation program where he is being prescribed Subutex. His local drugs clinic is offering him a shopping voucher if he can provide a clean urine sample at a weekly meeting with his key worker.

• What are the ethical concerns if incentives are offered to encourage healthy lifestyle choices and compliance with medical treatments?
• Do incentives effectively coerce consent?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Clinical Ethics and Law, Second edition. Carolyn Johnston, Penelope Bradbury, Series editor: Janice Ryme