title: Empowerment in healthcare policy making: three domains of substantive controversy.
abstract: This paper distinguishes between the uses of empowerment across different contexts in healthcare policy and health promotion, providing a model for the ethical and political scrutiny of those uses. We argue that the controversies currently engendered by empowerment are better understood by means of a historical distinction between two concepts of empowerment, namely, what we call the radical empowerment approach and the new wave of empowerment. Building on this distinction, we present a research agenda for ethicists and policy makers, highlighting three domains of controversy raised by the new wave of empowerment, namely: (1) the relationship between empowerment and paternalistic interferences on the part of professionals; (2) the evaluative commitment of empowerment strategies to the achievement of health-related goals; and (3) the problems arising from the emphasis on responsibility for health in recent uses of empowerment. Finally, we encourage the explicit theorisation of these moral controversies as a necessary step for the development and implementation of ethically legitimate empowerment processes.
authors.affiliation: European Institute of Oncology, via Adamello 16, 20139 Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Chiapperino
authors.affiliation: Faculty of Health and Society, Jan Waldenströms gata 25, Malmö University, 20506 Malmö, Sweden.
authors.forename: Per-Anders
authors.initials: PA
authors.lastname: Tengland
mesh_terms: D001291:Attitude of Health Personnel; D006291:Health Policy; D006293:Health Promotion / Q000941:ethics*; D006801:Humans; D008962:Models, Theoretical; D026706:Paternalism; D011050:Policy Making; D011209:Power, Psychological