The latent function of ‘responsibility for one’s health’ in Swedish healthcare priority-setting

Abstract

Applying Luhmann’s theoretical framework, this article analyses the function of the notion ‘responsibility for one’s health’ in prioritisation in Swedish healthcare. A document called ‘Ethical Platform’ was adopted in 1997 in order to guide decisions about prioritisation. Evaluations deemed it a failure. Against its official purpose, we argue that this document is not a failure as it has the latent function of protecting the credibility of the self-description of the Swedish political system as a highly inclusive and caring welfare-state. Since prioritisation implies exclusion it poses a threat for this self-description.

The responsibility principle, suggested in 2007 as an improvement for the platform, has the latent function of helping overcoming the contradiction between the self-description of the welfare-state (inclusion) and prioritisation (exclusion). While inclusion into healthcare is still offered for everybody (respect), this right becomes conditional when citizens are regarded as agents who account for their unhealthy lifestyle (responsibility).

Keywords:

• latent function
• Luhmann
• healthcare prioritisation
• responsibility
• sociology
• welfare-state