"In its groundbreaking Loneliness Strategy, this Government gives GPs in England permission to prescribe for their patients social activities such as dance classes, art groups, walking clubs, and volunteer work. This initiative raises several ethical questions:
Is it paternalistic to give someone a ‘social prescription’? Is it like being prescribed broccoli on the NHS?
Will social prescriptions heighten or lessen the stigma of loneliness and unwanted social isolation?
Are social prescriptions risky or harmful, since they send potentially vulnerable people into new settings with new people?
Does the ‘doctor’s orders’ motivation for participating in a social activity corrupt the bonds that a person might form there?
What happens for a person when her course of social ‘treatment’ finishes?
Despite the ethical issues that this new policy raises, we can be optimistic about its moral credentials.
First, if we normalize the fact that people can need assistance to integrate, just as they can need medicine to treat ordinary ailments, we can work to reduce the stigma of loneliness and unwanted isolation.
Second, there may well be some risks in ‘social prescriptions’, but there are risks in drug prescriptions too. The question is whether those risks are appropriate.
Third, being propelled by ‘doctors’ orders’ to attend a social activity need not corrupt the bonds we make there. Children must go to school, but that doesn’t corrupt the friendships they form there. Teachers, nurses, and doctors are all paid for their work, but that doesn’t prevent them from being caring and committed to the people they serve.
Fourth, the end game does matter. The policy must attend to how we carry on once our NHS funded social ‘treatment’ is completed. Social connections are not like ordinary courses of medicine. We have deep interests in being able to ensure that our bonds persist.
Ensuring that a person can continue in the social activity is particularly important when she cannot afford to pay for the activity herself once the NHS allocation runs out. It also puts the onus on community providers of social activities to ensure the activities are maintained over time."
15 October 2018
- Professor Brownlee is available for interview by telephone, email or on camera in our campus studio.
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