Complex and Conflicting Thoughts on Personal Responsibility

I’m really hesitant to criticize others for not taking sufficient personal responsibility for the ways they live and the outcomes of their lives. A lot of factors influence whether you are economically successful or whether you are fit and healthy. Some things we seem to have a lot of control over, but many things are matters of chance and circumstance. Placing too much blame on the individual doesn’t seem fair, yet at the same time, there is clearly an element of personal responsibility involved. I’m not sure where I land on how we should think about this division.

 

What is clear, however, is that there can be negative consequences when we take away people’s agency in their decision-making and life outcomes, and when we erode the authority of those who are reasonably critical of negative lifestyles and ways of thinking and being, we can put ourselves and societies in vulnerable positions.

 

Sam Quinones writes about these tensions in his book Dreamland and he highlights how patient responsibility and physician authority devolved between the 1980’s and twenty-teens as a quick fix, there’s-a-drug-for-that mindset took hold of the American healthcare system. He writes, “…patients were getting used to demanding drugs for treatment. They did not, however, have to accept the idea that they might, say, eat better and exercise more, and that this might help them lose weight and feel better. Doctors, of course, couldn’t insist. As the defenestration of the physician’s authority and clinical experience was under way, patients didn’t have to take accountability for their own behavior.”

 

I’m usually hesitant to say that the problem is people’s lack of accountability, because how often do we really control how much exercise we can get when many of us live in places where walking is difficult because our streets are not safe, or are not well designed for pedestrian use, or because half the year it is dark early and we get lots of snowfall? How often do we not know what kinds of exercises we should do, and how often do we have people who are only critical of our current state rather than supportive and encouraging? How often have we had a bad break and poor advice on how to get back, only leading to a further defeat, deflating our sense of self worth? In addition to all this, how often have we seen people use the personal responsibility argument in bad faith? To justify not helping others or to rationalize their greed or excessive self-aggrandizement?

 

But at the same time, as Quinones shows, responsibility is important. We need to think about what we can and should be doing to help improve our own lives, without hoping for an easy fix in the form of a miracle pill. We can’t just throw out the opinions of experts and devalue their authority because they are willing to say things that are discomforting for us, but are likely correct in terms of how we can make our lives better. Somehow we need to work together to build a society that recognizes the barriers and challenges that we face toward becoming the successful and healthy people that we want to be, but encourages us to still work hard and overcome obstacles by taking responsibility for our actions and (at least some percentage of) our outcomes. I don’t know what this looks like exactly, and I’m not sure where the line falls between personal responsibility and outside factors, but I am willing to have an honest discussion about it and about what it all means for how we relate to each other.

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