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Anne-Maree Farrell

In an interconnected world, the potential for the rapid cross-border spread of health threats is growing with often wide-ranging social, political and economic consequences for nation-states, and tragic consequences for their citizens’ health and wellbeing. When such threats occur, doctors are often on the frontline in terms of treating infected individuals, as well as engaging in risk assessment and management at the population level. Drawing on the concept of medicalization, this chapters examines the way in which doctors seek to extend their influence and power through engagement with securitization discourse and practices in managing health threats. It is argued that taking account of the key roles played by ethics and regulation in medical practice in such circumstances provides a fuller and more nuanced account of how the process of medicalization is impacted by both the individual patient-doctor relationship and the management of health threats at the population level.

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Muireann Quigley and Anne-Maree Farrell

This chapter examines how the political context impacts the use of behavioural insights in public policy. Specifically, we explore how the political context, which frames the use of nudges in matters of public health, has led to a mismatch between policy intent and implementation. This problem of mismatch is explored through two examples: health promotion and organ donation. In the first example, it is suggested that behavioural health promotion focuses too much on individual lifestyle preferences, with insufficient account being taken of the wider social determinants of health. The example of organ donation is used to show that the nudges may be an inadequate tool for addressing complex public policy problems. Drawing on such examples, the chapter concludes with a consideration of how this mismatch impacts upon broader questions concerning evidence-based policy and political legitimacy.