The recent inclusion of behavioural conditionality in health-related benefit programmes raises questions about frontline workers' (FWs') discretionary use of sanctioning. Using an experimental vignette design in a survey of 824 FWs in the Norwegian Labour and Welfare Administration (NAV), we investigated whether FWs' perceptions of diagnosis and sick recipients' obligations affect their propensity to sanction for non-compliance. We find that the recipients' diagnoses did not influence FWs' propensity to sanction for non-compliance. Recipients with a symptom diagnosis (ME/CFS) were sanctioned to the same degree as those with a diagnosis based on objective medical evidence (Bekhterev's disease). However, FWs who generally found it difficult to impose activity requirements on recipients with health-related problems were also less prone to enact sanctions. Our results support the notion of competing approaches to activating and sanctioning the sick. FWs who agree that it is difficult to activate the sick also tend to avoid sanctioning, whereas the propensity to sanction is more widespread among those who disagree that activating the sick is difficult.

中文翻译：

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制裁病人：激活病人和诊断的看法重要吗？

最近在与健康相关的福利计划中纳入行为条件引发了对一线工人 (FW) 酌情使用制裁的质疑。我们在挪威劳工和福利管理局 (NAV) 对 824 名 FW 的调查中使用实验性小插曲设计，调查了 FW 对诊断和患病接受者义务的看法是否会影响他们对违规行为进行制裁的倾向。我们发现接受者的诊断并没有影响 FW 对违规行为进行制裁的倾向。具有症状诊断 (ME/CFS) 的接受者与那些基于客观医学证据（Bekhterev 病）诊断的接受者受到相同程度的制裁。然而，普遍认为难以对有健康相关问题的接受者施加活动要求的 FW 也不太容易制定制裁措施。我们的结果支持激活和制裁病人的竞争方法的概念。同意很难激活病人的 FW 也倾向于避免制裁，而在那些不同意激活病人很困难的人中，制裁的倾向更为普遍。