Medical and non-medical experts increasingly argue that individuals, whether they are diagnosed with a specific chronic disease or condition or not (and whether they are judged at minimal risk of these consequences or not), have an obligation to make ‘healthy’ food choices. We argue that this obligation is neither scientifically nor ethically justified at the level of the individual. Our intent in the article is not simply to argue against moralization of the value of prudential uses of food for nutritional (...) health, but to situate nutritional advocacy in the context of Western liberal democracy that values free choice. We have two objectives: (i) to untangle and examine the substance of discourses on ‘healthy’ food choice that simplify nutrition science and place a moral obligation on individuals and (ii) to establish a more comprehensive view of the relationship among food, ethics and health. Although critical of certain features of the liberal political and moral tradition, we argue that John Stuart Mill’s notion of experiments in living provides fertile ground for an improved ethical understanding of individual obligation and of the interconnections among food, health and well-being. (shrink)

Public health advocates, government agencies, and commercial organizations increasingly use nutritional science to guide food choice and diet as a way of promoting health, preventing disease, or marketing products. We argue that in many instances such references to nutritional science can be characterized as nutritional scientism. We examine three manifestations of nutritional scientism: the simplification of complex science to increase the persuasiveness of dietary guidance, superficial and honorific references to science in order to justify cultural or ideological views about food (...) and health, and the presumption that nutrition is the primary value of food. This paper examines these forms of nutritional scientism in the context of biopolitics to address bioethical concerns related to the misuse of scientific evidence to make claims regarding the effect of diet on health. We argue that nutritional scientism has ethical implications for individual responsibility and freedom, concerning iatrogenic harm, and for well-being. (shrink)

What makes a food good, for you? With respect to food, the expression “good for you” usually refers to the effect of the food on the nutritional health of the eater, but it can also pertain more broadly. The expression is often used by a person who is concerned with another person’s well-being, as part of an exhortation. But when framed as a question and addressed to you, as an individual, the question can require a response, calling for accountability beyond (...) the realm of nutrition or other material qualities of the food. Economic value may be considered as a ratio: goodness/price. In this paper, we examine the numerator, exploring a broad range of values domains related to food, attempting to obtain a more comprehensive understanding of the meaning of goodness of food. We present a typology of values domains with respect to food, divided into three main categories: (1) material considerations, (2) psychological, psychosocial, and spiritual health, and (3) the well-being of society. This understanding that results from comprehensive consideration of these values domains has important implications for an individual for use in considering the question “what food is good for you?” in order to guide his or her future actions, helping to distinguish between what Dewey termed immediate good and reasonable good. A pragmatic approach to a fuller consideration of food-related values domains by individuals also has broad social, political, and economic implications. If, according to the FAO, food security involves both needs and preferences, consideration of what preferences are appropriate is fundamental to achieving food security. The questions about what is considered to be good food are central to questions about the sorts of food and agricultural systems human societies will seek to sustain. The approach to resolving this important aspect of sustainability might help inform a more general question as to appropriate limitations on preferences, a question fundamental to achieving sustainability in general. (shrink)

We argue that an unqualified use of the term solidarity in public health is not only equivocal but problematic toward the ends of public health. The term may be deployed normatively by public health advocates to strengthen the bonds among public health practitioners and refer to an ideal society in which the importance of interdependence among members ought to be acknowledged throughout the polity. We propose an important distinction between partisan solidarity and societal solidarity. Because any moralized belief in a (...) vision of a broad societal solidarity will be a contested political ideal, political reality would limit solidarity based on such a vision to partisan solidarity. An idealized vision of societal solidarity is simply not politically feasible in pluralistic, liberal, democratic societies. However, although societal solidarity is unlikely with respect to any particular policy, it might be hoped for with respect to constitutional procedures that provide boundaries for the agon of the political process. We suggest that moralizing assertions of a solidaristic ideal in a pluralistic society might be counterproductive to generating the political support necessary for public health per se and establishing legitimate public health policy. A pragmatic political approach would be for public health advocates to generate sufficient strong political support for those public health policies that are most amenable to the political and social realities of a time and place. (shrink)

The contribution of food and diet to health is much disputed in the background culture in the US. Many commercial or ideological advocates make claims, sometimes with health as a primary goal, but often accompanied by commercial or ideological interests. These compete culturally with authoritative recommendations made by publicly funded groups. For public policy concerning diet and health to be legitimate, not only should it not be inconsistent with the scientific evidence, but also it should not be inconsistent with the (...) political environment. Healthy Eating Policy and Political Philosophy (HEPPP), by Barnhill and Bonotti (2022), addresses how policy in this complex area might be justified. In the present essay I highlight some important strengths of their work and also make some points about how it might be clarified or enlarged in scope. The great strength of HEPPP is that it emphasizes the role of a political philosophy in evaluating the legitimacy of public policy. They presume a well-off liberal democratic state, and specifically they draw on Rawls’ political liberalism, as developed in Political Liberalism (PL). One of several interlocking technical concepts developed in this book, public reason speaks to the boundaries of what should be acceptable in public deliberation about constitutional essentials and basic justice. HEPPP explores the application of an extension of public reason to the justification of policies related to “healthy eating.“ Public reason has two components, both of which pertain to a common understanding among citizens: (1) a common understanding of the principles and ideals that are the foundation of the political society, and (2) a common understanding of the standards that govern reason and evidence, including common sense. HEPPP argues that even though for diet and health the complexity of the scientific evidence goes far beyond anything like common sense for a typical citizen, the technical idea of “accessibility” of the scientific evidence justifies reliance on it within the concept of public reason. I question this accessibility argument about scientific evidence and public reason because the nature of the population-level epidemiological evidence about diet and health is that it often includes judgments that are based on arguable interpretations, framing incidence in terms of risk and prevention; thus the issue is more than one of potential accessibility of scientific evidence. Nevertheless, evaluation and consideration of the scientific evidence is of obvious practical importance in policy deliberation concerning policy related to what Rawls call “ordinary legislation.“ Even though public reason applied to healthy eating policy may not be as pertinent as it is for constitutional essentials and basic justice, and even though it is unlikely to result in a “correct outcome,“ invoking reasons based on political values and principles held in common has important value even in these deliberations about more ordinary questions. That value applies not to the specifics of the particular issue, but to the larger context for the particular policy being deliberated, as a potential contribution to an overlapping consensus that is stable for the right reasons. If this vision of political liberalism were achieved, then contentious debate about health eating policy and its scientific basis could occur within that context and be resolved within the basic political structure. Because public health and political liberalism have a common concern for a good at the population level, they have an underlying affinity. Healthy eating policies could be evaluated in two not-unrelated ways: based on their instrumental contribution to the good of the public body of citizens as population-level health, and according to their stabilizing contribution to an overlapping consensus among citizens. In this latter way a policy would contribute to a conditional integral common good a la Sulmasy, one that has the prospect of conditioning a political system, and by doing so create the conditions of the possibility of a constitutive integral common good that is constituted on the right reasons for allegiance to an overlapping consensus. To conclude with reference to HEPPP, public reason may play an important function with respect to the political common good, even as debates about the weight and meaning of scientific evidence from epidemiology play out in deliberation of ordinary legislation concerning healthy eating. (shrink)

The term natural is effective in the marketing of a wide variety of foods. This ambiguous term carries important meaning in Western culture. To challenge an uncritical understanding of natural with respect to food and to explore the ambiguity of the term, the development of Western ideas of nature is first discussed. Personification and hypostasization of nature are given special emphasis. Leo Marx’s idea of the pastoral design in literature is then used to explore the meaning of natural as applied (...) to food, emphasizing Marx’s distinction between a sentimental and a complex pastoral. The latter is applied to natural as a means of collapsing a dichotomy of man and nature to the idea of second nature. From this perspective an understanding of the industrialization of the food system and the importance of local and organic food are considered. The extent to which processed foods might properly be considered natural is raised and discussed for several common foods. Although marketing of natural foods might make us think that we consume nature, I suggest that what is consumed is more appropriately second nature. I suggest that in order to maintain a critical perspective about one’s relationship to the natural world, everyone should make an attempt to experience the complex pastoral with respect to at least something that is consumed as food. When nature is understood as second nature in the context of a complex pastoral, the question of whether a food or ingredient is to be considered natural is replaced by deliberative thought based on our best knowledge and judgment, and the result will be less constrained by ideology. (shrink)