In an effort to address healthcare disparities in lesbian, gay, bisexual, transgender, and queer populations, many hospitals and clinics institute diversity training meant to increase providers’ awareness of and sensitivity to this patient population. Despite these efforts, many healthcare spaces remain inhospitable to LGBTQ patients and their loved ones. Even in the absence of overt forms of discrimination, LGBTQ patients report feeling anxious, unwelcome, ashamed, and distrustful in healthcare encounters. We argue that these negative experiences are produced by a variety (...) of subtle, ostensibly insignificant features of healthcare spaces and interpersonal interactions called microaggressions. Healthcare spaces and providers often convey heteronormative microaggressions, which communicate to LGBTQ—and, we suggest, intersex and asexual —people that their identities, experiences, and relationships are abnormal, pathological, unexpected, unwelcome, or shameful. We identify heteronormative microaggressions common to healthcare settings and specify how they negatively impact LGBTQIA patients. We argue that standard diversity training cannot sufficiently address heteronormative microaggressions. Despite these challenges, healthcare institutions and providers must take responsibility for heteronormative microaggressions and take steps to reduce their frequency and mitigate their effects on LGBTQIA care. We conclude by offering strategies for problem-solving at the level of medical education, institutional culture and policy, and individual awareness. (shrink)

This paper contends that eating shapes the self; that is, our practices and understandings of eating can cultivate, reinforce, or diminish important aspects of the self, including agency, values, capacities, affects, and self-understandings. I argue that these self-shaping effects should be included in our ethical analyses and evaluations of eating. I make a case for this claim through an analysis and critique of the hypothesis that young women’s vegetarianism is a risk, sign, or “cover” for eating disorders or disordered eating. (...) After outlining the relevant empirical literature, I suggest that the evidence for this hypothesis is inconclusive. Given this uncertainty, we should consider the risks of making a mistake when accepting or rejecting this understanding of young women’s eating. I argue that these risks importantly include negative effects on the self, such as damage to moral and epistemic agency. Along with other potential consequences of mistakenly accepting the hypothesis, these effects give us reason to reject it pending more conclusive research. Overall, this paper offers a philosophical intervention into the debate over the relationship between vegetarianism and eating disorders while illustrating the ethical importance and relevance of eating as a self-shaping activity. (shrink)

This paper argues that common social narratives about unhealthy eaters can cause significant damage to agency. I identify and analyze a narrative that combines a “control model” of eating agency with the healthist assumption that health is the ultimate end of eating. I argue that this narrative produces and enables four types of damage to the agency of those identified as unhealthy eaters. Due to uncertainty about what counts as healthy eating and various forms of prejudice, the unhealthy eater label (...) and its harms to agency are more likely to stick to some people than others and may reinforce patterns of oppression. I argue that fat people are especially vulnerable to this identification and the damage it can do. I then consider possible “counterstories” about unhealthy eaters, alternative narratives that might be less damaging to agency than the control narrative. I identify one promising counterstory but suggest that it may be limited when it comes to repairing damage to the agency of fat people. Overall, this paper illustrates some of the complex ways that healthism about eating affects agency, and emphasizes the ethical importance of the ways we think about and discuss eating and eaters. (shrink)

The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the (...) variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)

This paper offers a defense of the practice of mindless eating. Popular accounts of the practice suggest that it is non-autonomous and to blame for many of society’s food related problems, including the so-called obesity epidemic and the prevalence of diet related illnesses like diabetes. I use Maureen Sie’s “traffic participation” account of agency to argue that some mindless eating is autonomous, or more specifically, agential. Insofar as we value autonomous eating, then, it should be valued. I also argue that (...) mindless eating can be substantively good: it can help us achieve valuable ends, like creating and maintaining community. Acknowledging the agency and value in mindless eating has both practical and ethical benefits. I contend that it can help us preserve the value in mindless eating while suggesting more effective ways to change it, and, by offering a new narrative about mindless eaters, may be less damaging to agency than popular narratives. (shrink)

We likely do not need to convince readers of this journal that “obesity” is a topic of great contemporary importance.1 Claims about the “rapidly growing” prevalence of overweight and obese people worldwide (World Health Organization (WHO) Consultation on Obesity 2000), the threat that obesity poses to individuals’ and especially children’s health (Mauro et al. 2008, 173; Centers for Disease Control and Prevention 2014a; World Health Organization (WHO) Consultation on Obesity 2000; World Health Organization 2014; Centers for Disease Control and Prevention (...) 2014c), and the “enormous economic burden” that overweight and obese people place on healthcare systems and governments (Mauro et al. 2008, 173; Centers for .. (shrink)

Although “you are what you eat” is a well-worn cliché, personal identity does not figure prominently in many debates about the ethics of eating interventions. This paper contributes to a growing philosophical literature theorizing the connection between eating and identity and exploring its implications for eating interventions. I explore how “identity-policing,” a key mechanism for the social constitution and maintenance of identity, applies to eating and trace its ethical implications for eating interventions. I argue that identity policing can be harmful (...) and that eating interventions can subject people to these harms by invoking identity policing qua intervention strategy or by encouraging people to eat in ways that subject them to policing from others. While these harms may be outweighed by the benefits of the intervention being promoted, they should nonetheless be acknowledged and accounted for. To aid in these evaluations, I consider factors that modulate the presence and severity of identity-policing and discuss strategies for developing less harmful eating interventions. I conclude by considering the relationship between identity-policing and identity loss caused by long-term diet change. This paper contributes to the centering of identity in food ethics and to a more comprehensive picture of identity’s ethical importance for eating interventions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Allergic Intimacies: Food, Disability, Desire, and Risk by Michael GillMegan A. Dean (bio)Review of Michael Gill, Allergic Intimacies: Food, Disability, Desire, and Risk (Fordham University Press, 2023)In the early days of the COVID-19 pandemic, the mundane activity of eating with or near others became physically hazardous and normatively fraught. Nourishing oneself outside one's home could raise serious risks to one's health and wellbeing, and was suddenly subject to (...) new policies and prohibitions aimed at minimizing harm and liability. The decision to eat out demanded personal calculations of risk and benefit, as well as interpersonal negotiation, sometimes prompting contentious conversations about the realities of disease transmission and our moral responsibilities. For many people, coming to think about eating outside the home as a pressing and significant threat to health and life was a radical shift. Yet, as Michael Gill's Allergic Intimacies: Food, Disability, Desire, and Risk details, the experience of eating meals as risking lethal consequences, demanding active personal risk management (including knowledge and negotiation of laws and policies), and straining important interpersonal relationships, is quite familiar to those living with food allergies.Allergic Intimacies offers a rich and generative exploration of the challenges of living with food allergies in the United States. A disability studies scholar, Gill frames the book as an examination of the "meanings" of food allergy from an intersectional perspective that centers both disability and race (ix). The book analyses various cultural representations of and narratives about food allergy, and traces the health effects of social and institutional structures, policies, and practices, while interweaving these findings with Gill's personal experiences with nut allergies. The focus throughout is on IgE-mediated food allergies, the sort which can cause anaphylaxis and which are exemplified by peanut allergies. The book's central claim is that common individualistic approaches to food allergy—approaches that emphasize personal and familial responsibility for allergy management—are inadequate, failing to address the systemic and structural issues that significantly disadvantage food-allergic people in marginalized groups in the U.S., especially Black people. These structural [End Page 421] issues include barriers to accessing not only food and medicine, but also the social and economic resources necessary to advocate for food allergy needs.The book contains a preface, introduction, and brief conclusion, along with four main chapters. The introduction presents a medical and epidemiological overview of food allergies, including various hypotheses about the apparent increase in the prevalence of food allergy in recent decades. It also discusses four "scenarios" to motivate the need to move beyond an individualistic, "single-axis" (i.e., non-intersectional) analysis of food allergy: access to epinephrine injectors (8-14), food industry allergen labelling practices (14-16), airline food allergen policies (16-18), and the treatment of food allergies on The Great British Bake Off (18-23). The first chapter, "Relational Food Allergy, Immunity, and Environments," explores responsibilities toward those who have food allergies and other dietary constraints, discussing themes of risk management, identity, and the ethics and politics of allergen-free spaces, including shared meals, schools, and airplanes. The second chapter, "Nut-Free Squirrels and Princesses with Peanut Allergies: Food Allergies, Identity, and Children's Books," offers a critical analysis of children's books about food allergies, suggesting that most English-language books center white boys with peanut allergies whose experiences reflect significant economic and social privilege. These children's books largely ignore challenges experienced by many marginalized families, such as the need to fight to have food allergies recognized and accommodated by schools, pushback from community members resistant to making such accommodations, and difficulty accessing allergen-free foods. The third chapter, "Allergic Reactions through Fluid Exchanges," raises questions about the ethics of kissing and sex for food-allergic people. Because allergens can be passed through bodily fluids, food allergies complicate what counts as "safe" intimate physical contact (57-58). Gill draws upon Mia Mingus' concept of "access intimacy" (2011) to argue for an ethics of interdependence that centers communication and consent while making space for pleasure and spontaneity. The final chapter, "You Ate What? Intentionality, Accidents, and Death," explores discourses of risk, responsibility, and blame in relation to those who intentionally... (shrink)

It is a common practice for family members to bring food to hospitalized loved ones. However, in some cases, this food contravenes a patient's dietary plan. Such situations can create significant tension and distrust between health care professionals and families and may lead the former to doubt a family's willingness or ability to support patient recovery. This case‐study essay offers an ethical analysis of these situations. We draw on Hilde Lindemann's work to argue that providing food to family members is (...) an important way that families discharge their moral functions of caring for their members and holding them in their identities. When family members are hospitalized, other means of performing these functions are limited. Acknowledging the ethical importance of feeding family members alongside the medical need for dietary restrictions, we offer strategies for creative problem‐solving that center diet as a subject for shared decision‐making and regular, ongoing communication among health care professionals, patients, and families. (shrink)

I am a feminist bioethicist whose work focuses on the ethics of eating. Though COVID-19 is not a foodborne illness, it has had significant impacts on eating around the world, including increases in food insecurity, dining restrictions and closures of restaurants, interruptions in supply chains, and rising food prices. Many people have been eating at home more often—some alone, others with members of their households—and emotional or stress eating is on the rise.A feminist perspective is indispensable for understanding and responding (...) appropriately to these changes. The costs of these changes have not been distributed equally, and drawing attention to how disproportionate harm tracks gendered and intersectional... (shrink)

Lack of time is a commonly reported barrier to healthy eating, but a literal lack of time is only one way that time may compromise eating well. This article explores how the first-personal lived experience of time shapes and is shaped by eating. I draw upon phenomenology and feminist theory to argue that the dynamic relationship between eating and temporality matters for food ethics. Specifically, temporalities and related ways of eating can be better or worse vis-à-vis key ethical concerns. I (...) highlight the possibility of altering temporalities through strategic eating and consider implications for individual food choice and structural change. (shrink)

ABSTRACT:This paper offers a novel argument for the claim that "environmental" explanations of obesity meant to help address racial health disparities may actually reinforce racism. While some contend that these explanations reinforce racist and sizeist interracial dynamics, we argue that environmental explanations can bolster intraracial hierarchies of whiteness that reinforce white supremacy. Deployments of environmental accounts in contexts like the U.S. invoke and intertwine two damaging dichotomies: the "good fatty/bad fatty" and the "good white person/bad white person." This supports a (...) cultural system that oppresses people of color and enables thin, white proponents to position themselves as "good white people" against those who deploy racist, moralizing accounts of obesity, and against fat white people, who are implicitly framed as morally inferior. This analysis furthers our understanding of racist and sizeist discourse about fatness and the insidious ways that attempts to address racism can reinforce it. (shrink)

Based on the poem by Saint Augustine "The Beauty of Creation Bears Witness to God," this is a story about how the author's son, Nick, sees the wonderful presence of God in nature, and how the wonder of Nick himself shines through the story of his wonder watching.

In 2012, a Venn diagram appeared on the blog The Kitchn detailing the characteristics of what it called the “worst dinner guest ever.” This maligned guest is not only vegan but also gluten and lactose intolerant and allergic to nuts and eggs. While a few commenters agreed with the implication that dietary constraints indicate a failure of appropriate guest behavior, most echoed what Lisa Heldke and Raymond Boisvert (2016) suggest is the dominant American view: hosts are generally obliged to accommodate (...) the dietary restrictions of their guests. For Heldke and Boisvert, this is most obviously true when guests have food allergies and serious harm can be easily avoided by a change in menu. In this essay I argue that epistemic barriers can obscure hosts’ perception of these ostensibly obvious cases, preventing them from fulfilling their obligations. Specifically, I argue that guests with food allergies and other “gut issues” can be subject to testimonial injustice that undermines their credibility, leading hosts to doubt or disbelieve their need for accommodation. Such guests may also be subject to testimonial smothering, discouraging them from disclosing their dietary restrictions in the first place. I argue that these forms of epistemic injustice raise multiple moral concerns and that hosts have a responsibility to practice epistemic humility regarding guests’ reports of gut issues. Overall, this paper aims to enable hosts and guests with gut issues alike to recognize and overcome epistemic obstacles to good hospitality—the importance of which extends far beyond the dinner table. (shrink)

Drawing on the relation between disciplinary power and aesthetics, Honi Fern Haber argues that the muscled woman’s “revolting” body undermines patriarchy and empowers women. Consequently, female bodybuilding can be a Foucauldian and feminist practice of resistance. I will argue that Haber’s insistence on the visibility of embodied resistance is flawed. By positing a static goal and failing to sufficiently consider non-visible aspects of normalization, namely pleasure and pain, Haber risks reinscribing the muscled woman into yet another normalizing scheme. In the (...) light of recent work on Foucault's ethics and embodied resistance, I suggest that weight lifting may be more successfully recommended as a practice of resistance when undertaken to increase capacities and for the pleasure of the activity itself. (shrink)

As philosophers, we may be accustomed to asking ourselves—or at least having to explain to others—why we do philosophy. In Categories We Live By: The Construction of Sex, Gender, Race, and Other So...