This is a chapter written for an audience that is not intimately familiar with the philosophy of animal consumption. It provides an overview of the harms that animals, the environment, and humans endure as a result of industrial animal agriculture, and it concludes with a defense of ostroveganism and a tentative defense of cultured meat.

Religious dietary practices foster a sense of communal identity, certainly, but traditionally they are also regarded as pleasing to God (or the gods, or the ancestors) and spiritually beneficial. In other words, for many religious people, the effects of fasting go well beyond what is immediately observed or empirically measurable, and that is a large part of what motivates participation in the practice. The goal of this chapter is to develop that religious way of thinking into a response to (...) a motivational problem that arises from our awareness of the insensitivity of contemporary food supply chains. If someone can have faith, or at least tenacious hope, that the significance of her food choices goes well beyond what is immediately observed or empirically measurable, then she may be less demoralized by the apparent inefficacy of those choices. The chapter concludes by considering a way in which this broadly religious way of thinking might be available to secular people as well. (shrink)

Dietary guidelines are mostly issued by agrifood departments or agencies of governments, and are the result of power play between interest groups and values. They have considerable influence over food preferences and purchases of consumers. Ethical problems are at stake not only with respect to power strategies and their influence on consumers. In this paper I will consider three different types of guidelines: a nutrient oriented type, a process oriented type and a meal oriented type. In the nutrient oriented (...) guidelines healthy nutrients and food stuffs are mentioned that excel in containing one or more ‘healthy’ nutrients. Bio- and nutrition scientists and the producers of nutrients, like the sugar, dairy and animal industry, have a lot of influence in this variant. The nutrient oriented framing of food is focussed on individual health. Individuals are implicitly addressed to take responsibility for their own long term health; they have to acquire surveillance and cognitive skills in interpreting their bio data. They don’t need to acquire skills to cook. In the process oriented type, foods and ingredients are categorized according to minimal, refined and reconstituted production processes. Nutrition scientists have the last say here. Consumers do need some food skills to handle fresh products. In the meal oriented guidelines, politicians, social scientists and fresh food producers have prominent responsibilities with respect to the formulation of the guidelines and their application. Buying fresh products, preparing and eating together are the main themes. Food is framed in terms of cooking, and eating and sharing meals. Consumers have to spend time in buying fresh ingredients and cooking; they have to develop food capabilities. The formulation of dietary guidelines is not a neutral operation, but determined by controversies about framings of food and health, responsibilities and also by integrity and self-confidence of experts. It is striking that biological and nutrition scientists often proclaim to possess the final truth on the healthiness of nutrients, and heap scorn on diet gurus. They don’t care that their often incoherent recommendations cause a lot of confusion with consumers and sometimes even lack of trust. I discuss these themes in the paper and will also give some arguments why in the current situation the meal oriented type is ethically more acceptable. (shrink)

An examination of human dietary choice as a unifying cause for both the environmental and animal-rights movements.

In this article, I aim to contribute to the remedy of the current under-theorization of discourse on food ethics and politics from the perspective of the Islamic food tradition by proposing a formulation of an Islamic conception of food justice that extends the religious discourse on food beyond that of dietary laws. The conception of Islamic food justice that I propose makes explicit the connections between the religious, ethical, and political discourses on food. First, I argue that the (...) similarity between the central question of the secular approach to food ethics and that of the modern interpretation of the religious approach to food is best understood as a consequence of the shared assumption of the modern concept of subjectivity. Second, I argue that problematizing the concept of subjectivity that underlies both the secular and the religious approaches to food ethics is key to challenging the boundaries of the current disciplinary-bound discourses as it would allow for a reformulation of the central question beyond that of individual identity and extend the religious discourse on food to the realm on politics. (shrink)

BackgroundThe participant recruitment process is a key ethical pivot point when conducting robust research. There is a need to continuously review and improve recruitment processes in research trials and to build fair and effective partnerships between researchers and participants as an important core element in ensuring the ethical delivery of high-quality research. When participants make a fair, informed, and voluntary decision to enroll in a study, they agree to fulfill their roles. However, supporting study participants to fulfill study requirements is (...) an important ethical obligation for researchers, yet evidenced as challenging to achieve. This paper reports on participants’ motivations to volunteer and remain part of a dietary study conducted in Kasungu District, Malawi.MethodsWe conducted twenty in-depth interviews (with chiefs, religious leaders, trial participants, and health surveillance assistants), five systematic ethnographic observations, and fourteen focus group discussions with trial participants and their partners. Interviews were audio-recorded and transcribed verbatim. We used a grounded theory methodology to analyse data that included coding, detailed memo writing, and data interpretation.FindingsThe findings reveal that many participants had concerns during the trial. Thematically, experiences included anxieties, mistrust of researchers, rumours, fears of exploitation, and misconceptions. Anonymous concerns collected from the participants were reported to the trial team which enabled the researchers to appropriately support participants. Despite initial concerns, participants described being supported and expressed motivation to take up their role.ConclusionThese findings highlight a diverse map of multiple notions of what is ethically relevant and what can impact participation and retention within a study. The study has revealed how embedding a responsive approach to address participants’ concerns and ethical issues can support trust relationships. We argue for the need to employ embedded ethics strategies that enhance informed consent, focus on participants’ needs and positive experiences, and support researchers to fulfill their roles. This work highlights the need for research ethics committees to focus on the risks of undue influence and prevent exploitation especially in settings with a high asymmetry in resources and power between researcher and participant groups.Trial Registration: The Addressing Hidden Hunger with Agronomy (Malawi) trial was registered on 5th March 2019 (ISCRTN85899451). (shrink)

The purpose of this article is to comprehensively review studies that have examined the relation between diet and childhood obesity. The review specifically considers the roles of total energy intake and energy density; dietary composition; individual foods, food groups, and dietary patterns; beverage consumption; and eating behaviors. The paper also discusses methodological considerations and future research directions and concludes by summarizing the evidence presented and highlighting the ethical issues surrounding providing dietary advice.

The Institute of Medicine’s 2005 publication, Dietary Supplements: A Framework for Evaluating Safety, is authoritative and thorough, and thus representative of other reports by the Institute of Medicine. What makes this report particularly interesting, however, is the rich political subtext that exists in the interstices of the report, popping up here and there in brief comments and barely suppressed yelps of exasperation. To understand this context, it is useful to reflect for a moment on the special nature of the (...) IOM and its relationship to government.IOM is part of the National Academy of Sciences, and is a private, non-governmental organization that does not receive direct federal funding for its work. Rather, IOM studies are often funded by contract with governmental entities that request reports on particular topics. As a case in point, the dietary supplement study was requested and paid for by the FDA. (shrink)

Childhood obesity is a serious problem for increasing numbers of children around the world. According to the International Obesity Task Force, 1 of 10 schoolaged children worldwide is overweight or obese, a number totaling 155 million; of these, 2-3% are obese. Prevalence is highest in the Americas and Europe, followed by the Near/Middle East, with smaller but growing numbers in the Asia-Pacific and Sub-Saharan regions of the world.In the United States, which provides the data for much of this report, prevalence (...) continues to rise. The most recent nationally representative data indicate that 33.6% of individuals aged 2-19 years were overweight and 17.1% were at risk for overweight in 2003-2004, compared to 28.2% and 13.9% in 1999-2000, respectively. In this age group, the prevalence of overweight or at risk for overweight was highest among Mexican Americans, followed by Non-Hispanic blacks and Non-Hispanic whites, and a higher percentage of males were overweight compared to females. (shrink)

Brussen, Kerri Anne The National Health and Medical Research Council released a new set of dietary guidelines on 18 February 2013, to help ensure that Australians continue to make healthy food choices based on the best available scientific evidence. Unlike the 2003 guidelines which were based on nutrients, these guidelines are based on food and food groups. The guidelines encourage the consumption of a varied diet and physical exercise. They also encourage the limiting of energy-dense nutrient-poor food. By making (...) these food choices, we can help to reduce our risk of diet-related disease. (shrink)

Despite decades of action to reduce global malnutrition, rates of undernutrition remain stubbornly high and rates of overweight, obesity and chronic disease are simultaneously on the rise. Moreover, while volumes of robust research on causes and solutions to malnutrition have been published, and calls for interdisciplinarity are on the rise, researchers taking different epistemological and methodological choices have largely remained disciplinarily siloed. This paper works to open a scholarly conversation between “mainstream” public health nutrition and “critical” nutrition studies. While critical (...) nutrition scholars collectively question aspects of mainstream nutrition approaches, they also chart a different way to approach malnutrition research by focusing on politics, structural conditions, and the diverse ways people make sense of food and malnutrition. In this paper, we highlight the key research agendas and insights within both mainstream and critical nutrition in order to suggest spaces for their potential conversation. We ultimately argue that global public health nutrition interventions might achieve greater success in more equitable ways if they are informed by critical nutrition research. We aim for this intervention to facilitate more substantial crossing of disciplinary boundaries, critical to forging more socially and environmentally just dietary futures in the global South and beyond. (shrink)

Paul B. Thompson’s From the Field to Fork: Food Ethics for Everyone explains the growing number of ways that food connects to ethical questions concerning our consumption, production, storage, and distribution of food. Although this book serves as an introduction to food ethics for non-experts, professionals in agricultural science and food production, food activists, and philosophers will have a lot to learn from Thompson’s insight, careful argumentation, and mastery of the economic, scientific, and political issues that ground our (...) current debates about food. In my comments, I will first briefly provide an overview of Thompson’s thoughtful book. I will explain the methodology employed in this book and how his methodology applies to specific philosophical questions within food ethics. I will focus my commentary on how Thompson frames the ethics of diet and obesity. I will then raise a few questions concerning food choice and paternalism that were omitted from this book, but that I think raise substantial ethical concerns in affluent countries. I will close with a very brief comment on Thompson’s methodology. (shrink)

This paper draws from data collected from 500+ surveys, distributed twice from the same respondents (2020 and 2021), and forty-five face-to-face interviews (2022). The location studied is a metropolitan county in Colorado (USA). The research examined the discourses and practices having to do with organic and natural food consumption—note, too, the data were collected at the height of the COVID-19 pandemic. The findings upend conventional understandings of, and frameworks used to explain, consumer behavior. What are often presented as motivations in (...) prior studies are shown, instead, to be justifications; rationalizations after-the-fact. The paper troubles decision-making frameworks that cast motivations, attitudes, and intentions as “antecedents” to consumer behavior. Rather, the findings point to the significance of social networks, and in particular network diversity, for understanding and explaining the sayings (discourses) and doings (practices) of “individual” consumers. Discourses linked to health are also shown to be salient variables, though when situated within social networks those discourses are shown to have politics. Particular attention is devoted to explaining dietary shifts among those who reported the largest increases in the consumption of organic and natural foods between 2020 and 2021/22. The paper concludes discussing what the data mean from the standpoint of envisioning just and inclusive food system futures and agrifood policy that delivers on those ends. (shrink)

In Haiti, as in many developing countries, the prospect of enhancing food sovereignty faces serious structural constraints. In particular, trade liberalization has deepened patterns of food import dependence and the export orientation of peasant farming. But there are also powerful cultural dimensions to food import dependence that further problematize the challenge of pro-poor agrarian change. Food cultures are sometimes underappreciated in the food sovereignty literature, which tends to assume that there will be a preference for local or ‘culturally appropriate’ foods. (...) In Haiti, historically ingrained and persistent ideologies of racism magnify class hierarchies and the common perceptions of peasants at the bottom of the social order. This paper explores the intersection of socially constructed ideologies of racism with peasant aspirations for socio-cultural mobility, drawing from 30 qualitative interviews with key informants in government, non-governmental organizations, and social movements, and 108 qualitative interviews and 216 food preference surveys that were conducted in three sites in rural Haiti between November 2010 and July 2013. The core argument is that racially-coded class hierarchies exert a powerful influence on dietary aspirations, as ‘peasant’ foods like millet, root crops and molasses bread are commonly denigrated by Haiti’s poor, including peasants themselves, while ‘elite’ and ‘foreign’ foods like white flour bread, Corn Flakes, and spaghetti get held up as superior. This suggests a need to appreciate how the cultural geographies of food interact with—and can in fact exacerbate—political and economic inequalities, which raises challenging questions for peasant movements and advocates of food sovereignty. (shrink)

Objective: To estimate the level of complementary feeding pattern (CFP) among children aged between 6 to 23 months and to identify the determinants in individual, household and community level in Bangladesh. Methods: From secondary data of Bangladesh Demographic Health Survey (BDHS) 2011 was used in this study. A total of 2,373 children aged between 6 to 23 months were selected. To estimate the level of CFP dimension index and the “score of the index” was used as dependent variables. Statistical analyses (...) and tests were guided by the nature of the variables. Multivariable logistic regression analyses were performed to identify the significant determinants of CFP. Results: The overall level of CFP among children aged between 6 to 23 months was low. More than 95% of the children experienced inadequate (92.7%) CFP level. The mean levels of CFP as well as percentages of no or inadequate (94.1%) CFP were significantly lower among children of the youngest age group (06 months), uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. However, only few variables remained significant for adequate CFP in the multivariable logistic regression analysis. Adequate CFP was significantly lower among the children aged between 6 to 23 months (OR: 0.22, 95% CI: 0.10-0.47), children of illiterate fathers (OR: 0.32, 95% CI: 0.11-0.95) and socio-economically middle-class families (OR: 0.28, 95% CI: 0.09-0.86) as compared to their reference categories. Conclusion: Inappropriate and inadequate CFP may cause serious health hazards among children of 6 to 23 months in Bangladesh. It is ethical to take effective interventions and strategies by the government and other concerned stakeholders to improve the overall situation of CFP in Bangladesh. (shrink)

The idea that the degree of infringement public health interventions have on individual rights should be proportional to the degree of expected benefits has emerged as an influential principle in public health ethics and policy. While proportionality makes sense in theory, it may be difficult to implement in practice, due to the inherent conflict between individual rights and the common good underlying the principle. To apply the proportionality principle to a decision of policy, one must still find a reasonable (...) way of balancing these competing values in light of the available options and empirical evidence. In this article, I consider how the proportionality principle applies to the regulation of dietary supplements and examine some critiques of the current oversight system. I argue that it may be difficult maintain proportional oversight because the risks of dietary supplements vary considerably. Strengthening the regulations may therefore promote an appropriate level of regulation in some cases but lead to overregulation in others. (shrink)

Around the world, unhealthy diets are a leading cause of disease. Shifting population diets in a healthier direction will require downstream policy interventions. This means changing the composition of the processed food supply, particularly reducing salt, sugar and fat. Mandatory nutrient limits imposed by government are one way of achieving this. However, they have been criticized as a particularly intrusive regulatory option, interfering with both free markets and free choices. At the same time, voluntary industry reformulation has become an intervention (...) favoured by national governments, the World Health Organization and the food industry. This article uses a comparison of the two interventions—which share a common public health goal, albeit achieved through different regulatory means—as a basis to evaluate the ethical charges against mandatory nutrient limits. It makes three main findings: that both affect free dietary choice in very similar ways; that dominant public health ethics frameworks are not well equipped to compare mandatory and voluntary forms of regulation; and that food governance is inherently multisectoral, involving markets, governments and the public. Taking these findings into account, the article calls for a more nuanced ethical evaluation of food reformulation policies. (shrink)

Since the turn of the millennium, rapid advances in technology, globalized markets, and atomized politics instigated in the American and Israeli Jewish communities questions about the morals of food consumption. Contemporary issues such as workers' rights, animal welfare, environmental protection, among others, intersect with basic Jewish food ethics: while Jewish communities respect ancient laws, they also appreciate the importance of progress and look forward to a more repaired world. In these pages, readers will have the unique opportunity to delve (...) into the minds of the brightest Modern Orthodox thinkers of the current generation. The contributions contained in Kashrut & Jewish Food Ethics are rich in detail and offer new paradigms for the practical observance of kashrut that have swirled in thec ether for generations. (shrink)

Nigeria agriculture, food security and dietary intake have not been exempted from the disruptions in countless sectors around the world due to the outbreak of COVID-19. The country first experienced the outbreak on February 27, 2020, and the experience since then has shown negative effects not only on the socioeconomic conditions but also on agriculture, food security and dietary intake. Long term in-depth analysis of the effects of this pandemic on food security and dietary intake using quantitative (...) data is still very difficult due to paucity of data and the great level of the improbability of the trajectory of the spread of the Virus. This study is a rapid assessment of the short and long-term potential effects of the disease. It relied on a review of situation reports especially by the Nigeria Centre of Disease Control and other reports around the world on COVID-19, personal observations, and public opinion via mobile telephone survey of Lagos and Oyo States, Nigeria. Findings show that food demand and supply shocks caused by COVID-19 outbreak affect agriculture, food and dietary intake negatively through COVID-19 policies. It leads to a reduction in household income coupled with hike in food prices. Owing to the Nigeria’s crude farming practice, there was a scarcity of hired labour required for production process during 2020 farming season. This implies a high likelihood of low output and further surge in food prices in the future. Food access was also compromised with the accumulation of unsold fresh produce by the smallholder farmers and the low salary earners during movement restrictions and of loss income as a result of international border closure. Food and dietary intake is affected as people are shifting diets to more affordable and low quality foods, while food stability is not guaranteed due to market insecurity, prompting an extraordinary level of indecision. The study concludes that the shock of COVID-19 is not only a demand management problem but a multidimensional crisis requiring monetary, fiscal, and health policy responses with global collaboration and cooperation. (shrink)

On December 30, 2003, the FDA announced that it will publish a rule banning sales of ephedra - a dietary supplement often utilized for weight loss, increased energy, and enhanced athletic performance - because it poses an unreasonable health risk.The ban will be issued under the auspices of the Federal Food, Drug, and Cosmetic Act and the Dietary Supplement Health and Education Act of 1994, in response to a process that began in June of 1997, when the FDA (...) first proposed a mandatory warning statement on dietary supplements containing ephedra. FDAs analysis of the scientific evidence has led it to conclude that dietary supplements containing ephedrine alkaloids present an unreasonable risk of illness or injury and are therefore adulterated under Section 402 of the Federal Food, Drug, and Cosmetic Act? (shrink)

: This essay appropriates the understanding of ethics developed by Michel Foucault in his courses at the Collège de France from 1980 until his death in 1984, with the aim of formulating a progressive environmental politics. As such, it attempts to navigate some of the long–standing divides between the movement for animal rights and environmental ethics proper, finding in the practice of vegetarianism a form of self-relation that is conducive to critical forms of speech and politics. The final (...) phase of Foucault's work is replete with insights into how the care of the self can serve as a resistance to forms of power and political stasis. This paper presents these unpublished materials, allowing for a glimpse of the unknown Foucault, and reinterprets vegetarianism as a form of self-practice that is linked with truth and critical speech. (shrink)

Orthorexia Nervosa has gained increased attention in academia since 1997. However, like other “Exia” conditions, there is debate around its inclusion in the Diagnostic and Statistical Manual of Mental Disorders. This study aimed to examine the experiences of those following a diet indicative of ON in the United Kingdom. This information is essential to the development of diagnostic criteria and classification of ON. Behavioural Reasoning Theory was used to explore reasons contributing to the development of ON. Ten individuals, aged 23–35 (...) years, took part in semi-structured interviews. Inductive thematic analysis was used to analyse the results. Four themes emerged from the data—journey, social, rules/control, and ethical considerations which highlighted contributing factors to the development of ON behaviours, the impact of these behaviours on individuals' social lives, and a strive for control. These findings are the first to suggest that ON involves a more complex set of behaviours than current definitions and proposed diagnostic criteria suggest and highlight the need to consider a variety of reasons for restricted diet when developing diagnostic criteria, screening tools, and classification in the DSM. (shrink)

The animal agriculture industry causes animals a tremendous amount of pain and suffering. Many ethical vegans argue that we therefore have an obligation to abstain from animal products in order to reduce this suffering. But this argument faces a challenge: thanks to the size and structure of the animal agriculture industry, any individual’s dietary choices are overwhelmingly unlikely to make a difference. In this paper, we criticize common replies to this challenge and develop an alternative argument for ethical veganism. (...) Specifically, we argue that individuals should abstain from animal products because vegans, as a group, successfully reduce animal suffering, and individuals are obligated to participate in, rather than free ride on, this collective endeavor. Or, at the very least, individuals have strong reasons to purchase fewer inhumanely raised animal products—even if they are not obligated to go vegan per se. (shrink)

Objective: To estimate the level of complementary feeding pattern among children aged between 6 to 23 months and to identify the determinants in individual, household and community level in Bangladesh. Methods: From secondary data of Bangladesh Demographic Health Survey 2011 was used in this study. A total of 2,373 children aged between 6 to 23 months were selected. To estimate the level of CFP “dimension index” was used and the score of the index was used as dependent variables. Statistical analyses (...) and tests were guided by the nature of the variables. Multivariable logistic regression analyses were performed to identify the significant determinants of CFP. Results: The overall level of CFP among children aged between 6 to 23 months was low. More than 95% of the children experienced either no or inadequate CFP. The mean levels of CFP as well as percentages of no or inadequate CFP were significantly lower among children of the youngest age group, uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. No weekly exposure to mass media also revealed significant associations with CFP. However, only few variables remained significant for adequate CFP in the multivariable logistic regression analysis. Adequate CFP was significantly lower among the children aged between 6 to 23 months, children of illiterate fathers and socio-economically middle-class families as compared to their reference categories. Conclusion: Inappropriate and inadequate CFP may cause serious health hazards among children of 6 to 23 months in Bangladesh. It is ethical to take effective interventions and strategies by the government and other concerned stakeholders to improve the overall situation of CFP in Bangladesh. (shrink)

As the collective impact of human activity approaches Earth’s biophysical limits, the ethics of food become increasingly important. Hundreds of millions of people remain undernourished, yet only 60 percent of the global harvest is consumed by humans, while 35 percent is fed to livestock and 5 percent is used for biofuels and other industrial products. This essay considers the ethics of such use of edible nutrition for feedstock and biofuel. How humanity uses Earth’s land is a reflection of (...) its values. The current land-use arrangements, which divert 40 percent of all food to feed animals or create fuels, suggest that dietary and transportation preferences of wealthier individuals are considered more important than feeding undernourished people, or the stability of the wider biotic community. (shrink)

This case study appeared in full in the last issue of Research Ethics Review ; 1: 134). It concerned the design of a randomized controlled trial to examine dietary practices among South Asian women during pregnancy.

The coming decades will present an immense challenge for the planet: sustainably feeding nearly ten billion people that are expected to be alive by 2050. This is no small task, and one that intersects with climate change, geopolitics, the increased globalization of agricultural markets, and the emergence of new technologies. The world faces a challenge of increased demand, propelled by an expanding world population and a global shift in dietary patterns toward more resource-intensive foods. Moreover, changes in demand occur (...) in the context of declining soil fertility and freshwater availability, agriculture's growing contribution to water pollution and climate change, and the emerging threats to agricultural productivity caused by climate disruption. (shrink)

Background Fecal microbiota transplant (FMT) is a treatment modality that involves the introduction of stool from a healthy pre-screened donor into the gastrointestinal tract of a patient. It exerts its therapeutic effects by remodeling the gut microbiota and treating microbial dysbiosis-imbalance. FMT is not regulated in Jordan, and regulatory effort for FMT therapy in Jordan, an Islamic conservative country, might be faced with unique cultural, social, religious, and ethical challenges. We aimed to assess knowledge, attitudes, and perceptions of ethical and (...) social issues of FMT use among Jordanian healthcare professionals. Methods An observational, cross-sectional study design was used to assess knowledge, attitudes, and perceptions of ethical and social issues of FMT among 300 Jordanian healthcare professionals. Results A large proportion (39 %) thought that the safety and efficacy of this technique are limited and 29.3 % thought there is no evidence to support its use. Almost all (95 %) responded that they would only perform it in certain cases, if ethically justified, and 48.3 % would use it due to treatment failure of other approaches. When reporting about reasons for not using it, 40 % reported that they would not perform it due to concerns about medical litigation, fear of infections (38 %), and lack of knowledge of long safety and efficacy (31.3 %). Interestingly, all practitioners said they would perform this procedure through the lower rather than upper gastrointestinal tract modality and the majority will protect the patient’s confidentiality via double-blinding (43.3 %). For a subset of participants (n = 100), the cultural constraints that might affect the choice of performing FMT were mainly due to donor’s religion, followed by dietary intake, and alcohol consumption. Conclusions Our healthcare practitioners are generally reluctant to use the FMT modality due to religious and ethical reasons but would consider it if there was a failure of other treatment and after taking into consideration many legislative, social, ethical and practice-based challenges including safety, efficacy and absence of guidelines. (shrink)

The use of doll therapy for people with dementia has been emerging in recent years. Providing a doll to someone with dementia has been associated with a number of benefits which include a reduction in episodes of distress, an increase in general well-being, improved dietary intake and higher levels of engagement with others. It could be argued that doll therapy fulfils the concepts of beneficence and respect for autonomy. However, some may believe that doll therapy is inappropriate when applied (...) to the concepts of dignity and non-maleficence. The absence of rigorous empirical evidence and legislative guidelines render this a therapy that must be approached cautiously owing to the varied subjective interpretations of Kitwood’s ‘malignant social psychology’ and bioethics. This article suggests that by applying a ‘rights-based approach’, healthcare professionals might be better empowered to resolve any ethical tensions they may have when using doll therapy for people with dementia. In this perspective, the internationally agreed upon principles of the United Nations Convention on the Rights of Persons with Disabilities provide a legal framework that considers the person with dementia as a ‘rights holder’ and places them at the centre of any ethical dilemma. In addition, those with responsibility towards caring for people with dementia have their capacity built to respect, protect and fulfil dementia patient’s rights and needs. (shrink)

After a century of major technicaladvance, essentially achieved by and for theindustrialized countries, the evolution of thefood sector in southern countries should nolonger be thought of in terms of a ``headlongpursuit.'' In the present context of demographicgrowth, urbanization, poverty and disparities,environmental degradation, and globalization oftrade, new priorities have emerged, and newethical questions have been raised, mainlyrelated to sustainability and equity. Thispaper analyses these ethical concerns in thefollowing terms: can the model of food sectordevelopment initiated by the industrializedcountries be applied to (...) the entire world on asustainable and equitable basis, given theeffects of this development with regard to theenergy consumed, the changes in dietarybehavior and related nutritional problems, thenew demands in terms of food safety, thequestions of biodiversity, ownership ofknowledge, cultural identities, gender issues,and Man's relationship to food and Nature? (shrink)

The methodology of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study raises a number of important ethical questions. Many of these are already well recognised in ethical guidelines that uphold principles of individual and parental consent, confidentiality and scientific review. There are, however, wider issues that require ethical reflection. In this paper, we focus on a set of problems surrounding the evaluation of complex social interventions, and argue that comprehensive and objective (...) evaluation is a much more ethically charged aim than it may first appear. In particular, we contend that standard scientific measures - of body size and biomarkers - convey only part of the story. This is partly because, when we intervene in communities, we are also concerned with complex social effects. These effects are made even more complex by contemporary social anxieties about fat and physical appearance, as well as about the safety and security of children. Such anxieties increase the risk of undesirable side effects that are themselves difficult to gauge. In the face of these and other complexities, we argue that the evaluation of interventions should involve a strong ethical dimension. First, it must include - as does the IDEFICS study - consideration of the opinions of the people affected, who are subjected to interventions in ways that necessarily go beyond individual consent. Second, we suggest that interventions might also be assessed by how much they empower people - and especially those persons, such as children, who are otherwise often disempowered. (shrink)

Our current planetary emergency is one in which we are facing significant global warming as a result of human-driven climate change. This is having and will continue to have catastrophic results for the earth’s ecosystems and for life as we know it. The Christian tradition often works actively against the seriousness of these challenges due to its eschatological outlook. Process theology, as one stream within the Christian tradition, embraces a different vision of the future that fosters engagement in current concerns (...) rather than an escapist approach. A process theological proposal is therefore offered that calls for an embodied ethic that embraces the acronym SHE. SHE stands for Sustainability, Health, and Ethics. It provides a dietary grid as a way to embody ethics to bring about societal change in light of environmental challenges. SHE is proposed against a background that argues for Christian engagement in our current global crisis. The idea of “small turnings” as a conceptual idea is adopted to help frame how the SHE grid might be understood. (shrink)

Inadequate diet is the leading risk factor for morbidity and mortality worldwide. However, approaches to identifying inadequate diets in clinical practice remain inconsistent, and dietary interventions frequently focus on facilitating ‘healthy choices’, with limited emphasis on structural constraints. We examine the ethical implications of introducing a routine question in the medical history about ability to access food. Not collecting data on food security means that clinicians are unable to identify people who may benefit from support on an individual level, (...) unable to consider relevant dietary risk factors for disease and disease progression and unable to monitor population trends and inequalities in dietary access in order to design effective policy interventions. We argue that the current lack of routine screening for food insecurity is inconsistent with our approach to other health behaviours, as well as with doctors’ frequent informal role as gatekeepers to the food aid system, and recent calls for governmental action on food insecurity and health inequalities from individual clinicians and professional bodies. Potential ethical barriers to asking patients about food security are addressed, including concerns about stigma, limiting autonomy, fair resource allocation, unclear professional remits and clinicians’ ability to offer effective interventions. We suggest that there is an ethical imperative for doctors to ask patients about their ability to access healthy food. Gathering this data provides a valuable first step in re-framing the social determinants of health as modifiable risks, rather than inevitable inequities. No data are available. (shrink)

Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia management. The case examines (...) a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. (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)

Again and again utopian hopes are connected with the life sciences (no hunger, health for everyone; life without diseases, longevity), but simultaneously serious research shows uncertain, incoherent, and ambivalent results. It is unrealistic to expect that these uncertainties will disappear. We start by providing a not exhaustive list of five different types of uncertainties end-users of nutrigenomics have to cope with without being able to perceive them as risks and to subject them to risk-analysis. First, genes connected with the human (...) body or nutrients can have different functions in interaction with their environment (for instance, one nutrient can be healthy for the heart, but can also be a high risk in relation to cancer). Secondly, uncertainties are formed by risk analyses. Will it be possible to calculate a certain risk of getting a certain condition with a certain lifestyle? Will it be difficult to separate the genetic component and the lifestyle component? How high will these risks be? How will these risks be handled by the actors? In the case of personal genotyping, it is unclear how frequent an adverse polymorphism will occur. Will every individual have a certain vulnerability to a certain disease or will it only be applicable to a small group of the population or particular populations? Thirdly, dietary advices are subject to uncertainties and still to be developed professional standards: some will have adverse outcomes, some will not delay the disease, and some will assume uncertain associations between nutrients, lifestyle, and genetic vulnerabilities. Fourth, with regard to the usefulness of tests it is uncertain to what extent risks indications about obesity and diabetes and other vulnerabilities really influence people to live healthier and therefore will help to prevent these conditions. Fifth, it is uncertain how and what nutrigenomics products will be developed and used. Will it be possible to develop more effectively health improving products? Or is this too difficult and will nutrigenomics continue to be used in not always justified health claims as a commercial and marketing tool? Present-day ethics and theories of responsibilities presuppose that uncertainties will disappear and concentrate on what seems to be fixed and stable in science. We develop provisional thoughts that assume that the dynamic of science to produce uncertainties and dilemmas is endemic, and we stress the need for consumers to institutionalize value searching, exploring, and deliberating devices in the health and food sector to find out the most important uncertainties and correspondingly socially desirable research priorities. (shrink)

Healthy Eating Policy and Political Philosophy: A Public Reason Approach by Barnhill and Bonotti is a terrific effort to provide a systematic method for appraising the ethical aspects, broadly understood, of regulations and policies connected to food, diet, and eating. In this commentary I purport to highlight the originality and the merits of the volume by considering what it doesn’t accomplish in three of its parts. I first call attention to the specific construction of the subject matter, namely on the (...) question whether to be at stake are eating behaviors, dietary patterns, or certain food items; while Barnhill and Bonotti do not problematize it, this question is arguably pivotal to design effective policies and to adequately assess them. Second, I discuss the technical concept of “constitutive evaluative standards,” used by Barnhill and Bonotti to lay out their view, as this part of their work calls for an alignment with research on the philosophy of nutritional science and, more generally, philosophy of science. Finally, I take up the technical concept of “accessible reason,” which plays a central role in ascribing the public status to reasons, advocating for a more thorough determination of this concept based on recent work in epistemology. (shrink)

One of the starting assumptions in the debate over the ethical status of animals is that someone who is committed to reducing animal suffering should not eat meat. Steven Davis has recently advanced a novel criticism of this view. He argues that individuals who are committed to reducing animal suffering should not adopt a vegetarian or vegan diet, as Tom Regan an other animal rights advocates claim, but one containing free-range beef. To make his case Davis highlights an overlooked form (...) of animal harm, that done to field animals in crop production. Yet while Davis's argument is ingenious and thought-provoking, it is not a successful challenge to vegetarianism and veganism's status as the diets that most advance animal rights. Scientific studies of crop production that Davis draws on document two different forms of harm done to field animals: those that are directly killed by harvesting equipment and those that are killed by other animals. Once this distinction is made explicit, the degree to which such studies pose a problem for animal protection theory considerably weakens. Davis also overlooks philosophically significant forms of harm to human beings that are present in beef production but not crop harvesting. Finally, he bases his argument on the controversial assumption that there is no difference between deliberate and accidental killing - either of animals or people. Although these problems defeat Davis's attempt to offer an immanent critique of Regan's animal rights position, his analysis does have important dietary ramifications that animal advocates should take into account. (shrink)

As a moral foundation for vegetarianism and other consumer choices, act consequentialism can be appealing. When we justify our consumer and dietary choices this way, however, we face the problem that our individual actions rarely actually precipitate more just agricultural and economic practices. This threshold or individual impotence problem engaged by consequentialist vegetarians and their critics extends to morally motivated consumer decision-making more generally, anywhere a lag persists between individual moral actions taken and systemic moral progress made. Regan and (...) others press just this point against Singer's utilitarian basis for vegetarianism; recently Chartier criticizes act-consequentialist vegetarianism by identifying many factors weakening the connection between individual meat purchases and changes in animal production. While such factors are relevant to act-consequentialist moral reasoning, I argue, they need not defeat the act-consequentialist case for vegetarianism and consumer ethics. This is shown by offering a probabilistic account of the threshold issue and discussing the positive and negative role-modelling effects of our morally motivated dietary and consumer choices. (shrink)

Zemyarska MS. Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it? J Med Ethics 2019;45:346–50. doi: 10.1136/medethics-2018-104983. The Acknowledgements section of ….

Animals in Brazil: Economic, Legal and Ethical Perspectives presents a broad overview of the complicated role of animals in Brazilian society. Its four substantive chapters survey the landscape of animal agriculture, animal protection laws, recent animal jurisprudence, and the underlying cultural factors that have shaped the Brazilian people's relationship with and treatment of animals. Despite the book's title, there is no chapter addressing economics. However, it represents the first book in English addressing the plight of animals in Brazil and makes (...) a marked contribution to animal ethics in Latin America. At its best, it is very good, and overall, the volume is a worthwhile addition to the bookshelf of anyone interested in Brazilian animal law.The introduction by the book's editor, Carlos Naconecy, does exactly what an introduction should do: it succinctly describes the content of the chapters to follow. My quibble is that while Naconecy has excellent English and expresses himself well, the essay badly needed the editorial scrutiny of a native English speaker. The succeeding chapters each begin with an abstract, a simple but useful aid to any scholar who might not be interested in all of the issues the book covers.Chapter 1, “Food Animals in Brazil: Five Decades of Transformation,” ably describes Brazil's progression from a primarily subsistence-based agrarian culture to its full-scale embrace of industrial agriculture with all of its incumbent horrors. In just 50 years, Brazil has gone from a net importer to the world's second-largest exporter.The story of the country's transition to confinement, meat-based agriculture is all too familiar. It wrought havoc on community and family ties and overwrote traditional dietary practices, leading to widespread obesity, disease, and nutrient deficiencies. It also made indifference toward agricultural animals a new national norm. The level of cruelty that is both legal and common in Brazilian industrial agriculture would strain credulity if it weren't so similar to those of so many other countries. Indeed, the authors’ discussion of the systemic animal mistreatment, devastating environmental consequences, and accompanying cultural erosion in Brazil could easily have been cut and pasted into a chapter surveying the last 50 years in the United States.The second chapter is the strongest in the collection. “The Legal Protection of Animals in Brazil: An Overview” summarizes the country's animal-legal framework and situates it within the context of Brazil's constitutional prohibition against animal cruelty. The authors explain why the constitution offers little practical protection. Under the prevailing view, only those acts undertaken for the purpose of causing needless suffering constitute cruelty. Since much animal cruelty is ostensibly done for other reasons (food, science, etc.), the cruelty prohibition does not reach the majority of offenses.The authors next construct a syllogistic argument that the current legal classification of animals as “things” rather than beings who are the subjects of rights is logically and ethically flawed. Since cruelty involves suffering, and objects cannot suffer, and since animals suffer (otherwise animal cruelty laws would be pointless), then animals must be subjects of the law. Phrased differently, animals must be rights-holders. This leads into a compelling argument that the constitution not only supports but requires such an interpretation.“Cases and Debates in the Brazilian Animal Rights Arena” does exactly what its title suggests. It looks at recent animal-related judicial developments and situates them within a broader cultural and legal context. For example, the Supreme Court recently held that the Vaquejada, a rodeo-like event involving chasing and tackling terrified cows, was unconstitutional.Immediately following the decision, the legislature amended the constitution to classify the Vaquejada as an important cultural activity and thus protected under a different constitutional provision. The courts are currently considering whether that constitutional amendment is itself unconstitutional. We are further told about movements against foie gras and vivisection and about recent developments regarding custody disputes over domestic animal companions.The final chapter, “Factors That Influence the Brazilian Ethos Regarding Animals” is a broad discussion of the ways Brazilian history and culture have impacted attitudes toward animals. It is argued that because Brazil was the last Western country to eliminate slavery, Brazilians are more prone to treat animals like property and that the Brazilian temperament makes them more likely to be passionate than pragmatic. We also learn that a cultural reluctance to protest against social wrongs enables Brazilians to remain silent in the face of animal injustice and that the country's Catholic tradition instilled the idea that only people were made in the image of God and that animals therefore matter less. These observations strike me as overbroad and problematic. For example, millions of Brazilians have spent much of the past decade protesting government corruption, and the country has an impassioned animal advocacy movement. Furthermore, it is not clear that Brazilians necessarily treat animals differently than people from other countries with very different histories.Overall, Animals in Brazil begins the work of new scholarship in English on animals in the Brazilian context. The fact that some chapters are more informative and useful than others is an inevitable by-product of an edited volume and should not deter those interested in Brazilian animal law from reading it. The excellence of the first two chapters alone makes the book worthwhile. (shrink)

The idea of personalized nutrition is to give tailored dietary advice based on personal health-related data, i.e. phenotoype, genotype, or lifestyle. PN may be seen as part of a general trend towards personalised health care and currently various types of business models are already offering such services in the market. This paper explores ethical issues of PN by examining how PN services within the contextual environment of four future scenarios about health and nutrition in Europe might affect aspects of (...) social justice according to Martha Nussbaum’s capability approach. The scenarios have been created by a mixed group of stakeholders and experts in three consecutive workshops. This resulted in the definition of four future scenarios within a scenario space consisting of two variables: the ‘logic of health care systems’ and ‘conception of health’. Within each scenario, PN is likely to play a more or less important role in improving health by influencing food consumption patterns in society. Nussbaum’s capability approach implies a concept of social justice as a function of a minimum standard of human dignity. This denotes an account for equality in terms of a minimum of entitlements. However, also the ability of achieving individual objectives is essential for social justice. Personalisation advice in health and food consumption patterns, as aimed for by PN, is therefore acceptable provided a minimum of entitlements is guaranteed to all members of a society, and at the same time freedom concerning personal preferences is respected. Potential variation of how different people might benefit from PN should therefore be consistent with the minimum required as defined by the list of capabilities. (shrink)

Human beings have engaged in animal husbandry and have slaughtered animals for food for thousands of years. During the majority of that time most societies had no animal welfare regulations that governed the care or slaughter of animals. Judaism is a notable exception in that from its earliest days it has included such rules. Among the Jewish dietary laws is a prohibition to consume meat from an animal that dies in any manner other than through the rigorously defined method (...) of slaughter known as shechita. In recent decades more and more attempts have been initiated by governments around the world to either outright ban or to control and modify the practice of shechita. This paper presents the requisite background about shechita and then analyzes the ethics of some of the recent legislation. The analysis includes a rebuttal of the assertion that shechita is an inhumane method of slaughter. It further presents the consequences on the Jewish community of legislation to impose pre-slaughter stunning and explains why such legislation is unethical. The actual effect of labeling laws is discussed and it is shown why such laws are also un-ethical. (shrink)

Monrad JT. Ethical considerations for epidemic vaccine trials. J Med Ethics 2020;46:465–9. doi:10.1136/medethics-2020-106235 This ….