Public health: ethical issues

Being overweight or obese is a risk factor for several health conditions, including diabetes, stroke, some cancers, and lung and liver problems. The number of people who are obese has increased substantially over the past few decades in the UK and in many other countries. The UK currently has the highest rate of obesity in Europe. The causes of obesity are complex, and there are no simple solutions.

‘Obesogenic’ environments

In today’s environment, it is more difficult for people to lead an active life, and foods are increasingly accessible, affordable and energy-dense. Modifying the design of urban environments and buildings is one way of making it easier for people to increase their activity levels. This could include segregating walking and cycling routes from heavy traffic, and maintaining more public parks and children’s playgrounds.

We conclude

Town planners and architects should be trained to encourage people to be physically active through the design of buildings, towns and public spaces.

Food labelling

Businesses such as the food industry have an ethical duty to help individuals make healthier choices. Several different ways of providing front-of-pack information on food packaging have been introduced, and in 2007, a major study on whether food labelling contributes to healthier choices was commissioned.

We conclude

When the results of the study on the effectiveness of labelling schemes are published, the scheme that is found to be most effective should be taken up. Where industry fails to do this, there is an ethical justification for introducing legislation.

Protecting children

Increasing levels of childhood obesity are a particular concern. Children require special protection from harm, and are particularly vulnerable due to their limited ability to make genuine choices, and their susceptibility to influences such as food marketing.

We conclude

There is an ethical justification for the state to intervene in schools to achieve a more positive attitude towards healthy eating, cooking and physical activity.

Personal responsibility and NHS treatment

It has been argued that if a person’s behaviour has contributed to their need for NHS treatment, they should not have the same access to treatment as other people. Obesity, however, is often related to factors outside the individual’s control, such as living in an environment that makes it difficult to exercise or eat healthily.

We conclude

It would generally be inappropriate to deny NHS treatment to people simply on the basis of their obesity. However, persuading them to change their behaviour could be justified, provided that this would make the medical intervention more effective and that they were offered assistance.