Ethical issues in obesity interventions for populations
Craig L. FryHealth Ethics and Policy, Murdoch Childrens Research Institute
Email: craig.fry@mcri.edu.au
NSW Public Health Bulletin 23(6) 116-119 https://doi.org/10.1071/NB12062
Published: 28 June 2012
Abstract
Beyond the usual technical and evidentiary considerations, there are ethical questions that we must consider in the justification of our obesity interventions in the name of expected population health gains. These relate to the types of health identities that are permitted in society, the possible unintended consequences of preferencing certain health identities over others, and the manner in which public health policies and interventions are justified. The prevalence of overweight and obesity in Australia highlights some of the areas of uncertainty and identifies some important ethical questions that arise as a result of this uncertainty. I propose that the Australian obesity prevention strategy could be evaluated using the Nuffield Council on Bioethics stewardship model of public health to assess whether any current approaches exceed recommended intervention constraints or limits. My aim is to prompt further debate on this topic.
References
[1] Fry CL. Critical questions we should ask in a changing Australian preventative health landscape: Competing interests, intervention limits, and permissible health identities. Health Promot J Austr 2010; 21 170–5.[2] Fry CL, Buchman DZ. Toward a lay descriptive account of identity in addiction neuroethics. In: Carter A, Hall W, Illes J, editors. Addiction neuroethics – the ethics of addiction neuroscience research and treatment. London: Elsevier; 2011, pp. 175–93.
[3] Adams PJ. Fragmented intimacy: addiction in a social world. New York: Springer; 2008.
[4] Sulkunen P, Rantala K, Määttä M. The ethics of not taking a stand: dilemmas of drug and alcohol prevention in a consumer society – a case study. Int J Drug Policy 2004; 15 427–34.
| The ethics of not taking a stand: dilemmas of drug and alcohol prevention in a consumer society – a case study.Crossref | GoogleScholarGoogle Scholar |
[5] Australian Bureau of Statistics. National Health Survey: Lifestyle and Health, 1989–90. Catalogue No. 4366.0. Canberra: Australian Bureau of Statistics; 1991.
[6] Australian Bureau of Statistics. National Health Survey: Summary of Results, 2007–08. Catalogue No. 4364.0. Canberra: Australian Bureau of Statistics; 2009.
[7] Australian Government. Obesity in Australia: a need for urgent action. Technical report no 1. Prepared for the National Preventative Health Taskforce by the Obesity Working Group; 2009. Available at: http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/tech-obesity. (Cited 1 December 2011).
[8] Meetoo D. The imperative of human obesity: an ethical reflection. Br J Nurs 2010; 19 563–8.
[9] ten Have M, de Beaufort ID, Teixeira PJ, Mackenbach JP, van der Heide A. Ethics and prevention of overweight and obesity: an inventory. Obes Rev 2011; 12 669–79.
| 1:STN:280:DC%2BC3MfgtlKnuw%3D%3D&md5=725eb08cf8564a388b99c20478a061e6CAS |
[10] Egger G. Obesity and chronic disease: have we missed the point? Med J Aust 2011; 195 377
| Obesity and chronic disease: have we missed the point?Crossref | GoogleScholarGoogle Scholar |
[11] Allender S, Gleeson E, Crammond B, Sacks G, Lawrence M, Peeters A, et al. Policy change to create supportive environments for physical activity and healthy eating: which options are the most realistic for local government? Health Promot Int 2011; Mar 18
[12] Cochrane Library. Prevention of obesity. Special Collection: Published 7 December 2011. Available at: http://www.thecochranelibrary.com/details/collection/1417657/Prevention-of-obesity.html (Cited 9 December 2011).
[13] Thomas SL, Lewis S, Hyde J, Castle D, Komesaroff P. “The solution needs to be complex”. Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity. BMC Public Health 2010; 10 420
| “The solution needs to be complex”. Obese adults' attitudes about the effectiveness of individual and population based interventions for obesity.Crossref | GoogleScholarGoogle Scholar |
[14] Saarni SI, Anttila H, Saarni SE, Mustajoki P, Koivukangas V, Ikonen TS, et al. Ethical issues of obesity surgery-a health technology assessment. Obes Surg 2011; Apr 10
[15] Espinel PT. King L. A framework for monitoring overweight and obesity in NSW. Sydney: NSW Department of Health and the Physical Activity Nutrition Obesity Research Group; 2009.
[17] Peckham S, Hann A. Constructing the obesity epidemic: loose science, money and public health. In: Peckham S, Hann A, editors. Public Health Ethics and Practice. Bristol: The Policy Press; 2010.
[16] Wickins-Drazilova D, Williams G. IDEFICS Consortium. The ethics of evaluating obesity intervention studies on children. Int J Obes (Lond) 2011; 35 S24–9.
| IDEFICS Consortium. The ethics of evaluating obesity intervention studies on children.Crossref | GoogleScholarGoogle Scholar |
[18] Nuffield Council on Bioethics. Public health: ethical issues. London: Nuffield Council on Bioethics; 2007. Available at: http://www.nuffieldbioethics.org/public-health (Cited 9 December 2011).
[19] Calman K. Beyond the ‘nanny state’: Stewardship and public health. Public Health 2009; 123 e6–10.
| Beyond the ‘nanny state’: Stewardship and public health.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1M7hs1KhsQ%3D%3D&md5=3bfbe65ff4d8c9939d0312d2b7d73e64CAS |