Down the Slippery Slope?

61 D o w n t h e S l i p p e r y S l o p e ? I n e z d e B e a u f o r t Down the Slippery Slope? Ethicists should be very ethical in their private lives; so regular checks for venereal diseases and substance abuse are in order. They cannot be overweight because that undermines their reputation as people who are concerned with the higher issues in life, not mundane things such as food. Chefs, on the other hand, may be at least slightly overweight, because a thin chef is not conveying the right message. Politicians with their high public visibility should of course have a waistline similar to the policemen (after Operation Pot Belly). Operation Tooth Pick is for bankers who, as of now, should all look anorexic to free them from the image of self-interested gain. They should also look slightly unhealthy and cultivate an indoor tan. One should not be led to think by their appearance that they have been golfing or enjoying luxury pastimes. Operation Rosy Cheeks will apply to people who sell flowers, Operation Great Smile for people who work in sweet shops, Operation Lean and Mean for lawyers; there are many possible “Operations” involving lifestyle changes, surgical interventions or the use of drugs to effect the required changes. Persons with vivid imaginations can envisage scenarios when the issues of health, work, appearance and image converge; and it is at the crossroad of these elements that Operation Pot Belly needs to be situated.1 Eurobese Since more and more people all over the world are overweight or obese — the term “globesity” has been used — public health experts, along with doctors, other health care professionals, and also institutions such as schools and communities have developed treatments or strategies to help people lose weight, or to prevent them from gaining weight. And given the health risks of being seriously overweight or obese, there are good reasons for prevention and treatment. This C A S E C O M M E N T A R Y Asian Bioethics Review March 2009 Volume 1, Issue 1 61–64 A s i a n B i o e t h i c s R e v i e w M a r c h 2 0 0 9 Vo l u m e 1 , I s s u e 1 62 particularly holds true for children where all possible measures, interventions, programmes, and treatments must be considered carefully from the scientific perspective. Scientists and policy makers should ask, do we have enough good reasons (plausibility, solid evidence) that this will indeed be successful and what do we mean by “success”: public attention and awareness, behavioral change, and/or real weight loss? These measures also should be evaluated from the ethical perspective. That is why we carried out an international interdisciplinary research project to study the ethical issues involved in these programmes. This project, called Eurobese, funded by the European Union (www.eurobese. com), analysed the theme of obesity from different perspectives. We examined the importance of eating cultures. Food is very important for us. It gives us pleasure, it provides social occasions, it is linked to certain images, for instance, young people hanging out at fast food restaurants. In such a complex web of meaning one cannot simply interfere, there must be awareness of these meanings. We looked at the images of obesity. Obesity is often associated with bad moral characteristics (fat is bad) and obese persons are often stigmatised. One of the main results of the project is an ethical framework to evaluate interventions. This framework is still a work in progress so we cannot apply it yet in the case of Operation Pot Belly. It can be used in a similar way as Kass’ framework that Toledano uses in her commentary on this case; as a tool to structure the debate to ensure that all relevant issues have been taken into account. It is important to realise that obesity is not an isolated health issue but a phenomenon that is closely intertwined with crucial areas of our lives. Conflation of Goals There is little I...