Morten Ebbe Juul Nielsen

Should we hold the obese responsible? - some key issues.

It is a common belief that obesity is wholly or partially a question of personal choice and personal responsibility. It is also widely assumed that when individuals are responsible for some unfortunate state of affairs, society bears no burden to compensate them. This article focuses on two conceptualizations of responsibility: backward-looking and forward-looking conceptualizations. When ascertaining responsibility in a backward-looking sense, one has to determine how that state of affairs came into being or where the agent stood in relation to it. In contrast, a forward-looking conceptualization of responsibility puts aside questions of the past and holds a person responsible by reference to some desirable future state of affairs and will typically mean that he or she is subjected to criticism, censure, or other negative appraisals or that he or she is held cost-responsible in some form, for example, in terms of demanded compensation, loss of privileges, or similar. One example of this view is the debate as to whether the obese should be denied, wholly or partially, free and equal access to healthcare, not because they are somehow personally responsible in the backward-looking sense but simply because holding the obese responsible will have positive consequences. Taking these two conceptions of responsibility into account, the authors turn their analysis toward examining the relevant moral considerations to be taken into account when public policies regarding obesity rely on such a conception of responsibility.

The Ethical Foundations for CSR

In this chapter we will discuss the ethical foundations of CSR. The chapter consists of three major parts. First, we discuss three different approaches to CSR, namely (a) an instrumental approach, (b) an ethical approach and (c) a hybrid approach, attempting to combine the instrumental and the ethical approach. We will conclude that the ethical approach to CSR is the most reasonable of the three alternatives. Second, we introduce some of the most influential ethical theories and their key principles, namely (a) the utilitarian principle of maximizing well-being, (b) theories of rights, and (c) social contract principles concerning fairness, and discuss how they might relate to CSR in general. Third, we present and discuss some specific ethical challenges characteristic for CSR including whether companies should focus solely on avoiding harmful actions or whether they also have obligations to actively do good.

Should Europe follow the US and declare obesity a disease?: a discussion of the so-called utilitarian argument

In 2013, the American Medical Association (AMA) decided to recognize obesity as a disease. One of the main arguments presented in favor of this was broadly ‘utilitarian’: the disease label would, it was claimed, provide more benefits than harms and thereby serve the general good. Several individuals and groups have argued that this reasoning is just as powerful in the European context. Drawing mainly on a review of relevant social science research, we discuss the validity of this argument. Our conclusion is that in a Western European welfare state, defining obesity as a disease will not on balance serve the general good, and that it is therefore more appropriate to continue to treat obesity as a risk factor. The main reasons presented in favor of this conclusion are: It is debatable whether a disease label would lead to better access to care and preventive measures and provide better legal protection in Europe. Medicalization and overtreatment are possible negative effects of a disease label. There is no evidence to support the claim that declaring obesity a disease would reduce discrimination or stigmatization. In fact, the contrary is more likely, since a disease label would categorically define the obese body as deviant.

In a class of their own: the Danish public considers obesity less deserving of treatment compared with smoking-related diseases

Background/objectives:This study examined public support for publicly funded treatment of obesity (weight-loss surgery and medical treatment) and two pulmonary diseases (chronic obstructive pulmonary disease (COPD) and lung cancer) in Denmark. It also investigated whether beliefs about the causes of lifestyle-related diseases (external environment, genetic disposition and lack of willpower) and agreement that ‘people lack responsibility for their life and welfare’ influenced support.Subjects/methods:This was a questionnaire study in which a sample of 1003 Danes (age 18–65 years) drawn from an Internet database were surveyed.Results:Approximately one in three supported publicly funded weight-loss surgery (30%) and medical treatment of obesity (34.4%). A large majority supported treatment for lung cancer (86.1%), and a clear majority also supported treatment for COPD, whether it was framed as ‘smoker’s lung’ (61.9%) or COPD (71.2%). The belief that lifestyle-related diseases are caused by the external environment or genetic disposition did not systematically influence support. Agreement that ‘people lack responsibility for their life and welfare’ reduced support significantly for all treatment types. However, in contrast with pulmonary diseases, support for publicly funded obesity treatments decreased considerably when beliefs about individual failure (that is that people lack ‘willpower’ and ‘individual responsibility’) were detected.Conclusions:Support for publicly funded COPD and lung cancer treatment is considerably higher than that for obesity treatment. This could encourage institutional discrimination through policies that involve charging patients for the treatment of obesity but not for the treatment of other lifestyle-related diseases.

Personal Responsibility and Lifestyle Diseases

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal influences-such as genetic make-up or certain social circumstances-diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible.

Political Institutions and Corporate Social Responsibility: A Nordic Welfare State Perspective from Denmark

In this chapter we present an overview of what characterizes the Danish approach to CSR. The purpose is to present an outline of Danish companies’ CSR commitment and how this commitment is influenced by the political and institutional environment in Denmark. The chapter consists of three major parts. First, we present an introduction to CSR in Denmark. More specifically we provide an introduction to: (a) the Danish welfare state and its business environment, (b) how and why Danish companies are engaged in CSR and (c) the relation between the Danish welfare state and Danish companies’ CSR commitment. Second, we discuss whether CSR should be seen as extra-legal activities, i.e. something that goes beyond the demands of the state and the law. Here we conclude that CSR should not be regarded solely as social and environmental activities that companies voluntarily engage in, since companies might be said to do CSR just by acting in accordance with the demands of the state and the law. This follows recent developments in the understanding of CSR in the EU. Third, we present some future perspective on CSR in Denmark, including a suggestion to address the “new pathologies” affiliated with contemporary work life, i.e. the collapse of the work/life balance, stress, and so on. In our view there seems to be the basis for a “win-win” scenario when it comes to more focus on protection of the workforce against stress etc.

Obesity as a showcase for transdisciplinary research.

Obesity is one of the main health problems in the world with high societal and individual costs. To tackle the obesity epidemic, we need to collaborate across scientific boarders to fundamentally broaden the perspectives on the obesity epidemic as a complex phenomenon.

Intra-Family Inequality and Justice

In “The Pecking Order,” Dalton Conley argues that inequalities between siblings are larger than inequalities at the level of the overall society. Our article discusses the normative implications for institutions of this observation. We show that the question of state intervention for curbing intra-family inequality reveals an internal tension within liberalism between autonomy and toleration, which bears on the forms that the intervention of institutions may take. Despite the pros and cons of both commitments, autonomy-based liberalism appears more compatible with the involvement of the state for egalitarian reasons within the family than toleration-based liberalism.

A Conflict Between Representation and Neutrality

Abstract The nub of the following argument is that there is a conflict between the idea of (liberal) neutrality on the one hand, and an intuitively plausible idea of political representation on the other. The conflict arises when neutrality is seen as a condition for political legitimacy: neutralist political representation is only legitimate insofar as the representative does not advance political ideas based on conceptions of the good that are not endorsed by the whole of the (reasonable) polity. However, we often encounter examples of political representation that do not live up to this demand but nevertheless seem legitimate. Hence, neutralists should explain either why this counterintuitive notion of representation does not follow from neutrality or explain what representatives are meant and allowed to do in such a political arrangement. A plausible neutralist rejoinder to this is to say that legitimacy is not dependent on neutrality for all political decisions. Neutrality is important (only or predominantly) regarding a certain body of political decisions, viz., using the Rawlsian idiom, ‘constitutional essentials and matters of basic justice.’ However, such a two-levelled approach is not without its problems. I argue that a skein of theoretical and practical challenges to the two-levelled approach undermines, or at least weakens, this attempt to solve the problem about representation and neutrality, and that the two-levelled approach is unclear in certain key aspects. The aim of the article is, however, quite modest. It is not to challenge neutrality per se; rather, it is a call for further clarification of the issues pertaining to the relationship between neutrality and representation.

Racial dodging in the porn industry: a case with no silver bullet

Racial dodging is endemic in the porn industry. It mostly takes place when Caucasian female performers refuse to shoot scenes with African American male performers, ask them to be removed from prod...