258953 Case of childhood obesity: Identified and statistical lives saved and the moral obligation to overcome victim and alleviation bias

Tuesday, October 30, 2012 : 4:30 PM - 4:50 PM

Joseph E. Balog, PhD , Health Science, State University of New York, College at Brockport, Brockport, NY
In philosophy, the use of thought experiments and hypothetical cases are frequently used to help clarify complex dilemmas and to explore and justify ethical decisions. When these methods are applied to the problem of how to allocate a fair distribution of health care resources between treatment and prevention, research demonstrates that humans value treatment over prevention related to such ideas as a bias for identified victims over statistical victims, the preference for alleviating harm over preventing harm, the “rule to rescue,” the affect that compassion, spatial and temporal proximity and vividness of suffering have on decisions about real versus potential lives, and how fear influences people to treat losses as more important than comparable gains. However, the reality of increasing rates of childhood obesity, accompanied by a low chance of reversing obesity in individuals, challenges the theoretical idea that there is a moral relevant difference between identified and statistical victims that should favor identified persons. This paper, through a moral inquiry, a thought experiment and epidemiological evidence, argues that identified and statistical victims are the same people whose conditions worsen if compulsory prevention interventions are not implemented to prevent such harm and counter natural and societal factors that lead to harm. A position is taken that fairness requires social policy to value children equally by giving them equal chances at “rescue.” Also, social justice suggests that there is a stronger claim to prevent harm than to alleviate harm especially if harm is avoidable and among vulnerable populations.

Learning Areas:
Advocacy for health and health education
Chronic disease management and prevention
Ethics, professional and legal requirements
Provision of health care to the public
Public health or related education
Public health or related public policy

Learning Objectives:
At the conclusion of this presentation, the participant in this session will be able to: 1. Describe from a theoretical and epidemiological perspective why identified and statistical victims should be viewed as the same persons; 2. Explain why moral reasoning and scientific evidence should be used to overcome an inclination of compassion that prefers the alleviation of harm over the prevention of harm; 3. Describe why a higher priority should be given to preventing harm over alleviating harm; and 4. Discuss how and why paternalism-based childhood obesity prevention programs are necessary and justified to achieve health and social justice for children.

Keywords: Children's Health, Bioethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working in the area of public health, health education and ethics for over 30 years and I have been published in such journals such as American Journal of Public Health. Recently, I was awarded a fellowship to the Hastings-Yale Bioethics program where I will be working on a project dealing with childhood obesity, ethics, the meaning of health and social justice.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.