Abstract
The World Health Organization highlights fiscal policies as priority interventions for the promotion of healthy eating in its Action Plan for the Prevention and Control of Non-communicable Diseases. The taxation of sugar sweetened beverages (SSBs) in particular is noted to be an effective measure, and SSBs taxes have already been implemented in several countries worldwide. However, although the evidence base suggests that this will be effective in helping to combat rising obesity rates, opponents of SSBs taxation argue that it is illiberal and paternalistic, and therefore should be avoided. Bioethical analysis may play an essential role in clarifying whether policymakers should adopt SSBs taxes as part of wider obesity strategy. In this article we argue that no single ethical theory can account for the complexities inherent in obesity prevention strategy, especially the liberal theories relied upon by opponents of SSBs taxation. We contend that a pluralist approach to the ethics of SSBs taxation must be adopted as the only suitable way of accounting for the multiple overlapping, and sometimes, conflicting factors that are relevant to determining the moral acceptability of such an intervention.
Highlights
Bioethics is a multifaceted field of study
Fiscal policies are outlined as a priority intervention in the promotion of healthy eating on the Action Plan for the Prevention and Control of non-communicable diseases (NCDs) in the WHO European Region 2016–2025, with taxes on sweetened beverages highlighted as an effective measure (3)
Since basing an ethical argument on only one ethical theory tends to mean it is based on factually inaccurate premises, we argue that grounding ethical analysis in several ethical theories will result in the premises of that analysis better reflecting the complexity of the evidence base surrounding sugar-sweetened beverages (SSBs) taxation, leading to sounder ethical conclusions
Summary
Bioethics is a multifaceted field of study. Even though it has evolved over recent decades, it is often mistaken as only representing medical ethics (1). Perhaps one could argue that consumers’ autonomy could be compromised without them realizing, but this would seem to support the argument for SSBs taxation—if the way in which an individual thinks about their food decisions can be manipulated by subtle changes to the decisionmaking context without the individual ever realizing this, as behavioral and marketing evidence shows that it can (19), this would support affording the protection of autonomy a less privileged position in public health decision making, and instead privileging how policies can prevent consumer decisions from being manipulated Both premises in the deontological argument based on autonomy are factually inaccurate—governments have more (and arguably more important) duties than to protect consumer autonomy, and SSBs taxation probably does not appear to influence consumer autonomy to a very large extent (and testing this more forensically would constitute an acknowledgment that consumer autonomy is a frail concept). Evaluated on the strength of its reasoning, the argument from autonomy that SSBs taxation is unethical should be seen as unsound
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