Is Health a Moral Issue?

With obesity and diabetes on the rise in the United States and so-called “sin taxes” on sodas and fast foods touted as public health measures, several critics have pushed back against this association of poor health and vice. In “Stop making health and well-being a moral issue,” Rafael Euba argues that we attribute moral judgments like “good” and “bad” to food and lifestyle choices based on “a perceived inverse correlation between pleasure and health.” Euba implies that the targets of his critique equate morality with longevity and believe “a wholesome and unpleasurable diet, in conjunction with daily, and equally unpleasurable and strenuous exercise, will earn us the right to prolong our lives, while indulging in unearned and therefore illicit pleasure (such as alcohol, fats and sugar) will be punished with an early death.” Chris Sandel echoes Euba’s complaints in “Weight As A Moral Issue,” arguing that we attach a moral stigma to obesity which we do not associate with other proven unhealthy behaviors like overwork and lack of sleep. In this article, I delve into the meaning of morality and examine its relationship to physical health.

Let’s begin by clarifying some terminology. By ethics, I mean the set of guidelines governing what a person should do. Putting it another way, a particular action is ethical if, all things considered, it would be better to perform that action than not. Ethical guidelines are further composed of moral and non-moral actions and virtues (or good qualities). Moral actions or virtues are other-directed. To have the quality of being generous (to others) is a moral virtue, and murder is an immoral action. In contrast, non-moral virtues are self-directed. To have the quality of being intelligent is a non-moral virtue, and to act intemperately is to exhibit a non-moral vice (at least according to Aristotle).

The above-mentioned articles seem to conflate two questions: first, whether there is such a category as non-moral vices; and second, whether health is related to moral action. Beginning with the first question, some people regard suicide as an unethical non-moral action, meaning it is a self-directed action they think a person should not perform.^* A similar rationale could apply to other forms of self-harm, including excessive drug use, overeating or extreme sloth. One could counter the prohibition against self-harm by arguing that all humans should be free to act as they choose, so long as they do not harm others. Euba also suggests that longevity should not outweigh hedonistic pleasures. However, as I have previously argued, a truly devoted hedonist is going to have to work very hard to argue that a shortened life of pleasure would produce more net enjoyment than a longer life of moderated pleasures and reduced side effects.

Turning to the second question, moral qualities and actions are not necessarily related to non-moral qualities and actions. There is no inconsistency in conceiving of an intelligent murderer or an intemperate philanthropist. It is perfectly possible to be physically unhealthy (even as a result of one’s own free choices) and generous, honest, compassionate and otherwise moral in one’s actions with others. Yet there are occasions when physical health impinges on questions of morality.

To use a previous example of mine, imagine that you are caught in a burning building with an unconscious person of approximately equal weight to yourself. Ethically speaking, you should move that person out of harm’s way if you can do so without risking your own safety. The only obstacle to performing this action is your strength. But since a fully able adult human is capable of lifting his or her own body weight, to say you did not save this person because you chose not to cultivate your own physical abilities makes you morally culpable. In short, non-moral virtues (like health) may enhance your ability to act morally.

Returning to the critiques of Euba, Sandel and others, we can see that body composition, food choices and physical health fall under the category of non-moral virtues/vices. Euba and Sandel are correct in this respect since physical health is primarily a self-directed pursuit. At the most basic level, choices like whether or not to eat healthy or exercise have no effect on other people and are not moral choices. These actions alone do not target or affect other people and do not deserve interpersonal condemnation. It is only when physical fitness has the potential to contribute to moral action, e.g. when strength allows one to be brave and compassionate, when mobility allows one to display empathy and respect, when speed allows for cooperation and generosity (again, see The Ethics of Human Movement), that an individual’s health warrants praise or blame.

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*- It is possible to argue that suicide has ramifications beyond the agent, such as causing grief to the agent’s friends and family. But we can at least imagine a person without friends or family committing suicide in a way that has minimal or no ramifications, such as by jumping off the deck of a very tall ship in the middle of the ocean with no witnesses and very little chance of anyone finding the corpse.