Food packaging matters more than informed consent to treatment

Packets of cigarettes carry pictures showing purchasers what their lungs or their arteries will look like if they carry on smoking. Consumers International and the World Obesity Federation are now suggesting that some foods should bear similar images.

Assume for the sake of argument that the practice would be effective in discouraging the purchase of health-truncating foods. If the images work by telling consumers something about what they are buying that they would not otherwise know, surely there can be no coherent objection to them. Knowledge of that sort is always good – assuming that the consumer has a real choice as to whether to buy the bad product or a better one.

If they work by pushing to the forefronts of consumers’ minds information that their grosser appetites conveniently suppress when they are wandering down the mall, there may be an argument against them. This would presumably be on the broad basis that the images manipulate the person away from being what they authentically are (a fructose-guzzling cardiac-cripple-in-waiting) towards something else. This argument would assert that there’s a sort of ethical imperialism at work: that those would stamp pictures of limbless diabetics on junk sweet packs are tyrannously seeking to impose an arbitrary normative idea of the good life.

I have little sympathy with this second view. If anyone says in a normative voice that it’s good to be diabetic, they’re insane. If anyone says in an empirical voice that it’s better to be diabetic than non-diabetic, they’re misinformed. If anyone says in the voice of a hedonistic utilitarian that the overall pleasure gained by the consumption of lard outweighs the detriments, I’d invite them to get thin, do all the Munros, and then revisit their original judgment. If anyone thinks that they’re more authentically themselves by being ill might have a point once their illness is long-standing and has truly become a defining characteristic. But before the illness is triggered, aren’t they more themselves without clogged arteries or the need to inject insulin five times a day?

If the packaging proposal is adopted, some interesting questions arise. Should good foods be branded with pictures of the condition you’ll be in or the advantages you’ll have if you eat them? Aphrodisiac oysters would display the beaming visages of satisfied sexual partners. Green tea would show lean centenarians on trampolines. Or perhaps those good foods should show the things that they’ll spare you: prostate-preserving tinned tomatoes might show an unoccupied midnight toilet.

Perhaps other, wider concerns should feature. Tins of palm oil should show dead orangutans. Milk should show the mournful face of a calf-less cow alongside the pictures of healthy, non-osteoporotic bone-scans.

While it’s easy to multiply absurdities, the proposal is basically a very good thing. It’s a good thing for at least some of the reasons that the notion of informed consent to medical treatment is endorsed. If you’re keen on informed consent to treatment, a fortiori you’ll be keen on food package images. In fact, I suggest, you should be more keen on those images. They’re more important.

In addition to the general reasons for questioning the importance of informed consent to treatment, which I discuss here, there are three main reasons for this.

First: you have to eat: if you don’t, you’ll die. This is not true for most medical treatment.

Second (and relatedly): you have to eat often. Decisions about what you eat are pertinent far more often than are decisions about medical treatment.

And third, and most importantly: most suggestions by clinicians about medical treatment are likely to be in your objective best interests. On balance, if you submit to your clinicians, you’re likely to be better off than if you don’t. The same is not true of the blandishments on food packets.

So: out with the consent forms: in with the photos from the Coronary Care Unit.

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3 Responses to Food packaging matters more than informed consent to treatment

  • Anonymous says:

    So… in short, put a picture of cancer ON EVERYTHING?

    Or maybe just a picture of a fatty on everything carby – so all the kids get eating disorders.

    I don’t think pictures inform you of anything when it relates to food. It’s content, uses, implications and effects are so diverse – there are many inescapable variables (someone’s genetics), and some we have a lot of work to do on (pseudo-science crap out there on what is ‘good’ or ‘bad’ medically). This is just scare-mongering nonsense. Not a good idea.

    If you care about informing a patient, you don’t just starting screaming at them whilst holding a picture of something grotesque.

  • Nikolas Schaffer says:

    Seems to me a silly idea because the problems associated with obesity are caused by eating too much. Eat too much “healthy” food, you’ll still get fat and experience the associated health problems. As for foods high in carbs and fat, they should be eaten in moderation because they’re high in energy, not because they’re “bad for you”. Getting the message across that energy-in needs to be balanced by energy-out is much more sensible than misleadingly scaring people away from foods that are quite harmless when eaten in moderation.

  • anthony drinkwater says:

    Thanks for your (as usual) interesting post, Charles
    I would like to place a weekly order for four dozen of your oysters and perhaps you could advise me on the appropriate quantity of anti-prostate-cancer tinned tomates I should eat. I assume that there is a “satisfaction or money back” guarantee with both ?
    PS : I agree with you overall on informed consent – but (your guarantee notwithstanding) should a positive PSA test lead my doctor to recommend prostate surgery, I reserve the right to refuse.

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