Anne Barnhill

• PhD
• Researcher at Johns Hopkins University

Liberal commitments to upholding civil liberties and relying on representative democratic procedures may seem incompatible with an effective response to an emergency like a pandemic. At the same time, the high stakes of pandemic policy-making and disagreement about the best way to respond arguably highlight the importance of other liberal commitmen...

The United States takes a federalist approach to pandemic responses while the bulk of pandemic powers sits at the state level. Thus, comprehensive accounts of how state health officials managed the crisis and how the federal government affected those efforts are needed to better understand the governmental response to the COVID-19 pandemic. This ar...

A just food system transformation is imperative to meet this century’s goals of environmental sustainability, economic fairness, and equitable social well-being. While considerations of justice are beginning to inform food system transformation debates, there remains a lack of conceptual and practical integration of these two historically separate...

The state‐level COVID‐19 response in the United States necessitated collaboration between governor' offices, health departments and numerous other departments and outside experts. To gain insight into how health officials and experts contributed to advising on COVID‐19 policies, we conducted semi‐structured interviews with 25 individuals with a hea...

Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it has become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating...

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The “data protection model” emphasizes privacy protections at the...

As the COVID-19 pandemic continues to evolve, taking its toll on people’s lives around the world, vaccine passports remain a contentious topic of debate in most liberal democracies. While a small literature on vaccine passports has sprung up over the past few years that considers their ethical pros and cons, in this paper we focus on the question o...

Background Slowing climate change is crucial to the future wellbeing of human societies and the greater environment. Current beef production systems in the USA are a major source of negative environmental impacts and raise various animal welfare concerns. Nevertheless, beef production provides a food source high in protein and many nutrients as wel...

This paper argues that individuals in many high-income countries typically have moral reasons to limit their beef consumption and consume plant-based protein instead, given the negative effects of beef production and consumption. Beef production is a significant source of agricultural greenhouse gas emissions and other environmental impacts, high l...

Even though the phenomenon of gentrification is ever-growing in contemporary urban contexts, especially in high income countries, it has been mostly overlooked by normative political theorists and philosophers. In this paper we examine the normative dimensions of gentrification through the lens of food. By drawing on Huber and Wolkenstein’s (Huber...

The introduction illustrates how contemporary states are increasingly adopting efforts aimed at changing people’s dietary habits, such as sugary drink taxes and food bans. These kinds of measures have often been criticized as instances of government paternalism, i.e. efforts aiming to make people better off that are motivated by a negative judgment...

This chapter develops an ethics framework that can be used by public health policymakers, and others, to help them to navigate the complex empirical and moral issues surrounding healthy eating efforts discussed in the previous chapters. First, the chapter sketches a ‘public reason framework for healthy eating efforts’ that public health officials,...

This chapter employs the accessibility conception of public reason to critically assess healthy eating efforts in liberal democracies and identify respects in which these efforts may be unreasonable, i.e. publicly unjustified and therefore illegitimate. In order to do so, the chapter disaggregates the concept of ‘evaluative standards’ that is centr...

This chapter examines the implications of John Stuart Mill’s liberalism for healthy eating efforts. Mill is one of the key representatives of perfectionist liberalism, a strand in liberalism that is centred around the value of individual autonomy and the importance for the state to legislate in ways that advance citizens’ autonomous flourishing in...

This chapter illustrates the implications of key debates on justice in political philosophy for the analysis of healthy eating efforts. The chapter may be especially interesting to readers who are not familiar with key concepts and theories in political philosophy. It first considers different conceptions of freedom in political philosophy, includi...

This book develops a ‘public reason approach’ to healthy eating efforts. Public reason is the view that political rules are legitimate only if they are justified on the basis of reasons that are public, i.e. reasons that all citizens can accept at some level of idealization despite their different values and worldviews. The book applies the idea of...

This chapter concludes the book by providing a summary of the key themes examined throughout it and by outlining three areas of investigation that we believe will deserve further attention in future research on food policy. First, while in this book we have only briefly surveyed key debates in political philosophy in relation to healthy eating effo...

This chapter applies a public reason approach to healthy eating efforts. Public reason is the view that political rules are legitimate only if they are justified on the basis of reasons that are public, i.e. reasons that all citizens can accept at some level of idealization despite their different conceptions of the good. This chapter asks when, if...

This chapter introduces healthy eating efforts and briefly illustrates some ethical objections to them. The chapter also outlines a conception of eating and food experiences that underlies the book: food and eating have many kinds of value for individuals, families, and communities, and the value of food and eating can be both positive and negative...

This chapter introduces and critically examines debates about paternalism and healthy eating efforts in bioethics and political philosophy. These debates normally emphasize views about autonomy, including controversial substantive views about the importance of autonomy in the good life. The chapter focuses instead on an objection to paternalism adv...

This book develops a ‘public reason approach’ to healthy eating efforts. Public reason is the view that political rules are legitimate only if they are justified on the basis of reasons that are public, i.e. reasons that all citizens can accept at some level of idealization despite their different values and worldviews. The book applies the idea of...

We propose that marketing of unhealthy foods and beverages to Black and Latino consumers results from the intersection of a business model in which profits come primarily from marketing an unhealthy mix of products, standard targeted marketing strategies, and societal forces of structural racism, and contributes to health disparities.

This volume addresses the nature and identity of recipes from a cross-disciplinary perspective. Contributors study the values and norms guiding the naming, production, and consumption of recipes, scrutinizing their relationship to territory, makers, eaters, and places of production. Along the road, they uncover the multifaceted conceptual and value...

Humans, animals, and the environment face a universal crisis: antimicrobial resistance (AR). Addressing AR and its multi-disciplinary causes across many sectors including in human and veterinary medicine remains underdeveloped. One barrier to AR efforts is an inconsistent process to incorporate the plenitude of stakeholders about what AR is and how...

Clinical use of placebos is controversial among bioethicists. While placebos have been shown to provide benefit for patients with some conditions, offering placebos to patients without disclosing that they are placebos raises ethical concerns, including the concern that this lack of transparency about the nature of placebos amounts to deceiving pat...

This essay uses a specific example—proposals to exclude sugary drinks from the Supplemental Nutrition Assistance Program (SNAP)—to explore some features of the contemporary U.S. administrative state. Dating back to the Wilsonian origins of the U.S. administrative state there has been uncertainty about whether we can and should separate politics and...

As part of the roundtable, “Ethics and the Future of the Global Food System,” this essay discusses some of the major challenges we will face in feeding the world in 2050. A first challenge is nutritional: 690 million people (9 percent of the world's population) are currently undernourished, while 2.1 billion adults (28 percent of the population) ar...

The pandemic of SARS-CoV-2 has led to unprecedented changes to society, causing unique problems that call for extraordinary solutions. We consider one such extraordinary proposal: ‘safer infection sites’ that would offer individuals the opportunity to be intentionally infected with SARS-CoV-2, isolate, and receive medical care until they are no lon...

Several countries have implemented warnings on unhealthy foods and beverages, with similar policies under consideration in the U.S. and around the world. Research demonstrating food warnings’ effectiveness is emerging, but limited scholarship has evaluated the ethics of food warning policies. Using a public health ethics framework for evaluating ob...

We identify multiple ways in which food waste matters ethically: because of its direct negative environmental effects, because of the environmental impacts of excess food production, and because of the foregone benefits that could have been achieved if wasted food had been consumed. The issue of food waste is complicated by competing views on how t...

In the United States, roughly one in four births occurs in a certified Baby-Friendly hospital. This paper offers a multidisciplinary perspective on the Baby-Friendly Hospital Initiative (BFHI), including empirical, normative, and historical perspectives. Our analysis is novel in tracing how medical practices of “quality improvement,” which have rec...

Ross and MacKay (2017) argue that excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program (SNAP) is ‘in principle morally permissible’ because it does not violate the central obligation that SNAP is meant to discharge—the obligation to ensure that citizens have secure access to food adequate to meet their nutritional...

Abstract The global obesity pandemic has public advocates and policymakers grappling with the question of how best to respond. Among the various policy options, unhealthy food and beverage taxes have gained attention as a potentially effective intervention to reduce non-nutritive caloric intake, while raising government funds for health promotion p...

Despite 2 decades of effort by the public health community to combat obesity, obesity rates in the United States continue to rise. This lack of progress raises fundamental questions about the adequacy of our current approaches. Although the causes of population-wide obesity are multifactorial, attention to food systems as potential drivers of obesi...

Behavioral weight loss interventions (BWLIs) that promote healthy eating as a way to achieve and maintain healthy weights do not work for most people. Most participants encounter significant challenges to behavior change and do not lose weight or maintain meaningful weight loss. For some, there may be negative consequences of participating in a BWL...

Eliminating formula giveaways ("banning the bag") has been embraced as a way to reduce the influence of formula marketing in hospitals and to increase breastfeeding rates among new mothers, but the policy raises ethical concerns in the mind of some, notably because it denies a useful benefit to mothers who have trouble affording formula. Hospital p...

States are increasingly implementing policies aimed at changing people's dietary habits, such as fat taxes, food bans, and nudges. In this article, we ask whether healthy eating policies are consistent with public reason, the view that state laws and policies should be justified on the basis of reasons that all citizens can accept at some level of...

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a...

This piece surveys recent work on the ethics of food production and distribution, paying closest attention to animal agriculture, plant agriculture, food justice, and food sovereignty.

This article surveys recent work on some issues in the ethics of food consumption. It is a companion to our piece on food justice and the ethics of food production.

Food ethics, as an academic pursuit, is vast, incorporating work from philosophy as well as anthropology, economics, environmental sciences and other natural sciences, geography, law, and sociology. This Handbook provides a sample of recent philosophical work in food ethics. This philosophical work addresses ethical issues with agricultural product...

To the Editor We read with great interest the article “Processed Food: An Experiment that Failed.”¹ We applaud efforts to bring attention to the public health effects of processed food. However, we are concerned that it misses the mark on 2 important issues related to families’ efforts to eat more healthfully.

Medical and public health organizations recommend that mothers exclusively breastfeed for at least 6 months. This recommendation is based on evidence of health benefits for mothers and babies, as well as developmental benefits for babies. A spate of recent work challenges the extent of these benefits, and ethical criticism of breastfeeding promotio...

In the midst of the recent Ebola outbreak, scientific developments involving infection challenge experiments on nonhuman primates (NHPs) sparked hope that successful treatments and vaccines may soon become available. Yet these studies pose a stark ethical quandary. On the one hand, they represent an important step in developing novel therapies and...

This commentary on Cass Sunstein’s “Fifty Shades of Manipulation†queries Sunstein’s account of manipulation as influence that does not sufficiently engage or appeal to someone’s capacity for reflection and deliberation. Manipulation sometimes undermines the target’s reflection and deliberation; but it is also possible to manipulate some...

Policies to promote breast-feeding often engender substantial controversy. While clearly involving disagreement over the appropriate limits to government authority, this controversy also reflects a related disagreement over whether infant-feeding practices are a public health matter or a private choice. Infant feeding practices are both a personal...

Harald Schmidt and Anne Barnhill highlight the need to ensure equity in the proposed Sustainable Development Goals.

In 'Placebo treatments, informed consent, and "the grip of a false picture"' Shane Nicholas Glackin argues that if a physician offers a patient an inert placebo with the following disclosure, this is compatible with informed consent and is not deceptive: 'I would like to offer you a pill which I believe can help lessen your suffering. I do not know...

In ‘(Why) should we require consent to research?’ Alan Wertheimer probes whether it is legitimate for the government to ‘coerce’ people into participating in biomedical research, including interventional biomedical research. In debating the rules that ought to govern participation in interventional biomedical research, we should distinguish two sep...

In a recent article in this Journal, Shlomo Cohen and Haim Shapiro (2013) introduce the concept of "comparable placebo treatments" (CPTs)-placebo treatments with biological effects similar to the drugs they replace-and argue that doctors are not being deceptive when they prescribe or administer CPTs without revealing that they are placebos. We crit...

Unhealthy eating can have value for individuals and groups, even while it has disvalue in virtue of being unhealthy. In this paper, we discuss some ways in which unhealthy eating has value and draw out implications for the ethics of policies limiting access to unhealthy food. Discussing the value and disvalue of unhealthy eating helps identify oppo...

In his response to our article (1,2), David Buchanan introduces some useful and important distinctions in the concepts of equality and autonomy. He highlights, for example, the distinction between inequality and inequity, which captures the insight that not all differences between people are unjust. Unjust inequalities are a subset of differences b...

In "Buying Health: the Costs of Commercialization and an Alternative Philosophy", Larry R. Churchill and Shelley C. Churchill discuss the commercialization of health and, in particular, the commercialization of nutrition. In this commentary on their article, I draw a connection between Churchill and Churchill's account of the commercialization of n...

Current regulation of caffeine-containing products is incoherent, fails to protect consumers' interests, and should be modified in multiple ways. We make the case for one of the regulatory reforms that are needed: all consumable products containing added caffeine should be required by the Food and Drug Administration (FDA) to include caffeine quant...

An active area of public health policy in the United States is policy meant to promote healthy eating, reduce overconsumption of food, and prevent overweight/obesity. Public discussion of such obesity prevention policies includes intense ethical disagreement. We suggest that some ethical disagreements about obesity prevention policies can be seen a...

One of six commentaries on "Obesity: Chasing an Elusive Epidemic," by Daniel Callahan, from the January-February 2013 issue.

Many anti-obesity policies face a variety of ethical objections. We consider one kind of anti-obesity policy - modifications to food assistance programs meant to improve participants' diet - and one kind of criticism of these policies, that they are inequitable. We take as our example the recent, unsuccessful effort by New York State to exclude swe...

The American Medical Association's Code of Ethics prohibits physicians from giving substances they believe are placebos to their patients unless the patient is informed of and agrees to use of the substance. Various questions surround the AMA policy, however. One of these has to do with what should be disclosed. The AMA holds that any treatment tha...

Sexual modesty is a feminist sexual virtue-in one sense, but not another. There are at least two distinct kinds of feminist sexual virtues: first, character traits that allow individual sexual flourishing given the realities of sexism within a specific social context; second, character traits related to sex that encourage feminist change. Modesty i...

The body and bodily experience make little appearance in analytic moral philosophy. This is true even of analytic sexual ethics—the one area of ethical inquiry we might have expected to give a starring role to bodily experience. I take a small step toward remedying that by identifying one way in which the bodily experience of sex is ethically signi...

A complete defense of deceptive placebo use must address this ethical objection: deceptive placebo use violates patient autonomy, because deceiving a patient about the placebo nature of a proposed treatment prevents her from giving informed consent to the treatment. Unfortunately, this objection isn't always recognized and clearly disambiguated fro...

The state of New York recently petitioned the US Department of Agriculture (USDA) for permission to conduct a demonstration project in which sweetened beverages would be excluded from the foods eligible to be purchased with Supplemental Assistance Nutrition Program (SNAP) benefits (i.e., food stamps) in New York City. The USDA and advocacy groups h...