tag:theconversation.com,2011:/uk/topics/nanny-state-849/articlesNanny state – The Conversation2020-06-03T14:55:19Ztag:theconversation.com,2011:article/1397892020-06-03T14:55:19Z2020-06-03T14:55:19ZSouth Africa’s lockdown: a great start, but then a misreading of how society works<figure><img src="https://images.theconversation.com/files/339256/original/file-20200602-133902-hefl0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The ban on the sale of alcohol has been partially lifted, but tobacco remains prohibited. </span> <span class="attribution"><span class="source">Roger Sedres/Gallo Images via Getty Images</span></span></figcaption></figure><p>South Africa’s government is proud that its response to Covid-19 relies on science. It might be prouder if it was also guided by knowledge of how society works.</p>
<p>When South Africa’s Covid-19 lockdown began <a href="https://www.gov.za/speeches/president-cyril-ramaphosa-extension-coronavirus-covid-19-lockdown-end-april-9-apr-2020-0000">on 27 March</a>, opposition from some quarters was inevitable. What was not expected was that the most vehement resistance would be aimed at a <a href="https://www.iol.co.za/business-report/companies/gloves-are-off-as-british-american-tobacco-sa-goes-to-court-over-cigarette-ban-48770972">ban on selling tobacco products</a>. Only around <a href="https://bhekisisa.org/article/2018-12-05-00-how-many-people-in-south-africa-smoke/">1 in 5 South Africans smoke</a> and previous government limits on smoking were not controversial.</p>
<p>The ban generated such heat because, when the government <a href="https://mg.co.za/article/2020-04-23-ramaphosa-announces-gradual-easing-of-covid-19-lockdown-in-south-africa/">began relaxing the lockdown</a>, President Cyril Ramaphosa announced that tobacco sales would be allowed. Then, at the apparent prompting of the minister responsible for lockdown rules, Nkosazana Dlamini-Zuma, <a href="https://mg.co.za/article/2020-04-29-level-four-lockdown-dlamini-zuma-stubs-out-south-africas-hopes-for-a-puff/">the decision was reversed</a>; the ban is still in force.</p>
<p>Dlamini-Zuma has an unfortunate tendency to lecture rather than persuade and her role seems to have turned muttered resentment among some into loud anger, directed not only at the tobacco ban but the <a href="https://businesstech.co.za/news/government/397953/da-to-challenge-irrational-lockdown-rules-in-court/">entire lockdown</a>. And, since the loudest opposition has come from <a href="https://www.dailymaverick.co.za/article/2020-05-28-tobacco-ban-unpacking-dlamini-zumas-defence/">white suburbanites</a>, it has revived the familiar conservative argument that a <a href="https://www.biznews.com/thought-leaders/2017/11/15/nanny-state-sa-tobacco-laws">“nanny state”</a> is telling citizens that it knows more about what is good for them than they do.</p>
<p>This complaint says more about the prejudices of those who make it than reality.</p>
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Read more:
<a href="https://theconversation.com/lockdown-is-riling-black-and-white-south-africans-could-this-be-a-reset-moment-138044">Lockdown is riling black and white South Africans: could this be a reset moment?</a>
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<p>All governments restrict citizens to protect their health and safety: this is why we have traffic lights. And all democracies allow governments to restrict freedoms to protect citizens in an emergency – by, for example, cordoning off areas hit by fire and flood. </p>
<p>The “nanny state” argument expresses a belief that some of us should not be told what to do by those they consider their inferiors.</p>
<p>But this does not mean health measures will be obeyed. It is here that knowledge of society is important.</p>
<h2>Erosion of legitimacy</h2>
<p>Addictive substances harm health. But knowledge of how humans act in society tells us that, precisely because they are addictive. They can be regulated but <a href="https://theconversation.com/legal-highs-need-regulation-not-an-outright-ban-32462">banning them never works</a> since addicts find other ways to feed their addiction. </p>
<p>Besides the oft-quoted <a href="https://www.cato.org/publications/policy-analysis/alcohol-prohibition-was-failure">failure of American prohibition</a>, when white governments in South Africa banned black people from consuming <a href="https://www.jstor.org/stable/183619?seq=1">“European liquor”</a>, this created <a href="https://www.jstor.org/stable/41143613?seq=4#metadata_info_tab_contents">shebeens</a> (speakeasies) which remain a feature.</p>
<p>South Africa’s bans on cigarette and alcohol sales <a href="https://www.fin24.com/Economy/South-Africa/cigarette-ban-is-failing-can-create-lasting-illicit-market-study-20200516">prompted an illicit cigarette trade</a>, <a href="https://businesstech.co.za/news/business/389117/16-liquor-stores-looted-in-the-western-cape-since-lockdown/">the looting of liquor stores</a> and a <a href="https://www.timeslive.co.za/news/south-africa/2020-04-28-pineapple-sales-soar-to-90000-in-a-day-from-10000-amid-booze-ban/">sharp rise in the price of pineapples</a> which were used to ferment beer. Dlamini-Zuma’s belief that the ban will prompt “a sizeable number” of people <a href="https://www.timeslive.co.za/news/south-africa/2020-05-27-this-is-why-we-banned-cigarette-sales-nkosazana-dlamini-zuma-tells-court/">to give up smoking</a> is contradicted by knowledge of society.</p>
<p>This knowledge also tells us that, even among the vast majority who are not addicts, restrictions will fail if they lack legitimacy: people may not like obeying them, but, if they accept they are there for a good reason, they will comply. If they don’t, even thousands of troops will not get them to obey.</p>
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Read more:
<a href="https://theconversation.com/pandemics-dont-heal-divisions-they-reveal-them-south-africa-is-a-case-in-point-134002">Pandemics don’t heal divisions -- they reveal them. South Africa is a case in point</a>
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<p>South Africa’s lockdown rules started with high legitimacy. But it has been eroded and has now dissolved.</p>
<p>The country locked down early, when cases and deaths were <a href="https://www.gov.za/speeches/president-cyril-ramaphosa-extension-coronavirus-covid-19-lockdown-end-april-9-apr-2020-0000">relatively few</a>. This creates a legitimacy problem: people must sacrifice yet they do not see the fatalities and overloaded hospitals which influenced citizens of some European countries. But this problem was largely solved because citizens knew – and feared - what was happening elsewhere.</p>
<p>Legitimacy could have remained high if, like some other countries, South Africa’s had done what early lockdowns are meant to do - cut infections and deaths to a handful.</p>
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<img alt="" src="https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=362&fit=crop&dpr=1 600w, https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=362&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=362&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=454&fit=crop&dpr=1 754w, https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=454&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/339186/original/file-20200602-133875-7t2ddt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=454&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Cooperative Governance minister Nkosazana Dlamini-Zuma.</span>
<span class="attribution"><span class="source">Luiz Rampelotto/Pacific Press/LightRocket via Getty Images</span></span>
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<p>But this was never an option because the scientists who advise the government insisted that restrictions were not meant to stop the virus transmitting, merely to slow it down so that, when the “inevitable” surge arrived, <a href="https://www.dailymaverick.co.za/article/2020-04-14-lockdown-has-bought-us-time-expert-says-as-sa-bucks-the-trend/">the health system was ready</a>.
They have not been challenged to defend this view because the debate never asks scientists difficult questions. An illustrative example is the claim (which she later clarified) by Professor Glenda Gray, chair of the country’s Medical Research Council, that Soweto’s Baragwanath hospital had <a href="https://www.news24.com/news24/SouthAfrica/News/unscientific-and-nonsensical-top-scientific-adviser-slams-governments-lockdown-strategy-20200516">no malnutrition cases before the lockdown</a>. But it has created a legitimacy nightmare.</p>
<p>By Ramaphosa’s <a href="https://ewn.co.za/2020/05/31/president-s-notes-ramaphosa-s-interview-with-editors">own admission</a>, South Africa did not use its lockdown to establish the testing and tracing capacity which allowed some countries to beat back Covid-19. But, outside Western Cape Province, it restricted cases to about 11 000 and under 200 deaths <a href="https://sacoronavirus.co.za/category/press-releases-and-notices/">by the end of May</a>, figures similar to South Korea’s <a href="https://www.worldometers.info/coronavirus/country/south-korea/">successful fight against the virus</a>. Even in the Western Cape, there are a <a href="https://www.moneyweb.co.za/news/south-africa/south-africas-covid-19-deaths-surpass-700/">few hundred deaths</a>, not the thousands seen elsewhere in the world.</p>
<p>So, the lockdown has been effective enough to ensure that its opponents can demand an end to restrictions without seeming callous. But it has not been effective enough to ensure the drop in infections and deaths which the <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance">World Health Organisation</a> – and, initially, the chair of the government’s own <a href="https://news365.co.za/salim-abdool-karims-f/">medical advisory council</a> – say are needed to phase out restrictions.</p>
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Read more:
<a href="https://theconversation.com/coronavirus-corruption-in-health-care-could-get-in-the-way-of-nigerias-response-136913">Coronavirus: corruption in health care could get in the way of Nigeria's response</a>
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<p>The legitimacy which comes from victory over the virus is not available and the official insistence that the restrictions are not meant to stop transmission has handed opponents a good reason to demand that they end even when infections are rising.</p>
<p>Legitimacy has not been eroded among most citizens, who remain deeply concerned about Covid-19. But it has been weakened sufficiently in the policy debate to create an orgy of interest group lobbying for an end to restrictions.</p>
<p>Business began pressing for freedom to operate and has <a href="https://af.reuters.com/article/commoditiesNews/idAFL8N2DE112">largely succeeded</a>. This set off a chain reaction in which, once one lobby wins, the others smell blood and demand that they too be free to operate.</p>
<p>This lobbying has replaced the veneer of science shrouding government decisions: concessions seem based purely on who shouts loudest. Domestic business travel <a href="https://businesstech.co.za/news/government/403657/level-3-lockdown-rules-in-south-africa-here-are-all-the-changes-from-today/">is allowed</a>, which may allow the virus to spread; religious services are opened although they have been <a href="https://www.timeslive.co.za/news/south-africa/2020-03-20-entire-church-congregation-being-traced-in-response-to-coronavirus-in-free-state/">prime spreaders</a> of the virus <a href="https://www.latimes.com/california/story/2020-05-18/mendocino-county-church-service-linked-to-coronavirus-cluster">everywhere</a>; the government has tried to open schools although nearly 2 000 Covid-19 cases are below age 19. Only the tobacco ban remains.</p>
<h2>What’s been missing</h2>
<p>But the legitimacy of measures to fight Covid-19 are more important than ever because the only chance of curbing it is strict observance by businesses and other institutions of health measures.</p>
<p>The government is reduced to doing what it always does when it loses control – telling citizens they must look after themselves. Because people are worried by Covid-19, those who have access to trade unions or other forms of influence may do that. But, if the virus’s spread is stopped, it will be because people fear it, not because they believe that government measures are legitimate.</p>
<p>This might have been avoided if the government paid as much attention to knowledge of society as it says it is paying to science.</p><img src="https://counter.theconversation.com/content/139789/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Steven Friedman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>South Africa’s lockdown rules started with high legitimacy. But it has been eroded and has now dissolved.Steven Friedman, Professor of Political Studies, University of JohannesburgLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/526672015-12-30T23:10:11Z2015-12-30T23:10:11ZSenator’s call for return of cracker night … and burns, amputations and blindings?<figure><img src="https://images.theconversation.com/files/107045/original/image-20151230-11941-1qfqntj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Personal fireworks have been banned from sale in Australia since the 1980s.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/sterlic/18827553404/">Scott Akerman/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>With massive public displays of fireworks set for New Year’s eve tonight, the accidental Senator David Leyonhjelm has <a href="https://www.facebook.com/LDP.australia/videos/10153265199972672/">recently</a> called for the abolition of the ban on personal purchasing of fireworks throughout Australia so that people can again “set off a few double bungers”. </p>
<p>Leyonhjelm <a href="http://www.smh.com.au/national/how-mistaken-identity-and-luck-won-on-the-day-20131004-2uzse.html">won his Senate position</a> because of a combined donkey vote and many asleep-at-the-wheel voters confusing his Liberal Democratic Party with the Liberal Party. He now uses his position as a soapbox for his pet causes.</p>
<p>Fireworks have been banned from personal sales in all Australian jurisdictions except Tasmania and the Northern Territory since the 1980s.</p>
<p>Leyonhjelm’s news release argued that:</p>
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<p>Most of us who grew up with fireworks will remember good times and using common sense to manage our own safety. This was a good lesson that children no longer receive.</p>
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<a href="https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=502&fit=crop&dpr=1 600w, https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=502&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=502&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=631&fit=crop&dpr=1 754w, https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=631&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/107044/original/image-20151230-11932-1i1hy9l.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=631&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Leyonhjelm’s news release.</span>
<span class="attribution"><span class="source">Press release.</span></span>
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<p>I’m the same age as Leyonhjelm and grew up with the excitement of letting off fireworks. The lesson I recall receiving was that you could buy unlimited gigantic red bungers and cause mayhem. They were sold from every corner store and petrol station with none of Leyonhjelm’s dreaded nanny state dampeners on selling only to responsible adults. </p>
<p>I and my mates thought it was hilarious fun to load people’s letterboxes with bungers the size of a sausage and see what damage we could do. Accounts were legion of kids terrorising cats and dogs, throwing them at passing cars and cyclists, and of valorous guys who would hold an inch long double-happy while it exploded (I would only hold tom thumbs).</p>
<p>But when early injury surveillance work began to show that all this mayhem was not just “great fun” but caused often serious injury and very occasionally death, governments acted to make firework displays public events, set off by professionals. </p>
<p>It’s highly unlikely that anyone among the millions watching tonight around Australia will be injured by public fireworks.</p>
<p>In 2014, <a href="http://health.nt.gov.au/library/scripts/objectifyMedia.aspx?file=pdf/95/39.pdf&siteID=1&str_title=Bulletin%20September%202014.pdf">monitoring</a> of five Northern Territory hospital emergency departments found there were 21 firework-related injuries. Nineteen were burns. The majority were male (71%), young (median age of 18 with six being children). One severe injury required hospitalisation. Another 14 injuries were moderate, with the rest minor.</p>
<p>The Northern Territory has about 1% of Australia’s national population. So if we extrapolated the NT’s 2014 firework injury rate nationally, we might expect 2,079 injuries elsewhere in Australia, with 99 being severe. </p>
<p>However, it is probably wise to consider the NT’s 2014 rate as abormally high. A <a href="http://www.publish.csiro.au/?act=view_file&file_id=NB03032.pdf">ten year study</a> of post-ban firework hospital admission in NSW between 1992 and 2002 found 114 cases, with an age-standardised rate of 0.19 per 100,000 population.</p>
<p>The injuries sustained were not little mozzie-bite level singes. The report states:</p>
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<p>Almost one in five separations were for traumatic amputation of part of the upper extremity. These included four complete or partial amputations of thumbs, 14 complete or partial amputations of other single fingers, one traumatic amputation at a level between the elbow and wrist and one amputation of the upper limb at an unspecified level. Other injuries included a variety of open wounds; fractures of nasal bones, mandible, ribs and bones of the arm, wrist and hand; traumatic pneumothorax; and traumatic haemothorax.</p>
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<p>In the <a href="http://www.ncbi.nlm.nih.gov/pubmed/25047335">United States</a> between 2000 and 2010 there were 97,562 firework-related injuries treated in emergency departments.</p>
<p>Just search Google images for “firework injuries” and you’ll get a good idea of what’s involved.</p>
<p>Leyonhjelm’s fetish for eradicating Australia from the vice-like grip of his loathed nanny state regulations has seen him delineate an important ethical distinction. He is not opposed to drink driving laws and other road injury-reduction measures because most of these do not just protect drivers from “choosing” to harm themselves, but such laws also protect those harmed by the actions of freedom-exercising drivers with a skinful or a liking for speed. </p>
<p>Similarly, while the <a href="http://www.theguardian.com/australia-news/2014/oct/02/thank-you-for-smoking-leyonhjelm-confirms-philip-morris-backing">tobacco industry-funded</a> Senator opposes most tobacco control because of his belief that smokers ought not be nudged into quitting or non-smokers into not starting, he does not oppose laws which prevent smokers from smoking near others, because of the mountain of evidence that secondhand smoke harms others.</p>
<p>But in calling for free access to fireworks, Leyonhjelm has now apparently abandoned this critical ethical distinction. In the Northern Territory study, half of those injured were bystanders. Risks to their safety are apparently just acceptable collateral to the rights of individuals to blow their own fingers off.</p>
<p>We also live in very different times to those when he and I got fun from letting off bungers or snapping throw-downs under people’s feet to startle them. With rising vigilance about terrorism, it takes little imagination to consider the prospect of hoons letting off volleys of bungers in crowded or culturally targeted places. We recently saw footage of Parisians panicked by exploding fireworks in the post terrorist days as they laid tributes.</p><img src="https://counter.theconversation.com/content/52667/count.gif" alt="The Conversation" width="1" height="1" />
With massive public displays of fireworks set for New Year’s eve tonight, the accidental Senator David Leyonhjelm has recently called for the abolition of the ban on personal purchasing of fireworks throughout…Simon Chapman, Professor of Public Health, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/464022015-10-25T19:13:06Z2015-10-25T19:13:06ZStates have the right to decide who can parent when they provide IVF<figure><img src="https://images.theconversation.com/files/97896/original/image-20151009-9153-1nsh54d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Decision-making about access is about ensuring a minimally acceptable environment for any child to be raised in.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/hernanpc/21105416240/">Hernán Piñera/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>In circumstances where the state is involved in creating or separating families through adoption, permanent and foster care, and custody disputes, it’s justified to intervene because of the generally recognised duty of care to children. And where it plays a role in creating a child via assisted reproductive technology (ART), the state is ethically justified in imposing restrictions or conditions on its assistance. </p>
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<p><em>Read the <a href="http://theconversation.com/states-have-no-right-to-stop-anyone-wanting-to-access-ivf-46982">argument against state intervention</a> in assisted reproduction.</em></p>
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<p>In many jurisdictions – both in Australia and internationally – the welfare and best interests of the child are paramount. While the situation may superficially seem different in ART, the birth of a child is the intended and foreseeable outcome of the intervention. And ensuring a minimally acceptable level of basic physical safety and emotional well-being for that future child is no less real or important. </p>
<p>In essence, ART is a form of state-assisted family formation and, for that reason, the state has a moral obligation to consider whether people who want to use it will be “<a href="https://nonoedipal.files.wordpress.com/2009/09/transitional-objects-and-transitional-phenomenae28094a-study-of-the-first-not-me-possession.pdf">good enough</a>” parents. Where serious and significant child welfare concerns exist, state intervention is not only ethically justifiable but, arguably, obligatory. </p>
<h2>Reproductive liberty</h2>
<p>The state needs to be satisfied that the woman applying for assistance to have a child, and any partner she has, are <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1852928">able to minimally fulfil</a> parental duties to that child. Opponents of this position might point out – rightly – that anybody can have a child naturally without state intervention. They could argue that access to ART is merely an extension of this reproductive right. </p>
<p>But reproductive liberty doesn’t automatically extend to unfettered ART access. Respecting the reproductive right in “natural” reproduction is about allowing people the freedom to decide when and how many children to have – or none at all. It’s an individually held liberty tied to the idea of bodily autonomy. </p>
<p>Although we think of the right to reproduce as an individual right, the right to have a child can only ever be collectively realised, as reproduction in all its forms is a collaborative project. Even in “natural” reproduction, assistance is required from a sexual partner. And that partner is perfectly entitled to refuse to be involved in procreation, based on their own, equal, reproductive right to not have a child. </p>
<p>When accessing ART that’s publicly funded, the applicant is asking the state to help her via regulation and subsidy. It’s therefore ethically justifiable for this third-party assistor to weigh up all the likely outcomes of providing treatment. And where an ART applicant displays identified and established patterns of harm to children, or has a mental health profile associated with at-risk parenting, then restriction to access is ethically justified.</p>
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<img alt="" src="https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=318&fit=crop&dpr=1 600w, https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=318&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=318&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=400&fit=crop&dpr=1 754w, https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=400&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/97897/original/image-20151009-9157-at2rzf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=400&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The right to have a child can only ever be collectively realised, as reproduction in all its forms is a collaborative project.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/grooovy_easy/5190263592/">Christoph Lehmann/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<h2>A case study</h2>
<p>A <a href="http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VCAT/2015/1188.html?stem=0&synonyms=0&query=%22human%20rights%20list%22">recent case in Victoria</a>, the only state in Australia with a mandatory police check for all ART applicants, provides an excellent case study. In August, a 45-year-old woman with a long and troubling history of emotional abuse and neglect of her six children and her partner were denied ART, after an appeal at the Victorian Civil and Administrative Tribunal (VCAT). </p>
<p>Four of the woman’s children had been removed by child protection services following substantiated welfare concerns about their welfare, revealed by Victoria’s mandatory criminal check and triggering an automatic treatment ban, in line with Victorian legislation. The police history provided clear evidence of substantial risk to the welfare of any future child. </p>
<p>Critics of the Victorian legislation are unhappy about the mandatory police check, saying it discriminates against infertile people and treats all prospective parents like criminals. But the approach is not discriminatory because the test is universally and equally applied to all applicants. And it’s not imposed because they’re infertile, but because they’re asking for help. </p>
<h2>About the child</h2>
<p>Nobody voices similar objections to “<a href="http://www.workingwithchildren.vic.gov.au/">Working with Children Checks</a>” for adults involved in children’s sport or other activities, yet both are about protecting children. If ART is considered through the child welfare paradigm, these routine checks are simply there to flush out exactly this type of case. How else are such cases to be uncovered?</p>
<p>These police checks and the additional legislative requirement for mandated counselling by fertility counsellors in Victoria often reveal worrying information, but don’t trigger automatic presumption against treatment. </p>
<p>Making decisions about ART access is not about judging someone’s lifestyle or punishing them for past behaviour; it’s not about rejecting or supporting their reproductive desires as such. It’s not even about establishing a “best parent” standard. Rather, it’s for framing a minimally adequate or “good enough” parenting benchmark that applies equally to all prospective ART applicants. </p>
<p>Indeed, decision-making about access is not really about the applicant at all. It’s about ensuring a minimally acceptable environment for any child to be raised in. Where the state has an active role in bringing children into being, it would fail future children by not acting to ensure their well-being. </p>
<hr>
<p><em><a href="http://theconversation.com/states-have-no-right-to-stop-anyone-wanting-to-access-ivf-46982">Read the opposite perspective</a> on the right of states to intervene in reproductive choices here.</em></p><img src="https://counter.theconversation.com/content/46402/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Should people who need subsidised medical assistance to conceive have to show the state they will be good parents? These ethicists think they do.Georgina Hall, PhD Candidate, Centre for Health Equity, The University of MelbourneLynn Gillam, Academic Director/ Clinical Ethicist, Children’s Bioethics Centre at the Royal Children’s Hospital, and Associate Professor in Health Ethics at the Centre for Health and Society, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/469822015-10-25T19:12:59Z2015-10-25T19:12:59ZStates have no right to stop anyone wanting to access IVF<figure><img src="https://images.theconversation.com/files/97726/original/image-20151008-9688-1tq333a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Since fertility isn't linked to one’s calibre as a parent, the state can only be justified in placing conditions on all prospective parents, regardless of fertility status. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/bunchesandbits/3887365681/">PROBunches and Bits {Karina}/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>There’s no moral difference between people who have children “naturally” and those who need medical help, so imposing conditions on the latter without good moral reasons is just plain discriminatory. But that hasn’t stopped some governments from not allowing access to reproductive assistance equally.</p>
<hr>
<blockquote>
<p><em>Read the <a href="http://theconversation.com/states-have-the-right-to-decide-who-can-parent-when-they-provide-ivf-46402">argument for state intervention</a> in assisted reproduction.</em></p>
</blockquote>
<hr>
<p>In the Australian state of Victoria, for instance, assisted reproduction clinics impose non-medical conditions on access to treatment (following the state’s Assisted Reproduction Treatment Act 2008). These conditions include undergoing mandatory criminal background and child protection order checks prior to being eligible for treatment. The restrictions make Victoria the only jurisdiction in the world that puts such <em>moral</em> demands on prospective patients. </p>
<p>The motivation behind these barriers to access is ostensibly a good one: to protect the well-being of future children. And it’s laudable that the state has this aim. But, promoting it in this way is unjust: it’s unduly discriminatory against all people who need help building their family. Indeed, it’s unjustified treatment of different kinds of family builders, based on false assumptions about the connection between fertility status and parenting ability.</p>
<p>Assisted reproduction is subsidised in Victoria, as applicants can receive Medicare reimbursement for some of their expenses. If the reason why non-medical conditions are being put on infertile couples is that the public bears the cost, then couples should have the option of paying for the treatment themselves and buying themselves out of the checks.</p>
<h2>Not a level field</h2>
<p>Consider the recent case of a woman known as TRV who <a href="http://www.sbs.com.au/news/article/2015/08/17/vic-mother-six-refused-ivf-treatment">was denied IVF treatment</a> because of previous child protection orders against her. </p>
<p>The only reason people who seek reproductive assistance in Victoria are being asked to undergo checks is because they need this help. Otherwise, they would be able to exercise their reproductive liberty without being subject to state interventions, regardless of parenting skills or criminal histories. </p>
<p>And the only reason the clinic knows that TRV is a “bad parent” is because of her fertility status. Indeed, if she lived elsewhere in Australia (or the world, for that matter), she would not have been denied treatment for these reasons.</p>
<p>The Victorian law isn’t discriminatory against bad parents, or convicted criminals, it’s discriminatory against infertile people. There’s nothing about being infertile by itself that says anything about whether someone is likely to be a bad parent to their future child. And since fertility isn’t linked to one’s calibre as a parent, the state can only be justified in placing conditions on <em>all</em> prospective parents, regardless of fertility status. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/97895/original/image-20151009-9106-1o1e9sd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There’s no moral difference between people who have children ‘naturally’ and those who need medical help.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/48590810@N04/4885882921/">RebeccaVC1/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>A common response to this argument is that the state cannot practically regulate “natural” procreation. If that is indeed true, it’s only true to an extent. While the state may not be able to intervene in the conception process, it could require mandatory parenting classes for all family builders, for instance. Whether this sort of involvement would be morally justified is an open question, but it would lessen the systematic discrimination currently being practiced in Victoria.</p>
<p>Mandatory registration of one’s intent to procreate with a state agency would be another way to bring the treatment of fertile couples in line with current treatment of infertile people in Victoria. Failure to register could carry penalties; in order to be consistent, there would also need to be a way to prevent such people from pursuing their family building goals altogether, if necessary. </p>
<p>Despite these legitimate possibilities for state intervention into everyone’s reproductive choices, the state only intervenes <em>ahead of time</em> when people require help.</p>
<h2>A think wedge</h2>
<p>We should be wary of these sorts of state interventions into the autonomous decisions of citizens, especially if we take procreative liberty seriously. </p>
<p>In “natural” procreation, there’s a presumption that the prospective parent is best placed to, and capable of, gauging and promoting the best interests of his or her future child. But this presumption is denied to people who are infertile – or homosexual, or have undergone a preventative hysterectomy.</p>
<p>It’s helpful to consider how much wider this door could be opened by the state, since it already has its foot inside. It could decide people within or below a certain income bracket are likely to be less-than-adequate parents, and so levy minimum income conditions on access to assisted reproduction <em>in order to protect the unborn</em>. </p>
<p>Or, we could come to see a future where all assisted reproduction patients are required to provide genetic information prior to being eligible for treatment, so predispositions believed by the state to be inimical to adequate parenting are weeded out. </p>
<p>Removing the state’s current presumptions against treatment would mean a small number of people who would otherwise have previously been disqualified will receive fertility treatment in Victoria. Some of them may turn out to be lousy parents, and some children may be harmed. This is a regrettable outcome, and it’s understandable why the state wishes to prevent such harm. But this is par for the course of “natural” reproduction. </p>
<p>Because the state is not the parent, and because these non-medical conditions are being imposed in a manner that’s discriminatory, they are morally unjustified. What the state <em>is</em> justified in doing is promoting responsible reproduction in <em>all</em> kinds of family builders, through widespread and sustained education programs, family planning services, and other kinds of support. All with the goal of creating better parents, rather than preventing some people from becoming parents for morally irrelevant and discriminatory reasons.</p>
<hr>
<p><em><a href="http://theconversation.com/states-have-the-right-to-decide-who-can-parent-when-they-provide-ivf-46402">Read the opposite perspective</a> on the right of states to intervene in reproductive choices here.</em></p><img src="https://counter.theconversation.com/content/46982/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ryan Tonkens does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Should people who need subsidised medical assistance to conceive have to show the state they will be good parents? This ethicist argues such checks are discriminatory.Ryan Tonkens, Lecturer in Bioethics, in the Centre for Human Bioethics, School of Philosophical, Historical and International Studies, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/474752015-09-24T20:17:30Z2015-09-24T20:17:30ZIs the minimal state a reasonable response to the nanny state?<p>The <a href="http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Economics/Personal_choice">Senate inquiry</a> titled “Personal Choice and Community Impacts” has begun. The intent is to examine government measures “introduced to restrict personal choice for the individual’s own good”. Steering the ship is David Leyonhjelm, who suggests that the “nanny state” is an unacceptable violation of individual liberty. </p>
<p>Leyonhjelm recently <a href="http://www.theaustralian.com.au/national-affairs/david-leyonhjelm-declares-war-on-nanny-state/story-fn59niix-1227415288323?sv=269b8156e7f4031a81b36975114c4e93">said</a> that your choices are:</p>
<blockquote>
<p>… not the government’s business unless you are likely to harm another person. Harming yourself is your own business, but it’s not the government’s business.</p>
</blockquote>
<p>The Liberal Democratic Party (LDP) <a href="http://www.ldp.org.au/index.php/policies/1158-lifestyle-choices">suggests</a> that having a right to choose:</p>
<blockquote>
<p>… inevitably means some people will make … choices of which others strongly disapprove. That does not entitle them to seek to interfere in those choices.</p>
</blockquote>
<p>These claims can be traced back to John Stuart Mill’s 1859 classic <a href="https://en.wikipedia.org/wiki/On_Liberty">On Liberty</a>. Mill <a href="http://www.econlib.org/library/Mill/mlLbty1.html">argued</a> that:</p>
<blockquote>
<p>… the only purpose for which power can be rightfully exercised … is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.</p>
</blockquote>
<p>Despite its intuitive appeal, this is in fact a very radical position. We don’t know what will come out of the Senate inquiry, but we do have some idea about what the “ship of state” would look like based on these principles.</p>
<h2>Drug policy</h2>
<p>The LDP website <a href="http://www.ldp.org.au/index.php/policies/1268-cannabis">argues for</a> the legalisation of cannabis:</p>
<blockquote>
<p>Crimes associated with the cultivation, sale and use of cannabis by adults are “victimless” as only those who have consented are involved.</p>
</blockquote>
<p>The party position is not fully articulated for other substances, but the same arguments seem to apply to most illegal drugs. Some drugs can cause more harm to the individual than cannabis, but the harm principle rules out intervening in these cases.</p>
<p>Some drugs can cause harm to others, but alcohol is still the drug that creates the most carnage in this respect and would have to be banned under any consistent policy aimed at prohibiting drugs because they harm others. The LDP would be unlikely to go down that path. </p>
<p>So far so good – on drug policy I’m broadly on board with Leyonhjelm.</p>
<h2>Sexual preferences</h2>
<p>In the section of the website titled “lifestyle choices”, the LDP <a href="http://www.ldp.org.au/index.php/policies/1158-lifestyle-choices">says</a> that:</p>
<blockquote>
<p>… private sexual activities and lifestyle choices voluntarily undertaken by adults are not matters for government intervention except to prevent coercion and protect children.</p>
</blockquote>
<p>True to his ideals, Leyonhjelm <a href="http://www.smh.com.au/federal-politics/political-news/liberal-democrat-david-leyonhjelm-introduces-samesex-marriage-bill-20141126-11uolh.html">introduced</a> a bill into the Senate to legalise same-sex marriage. </p>
<p>There are other activities, not discussed on the party website, that some will find less appetising than same-sex marriage. At least some forms of incest seem compatible with libertarianism. Two related consenting adults are not harming anyone by choosing each other as partners (as long as they do not procreate). A person choosing to have several spouses also seems acceptable as long as the relationships are not harmful.</p>
<p>Logical consistency, something that Leyonhjelm advocates, means the libertarian position also allows bestiality. Leyonhjelm argues that the state should not interfere because an act is offensive or immoral. The justification for intervention is that the act is harmful to others. </p>
<p>One might claim that the animal is being harmed or not consenting, but I doubt that Leyonhjelm would go down this path given that he supports the use of animals for food production. </p>
<p>You might be a bit green around the gills at this point but still agree with libertarians that repulsion at such acts doesn’t mean we should make criminals of people who perform them.</p>
<h2>Firearms</h2>
<p>It’s definitely time to head for the lifeboats when it comes to the LDP’s gun policy. The <a href="http://www.ldp.org.au/index.php/policies/1152-firearms">party position</a> is:</p>
<blockquote>
<p>Sport, hunting and self-defence are all legitimate reasons for firearm ownership …Those who wish to carry a concealed firearm for self-defence are entitled … to do so unless they have a history or genuine prospect of coercion.</p>
</blockquote>
<p>Leyonhjelm does not deny that guns can cause harm, but he doesn’t think we should curtail the freedom of the vast majority because of the actions of a few crazed individuals. He also suggests that an armed citizenry would prevent gun-related atrocities. </p>
<p>Leyonhjelm’s position is that it is acceptable, and preferable, for all Australians to be packing heat on the trip to the supermarket.</p>
<h2>Deregulation and privatisation</h2>
<p>The LDP opposes taxing people to pay for things like the NBN, ABC, SBS, Medibank Private, electricity generation, TAFE, universities, hospitals and schools. The state should also stop regulating liquor licences, workplace conditions, occupational licences, taxi services, retail trading hours, crash helmets for bikes and seatbelts for cars. </p>
<p>Road regulations should also be relaxed, but the LDP <a href="http://www.ldp.org.au/index.php/policies/1158-lifestyle-choices">says</a>:</p>
<blockquote>
<p>… should be accompanied by a health system that does not impose on society the cost of recovery of irresponsible and dangerous drivers.</p>
</blockquote>
<p>I take this to mean that the uninsured who harm themselves because they drive recklessly will receive only the most basic, if any, medical assistance. </p>
<p>Leyonhjelm’s economic vision is where I abandon ship. If freedom is about choice, as he suggests, the government has to have a redistributive role because resources have a big impact on choices. By ignoring this the libertarian position reveals itself for what it really is: a philosophy of freedom for the few.</p>
<h2>Where to from here?</h2>
<p>As we can see, an idea that seems intuitively appealing turns out to be quite radical. The great virtue of the harm principle is its clarity. As Mill <a href="http://www.econlib.org/library/Mill/mlLbty1.html">says</a>, it asserts:</p>
<blockquote>
<p>… one very simple principle as entitled to govern absolutely the dealings of society with the individual in the way of compulsion and control.</p>
</blockquote>
<p>For many people, including myself, this parsimony comes at too heavy a price. </p>
<p>It will be interesting to see whether an inquiry headed by a person of libertarian persuasion will offer something that is palatable to the Australian public regarding the appropriate limits to state intervention.</p><img src="https://counter.theconversation.com/content/47475/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David van Mill does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We don’t know what will come out of the Senate inquiry into the ‘nanny state’, but we do have some idea about what Australia would look like based on libertarian principles.David van Mill, Associate Professor in Political Science and International Relations, The University of Western AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/452942015-07-29T04:19:37Z2015-07-29T04:19:37ZPolicing parenting: is the Family Court going to punish you for having a drink?<figure><img src="https://images.theconversation.com/files/90078/original/image-20150729-30867-wuq7k3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The “right to parent” according to one’s own values and proclivities isn't actually unfettered.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/photon_de/3302350307/">photon_de/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>News outlets have pounced on a Family Court “<a href="http://www.smh.com.au/national/health/family-court-orders-parents-to-stop-smoking-around-sixyearold-son-20150728-gimdrt.html">order</a>” for parents of a six-year-old boy to not smoke around the child and to limit their alcohol consumption while caring for him. <a href="http://www.theaustralian.com.au/national-affairs/health/family-court-to-parents-stop-smoking-cut-drinking-around-son/story-fn59nokw-1227459254074">Readers commented</a> that the case represents an unacceptable “intervention by the courts into the personal space of the individual”, and that it was an attempt at “social engineering”.</p>
<p>The idea of a court intervening in family life to prevent what might seem like fairly ordinary activities, such as occasional tobacco smoking or having a glass of wine or two, might seem like evidence of an overreaching “nanny state”. And perhaps it would be if that’s actually what happened - but it didn’t.</p>
<p>It is true, though, that the “right to parent” according to one’s own values and proclivities isn’t actually unfettered. The state can and will intervene in family life in various circumstances. </p>
<h2>A definite jurisdiction</h2>
<p>State Supreme Courts have powers to make orders under their protective jurisdiction to allow important medical treatment to go ahead if parents won’t consent, for instance. The NSW Supreme Court <a href="https://www.caselaw.nsw.gov.au/decision/54a63b193004de94513db1b8">did exactly that in a 2013 case</a> where a Jehovah’s Witness parent refused a life-saving blood transfusion on behalf of their child.</p>
<p>State agencies can also intercede in family life under child protection laws when a child is at risk of significant harm. This kind of coercive intervention is reserved for serious cases where the child’s basic needs are not being met. And it generally requires much more than a parent who smokes or drinks too much from time to time to trigger intervention.</p>
<p>But child protection laws have also <a href="http://www.smh.com.au/nsw/morbidly-obese-child-died-following-parental-neglect-and-systemic-failures-coroner-finds-20140926-10mqxu.html">been invoked</a> when parents of a severely overweight boy didn’t go to hospital for treatment, or appropriately manage his diet (the ten-year-old boy later died from heart failure associated with obesity). And when a father, who believed HIV was an invention of pharmaceutical companies, <a href="http://www.nzlii.org/nz/cases/NZHC/2015/304.html">refused to give his child the antiretroviral medication</a> prescribed by doctors.</p>
<p>Not everyone will agree on the limits drawn around decisions parents are allowed to make. But most will agree that the public interest in protecting children means limits must be placed somewhere. And “risk of significant harm” doesn’t seem like a bad starting point.</p>
<p>In addition to child protection laws, the Family Court will intervene in the parenting of children when asked to do so by parents who cannot agree on the relevant decisions themselves. In settling these disputes, the guiding principle is that the court will act to protect the “best interests of children”.</p>
<p>But how do courts interpret this rather wide concept, and where do the limits of personal parental prerogatives lie when a court tries to strike a balance between the strongly held views of parents who bitterly disagree?</p>
<h2>The particular case</h2>
<p>In the <a href="http://www.familycourt.gov.au/wps/wcm/connect/fcoaweb/judgments/full-court-judgments/judgment-results?query=arranzio&meta=%2Fau&mask_path=au%2Fcases%2Fcth%2FFamCA&mask_path=au%2Fcases%2Fcth%2FFamCAFC&search-judgments=Search">case</a> that has provoked so much comment, the Family Court decided that despite the fact the child’s mother was his primary carer and was “utterly dedicated to the child’s needs”, it would be in his best interests to live with his father. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/90073/original/image-20150729-30889-1nn4hix.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Family Court will make parenting decisions when asked to do so by parents who can’t agree on the decisions themselves.</span>
<span class="attribution"><span class="source">from shutterstock.com</span></span>
</figcaption>
</figure>
<p>The orders were influenced by the mother’s preference for the advice of her naturopath over an accredited medical practitioner, which the court found was to the detriment of the child; her “conscientious objection to vaccination”; and her “clear and unwavering belief that the child obtains nothing from an ongoing relationship with his father”.</p>
<p>The father, on the other hand, appeared to the court to have a better view of the child’s medical needs and was “the parent more likely to support [the child] in his relationship with his mother”.</p>
<p>Among the 45 orders the court made were two proposed by the mother – that both parents be “restrained from smoking in the presence of the child” and that they will refrain from consuming alcohol “to excess”, or at least to the point of being unable to drive, while the child is in their care. The father agreed to these, in a suite of orders in which his interests mostly prevailed.</p>
<p>These are known as “consent orders” - and they’re quite different to coercive interventions under child protection laws. In fact, health-related agreements are becoming a common feature of consent orders in a culture that increasingly values health and wellness, and in which many parents are likely to want assurances from the other that their child will be in a “healthy” environment when not in their care.</p>
<p>These kinds of concessions are negotiated in families every day of the week – “take Harry to the physio”, or “please can we not have pizza again because last time Sam got sick”. In this sense, consent orders reflect familiar family compromises and the parents’ own values – rather than an out-of-control nanny state imposing orders on passive parents. </p>
<p>It’s just that these fairly unremarkable agreements have been written down and stamped by the court because goodwill has evaporated and parents no longer trust each other to honour everyday deals.</p>
<h2>The long arm of the law?</h2>
<p>Indeed, the most interesting aspect of this case is perhaps not the agreement by both parents not to smoke in front of their child or get so drunk that they can’t drive, but that in determining a child’s best interests, the overriding priority for the court was securing “the benefit to the child of having a meaningful relationship with both of the child’s parents”.</p>
<p>To many people the idea that a father who had never been in a stable relationship with the mother and had little previous involvement with him should be entitled to a relationship with the child to the extent that his mother’s role as primary carer was lost, would seem ludicrous. But the Family Law Act takes the position that a relationship with both parents will, in the absence of risk of harm to the child, be considered paramount.</p>
<p>With regard to smoking and drinking, there was agreement between the parents with the imprimatur of the court – rather than an order being “imposed”. The most serious issue that remained in dispute was the child’s right to a relationship with both his parents - and this was where the court really did impose the values of the Family Law Act. </p>
<p>Otherwise, unilateral state intervention is reserved for much more serious cases where significant harm is in the offing. So, you can still have a smoko while your child is at home without fear of being touched by the long arm of the law.</p><img src="https://counter.theconversation.com/content/45294/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sascha Callaghan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A Family Court “order” for parents of a child to not smoke around him and to limit their alcohol consumption while caring for him have invited the same old accusations about the “nanny state”.Sascha Callaghan, Lecturer in Health Law & Bioethics, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/439162015-06-29T20:08:41Z2015-06-29T20:08:41ZOn ‘nanny states’ and race, Leyonhjelm exposes the moral thinness of libertarianism<figure><img src="https://images.theconversation.com/files/86487/original/image-20150626-18207-x7dn5j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Libertarians, such as David Leyonhjelm, refuse to see anything but individual liberty as having decisive moral weight.</span> <span class="attribution"><span class="source">AAP/Lukas Coch</span></span></figcaption></figure><p>Whatever you think of his views, or of how he came to <a href="http://www.abc.net.au/news/2013-09-09/nsw-sends-liberal-democrat-to-senate/4945080">sit in the Senate</a>, it’s hard to deny that David Leyonhjelm is the real deal: a conviction politician whose positions are governed by principle, not populism.</p>
<p>The problem for his supporters is that Leyonhjelm is exposing the disturbing moral thinness of the libertarian principles he espouses.</p>
<p>In the wake of a parliamentary committee <a href="http://www.abc.net.au/news/2015-06-24/government-labor-greens-show-support-for-indigenous-referendum/6571370">recommending a referendum</a> on constitutional recognition for Indigenous Australians, Leyonhjelm repeated the claim that there’s doubt in anthropological circles that the Aboriginal nations were the first inhabitants of the Australian continent.</p>
<p>That claim struck many as decidedly odd. However, this empirical claim is just one component of a larger position that Leyonhjelm outlined in a speech in March. Appeals to anthropological data and a curious concern not to exclude those who don’t respect Aboriginal culture are just ornaments to his main objection. That comes near the end of <a href="http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;db=CHAMBER;id=chamber%2Fhansards%2F0e04f51c-90a0-44db-b9b2-2bbc9d548cae%2F0077;query=Id%3A%22chamber%2Fhansards%2F0e04f51c-90a0-44db-b9b2-2bbc9d548cae%2F0000%22">his speech</a>, and is both perfectly consistent with his ideological commitments, and perfectly emblematic of what’s wrong with libertarianism:</p>
<blockquote>
<p>Every human being in Australia is a person, equal before the law. Giving legal recognition to characteristics held by certain persons – particularly when those characteristics are inherent, like ancestry – represents a perverse sort of racism. Although it appears positive, it still singles some people out on the basis of race.</p>
</blockquote>
<p>This is a familiar argument: if we’re all equal, and if it’s wrong to discriminate on the basis of race, then it’s just as wrong to discriminate positively as negatively.</p>
<p>The problem with talking about equality at this level of abstraction is that it makes the reality of material privilege invisible. And the bigger problem is that for libertarians, and a great many classical liberals, that’s not actually a problem at all.</p>
<h2>The skinless enlightenment man</h2>
<p>Treasurer Joe Hockey <a href="http://www.smh.com.au/national/treasurer-joe-hockeys-address-to-the-sydney-institute-20140612-zs5ok.html">insists</a> the state promises “equality of opportunity” but not “equality of outcome”. But “equality of opportunity” here is understood as mostly formal. It’s the equality Anatole France <a href="http://www.goodreads.com/quotes/361132-the-law-in-its-majestic-equality-forbids-rich-and-poor">spoke of</a>:</p>
<blockquote>
<p>The majestic equality of the law, which forbids rich and poor alike to sleep under bridges, beg in the streets, and steal loaves of bread.</p>
</blockquote>
<p>But if you can strip human beings back to a self so abstract that purely formal equality seems compelling, you can convince yourself that practical disadvantage doesn’t matter. Leyonhjelm’s speech name-checked the Enlightenment, and this is fitting. What emerges from the Enlightenment and its early modern antecedents is, as the philosopher Charles Taylor puts it, a <a href="http://blogs.ssrc.org/tif/2008/09/02/buffered-and-porous-selves/">“buffered” self</a>, an autonomous agent impervious to external forces. </p>
<p>The men of the Enlightenment – figures like Locke, Hume, Kant, Jefferson and Rousseau – laid out the value of liberty and the essential dignity of humans spectacularly well, but the humans they were describing looked an awful lot like themselves. Being white, male, heterosexual, well-educated and materially comfortable – qualifications which allow you to pass through the world without the kinds of friction that others encounter – makes it much easier to conceive of yourself as an objective centre of disembodied reason and freedom.</p>
<p>Abstract reason doesn’t go hungry. Abstract reason has no skin; it is not born into a body situated into a world of meanings it cannot control.</p>
<p>Nor does it have a history. In speaking of everyone “celebrating ancestry”, Leyonhjelm quite explicitly collapses the experiences of an Indigenous Australian, an asylum seeker, and an Anglo-Celt into one very big but very shallow bucket. Racial identity is reduced to “ancestry” and shunted back into a past that’s available for voluntary “celebration” but exerts no real force on the present. </p>
<p>The “buffered self” isn’t buffeted, let alone constrained or determined, by the winds of history. It stands above history just as it stands above embodiment.</p>
<p>And to suggest otherwise? To suggest that history and its sequelae must be acknowledged? Why, that would be singling people out on the basis of their race. That’s racist.</p>
<h2>Saving us from ourselves</h2>
<p>In some ways this is all in keeping with libertarianism’s refusal to see anything but individual liberty as having decisive moral weight. Freedom, just so we’re clear, is desperately important. It’s one of the main features of the moral landscape that politics must be responsive to. But a myopic focus on individual liberty, linked to a thin conception of persons that sees human dignity simply as the free exercise of autonomy, obscures other vital features of that landscape.</p>
<p>Leyonhjelm has apparently <a href="http://www.abc.net.au/am/content/2015/s4262236.htm">won support</a> for a parliamentary inquiry into the “Nanny State”. Once again, there is commendable philosophical clarity and consistency in his position:</p>
<blockquote>
<p>The issue here is, to what extent is the government entitled to legislate – and we’re not talking about just giving advice – but to legislate, to protect you from your own bad choices. Bicycle helmets are a very good example of that: nobody is hurt if you fall off. If you don’t wear a bicycle helmet, your head’s not going to crack into somebody else and damage them.</p>
</blockquote>
<p>This is the classic <a href="http://plato.stanford.edu/entries/mill-moral-political/#HarPri">Liberal Harm Principle</a>: no-one is entitled to interfere with your personal behaviour so long as it doesn’t impact on anyone else. Hence if you want to smoke, or ride a bike without a helmet, this is an essentially “personal” matter that no-one else should interfere with. </p>
<p>Leyonhjelm <a href="https://twitter.com/davidleyonhjelm/status/611657851996508160">hit back</a> against criticism for apparently being more concerned about the imaginary health effects of <a href="https://theconversation.com/au/topics/wind-turbine-syndrome">wind turbines</a> than the very real health effects of <a href="http://www.bbc.com/news/health-31600118">tobacco</a>. Such criticism misses the point: libertarians don’t care what you do to yourself, just to other people. Smoke ‘em if you got 'em.</p>
<p>I’ve <a href="https://theconversation.com/fuming-with-outrage-nazis-nannies-and-smoking-16682">noted before</a> that even classical liberals like Mill drew the line at suicide – as this destroys the very freedom that the Harm Principle is meant to respect – though some libertarians such as the late Robert Nozick were prepared to countenance a wider right of self-disposal.</p>
<p>But consider whether you have a right to wrestle a would-be suicide down from a window ledge or bridge. To conclude that this would be an unfair interference in their personal autonomy involves a certain blindness, a whittling of the person down to the point where their only remaining value is rational autonomy. The independent, buffered Enlightenment subject: a pure atomistic locus of self-directed freedom, including the freedom to jump.</p>
<p>What is bled out of that picture is the essential interconnection of persons, grounded in our intersubjective constitution. When John Donne famously <a href="https://web.cs.dal.ca/%7Ejohnston/poetry/island.html">declared</a> “no man is an island entire of itself”, he knew exactly what that implied:</p>
<blockquote>
<p>Any man’s death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee. </p>
</blockquote>
<p>No-one “merely” harms themselves, but inevitably harms those around them in doing so. My life is not entirely my own – nor is its value reducible to my autonomy.</p>
<h2>Thick value and power-blindness</h2>
<p>People – real, concrete, loving, feeling, people – matter in deep, distinctive ways, ways that strain the resources of our moral language. And, accordingly, their deaths – which rob the world of something inherently precious – also matter, at least enough for us to sometimes try and save people from their own objectively bad choices. But that sort of thick moral value is lost in the remorseless thinning-down of libertarian calculation. </p>
<p>Even Leyonhjelm’s <a href="https://theconversation.com/strange-bedfellows-euthanasia-same-sex-marriage-and-libertarianism-29651">support of same-sex marriage</a>, for instance, doesn’t seem to be grounded in a view that long-term same-sex relationships are intrinsically good things that deserve access to the same sort of recognition as heterosexual ones, so much as a pervasive dislike of governments saying “no” to people.</p>
<p>Also, when you denude the world of moral pith by abstracting people down into their Enlightenment ghosts in this way, you end up peeling away the level on which real power operates. That makes it easier to pretend we’re now living in some sort of post-racial utopia in which any attempt to redress ongoing power imbalances becomes “reverse racism”. </p>
<p>Equality, it seems, is achieved simply by refusing to acknowledge that inequality remains to be overcome, and by refusing to see the privilege of one’s own position. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/AypT0F-xv4Q?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">You know who talks about race? Racists.</span></figcaption>
</figure>
<p>Think of Human Rights Commissioner Tim Wilson <a href="http://www.news.com.au/national/nsw-act/human-rights-commissioner-tim-wilson-believes-race-hate-laws-are-bizarre-and-unequal/story-fnj3rq0y-1226868911981">complaining</a> that that the law – and not just social sanction – prohibits racially loaded terms being used by some people but not others. This misses the point that the words in question aren’t just words used to denigrate minorities: they’re words used by white people to denigrate others. </p>
<p>Wilson doesn’t magically stop being white when he speaks, and he doesn’t get to sidestep the historical meanings of a white man using those words. None of us gets to be the pure <a href="https://en.wikipedia.org/wiki/Monad_(philosophy)">monad</a> of ahistorical, acultural reason the Enlightenment imagined us to be.</p>
<p>But this charge of “reverse racism” is deeply attractive from a certain perspective. It’s a way of pretending you can talk about racism, or sexism, or homophobia, without talking about power. That’s comforting for those who sense true equality would mean that they – we – might have to give up some of that power.</p>
<hr>
<p><em>Patrick will be on hand for an author Q&A between 3PM and 4PM AEST on Tuesday, June 30. Post your questions in the comments section below.</em></p>
<p><em>Editor’s note: This piece was updated after publication to clarify Human Rights Commissioner Tim Wilson’s comments.</em></p><img src="https://counter.theconversation.com/content/43916/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Patrick Stokes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>David Leyonhjelm is a conviction politician whose positions are governed by principle, not populism. But he is exposing the disturbing moral thinness of the libertarian principles he espouses.Patrick Stokes, Senior Lecturer in Philosophy, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/439142015-06-26T06:21:08Z2015-06-26T06:21:08ZIs the ‘nanny state’ so bad? After all, voters expect governments to care<figure><img src="https://images.theconversation.com/files/86491/original/image-20150626-18237-1wj3edb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Libertarians have a deeply atomising picture about communities, states, even about what it is to be human.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/arselectronica/14697349890/">Ars Electronica/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Independent senator David Leyonhjelm has <a href="http://www.theaustralian.com.au/national-affairs/david-leyonhjelm-declares-war-on-nanny-state/story-fn59niix-1227415288323">launched</a> a parliamentary inquiry into what he calls “the nanny state”. He objects to what he sees as government interference with the freedom of people to make choices, including, if they want, bad choices. </p>
<p>“It’s not the government’s business unless you are likely to harm another person,” he says. “Harming yourself is your business.” </p>
<p>Leyonhjelm is a libertarian: someone who believes that individual liberty is paramount and should be restricted in as few ways as possible. But you don’t need to be a libertarian to feel some sympathy for his call for the government to butt out. </p>
<h2>Liberty and choice</h2>
<p>The principle he invokes – that it is the business of government to interfere only when we risk harming others – is actually a cornerstone of liberal thought. It’s often called Mill’s principle, after <a href="https://en.wikipedia.org/wiki/John_Stuart_Mill">John Stuart Mill</a>, the famous liberal, utilitarian and early feminist. </p>
<p>In his seminal text, <a href="http://www.bartleby.com/130/">On Liberty</a>, Mill wrote:</p>
<blockquote>
<p>the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. </p>
</blockquote>
<p>Leyonhjelm seems to invoke exactly this principle in decrying the nanny state.</p>
<p>Mill thought government interference in our choices was oppressive even if that interference was genuinely for our own good. Leyonhjelm agrees, though he also says as a matter of fact that we usually make better decisions for ourselves than the government would. </p>
<p>Most of us would probably agree that there ought to be limits on how much governments can interfere with our choices for our own good, and that we are often better judges in our own case than outsiders could be. But agreeing with this much leaves plenty of room for debate. </p>
<p>How much interference is too much? Are there domains in which we are not good judges of our own good and might benefit from – even welcome – outside interference?</p>
<p>There’s a large body of psychological literature on how good people are at making decisions that aim at their own well-being. The record is not encouraging: people regularly make choices that they think will make them happier but actually will not. </p>
<p>We have major problems with what psychologists sometimes call <a href="https://en.wikipedia.org/wiki/Affective_forecasting">affective forecasting</a>: we think we know how happy something will make us, but we’re wrong. This leads us to make bad choices with regard to money, in particular: people think that a pay rise, or <a href="http://apps.webofknowledge.com/home.do;jsessionid=55B867B93BBCE527D6B68F62C9E518EB?UT=WOS%3aA1978FM23000013&IsProductCode=Yes&mode=FullRecord&product=WOS&SID=T1tfcc3Pfkmne5HD3Nw&smartRedirect=yes&SrcApp=Highwire&DestFail=http%3a%2f%2fwww.webofknowledge.com%3fDestApp%3dCEL%26DestParams%3d%253Faction%253Dretrieve%2526mode%253DFullRecord%2526product%253DCEL%2526UT%253DWOS%253AA1978FM23000013%2526customersID%253DHighwire%26e%3dhH2zexpHRGS6PGgAE_lYJX79xEo.NgJm6EwhlKCknceKK53d.SavxjG.Ty779rBu%26SrcApp%3dHighwire%26SrcAuth%3dHighwire&Init=Yes&action=retrieve&SrcAuth=Highwire&Func=Frame&customersID=Highwire&DestApp=WOS&DestParams=%3faction%3dretrieve%26mode%3dFullRecord%26product%3dWOS%26UT%3dWOS%3aA1978FM23000013%26customersID%3dHighwire%26smartRedirect%3dyes">winning the lottery</a>, will increase their happiness, but if they’re already comfortably well off, the money makes little or no difference. </p>
<p>And that’s not because nothing can be done to increase our happiness: memorable <a href="http://www.forbes.com/sites/hbsworkingknowledge/2013/08/05/want-to-buy-happiness-purchase-an-experience/">experiences</a>, for instance, do lead to increases in well-being. </p>
<p>We also routinely make decisions we later regret. For instance, in countries where there’s no real national health system and no compulsory insurance – countries of the sort that Leyonhjlem wants Australia to emulate – people routinely go under-insured, and often pay a high price for it. </p>
<p>Part of the reason for this is that we tend to think of ourselves as much less likely to become seriously ill than we actually are. In terms of health, then, government interference may save us from ourselves.</p>
<h2>Your kind of society</h2>
<p>While Mill’s harm principle is very attractive, it may well be that it’s psychologically unrealistic. It was formulated at a time when optimism in the power of rationality was at its peak and scientific psychology was in its infancy. We now know that we are less rational than we had hoped and that we often make better decisions collectively than we would by ourselves.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=297&fit=crop&dpr=1 600w, https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=297&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=297&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=373&fit=crop&dpr=1 754w, https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=373&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/86485/original/image-20150626-18254-qttq8k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=373&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ulysses tied himself to the mast so he wouldn’t be seduced by the sirens’ song, but most of us don’t need to be as dramatic.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/freeparking/523448963/">freeparking/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Many people who recognise that they are apt to make bad decisions in the heat of the moment take steps to prevent themselves doing so. In <a href="http://classics.mit.edu/Homer/odyssey.html">The Odyssey</a>, for instance, Ulysses tied himself to the mast so he wouldn’t be seduced by the sirens’ song. </p>
<p>Many of us do something similar, if less dramatic. We salary-sacrifice into superannuation not merely to take advantage of higher interest rates but to put the money out of our own reach. We deliberately buy a smaller tub of ice-cream so the hassle of going out and buying more will prevent us from bingeing, and so on. We impose restrictions on ourselves. </p>
<p>In a democracy, voting for a nanny state may also be a way of imposing restrictions on ourselves. A minority of people may not like that, but that’s just how democracy works. So long as the restrictions are not unduly burdensome (how hard is to put on a seatbelt?) they don’t have much call on our sympathy.</p>
<p>We don’t want government interfering with our fundamental freedoms, even for our own good. One of our most fundamental freedoms is the freedom to live in accordance with our own conception of the sort of society we want to live in. </p>
<p>Leyonhjelm’s proposal is not philosophically neutral. He has deep-seated philosophical views about the community, the state, even about what it is to be human. He thinks of human beings, in classical liberal fashion, as essentially independent individuals, each choosing for him or herself and bound to one another only by chosen ties. It is this deeply atomising picture he hopes to impose on us all. </p>
<p>We may choose to fight and vote for a different conception of what it is to be human; one in which we are each deeply bound to and interdependent on one another, and in which we may rightly ask each other to bear certain burdens. </p>
<p>That, too, is not a neutral conception of a flourishing human life, but it doesn’t pretend to be. Both pictures will be found attractive by many of us. Contemporary Australia represents a compromise between them and perhaps is all the better for it.</p><img src="https://counter.theconversation.com/content/43914/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Neil Levy receives funding from the Australian Research Council and the Templeton Foundation. He has previously received funding from the Wellcome Trust.</span></em></p>David Leyonhjelm’s parliamentary inquiry into what he calls “the nanny state” reflects a view of human beings as essentially independent individuals. But that’s not kind of society most of us want.Neil Levy, Professor, Macquarie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/241332014-03-07T13:28:29Z2014-03-07T13:28:29ZAttacks on ‘nanny state’ are propped up by vested interests<figure><img src="https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Freedom for all is impossible.</span> <span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File:Smoking_and_drinking_during_pregnancy.jpg">Andrew Vargas</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=416&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=416&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=416&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=522&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=522&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43382/original/ym2p67zg-1394192583.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=522&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We can’t all be free to do what we want.</span>
<span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File:Smoking_and_drinking_during_pregnancy.jpg">Andrew Vargas</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>A few months ago I <a href="http://www.battleofideas.org.uk/2013">attended a debate</a> at the Barbican in London on the pros and cons of international aid and the debate veered into one of individual autonomy and the problems caused by state intervention. A colleague also recently told me that prisoners can only be encouraged (not told) to visit the gym or attend rehabilitation classes and that <a href="http://www.bbc.co.uk/news/uk-24170235">a smoking ban</a> would be a violation of their rights. </p>
<p>At the same time, tobacco companies persist in calling for the rights of smokers and I’ve been <a href="https://theconversation.com/columns/jane-ogden-96406">drawn into many debates</a> about the food industry, portion sizes and food labelling and the rights of consumers to choose what and how much they want to eat.</p>
<p>Suddenly libertarianism is everywhere and wherever I go, I hear arguments about autonomy, individual rights, freedom of choice and the problems of the nanny state. So why do people call upon this notion of freedom and is it all as libertarian as it initially seems?</p>
<h2>Sinister undertones</h2>
<p>The call of “the nanny state” is often, and most simply, a reaction to change. Whether it is seat belt laws, changes to licensing hours, Sunday shopping or even <a href="https://theconversation.com/two-cheap-ways-councils-can-fight-health-inequality-22093">variable speed limits</a>, the immediate reaction is often outcry to government intervention and resistance to change.</p>
<p>Sometimes the call for libertarianism genuinely reflects an ideological viewpoint and the belief that intervention does harm. Much as I regularly donate to my favourite charities I found the arguments at the Barbican that ongoing support to developing countries <a href="http://www.debatingmatters.com/topicguides/topicguide/trade_not_aid/">can engender</a> dependency and undermine local initiatives quite convincing. And perhaps prisoners have had enough of their freedoms removed without telling them how they can and can’t behave while in prison?</p>
<p>But, more worryingly, this call for freedom of choice often seems to have more sinister undertones, used by those with vested interests in people having the choice about how to behave and the hope (and expectation) that they will choose to behave in ways that are bad for them. The tobacco industry may dress their arguments up in libertarianism but in essence they want people to be free to kill themselves by smoking their cigarettes. Food manufacturers argue that the consumer is in charge and should be free to eat (or not eat) whatever is available, while knowing full well that most people will be unable to ignore their grab bags, duo bars or supersized portions. </p>
<p>And perhaps “getting” prisoners to therapy groups and “making” them take exercise or even “banning” smoking in public places inside prisons (as it is outside) is more about lack of staff, ease of management and keeping the peace than any grand ideological position.</p>
<p>With all this opposition how do changes ever happen that actually make a difference to everyone’s lives for the better? And how can we outmanoeuvre those industries who only have their own interests at heart?</p>
<h2>Follow the evidence</h2>
<p>First of all we can sit out the storm. Time is a great healer and after a while, new things like seat belt laws and even Sunday shopping becomes the norm and life without them would seem strange. And when it really is a genuine ideological debate about harm we should gather evidence and leave it to the experts to work it out.</p>
<p>But what can we do when it is really just vested interests dressed up as libertarianism? How can we reclaim the debate and beat them at their own game? I think the answer is a matter of freedom, but it’s about whose freedom we are talking about.</p>
<p>Smoking was first <a href="http://profiles.nlm.nih.gov/ps/retrieve/Narrative/NN/p-nid/60">linked to lung cancer</a> in the 1950s but it took more than 50 years before governments started to introduce smoking bans. And the catalyst for this shift was passive smoking. Smokers may have had the right to smoke and even to die if they so chose but suddenly they no longer had the right to <a href="https://theconversation.com/an-incontrovertible-truth-smoking-harms-foetuses-23843">harm others</a>. Passive smoking undermined the “freedom of the individual” argument. If smokers had rights then so did non-smokers and the ban could be introduced.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/g-9JR2P4wWI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Similarly, seat belts in back seats were seen as an intrusion <a href="http://think.direct.gov.uk/seat-belts.html">until campaigns</a> showed how they protected not only the wearer but the person in the front from being hit from behind, and we are even in the process of banning smoking in cars to protect children and non-smoking passengers. Now there is also talk of <a href="http://news.sky.com/story/1215845/call-to-make-drinking-while-pregnant-a-crime">banning drinking in pregnancy</a> to protect the unborn baby, and an Appeal Court case <a href="http://www.bbc.co.uk/news/uk-26031422">set to hear</a> whether a mother should pay compensation for a child born with foetal alcohol syndrome. </p>
<h2>‘Passive obesity’</h2>
<p>And then there’s obesity and the food industry. People have the right to eat what they like and become obese if they want we are told by the food industry. But what if their weight starts to harm others? What if there were “passive obesity” and a cost to those around them? What about these others’ freedom to be healthy or their rights to choose?</p>
<p>The biggest group of others is the general public – those who pay taxes and others who need to use health services. Obesity costs the health service millions each year for the treatment of heart disease, cancer, diabetes and joint trauma which takes away from the resources available for other services. This is a cost to others.</p>
<p>Obesity <a href="http://www.nejm.org/doi/full/10.1056/NEJMsa066082">is a form</a> of social contagion; the weight of our friends and those around us is a powerful predictor of our own weight in the future. This is also a cost.</p>
<p>But more powerfully, obese parents have a cost to their children. Obese parents are <a href="https://theconversation.com/time-to-face-hard-truths-when-it-comes-to-obese-children-15323">more likely to have</a> obese children who may well have health problems in childhood such as social anxiety, diabetes and asthma. These obese children are also <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621047/">more likely to have</a> health problems as adults, including all of those that their obese parents might have. There is even some evidence that suggests that <a href="http://news.bbc.co.uk/1/hi/health/7874804.stm">even in the womb</a>, unborn babies of obese mothers can become malnourished <a href="http://www.nature.com/news/developmental-biology-support-mothers-to-secure-future-public-health-1.14320">and more prone</a> to many illnesses later on in life.</p>
<h2>We can’t all be free</h2>
<p>The libertarian argument is a powerful one in a modern world where the rights of the individual loom large. And the call of the nanny state and the dangers of government intervention rings true for many, particularly when history has so many examples of when this has been abused. But change is necessary sometimes. And sometimes the government could intervene more than it does. So if passive smoking has done it for smoking and “being killed by someone you know” has done it for seat belts then maybe it’s time for “passive obesity” to do it for obesity. </p>
<p>Freedom is a good idea in the abstract but we can’t all be free. And perhaps only by highlighting the impact of one person’s behaviour on another’s can we be free from many health problems – even if we are no longer free to do exactly as we would like.</p><img src="https://counter.theconversation.com/content/24133/count.gif" alt="The Conversation" width="1" height="1" />
A few months ago I attended a debate at the Barbican in London on the pros and cons of international aid and the debate veered into one of individual autonomy and the problems caused by state intervention…Jane Ogden, Professor of Health Psychology, University of SurreyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/237832014-03-06T03:31:06Z2014-03-06T03:31:06ZFat nation: why so many Australians are obese and how to fix it<figure><img src="https://images.theconversation.com/files/43155/original/mkkn3vsz-1393995006.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Our changing food environment has undermined our capacity to be responsible in the first place.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-147876908/stock-photo-cheese-burger-american-cheese-burger-with-fresh-salad.html?src=pp-same_artist-147834092-scR10e22UU1_lfPVsmmPXA-2">Shutterstock</a></span></figcaption></figure><p>In <a href="http://theconversation.com/mapping-australias-collective-weight-gain-7816">1980</a> just 10% of Australian adults were <a href="https://theconversation.com/explainer-overweight-obese-bmi-what-does-it-all-mean-7011">obese</a>; by 2012 this figure had risen to 25%, among the highest in the world. The food industry lobby and their friends in government would have us believe this comes down to reduced <a href="http://theconversation.com/personal-responsibility-wont-solve-australias-obesity-problem-23723">personal responsibility</a> for what we eat and how much we move. </p>
<p>We might, then, expect to find evidence that people are becoming less responsible. But statistics show the opposite: we are much more likely to <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1370.0%7E2010%7EChapter%7ERoad%20safety%20(4.9.2)">drive more safely</a>, <a href="http://www.tac.vic.gov.au/road-safety/statistics/summaries/drink-driving-statistics">drive sober</a>, and <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4125.0main+features3320Jan%202013">not smoke</a>, for example. </p>
<p>Yet when it comes to food, something is different. Our changing food environment has undermined our capacity to be responsible in the first place.</p>
<h2>Commercialisation of food</h2>
<p>Once, not so long ago, food was scarce. As humans we were programmed to over-consume calories when food was plentiful and to store it as fat for when it was not. </p>
<p>So we have to acknowledge that in our <a href="http://www.ernaehrungsdenkwerkstatt.de/fileadmin/user_upload/EDWText/TextElemente/Publikationen/OEkologie_Ernaehrung/McMichael_Ecology_Nutrition_PHN_Sup_1_05.pdf">hunter-gatherer past</a>, consuming as much food as possible <em>was</em> personally responsible – those who didn’t would likely perish. And this has been hard-wired into our DNA. </p>
<p>Today, our environment is fundamentally different – cheap, energy-dense foods are abundant. In this light, obesity is just the superficial and normal human response to an increasingly “obesogenic” food environment. One with deeply-rooted commercial and political drivers.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1130&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1130&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43158/original/kvkwwrnf-1393995938.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1130&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We’re trying to exercise personal responsibility in a food environment that’s engineered to undermine it.</span>
<span class="attribution"><span class="source">Shutterstock.com</span></span>
</figcaption>
</figure>
<p>There is nothing more obesogenic than our commercial food supply. Today, industrial agriculture produces raw food ingredients at very low cost per calorie output. With <a href="http://www.ncbi.nlm.nih.gov/pubmed/16569239">globalisation</a>, ingredients can be sourced from wherever in the world production costs are lowest (such as Malaysian palm oil) or heavily subsidised (American sugar). </p>
<p><a href="http://www.theguardian.com/books/2013/feb/24/salt-sugar-fat-moss-review">Food science</a> has been harnessed by “<a href="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001246">Big Food</a>” companies to produce highly palatable and durable foods rich in sugar, salt and fat. <a href="http://www.choice.com.au/reviews-and-tests/food-and-health/diet-and-exercise/weight-loss/increasing-portion-sizes.aspx">Serving sizes</a> have grown remarkably – good for our wallets, perhaps, but not so good for our waistlines. </p>
<p>On the retail end, supermarkets have proliferated as the <a href="http://theconversation.com/big-supermarkets-big-on-junk-food-how-to-make-healthier-food-environments-20347">purveyors of processed foods</a>, driving down prices through their buying power and using data-driven product promotion.</p>
<p>We also have <a href="http://dro.deakin.edu.au/eserv/DU:30017421/hume-istheperception-2009.pdf">less time</a> for sourcing, preparing and eating food. And the food industry has responded with “ready-to-heat” meals, “ready-to-eat” snack foods and “fast-food” restaurants (see graph). </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=344&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=344&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=344&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=432&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=432&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43119/original/y9m6g85k-1393979667.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=432&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Growth in Australian fast food outlets and transactions, 1999-2013 with projects to 2017.</span>
<span class="attribution"><span class="source">Euromonitor International</span></span>
</figcaption>
</figure>
<p>The McDonaldisation of our society stems not only from our biological drive to crave energy dense food, but from our need to compress the time in which we source and consume it.</p>
<h2>Information asymmetry</h2>
<p>The concept of information symmetry states that markets work best when both sellers and buyers have full information about the costs and benefits of their buying and selling behaviours. And when it comes to Australian processed food labels, information is stacked heavily in favour of the seller. </p>
<p>Food companies collect reams of information about consumers (just think of supermarket loyalty cards), allowing for targeted advertising, pricing points and product placement. Yet most Australians <a href="http://theconversation.com/food-labels-are-about-informing-choice-not-some-nanny-state-23320">find existing food labels confusing</a>. To make an “informed choice” we have to interpret not only nutrition information panels, but also an array of (sometimes misleading) health claims.</p>
<p>Junk food advertising is also big business in Australia: in 2009 A$402 million and $149 million <a href="http://parlinfo.aph.gov.au/parlInfo/download/library/prspub/481449/upload_binary/481449.pdf">was spent</a> on advertising food and non-alcoholic beverages respectively. <a href="https://theconversation.com/would-you-like-a-side-of-advertising-with-your-happy-meal-8145">McDonald’s</a> alone <a href="http://www.cfac.net.au/downloads/briefing_paper.pdf">increased</a> its advertising spend from $6 million in 1983 to $55 million in 2005. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43156/original/xmvbmhwf-1393995308.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Food labels are confusing.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/jacopast/4992194034/sizes/l/">jacopast</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Why do companies advertise? Because it drives consumer behaviour in powerful ways. Especially when it comes to <a href="http://www.sciencedirect.com/science/article/pii/S0195666312001511">children</a> and their <a href="http://theconversation.com/pester-power-why-junk-food-ads-and-children-shouldnt-mix-1154">pester power</a>, much to the disdain of many parents.</p>
<p>Coming back to information asymmetry, advertising is less about communicating information as it is about conveying symbolic and social meaning – products come to be associated with fun, <a href="http://www.youtube.com/watch?v=nlpZRK2Yfd0">happiness</a>, sex appeal and prestige rather than information about their underlying costs and benefits in terms of health.</p>
<p>The end result is we’re trying to exercise personal responsibility in a food environment that’s engineered to undermine it. Food is available everywhere at any time. It is full of sugar, fat and salt – nutrients we’re hard-wired to crave. Per calorie, it has never been cheaper. </p>
<p>The information we have to inform our choices is heavily skewed by advertising and confusing labels. Government has done little about it. And we – as a nation – are fat.</p>
<h2>Reducing our collective waistline</h2>
<p>Here are some ideas – for us as citizens and for government – to turn the situation around.</p>
<p><strong>1. Re-think the role of government</strong></p>
<p>The conceptual cousin of the personal responsibility mantra is the “nanny-state” argument, that there is no role for government intervention that restricts the freedoms of Australian citizens. In reality, such arguments are nothing to do with regulating us as individuals. It’s just Orwellian <a href="http://en.wikipedia.org/wiki/Doublespeak">doublespeak</a> to oppose food industry regulation. </p>
<p>The true role of government is not to restrict individual freedoms, it is to <em>enable</em> them by creating an environment – through policy and legislation – in which we are truly free to exercise our personal responsibility.</p>
<p><strong>2. Change the food environment</strong></p>
<p>Without changing food environments through hard policy and legislation, it’s unlikely we will make any progress tackling obesity. Successful <a href="http://tobacco.health.usyd.edu.au/australian-tobacco-timeline/">tobacco control efforts</a> demonstrate that a variety of <a href="http://onlinelibrary.wiley.com/doi/10.1111/obr.12098/pdf">intertwining measures</a> need to be taken. </p>
<p><strong>3. Tax the junk</strong></p>
<p>We need to change the economics of our food supply. A tax on sugary, salty and fatty processed foods is one way forward. Following the lead of many countries overseas we could begin with <a href="https://theconversation.com/sugary-drinks-tax-could-swell-coffers-shrink-waistlines-19719">a tax on sugar-sweetened beverages</a> – relatively simple to implement, and <a href="http://www.nejm.org/doi/full/10.1056/nejmhpr0905723">likely to be effective</a>.</p>
<p><strong>4. Improve food labelling</strong></p>
<p>We need a food labelling system that enables personal responsibility. Let’s compare three options. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=448&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=448&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=448&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=563&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=563&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43229/original/3pvgysmd-1394064194.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=563&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Daily Intake Guide: energy 675 kg; DI* 8%</span>
</figcaption>
</figure>
<p>First is the food industry’s current “daily intake guide” (which it <a href="https://theconversation.com/industry-winning-the-fight-against-better-food-labelling-22472">continues to push</a>), calculated as the percentage one product serving contributes to the daily intake of an average adult of 8,700 kilojoules. </p>
<p>But <em>food manufacturers</em> are allowed to set the serving sizes, which are often unrealistic. And because the measure isn’t standardised, it’s difficult to make any meaningful comparison between products. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=409&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=409&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=409&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=514&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=514&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43161/original/b9fhr6ry-1393997199.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=514&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Star rating.</span>
<span class="attribution"><a class="source" href="http://www.choice.com.au/media-and-news/consumer-news/news/new-star-ratings-for-food-products.aspx">Choice</a></span>
</figcaption>
</figure>
<p>Second is the proposed <a href="http://theconversation.com/out-with-traffic-lights-in-with-stars-next-steps-for-food-labelling-11069">star system</a>. It’s a half-way point between what industry and public health advocates want, although its future is uncertain. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=191&fit=crop&dpr=1 600w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=191&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=191&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=240&fit=crop&dpr=1 754w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=240&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/43223/original/rqqbvq2h-1394060095.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=240&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Traffic light labelling.</span>
<span class="attribution"><a class="source" href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207588/FINAL_VERSION_OF_THE_2013_FOP_GUIDANCE_-_WEB.pdf">UK Department of Health</a></span>
</figcaption>
</figure>
<p>Third is the <a href="http://theconversation.com/food-industry-digs-in-heels-over-traffic-light-labels-311">traffic light system</a>. Research indicates that nine-out-of-ten Australians <a href="http://www.opc.org.au/latestnews/mediareleases/pages/mr20110905.aspx#.UxbJmvm1bYg">support</a> such a scheme. It was <a href="https://theconversation.com/food-industry-digs-in-heels-over-traffic-light-labels-311">designed by health experts</a> to promote an easy-to-understand message that encourages consumers to buy more food items with green lights and fewer items with amber and red lights. </p>
<p>Which one do you think will make it easier for consumers, especially less educated ones, to make an informed and personally responsible choice?</p>
<p><strong>5. Ditch junk food advertising to kids</strong></p>
<p>Over 75% of Australians <a href="http://lyceum.anu.edu.au/wp-content/blogs/3/uploads/Food%20Security_Poll.pdfhttp:/lyceum.anu.edu.au/wp-content/blogs/3/uploads/Food%20Security_Poll.pdf">support a ban</a> on junk food advertising in children’s television, and nearly 20% support a total ban. We know from tobacco control that this will be a key step in curbing obesity and <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960815-5/abstract">evidence</a> supports this.</p>
<p><strong>6. Change the political environment</strong></p>
<p>Perhaps the most potent way our food system undermines personal responsibility is when the food industry <a href="https://theconversation.com/big-food-lobbying-tip-of-the-iceberg-exposed-23232">lobbies against</a> the policies that would enable it in the first place. </p>
<p>Government needs to ensure our <a href="http://theconversation.com/junk-food-advertising-to-kids-whats-next-for-regulation-4665">regulatory institutions</a> are not conflicted. And it’s now time to recognise that industry self-regulation <a href="http://theconversation.com/side-stepping-the-censors-the-failure-of-self-regulation-for-junk-food-advertising-2006">doesn’t work</a>.</p>
<p>Finally, we, as citizens, can become politically active. Addressing this conflict brings into play not only the important roles of public health advocacy groups like the <a href="http://www.opc.org.au/">Obesity Policy Coalition</a>, but also citizen’s movements like the <a href="https://www.parentsjury.org.au/">Parents Jury</a>, to demand action. </p><img src="https://counter.theconversation.com/content/23783/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Phillip Baker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In 1980 just 10% of Australian adults were obese; by 2012 this figure had risen to 25%, among the highest in the world. The food industry lobby and their friends in government would have us believe this…Phillip Baker, Post-Doctoral Fellow, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/237232014-02-27T03:34:26Z2014-02-27T03:34:26ZPersonal responsibility won’t solve Australia’s obesity problem<figure><img src="https://images.theconversation.com/files/42598/original/xm2zgn95-1393457130.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The prevalence of obesity in Australia hasn't tripled in the last 30 years because we’ve all lost personal responsibility.</span> <span class="attribution"><a class="source" href="http://www.flickr.com/photos/picturesofthings/2395065912/sizes/l/">Flickr/confidence, comely.</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Almost <a href="http://www.abs.gov.au/AUSSTATS/abs@.nsf/Latestproducts/4364.0.55.001Media%20Release12011-12?opendocument&tabname=Summary&prodno=4364.0.55.001&issue=2011-12&num=&view">two thirds</a> of Australians are now overweight or obese. In fact, obesity and unhealthy diets now contribute to <a href="http://www.healthmetricsandevaluation.org/sites/default/files/country-profiles/GBD%20Country%20Report%20-%20Australia.pdf">more disease and illness in Australia</a> than smoking. This makes finding solutions to our obesity problem a big issue for all of us.</p>
<p>The <a href="http://www.smh.com.au/federal-politics/political-news/food-rating-fiona-nash-chief-of-staff-intervened-to-have-website-removed-20140211-32g3a.html">scandalous</a> removal of the website launching the <a href="http://ourhealth.org.au/news/star-rating-scheme-packaged-food-gets-green-light">new Australian food labelling system</a> and its accompanying <a href="https://theconversation.com/big-food-lobbying-tip-of-the-iceberg-exposed-23232">conflict-of-interest concerns</a> are only weeks old. And now Liberal MP Ewan Jones <a href="http://www.heraldsun.com.au/news/mp-ewen-jones-has-demanded-a-healthy-food-rating-system-be-dropped/story-fni0fiyv-1226837702692">tells us</a> we don’t even need the scheme because
:</p>
<blockquote>
<p>It’s not the government’s fault that I’m fat, it’s my fault and I live with the consequences. </p>
</blockquote>
<p>This raises the important question of whether a reliance on personal responsibility – a key <a href="http://www.smh.com.au/federal-politics/political-news/joe-hockey-the-age-of-personal-responsibility-has-begun-20140203-31xge.html">agenda</a> of the current government, led by a prime minister who <a href="http://www.heraldsun.com.au/news/special-features/is-tony-abbott-on-track-to-become-a-world-leader-in-fitness/story-fnho52jj-1226713577559">walks the talk</a> – is really appropriate in the area of obesity prevention.</p>
<h2>Why not rely on personal responsibility?</h2>
<p>While there is an inherent truth that weight gain is heavily dependent on what we put in our own mouths, the argument for personal responsibility as the obesity solution falls down pretty quickly when we ask the question, “Has the prevalence of obesity in Australia tripled in the last 30 years because we’ve all lost personal responsibility?”. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=840&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=840&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=840&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1056&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1056&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42601/original/9yw9hb3x-1393457893.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1056&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The effects of changes in food environments have been compounded by our inactivity.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/shoot-art/4939546349/sizes/l/">Josh Kenzer</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Of course the answer is no, with all the <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960813-1/abstract">evidence</a> pointing to changes in the food environment. Since the 1980s, we have seen an ever increasing supply of cheap, tasty, energy-dense food that is very effectively marketed and widely available. </p>
<p>These changes have been the <a href="https://theconversation.com/shaping-up-a-blueprint-to-reverse-our-40-year-weight-gain-3067">primary driver of population weight increases</a>, and the effects have been heightened by our <a href="http://www.ncbi.nlm.nih.gov/pubmed/21767729">sedentary lifestyles</a>.</p>
<h2>Nanny state vs informed choice</h2>
<p>In the case of the <a href="https://theconversation.com/industry-winning-the-fight-against-better-food-labelling-22472">Health Star Rating</a> food labelling initiative, Mr Jones has mistaken the provision of useful nutrition information for a nanny state intervention. </p>
<p>A nanny state is <a href="http://www.thefreedictionary.com/nanny+state">defined</a> as one in which the government makes decisions for people that they might otherwise make for themselves. With food labelling, no personal eating decisions are actually being made by the government – these are still clearly a personal responsibility. </p>
<p>The Health Star Rating system isn’t about “telling you … everything you eat is wrong”, to use the words of the MP, it is the simple provision of nutrition information in a format that might help us all make informed choices. This is surely useful, particularly when set against the <a href="http://www.opc.org.au/paper.aspx?ID=exposing-the-charade&Type=policydocuments#.Uw2QOPmSy5I">barrage of marketing</a> for unhealthy foods. </p>
<p>The UK government has seen the sense of this argument and set up a <a href="http://www.nytimes.com/2013/12/08/business/international/britains-ministry-of-nudges.html?_r=2&">whole ministry</a> whose goal is to nudge the population toward better choices.</p>
<h2>Leaving it up to the free market</h2>
<p>The MP, some of his colleagues and their friends at the anti-nanny-state <a href="http://www.ipa.org.au/sectors/nanny-state">Institute of Public Affairs</a> would rather leave obesity to the free market, and the personal responsibility of the people of Australia to fix. Perhaps then, we should contemplate what that strategy might achieve. </p>
<p>We don’t have to wonder for long though, because we are living it. With a market-driven food system based on ever-increasing consumption, our <a href="http://www.diabetesaustralia.com.au/PageFiles/7830/FULLREPORTGrowingCostOfObesity2008.pdf">very costly</a> level of obesity has been a <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960813-1/abstract">predictable outcome</a>. </p>
<p>While we might like to think that the choice of what we put in our mouth is our own and that demand dictates supply, the actual choices we are presented with and the way they are marketed are <a href="http://www.sciencedirect.com/science/article/pii/S0950329312002054">heavily influenced by the food industry</a>. Supermarkets, for example, where many of our food choices are determined, are thought to have been the <a href="http://www.routledge.com/books/details/9780415540292/">single biggest influence</a> on eating habits over recent decades.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=477&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=477&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42602/original/qjjh82df-1393458164.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=477&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s in the interests of food companies to frame obesity as an issue of personal responsibility.</span>
<span class="attribution"><a class="source" href="http://www.flickr.com/photos/77967821@N00/5560832028/sizes/l/">Flickr/Attila con la ca mara</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>The food industry commonly argues for <a href="http://www.deloitteaccesseconomics.com.au/uploads/File/DAE-AFGC%20reform%20FINAL%20281013.pdf">reduced regulation</a>. This is clearly driven by a push to maximise their own profits and their obligation to maximise returns to shareholders. </p>
<p>It is understandable for food companies to oppose the provision of readily understandable nutrition information if it has the potential to impact their bottom line. For this reason, it is in the interests of food companies to frame the obesity issue as one of personal responsibility. In this way, they hope to deflect attention from themselves and minimise government intervention. </p>
<h2>Government intervention to reduce obesity</h2>
<p>So, if the market is unlikely to help us here (and all <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962089-3/abstract">evidence</a> suggests that to be the case), are regulatory interventions likely to be any more successful? </p>
<p>Most of the biggest success stories in Australian public health (immunisation, smoking rates, road safety) that benefit us all have been heavily reliant on government intervention. In the case of seat belts, the laws clearly impact directly on personal choice. But the benefits of having our government “nanny” look after us are <a href="http://www.ors.wa.gov.au/campaigns-programs/seat-belts">very clear</a>.</p>
<p>In the area of obesity, interventions such as restrictions on <a href="http://www.ncbi.nlm.nih.gov/pubmed/19652656">food advertising to children</a>, taxes on <a href="https://theconversation.com/is-a-fat-tax-the-answer-to-australias-obesity-crisis-3712">unhealthy food</a>, and <a href="http://www.ncbi.nlm.nih.gov/pubmed/21079620">improvements to food labelling</a> are likely to be highly effective, while saving the government money.</p>
<p>The responsibility for reducing the national waistline is clearly a joint one between individuals and government. When we hear politicians attempting to frame the issue as a matter solely of personal responsibility, we need to wonder whether they are acting in the public interest or if they’re singing the gold-seeking tune of the private sector.</p><img src="https://counter.theconversation.com/content/23723/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gary Sacks receives funding from the National Health and Medical Research Council (NHMRC).</span></em></p><p class="fine-print"><em><span>Adrian Cameron receives funding from the National Health and Medical Research Council (NHMRC).</span></em></p>Almost two thirds of Australians are now overweight or obese. In fact, obesity and unhealthy diets now contribute to more disease and illness in Australia than smoking. This makes finding solutions to…Gary Sacks, Senior Research Fellow, WHO Collaborating Centre for Obesity Prevention, Deakin UniversityAdrian Cameron, Senior Research Fellow, WHO Collaborating Centre for Obesity Prevention, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/233202014-02-26T03:42:56Z2014-02-26T03:42:56ZFood labels are about informing choice, not some nanny state<figure><img src="https://images.theconversation.com/files/42522/original/d6ssry4t-1393379143.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Food labelling has been a central plank of the food regulatory system since it first emerged in the mid-1800s.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/tranpalitu/2362249322/sizes/o/">Marcos Pozo López/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Coalition MP Ewen Jones has <a href="http://www.abc.net.au/news/2014-02-26/ewen-jones-says-food-star-ratings-wont-work/5283940">spoken out against</a> reinstating the health star rating website controversially closed down by the assistant health minister. Jones says the government shouldn’t interfere with people’s lives, but food labelling requirements aren’t a manifestation of the nanny state, they’re there to provide accurate, easy-to-understand information. </p>
<p>Indeed, food labelling has been a central plank of the food regulatory system since it first emerged in the mid-1800s. Back then, it was not uncommon for products to be adulterated, or marketed with fraudulent claims.</p>
<p>There were reported cases of people being deceived about the weight of the food or its composition. One practice involved adding white colouring to water to create the appearance of milk. Labels provided an effective tool to help food regulators solve such problems.</p>
<h2>Things stay the same?</h2>
<p>The main issues confronting food regulators have now changed considerably, partly due to the availability of many more products. You might think this increased choice has provided increased opportunity to choose a healthy and varied diet, but that’s not necessarily the case.</p>
<p>Rather, what we have is a proliferation of high-energy, nutrient-poor “discretionary” or junk food constructed from the same basic highly-refined ingredients, such as corn, soy, sugar, fats and salt, typically coloured, flavoured, packaged and marketed in different ways. And the increased amount of information that has accompanied this proliferation often translates into increased confusion.</p>
<p>What’s more, many food products are still marketed with dubious claims. Highly-processed breakfast cereals containing a third of their weight in added sugar, for instance, are marketed as being healthy because they contain a number of added synthetic vitamins and minerals.</p>
<p>Food labels can now be the shopper’s ally by promoting informed choices for a healthy balanced diet, or adversary by promulgating misleading claims that create confusion and uncertainty.</p>
<p>Food regulators are supposed to use labels to help achieve two primary statutory objectives – to protect public health and safety and to provide adequate information relating to food to enable consumers to make informed choices. But there are many reasons why the current approach is inadequate.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=310&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=310&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=310&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=389&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=389&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42519/original/hgtqs3k4-1393378511.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=389&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A screenshot from the health star rating food labelling website shut down by the government.</span>
<span class="attribution"><span class="source">Christina Pollard</span></span>
</figcaption>
</figure>
<h2>Health claims</h2>
<p>Marketing products with health claims, such as “This product helps reduce the risk of heart disease” provides a strong angle for generating increased sales. And the food industry has fought hard for permission to use such claims on food labels.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/18375217">Despite evidence</a> showing these claims have little, if any, benefit for the health of the population, in early 2013, Australian ministers permitted the use of health claims on food labels. </p>
<p>Public health and consumer groups expressed concern that such claims make a nonsense of the fundamental nutrition principle that the balance of the total diet shapes health outcomes, not individual foods. </p>
<p>They also pointed out that junk food manufacturers would take advantage of the marketing potential of such claims. And the <a href="http://www.foodstandards.gov.au/industry/labelling/Pages/Notified-food-health-relationships.aspx">first notification</a> the food regulator received was from the manufacturer of a highly-processed food claiming to have a “calorie burning effect”. </p>
<p>If health claims are to genuinely be about protecting public health and not marketing, food labelling regulations might mandate them and link products’ added sugar with dental cavities, for instance, or their salt content with hypertension.</p>
<h2>Spreading confusion</h2>
<p>People are frequently confused about the information appearing on food labels. And this confusion isn’t helped by the use of words such as “natural” or “real”, which are undefined in labelling law but imply some kind of benefit.</p>
<p>Some products imply they’re made with fruit when, in fact, they contain little fruit and are very high in sugar. Following a complaint from the Obesity Policy Coalition about the potential misrepresentation of a “65% real fruit” claim on Uncle Tobys Roll-Ups, for instance, the <a href="http://registers.accc.gov.au/content/item.phtml?itemId=762395&nodeId=f4a5abbb563d78fb3dcd2d66b01a2313&fn=d06_62453.pdf">Australian Competition and Consumer Commission</a> took the view that the claim was potentially misleading and deceptive.</p>
<p>Confusion can also be created by what’s implied but not explicitly said. A claim such as “97% fat free”, for instance, might be displayed on products that wouldn’t usually contain fat anyway but have added sugar, such as confectionery.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=445&fit=crop&dpr=1 600w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=445&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=445&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=560&fit=crop&dpr=1 754w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=560&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/42518/original/f9nmfbbw-1393378427.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=560&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A screenshot from the health star rating food labelling website showing what the system would look like.</span>
<span class="attribution"><span class="source">Christina Pollard</span></span>
</figcaption>
</figure>
<p>Endorsement schemes displayed on food labels are another source of consumer confusion because the criteria used to endorse food products can vary among schemes and with nutrition policy recommendations. Concern has been expressed about the <a href="https://www.mja.com.au/insight/2011/7/rosemary-stanton-tick-program-misguides-consumers?0=ip_login_no_cache%3Da40209ecb0470c4aaba6c2788225e84b">National Heart Foundation’s “Tick” scheme</a>, for instance, because it’s not always consistent with Dietary Guideline recommendations.</p>
<p>The emphasis on most food labels is placed on persuading people to buy the product rather than informing them about it. That’s why the way information is framed on labels imply benefit.</p>
<p>Labels range from “information only” to information with an element of persuasion – “5% fat” is information only whereas “95% fat-free” is information plus persuasion. And people already interested in low-fat products <a href="http://www.ipcommunications.com.au/ipsocm.html">will be persuaded to choose</a> the 95% fat-free product.</p>
<h2>Protecting public health and promoting informed choice</h2>
<p>Clearly, there are problems with the current food labelling regime. But why does something that promotes informed choice have to be so difficult? </p>
<p>Why would Jones and the assistant health minister Fiona Nash want to maintain an information asymmetry in favour of the food industry and at the expense of the people they’re elected to represent? </p>
<p>At least seven years in the making, with the involvement of food ministers, government food regulation advisors, food industry representatives, consumer advocates, public health organisations, and an independent public health nutrition advisor, the Star Rating labelling system was a good start to positive change. </p>
<p>The approach is informative, easy to understand and targeted at helping correct dietary imbalances that are one of the major public health problems confronting food regulators.</p>
<p>But as the debacle with the website showing the system has illustrated, the challenge with developing and implementing informative food labelling is often less about evidence and more about the political will to stand up to the interests of the food industry to whom clear labels may not always be palatable.</p><img src="https://counter.theconversation.com/content/23320/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Lawrence is the Principal Investigator for an ARC-linkage funded project modelling policy interventions for food security and sustainability and a Chief Investigator with the NHMRC Centre for Research Excellence in Obesity Policy and Food Systems based at Deakin University. He does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article.</span></em></p><p class="fine-print"><em><span>Christina Pollard is the Principal Investigator on Curtin University’s Healthway funded Food Law, Policy and Communications to Protect Public Health. Curtin University has received 5 years of funding to assist the translation of research into practice through the FLPC project.
She works part-time for the Department of Health in Western Australia as a Nutrition Policy Advisor for the Chronic Disease Prevention Directorate. She has co-written this article as an academic and not as a public servant and not representing the views of the Department.</span></em></p>Coalition MP Ewen Jones has spoken out against reinstating the health star rating website controversially closed down by the assistant health minister. Jones says the government shouldn’t interfere with…Mark Lawrence, Professor of Public Health Nutrition, Deakin UniversityChristina Mary Pollard, Research Fellow, School of Public Health, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/166822013-08-03T06:32:54Z2013-08-03T06:32:54ZFuming with outrage: Nazis, nannies and smoking<figure><img src="https://images.theconversation.com/files/28582/original/xfk4jv68-1375499421.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">If you treat smoking as a purely personal choice you're not giving enough weight to the impact of dying young.</span> <span class="attribution"><span class="source">stolenscript/Flickr</span></span></figcaption></figure><p>A few years ago I saw <a href="http://www.kjukken.dk/rygekampagnen.php">a poster</a> stuck to the wall of a train station in Copenhagen. The poster was <a href="http://ekstrabladet.dk/flash/dkkendte/article1046636.ece">a protest paid for by a prominent Danish musician</a> against new regulations against smoking in public. At the top was a sarcastic “Congratulations on the smoking ban” followed by the German phrase “Gesundheit Macht Frei” (good health makes you free).</p>
<p>You might think invoking “<a href="http://en.wikipedia.org/wiki/Arbeit_macht_frei">Arbeit Macht Frei</a>,” the slogan above the gates at Auschwitz, to complain about not being able to smoke in bars is pretty tasteless. More likely than not, it’ll also distract from the message you’re trying to send.</p>
<p>So, lesson learnt, defenders of smoking: no more comparing smoking ban proponents to Nazis, okay?</p>
<p>Enter <em>The Australian’s</em> <a href="http://www.theaustralian.com.au/business/opinion/butt-out-of-individual-choices/story-fnc2jivw-1226689776522">Adam Creighton</a>, comparing the Rudd government’s increase on tobacco excise to <a href="http://www.ft.com/intl/cms/s/2/3d78d24a-c068-11df-8a81-00144feab49a.html">the anti-smoking campaigns of Nazi Germany</a>. This should end well.</p>
<p>Now, to his credit, Creighton isn’t just running a lazy “<a href="http://en.wikipedia.org/wiki/Reductio_ad_Hitlerum">argumentum ad Hitlerum</a>” i.e. “You know who else hated smoking?” Rather, he’s claiming that Australia’s attempts to discourage smoking are “being sold with the same flawed economic and moral arguments that underpinned Nazi Germany’s policies.” Which arguments are these?</p>
<h2>Individuals and the State</h2>
<p>What the Nazis and the Italian Fascists believed, roughly, is that individuals only have significance and purpose through and in the State. This sort of totalitarianism is indeed repugnant, not just because of the suffering it causes, but because of the distorting and reductive view of the moral value of human beings it presents.</p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/28581/original/qcm424n2-1375497449.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">poolski/Flickr</span></span>
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<p>Against this, Creighton appeals to the liberal <a href="http://plato.stanford.edu/entries/mill-moral-political/#HarPri">harm principle</a>, as championed by figures like John Stuart Mill. Again, very roughly, this principle states that we’re only entitled to interfere in the actions of others where those actions cause harm to other people. You are morally permitted to do whatever you like so long as you’re not harming anyone else in the process.</p>
<p>So according to defenders of smoking, coercive attempts to reduce smoking infringe on an area that, so long as no-one else is affected, is properly a matter of free individual choice. Creighton accepts that restrictions on smoking in public are legitimate given the dangers of second-hand smoke, but punitive measures designed to stop people smoking are not: </p>
<blockquote>
<p>government should butt out of individuals’ decision to smoke privately, or to engage in any other behaviour that might entail personal costs without harm to others.</p>
</blockquote>
<p>Part of the reason Mill’s harm principle is intuitively satisfying is that individual liberty does matter. Both classical liberalism and its more radical libertarian offshoot respond to genuine and important features of the moral landscape: all else being equal it’s better if we let people do what they want. At its best, strident liberalism is a healthy bulwark against excessive paternalism and coercion.</p>
<p>But these positions also rely on a hopelessly atomistic picture of what human beings are. They see each of us as a free, rational, self-contained, self-directed agent, an independent, sovereign individual living alongside other sovereign individuals, entering into free contracts for mutual benefit.</p>
<h2>Where does harm end?</h2>
<p>Philosophers have spent a lot of time taking that view of human nature apart: we are far less free, transparent-to-ourselves and rational than liberalism (and the economic theories it underpins) assumes. We’re also far more radically interconnected and dependent upon others. Our borders are considerably more porous than the sovereign individual model would suggest.</p>
<p>But even within his own liberal worldview, Creighton’s argument runs into serious problems. For one thing even Mill had to allow that there are some harms you’re not permitted to inflict even upon yourself, such as selling yourself into slavery or committing suicide. </p>
<p>If you wrestle a gun away from a would-be suicide, we don’t take you to be committing assault – but surely killing yourself is an essentially “private” matter if anything is? If we’re allowed to stop people throwing themselves off bridges, why aren’t we entitled to at least make it harder (if not impossible) for them to kill themselves with tobacco?</p>
<p>And is smoking only a harm to the individual? The harm principle notoriously runs into problems with questions like this. Creighton insists that things like the “psychological costs of premature death” are “purely personal costs” and so none of the state’s business. </p>
<p>But of course death does not only affect the person who dies; deaths ramify through families, friendship circles, workplaces, social networks – just where does the private end and the public begin?</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/28580/original/gc3rc7mw-1375497336.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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</figure>
<h2>There’s more</h2>
<p>And then there’s this:</p>
<blockquote>
<p>Amazingly - given smokers choose to smoke – popular estimates of “net costs” ignore any personal benefit smokers might derive from smoking. And they disregard the offsetting savings from substantially lower health and age-pension costs as a result of smoking-induced premature deaths.</p>
</blockquote>
<p>You read that right: we should factor in the money we save from smokers dying early as a benefit.</p>
<p>And therein lies the problem: casting this wholly as a private, personal freedom issue is basically a refusal to take the moral gravity of premature death seriously. That, in turn, involves denying that persons have an intrinsic worth, beyond whatever economic or social value they might happen to have – to understand the value of persons you have to understand what is lost to the world when they die, and vice versa.</p>
<p>Those who complain about a “nanny state” trying to stop people from getting themselves killed are ignoring the significance of death and the responsibilities that generates. And an outlook that thinks we should weigh that human tragedy against the money it saves us has long since lost any right to call itself morally serious.</p>
<p>None of this should be read as a plea to ban smoking: prohibition doesn’t exactly have a glittering history of success anyway. To reiterate, personal freedom matters, and we often need to leave people alone to make their own objectively dreadful choices.</p>
<p>But that right of non-interference may not be absolute, as the suicide and slavery examples show; and there is plenty of scope for policy moves designed to discourage people from harming themselves.</p>
<p>Of course, ideally we wouldn’t need to interfere in people’s lives at all. If you don’t want a nanny telling you what to do, maybe it’s time to grow up.</p><img src="https://counter.theconversation.com/content/16682/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Patrick Stokes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A few years ago I saw a poster stuck to the wall of a train station in Copenhagen. The poster was a protest paid for by a prominent Danish musician against new regulations against smoking in public. At…Patrick Stokes, Lecturer in Philosophy, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/89152012-08-22T20:13:50Z2012-08-22T20:13:50ZWhy banning cigarettes is the next step in tobacco control<figure><img src="https://images.theconversation.com/files/14410/original/3syfnd88-1345430947.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">If saving lives is the goal, a ban on tobacco looms large to anyone who cares to look.</span> <span class="attribution"><span class="source">David Hegarty</span></span></figcaption></figure><p>The Federal government’s High Court win on cigarette plain packaging is another sign that the carcinogenic mist is dispersing to finally reveal the smoking elephant in our collective lounge room. The pachyderm is the ban on tobacco that Australia wants, but can’t quite wrest from its subconscious and out into the light.</p>
<p>Australia now has smoking bans in workplaces, pubs, clubs, restaurants, educational institutions, entertainment venues, sports stadiums, patrolled beaches, playgrounds, cars carrying children, and on public transport. The dangers of passive smoke inhalation, including a nearly <a href="http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS">30% increased risk of lung cancer</a> in non-smokers, has led some jurisdictions to restrict hospitality workers entering outdoor areas where smoking is still permitted.</p>
<h2>Why hesitate?</h2>
<p>Such sweeping measures indicate a wide appreciation of the health threats posed by cigarettes. The practise kills <a href="http://www.who.int/mediacentre/factsheets/fs339/en/index.html">up to half of those who indulge</a>, and imperils those unlucky or unwary enough to share the same air space. Yet we still permit the sale and use of tobacco. It’s time we removed our tar-encrusted goggles, saw the smoking elephant in all its cankerous decay, and called a final halt to the decimation.</p>
<p>Nor would this be the act of a nitpicking nanny state meddling in the legitimately self regarding behaviour of adults. In <em>On Liberty</em>, John Stuart Mill laid a liberal foundation that most democracies embrace. He concluded the state was warranted in constraining individual liberty to prevent actions that harm others. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/14414/original/zyyb9kf5-1345434964.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Mike Rowe</span></span>
</figcaption>
</figure>
<p>The stunning breadth of anti-smoking statutes is testament to the reality of smoking’s third-party harms. These extend to the public health burden from smoking-related lung disease, diabetes, stroke, and heart attack, and the extra taxpayer dollars needed to fund it. This is not nannyism but justified state paternalism. </p>
<p>If you’re unconvinced, consider how you’d respond should someone decide to spray particles of highly carcinogenic blue asbestos into the air at a major train station. Most would deem this an act of biological terrorism, call 000, and in quiet horror shepherd their children out of harm’s way. It’s a fascinating quirk of social psychology that we don’t automatically place smoking in the same category. </p>
<p>Nearly a century of advertising and product placement in films has positioned tobacco as the pursuit of the rich, glamorous, and rebellious. And some doctors even recommended it to their patients. All before a swathe of compelling research revealed its true and malignant nature. Yet those aspirational associations persist in our neural circuitry and may take many years to fade.</p>
<h2>Increasing happiness</h2>
<p>The unwavering response from Big Tobacco appeals to a consequentialist ethic. Ultimately, things will become worse if tobacco is banned. Tobacco sales will shift underground, ciggies bootlegged at exorbitant rates will further cash-strap smokers, organised crime will step into the breach to bolster supply, the rebellious at heart will take up smoking to protest tar totalitarianism, and so on. And indeed, there is a real live public health experiment that provides some support for such claims. </p>
<p>Tiny Bhutan, already a world leader in promoting Gross National Happiness as an indicator of citizen well-being, bravely implemented <a href="http://www.time.com/time/world/article/0,8599,2057774,00.html">a ban on tobacco sales in 2005</a>. And subsequently there were reports of tobacco products appearing on the black market at inflated prices. But if consequences are to be weighed in the ethical balance, it is surely public health benefits that will prevail.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=468&fit=crop&dpr=1 600w, https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=468&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=468&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=588&fit=crop&dpr=1 754w, https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=588&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/14412/original/ddvsz6cy-1345431258.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=588&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">M. de Lipman/Wikimedia Commons</span></span>
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<p><a href="http://online.liebertpub.com/doi/abs/10.1089/jwh.2011.3305?journalCode=jwh">A public smoking ban in Colorado</a> was found to lessen the risk of preterm births; <a href="http://www.ncbi.nlm.nih.gov/pubmed/20466955">Arizona’s state-wide ban</a> reduced hospital admissions for angina, heart attack, stroke, and asthma; <a href="http://www.ncbi.nlm.nih.gov/pubmed/17204724">Ireland’s veto on smoking in pubs</a> led to improved pulmonary function in bar workers; hospital admissions for heart attack <a href="http://www.ncbi.nlm.nih.gov/pubmed/17901438">dropped by nearly 10% in New York State</a> after their smoking prohibition; and <a href="http://www.ncbi.nlm.nih.gov/pubmed/20929904">a Swiss study</a> estimated that anti-smoking laws could prevent the need for up to 41,000 hospital bed days, from the effects of passive smoking alone.</p>
<p>The anti-paternalist may still complain that we permit other risky practises, such as hang-gliding, which also place burdens on the health system when the inevitable crashes occur. But hang-gliding, like many sports, carries inherent risk that is significantly reduced by ensuring adequate training. By contrast, cigarette smoking is never without risk, even when carried out by skilled practitioners.</p>
<p>We are Nero, fiddling by inches towards a tobacco ban, but meanwhile Rome’s health continues to go up in smoke. Our intentions are honourable but they ignore their inexorable conclusion. If saving lives is the goal, a ban on tobacco looms large to anyone who cares to look.</p>
<p><em>Read the <a href="https://theconversation.com/bring-on-the-end-of-tobacco-use-but-not-a-total-ban-tomorrow-8881">argument against</a> banning cigarettes</em></p><img src="https://counter.theconversation.com/content/8915/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul Biegler receives funding from the Australian Research Council.</span></em></p>The Federal government’s High Court win on cigarette plain packaging is another sign that the carcinogenic mist is dispersing to finally reveal the smoking elephant in our collective lounge room. The pachyderm…Paul Biegler, Adjunct Research Fellow in Bioethics, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/44612011-11-28T03:33:45Z2011-11-28T03:33:45ZGovernment, parents or advertisers: who should decide what kids watch and eat?<figure><img src="https://images.theconversation.com/files/5921/original/2414110257-fcf39b5c63-b-1-jpg-1322441171.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The multi-country study concluded that in Australia, television advertising’s contribution to childhood obesity is between 10% and 28%.</span> <span class="attribution"><span class="source">Maggie Osterberg</span></span></figcaption></figure><p>A recent complaint to the Advertising Standards Board by the <a href="http://www.opc.org.au/">Obesity Policy Coalition</a> about a Smarties online colouring-in competition aimed at three- to ten-year-olds, and a bill introduced by Greens leader Bob Brown to ban junk food advertising to children, has fuelled debate about the ethics of advertising energy-dense and nutrient-poor foods and beverages to kids.</p>
<p>Bob Brown says he feels the food and beverage industry’s <a href="http://bob-brown.greensmps.org.au/category/issues/health-wellbeing/health-wellbeing/obesity/food/junk-food">“self regulation has clearly failed”</a>, so action must be taken by the government to shield children from junk food advertising. </p>
<p>The <a href="http://www.comlaw.gov.au/Details/C2011B00239">Protecting Children from Junk Food Advertising Bill 2011</a> would ban junk food advertisements at specified times, as well as ban companies from using the internet to promote junk food to children. </p>
<p>This raises the question of whether television advertising, or rather advertising in general to an audience of children, is responsible in some way for the rates of overweight and obesity we are currently seeing. </p>
<h2>The numbers</h2>
<p>There’s no denying that childhood overweight and obesity is a serious issue in Australia. </p>
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<img alt="" src="https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/5923/original/eeyore-27s-birthday-party-2010-kids-hanging-bars-jpeg-1322441856.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">Jen W</span></span>
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<p>The most recent <a href="http://www.health.gov.au/internet/main/publishing.nsf/content/66596E8FC68FD1A3CA2574D50027DB86/$File/childrens-nut-phys-survey.pdf">Australian National Children’s Nutrition and Physical Activity Survey</a>, showed that, across all age groups, 17% of children were classified as overweight and 6% were obese. That’s almost a quarter of all Australia children being classed as overweight or obese.</p>
<p>Meanwhile, <a href="http://www.ncbi.nlm.nih.gov/pubmed/20018123">a multi-country comparison</a> of the estimated effect of television advertising on childhood overweight and obesity showed Australian kids are likely exposed to 4.9 minutes of food advertising on television every day. </p>
<p>The study concluded that in Australia, television advertising’s contribution to the prevalence of childhood obesity is estimated at 10% to 28%.</p>
<h2>WHO knows</h2>
<p>In response to the recent actions by Bob Brown and the Obesity Policy Coalition, <a href="http://www.thepunch.com.au/articles/mmm-mmm.-the-nanny-state-cant-have-my-smarties/">The Punch</a> and <a href="http://mumbrella.com.au/why-the-greens-attack-on-junk-food-tv-ads-is-wide-of-the-mark-66412">Mumbrella</a> websites have posted articles with unfavourable views of the proposed restrictions. The authors of both articles advocate responsible parenting over advertising restrictions as the cure for the problem. </p>
<p>The vulnerability of children lies at the centre of this debate: television junk food advertisements and competitions presenting energy-dense and nutrient-poor foods in an overly favourable light, and often on a regular basis, are surely difficult for parents to compete with.</p>
<p>And placing the onus on parents to have sole responsibility for counteracting these potent junk food advertisements is unlikely to be the best strategy for change. </p>
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<img alt="" src="https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=437&fit=crop&dpr=1 600w, https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=437&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=437&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=549&fit=crop&dpr=1 754w, https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=549&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/5920/original/3257912877-1ae1d2a7ea-jpg-1322440910.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=549&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">Carol Moshier</span></span>
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<p>The World Health Organisation (WHO) says <a href="http://www.who.int/nmh/publications/ncd_report2010/en/">reducing marketing</a> of foods and non-alcoholic beverages high in salt, fat and sugar to children is a cost-effective way to reduce non-communicable disease. It recognises such measures as a “best buy” for healthy diet promotion. </p>
<p>The WHO <a href="http://www.who.int/dietphysicalactivity/publications/Hastings_paper_marketing.pdf">analysed available evidence</a> and found strong links between television advertising and children’s food knowledge, preferences, purchase requests and consumption patterns. </p>
<h2>Bigger effort</h2>
<p>Interestingly, <a href="http://onlinelibrary.wiley.com/doi/10.3109/17477166.2010.486836/abstract">20 countries have developed or are developing policies</a> relating to marketing to children. </p>
<p>In the United Kingdom, new restrictions on advertising food and drink to children were announced in February 2007. One of these restrictions stated that there should be no advertising of foods high in fat, salt or sugar in children’s programmes. </p>
<p>The UK’s <a href="http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_089129">evaluation of these restrictions</a> on children’s exposure to advertising found children aged four to 15 years saw 32% less overall food and drink advertising following the institution of advertising restrictions.</p>
<p>This suggests that while parental responsibility is paramount, government intervention is needed to reduce the incidence of overweight and obesity in children. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/5918/original/fast-food-01-ebru-jpeg-1322440222.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">ebru/Flickr</span></span>
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<p>The position of WHO is echoed in a 2007 <a href="http://daa.collaborative.net.au/files/DAA%20Submissions/ACMA_Submission_Final.pdf?">submission by the Dietitian’s Association of Australia</a> to the Australian Communications and Media Authority review of Children’s Television Standards. The Dietitian’s Association of Australia believe “changes to food and beverage television advertising regulation is part of the solution to the obesity crisis in children, as it will make it easier for parents to support their children to make healthier food choices”. </p>
<p>We need to acknowledge that junk food advertising in isolation is not solely responsible for the rates of childhood obesity we see in today’s society. But to combat this growing problem, we need a coordinated approach that includes healthy eating and physical activity and sensible, supportive regulation.</p><img src="https://counter.theconversation.com/content/4461/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma Richardson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A recent complaint to the Advertising Standards Board by the Obesity Policy Coalition about a Smarties online colouring-in competition aimed at three- to ten-year-olds, and a bill introduced by Greens…Emma Richardson, Lecturer (Nutrition & Dietetics), Queensland University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/22022011-07-06T04:32:25Z2011-07-06T04:32:25ZBreaking the booze cycle: why we need higher alcohol taxes<figure><img src="https://images.theconversation.com/files/2124/original/aapone-20080919000120312483-alcohol_stock-original.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Lack of discussion of alcohol's harm to others contributes to how little it is regulated.</span> <span class="attribution"><span class="source">AAP</span></span></figcaption></figure><p>A coalition of representatives from leading national health bodies are briefing parliamentarians today, calling for alcohol pricing to be placed on the agenda of the upcoming Federal Tax Forum in October.</p>
<p>Alcohol is widely used in Australia but its misuse causes substantial health and social harms. Increasing taxes is an effective strategy to reduce these harms. </p>
<p>Preventing harm from alcohol misuse hasn’t received as much attention as tobacco but lessons learnt from regulating tobacco use can arguably be applied to alcohol. </p>
<p>That’s because alcohol and tobacco are similar – both are addictive, toxic substances that are legal but highly regulated. Both cause a considerable health burden. </p>
<p>The harms caused by smoking are well documented. And despite resistance from the tobacco industry, much has been done to decrease tobacco consumption through restrictions on the availability and marketing of tobacco products. </p>
<p>Most recently, the Australian government, with <a href="http://theconversation.com/big-tobacco-v-australia-taking-the-battle-to-the-global-stage-2027">much opposition from the tobacco industry</a>, has introduced a Tobacco Plain Packaging Bill, which will mandate plain packaging for tobacco products.</p>
<p>The <a href="http://www.who.int/substance_abuse/publications/global_alcohol_report/en/index.html">negative consequences of alcohol consumption, including road traffic accidents and violence, are also prevalent, costly and cause substantial public concern</a>. </p>
<p>In Australia, the annual social burden of alcohol-related harm is estimated at $15.3 million, which is second only to tobacco for all drug-related costs. </p>
<p>On a global level, the burden from alcohol consumption is greater than the effects of other health problems that receive considerable attention. These include high cholesterol, greater body mass index, low fruit and vegetable consumption, physical inactivity and illicit drug use.</p>
<p>Yet, to date the growing evidence of alcohol-related social burden hasn’t been sufficient to generate interventions of equivalent effect as those for tobacco. </p>
<p>The reasons for this include: </p>
<ul>
<li><p>the high prevalence of alcohol consumption (approximately 83% of the Australian population over 14 years of age drink at least occasionally); </p></li>
<li><p>the resulting normalisation of drinking as part of the culture, </p></li>
<li><p>the perceived health benefits of alcohol and; </p></li>
<li><p>the marketing of alcoholic products. </p></li>
</ul>
<p>Significantly, the limited discussion of the extent of harms from alcohol to people other than the consumer is also a factor.</p>
<h2>Alcohol’s harm to others</h2>
<p>The effects of second-hand tobacco smoke or passive smoking, has received much attention and led to restrictions on consumption in public areas, restaurants and cars. </p>
<p>In contrast, <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02884.x/full">the “collateral damage” from alcohol, the damage or social harm from alcohol on people other than the drinker</a> – either another drinker or a non-drinker, including unborn children – are only now receiving attention. </p>
<p>A recent <a href="http://www.aerf.com.au/Harm_to_Others_Full_Report_with-errata.pdf">Australian study has highlighted the harm of alcohol on people other than the drinker</a>.</p>
<p>It includes many costs not incorporated in previous estimates and finds heavy drinkers cost those around them in excess of $13 billion in out-of-pocket expenses and in forgone wages or productivity. </p>
<p>Hospital and child protection costs add a further $765 million and other large intangible costs are estimated at a minimum of $6 billion dollars. </p>
<p><a href="http://ndarc.med.unsw.edu.au/NDARCWeb.nsf/resources/PressReleases5/$file/95408497.pdf">This study won the 2011 Excellence in Research award at the National Drug and Alcohol Awards on 24 June</a>.</p>
<p>Another study – a survey of residents in regional New South Wales as part of the Alcohol Action in Rural Communities (AARC) – found about two-thirds of the respondents thought someone they knew drank too much. </p>
<p>Almost half reported that alcohol had caused a significant problem for themselves or someone close to them. </p>
<p>In addition to survey data, the AARC study used routinely collected data at the local level to measure the extent to which alcohol impacts on communities.</p>
<p>It found that alcohol-related crime, hospital data and traffic accidents differ between towns, which suggests using local level data to inform and evaluate policies is essential.</p>
<p>Despite the extent of alcohol’s harm acting as a call for effective policy, there’s still a gap between practice and what is being done to reduce negative effects emanating from alcohol use. </p>
<p>Evidence-based strategies known to be effective in reducing the burden from alcohol include regulating the marketing environment, particularly price and availability. </p>
<p>Research has shown this to be a cost effective way of reducing alcohol-related harm. </p>
<p>Although not popular, there is strong evidence showing increasing the cost of alcohol reduces overall consumption. </p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/19149811">Price increases in a range of countries have shown a reduction in alcohol consumption and related harms in the general population and at-risk populations</a>, such as young people and heavy drinkers. </p>
<p>Conversely, price decreases have resulted in an increase in consumption and harm. </p>
<p>Banning alcohol advertising, random breath testing and <a href="http://www.who.int/choice/publications/p_2004_burden_alcohol_use.pdf">intervention for individuals identified as risky drinkers </a>are also cost effective. </p>
<h2>Moves in the right direction?</h2>
<p>There is now more discussion of the negative impacts of alcohol and regulatory efforts to reduce harm within the Australian government: <a href="http://www.theage.com.au/national/roxon-approves-national-plan-for-minimum-alcohol-price-20110607-1fr42.html?from=age_sb">Health Minister Nicola Roxon has agreed on a plan develop a minimum price for alcohol</a>. </p>
<p>The minimum price would operate separately from alcohol tax and make it illegal for any retailer to sell alcohol below a certain price for each standard drink.</p>
<p>Such attempts at increasing regulation have been touted by opponents as creating “nanny state”. </p>
<p>But we still need a discussion about whether the community is willing to countenance modest price increases or restrictions to improve the common good. </p>
<p>Data from the AARC project show the average household in rural New South Wales would be willing to pay an estimated $44 to reduce alcohol-related harm by a tenth. </p>
<p>There is also an argument that we need a greater focus on personal responsibility instead of regulation. But implementing this kind of behaviour change is difficult. </p>
<p>Alcohol causes substantial harm to people other than the drinker and the evidence to date suggests regulation, including appropriate taxation, is the most effective way to reduce this harm.</p>
<p>Let’s hope today’s briefings will set the government on the path to implementing real change to how alcohol is consumed in Australia.</p><img src="https://counter.theconversation.com/content/2202/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Courtney Breen is affiliated with the National Drug and Alcohol Research Centre, UNSW.</span></em></p>A coalition of representatives from leading national health bodies are briefing parliamentarians today, calling for alcohol pricing to be placed on the agenda of the upcoming Federal Tax Forum in October…Courtney Breen, Research Fellow, National Drug and Alcohol Research Centre , UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.