{"id":856,"date":"2011-02-03T21:09:27","date_gmt":"2011-02-03T20:09:27","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=856"},"modified":"2011-02-03T21:09:27","modified_gmt":"2011-02-03T20:09:27","slug":"promoting-wise-behaviour-or-mandating-it","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2011\/02\/03\/promoting-wise-behaviour-or-mandating-it\/","title":{"rendered":"Promoting Wise Behaviour, or Mandating it?"},"content":{"rendered":"<p>Following on from yesterday&#8217;s vaguely pro-paternalism post, my eye was drawn to <a href=\"http:\/\/www.bbc.co.uk\/news\/uk-scotland-glasgow-west-12345169\">this story<\/a>, concerning a prisoner who has won the right (or, rather, had the right confirmed) to have high-energy foods sent to him while he&#8217;s in chokey.\u00a0 The beeb has a few crowd-pleasing splutters about the crime for which he was imprisoned, but they&#8217;re not important.<\/p>\n<p>The fruit and nuts and bolts of the story is this:\u00a0a prisoner has a fitness regime that, he claims, means he has a need for high-energy foods that are not normally provided.\u00a0 He had these foods &#8211; things like Lucozade, protein bars and so on &#8211; sent to him from outside.\u00a0 The prison authorities banned this, admittedly not just for him, ostensibly on the grounds that 80% of inmates were obese (compared to 50% on the outside) and such supplies undermined a plan to reduce obesity.*\u00a0 The prisoner sued.\u00a0 He won.<\/p>\n<p>Good.<!--more--><\/p>\n<p>The fact that you&#8217;re in prison for nasty crimes means that you have certain civil rights &#8211; importantly, your right to liberty &#8211; taken from you.\u00a0 It doesn&#8217;t follow from this that you do or should lose all rights of any sort whatsoever.\u00a0 If other people have the right to decide to consume high-calorie foods if they can get them &#8211; irrespective of whether or not they&#8217;ll be burning off those calories &#8211; then it seems to me that prisoners have similar rights.\u00a0 Since the man in question hadn&#8217;t been sentenced to lose weight, he had the right not to have his food options arbitrarily curbed.<\/p>\n<p>Don&#8217;t the prison authorities have a duty of care?\u00a0 Well, yes.\u00a0 Obviously.\u00a0 But it&#8217;s not obvious that this would be discharged by mandating healthy eating; given that we&#8217;re dealing with adults, most of whom would presumably be perfectly capable of running their own lives in other circumstances, education would suffice for that.\u00a0 And, on the face of it, a prisoner with a demanding exercise regime isn&#8217;t likely to be at risk of obesity anyway; forbidding him from receiving high-calorie foods may actually be detrimental to his health, either by forcing him to undernourish himself, or to give up the exercise.<\/p>\n<p>How does this square with the pro-paternalism stance of yesterday&#8217;s post?\u00a0 I suppose there might be a worry about inconsistency here, if you take a legal requirement to wear a cycle helmet to be comparable with enforced low-cal eating.\u00a0 But I think that there is a number of differences.\u00a0 Notably, I claimed yesterday that the &#8220;decision&#8221; to go hatless is probably only a pseudo-decision in most cases; and I stand by that (Notwithstanding John Coggon&#8217;s comment in response to the post).\u00a0 The decision of the prisoner in this case was not a pseudo-decision.\u00a0 And people on the outside who decide not to wear a helmet still have a range of options available to them, from going with the law, to taking a chance about breaking it, to finding an alternative way of travelling.\u00a0 Our prisoner had none of this.<\/p>\n<p>I don&#8217;t have the visceral anti-paternalist reaction that a lot of people have &#8211; and I think that a lot of the reaction is no more than visceral &#8211; but that&#8217;s a long way from thinking that all paternalism is OK.\u00a0 If this was paternalism, it wasn&#8217;t the OK sort.<\/p>\n<p>I&#8217;d add that what is strange about this particular case is the way that the judge focused on the lack of consultation.\u00a0 I can&#8217;t see how that makes a difference.\u00a0 Suppose there had been consultation, and the majority of prisoners had said that they approved of supplies from outside being banned?\u00a0 Well, that still leaves the minority who don&#8217;t; and it&#8217;s not clear why their desires count for nothing just because more people desire something else. \u00a0Moreover, it&#8217;s not like one person&#8217;s getting goodies sent is antagonistic to another&#8217;s desire to eat more healthily. \u00a0Those who would prefer not to get stuff sent to them would need a prison policy; couldn&#8217;t they just ask their nearest and dearest to lay off the cake-parcels, or throw them out when they arrived?<\/p>\n<p>If you&#8217;re going to be paternalistic, at least be clever about it.<\/p>\n<p>*They&#8217;d also come up with some notion that chewing-gum could be remoulded as a key.\u00a0 Seriously.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Following on from yesterday&#8217;s vaguely pro-paternalism post, my eye was drawn to this story, concerning a prisoner who has won the right (or, rather, had the right confirmed) to have high-energy foods sent to him while he&#8217;s in chokey.\u00a0 The beeb has a few crowd-pleasing splutters about the crime for which he was imprisoned, but [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2011\/02\/03\/promoting-wise-behaviour-or-mandating-it\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,328],"tags":[],"class_list":["post-856","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-philosophy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Promoting Wise Behaviour, or Mandating it? - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2011\/02\/03\/promoting-wise-behaviour-or-mandating-it\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Promoting Wise 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