Applied Metaphysics

So weight problems are now officially a disease and, hence, covered by medicaire. It's about time! Our nutritional environment is easily as polluted as the our air and it seems a bit naive to think people can routinely navigate the available offerings (not to mention withstand the marketing) sufficiently well to eat healthy. I offer myself as an example. I am a reasonably intelligent person who knows quite a bit about nutrition (for a layman), but I find it challenging to eat a healthy diet.

It is becoming increasingly clear that weight problems are driven in large measure by physiological factors. Here are a couple: (1) Eating high carb foods innundates our cells with insulin, making them increasingly insulin resistant, causing us to crave more high carb foods; (2) One of the hormones (I forget which) which makes us feel hungry spikes in overweight people during the day (when they can eat), but spikes in "skinny" folks at night (when they sleep through it).

On the flip side, those who oppose using tax dollars to cover weight problems say that being overweight is a matter of free choice. Since being overweight is a matter of free choice, they say, it shouldn't fall to the taxpayers to cover the costs of weight loss programs.

Now, according to compatibilists (as I understand things), these two claims about weight problems are compatible: one can consistently maintain that weight problems are physically (physiologically) determined AND that they are the result of free choice. Suppose that all of this is true. How then are we to adjudicate the health care issue? The only way I can see to resolve the issue is to be utilitarian: if the benefits of covering weight problems out weight the costs (according to some measure of costs/benefits), then cover the problems; otherwise don't. Is this right? Does compatiblism entail utilitarianism wrt public decision making?

Comments

[J]

Hmmm. Casting this as a conflict between physiological determinism and free will sounds pretty strong--or, at least, it sounds like it you've got a pretty strong notion of "free will" going. For instance, whether a guy can grow a beard or not certainly depends upon physiological factors, and those factors vary from man to man. But that doesn't mean that there isn't an element of choice involved in keeping the chin clean; it just means that some of us have work harder to keep it clear of underbrush.

Keeping the beard under control, of course, is a lot easier than keeping the weight off, largely because there's a straightforward and easily understood method for the former but not for the latter. Keeping this in mind while sidling over to the topic of public policy, might it not be a good idea to keep from extending government programs until we understand the science of diet better and can better target and serve those whose exercise of choice is severely constrained by their uncooperative constitutions? That, of course, is a utilitarian argument of a different sort: a prudential claim that while we are still relatively ignorant we should husband resources rather than risk wasting too many.

[chad]

Hi Marc

You mention an argument to the effect that, since people are overweight by choice, they should not be bailed out of their health problems by the taxpayers. The argument is severely underdeveloped as it stands. But it seems to me that (i) it would, if sound, constitute one way of settling the relevant policy question (ii) it is not a utilitarian argument (iii) there is no obvious reason that the compatibilist cannot make this argument. You presumably would not have mentioned the argument unless you thought the argument was somewhat persuasive--at least persuasive enough to be worthy of consideration. So it seems to me that there is an argument that you find somewhat interesting or plausible--the very argument that you mention--which is open to the compatibilist, which is not a utilitarian argument, and which would settle the relevant policy question. So it seems that you should not say that compatibilism entails utilitarianism about matters of public policy.

Chad

[Nathan]

Seems to me like two issues, (1) compatiblism / incompatiblism and, (2) what sort of moral theory "we" ought to base health policy decisions on [= the most defensible theory? = the true theory?] are quite separate.

The only connection I can see is that they both (this isn't often as noticed in the ethics case; Ish Haji has written interesting stuff on this though) often depend on some conception of an "alternative" or "option" or presuppose that one "can" do other than what one does. Consequentialisms tend to build that into their theory: this action is wrong, in part, BECAUSE there was another one "available" that would have brought about more good.

So perhaps how one's understandings of the modalities involved in free will (or lack of) should be the same for the modalities of moral judgments.

Also, it's not eating merely "high carb foods" simpliciter that can lead to problems. Rather it's eating SIMPLE, REFINED carbohydrates like white bread and other highly processed foods that's the problem. Whole grains, vegetables and fruits (among other foods) are carbohydrates (they're not fats, they're not proteins..), but they are COMPLEX carbs, take a long time to digest and so don't result in the insulin spikes, etc.