Health and Food Ethics

Gut microbes matter clinically, so diets based on food availability in different markets matter ethically. But that's just one reason to care about food in health care ethics. Providing safe, nutritious, and environmentally sustainable food to all is a great challenge. Physicians in some US cities have been writing prescriptions for patients to obtain fresh produce through healthy food outreach programs. Clinical encounters, however, cannot fully reverse negative health effects of low-quality diets. If the global community cannot find solutions to address food quality and access, costs will be high. This issue investigates some of the compelling ethical issues at stake with food and health. 

Volume 20, Number 10: E911-1000 Full Issue PDF
  • From the Editor
    Oct 2018

    The Ethics of Food in the Health System Architecture

    Jessica Fanzo, PhD
    Interactions of food systems with health systems raise numerous ethical issues about individual and public health, environmental sustainability, and respect for cultural traditions. Clinicians can engage these issues during encounters with patients and through education and advocacy.
    AMA J Ethics. 2018;20(10):E913-917. doi: 10.1001/amajethics.2018.913.
  • Case and Commentary
    Oct 2018

    How Should Physicians Counsel Patients Who Live in Food Deserts?

    Annalynn Skipper, PhD, RDN
    Physicians can improve diets of patients who live in food deserts by providing nutrition materials, training in food preparation, and promoting nutritious food availability in communities where they practice.
    AMA J Ethics. 2018;20(10):E918-923. doi: 10.1001/amajethics.2018.918.
  • Case and Commentary
    Oct 2018

    Do Infant Formula Giveaways Undermine or Support Women’s Choices?

    Stephanie Morain, PhD, MPH and Anne Barnhill, PhD
    Health care organizations have obligations to support all patients mothering newborns in making informed choices about formula and breast feeding.
    AMA J Ethics. 2018;20(10):E924-931. doi: 10.1001/amajethics.2018.924.
  • Case and Commentary
    Oct 2018

    How Should Physicians Help Patients Who Are Ill Because They Work in Agriculture?

    Nicole Civita, JD, LLM
    Farmworkers can become ill due to toxic exposure in their work environments. Recommending specific restrictions, educating patients on protection strategies, and partnering with agribusiness owners and allied health workers can drive development of alternatives to agricultural practices with health risks.
    AMA J Ethics. 2018;20(10):E932-940. doi: 10.1001/amajethics.2018.932.
  • Original Research
    Oct 2018

    Addressing Medical Students’ Negative Bias Toward Patients With Obesity Through Ethics Education

    Gail Geller, ScD, MHS and Paul A. Watkins, MD, PhD
    Six cohorts of first-year medical students have been shown to have negative attitudes about obesity that are consistent over time. Attitudes can be improved, however, by using popular media and an ethics framework to discuss personal experiences and beliefs about obesity.
    AMA J Ethics. 2018;20(10):E948-959. doi: 10.1001/amajethics.2018.948.
  • Original Research
    Oct 2018

    Produce Rx Programs for Diet-Based Chronic Disease Prevention

    Haley Swartz, MPP
    Produce prescription programs can expand patient's food choices and provide financial incentives to change consumption behaviors. If these programs are not linked to established government assistance programs, however, growers could be at risks for bearing the cost.
    AMA J Ethics. 2018;20(10):E960-973. doi: 10.1001/amajethics.2018.960
  • Policy Forum
    Oct 2018

    Health Professionals as Partners in Values-Based Food Procurement

    Sarah Reinhardt, MPH, RD and Ricardo J. Salvador, PhD, MS
    Clinicians should contribute to healthful, equitable, sustainable food procurement initiatives consistent with their institutions' health-promotion missions.
    AMA J Ethics. 2018;20(10):E974-978. doi: 10.1001/amajethics.2018.974.
  • Policy Forum
    Oct 2018

    Does Global Goal Setting Matter for Nutrition and Health?

    Jessica Fanzo, PhD
    Millennium Development Goals on nutrition and health seek to end hunger and significantly reduce malnutrition and premature death by 2025. Health systems and health professionals have important roles in meeting these goals.
    AMA J Ethics. 2018;20(10):E979-986. doi: 10.1001/amajethics.2018.979.
  • Policy Forum
    Oct 2018

    What Lies Behind the Transition From Plant-Based to Animal Protein?

    Adam Drewnowski, PhD and Jean-Pierre Poulain, PhD
    Sociocultural and economic factors drive transition from plant-based to animal-based protein sources in rapidly developing and urbanizing countries of South Asia and Southeast Asia. Better understanding the health impact of this transition requires integrating epidemiological and social science research methods.
    AMA J Ethics. 2018;20(10):E987-993. doi: 10.1001/amajethics.2018.987.
  • Medicine and Society
    Oct 2018

    How to Improve Clinical Practice and Medical Education About Nutrition

    David L. Katz, MD, MPH
    Physicians need better education in nutrition science. Referring patients to nutrition experts for dietary counseling would motivate food availability and intake assessment as routine. Good clinical counseling considers patients' cultural traditions and environmental sustainability as key ethical values.
    AMA J Ethics. 2018;20(10):E994-1000. doi: 10.1001/amajethics.2018.994.
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    Podcast
    Oct 2018

    Ethics Talk: Why Should Clinicians Care About Nutrition?

    When patients look for strategies to improve their overall health, diet and nutrition are often a logical place to start—after all, what we consume has enormous impact on our susceptibility to disease and disability. But health care professionals don’t always have the time or expertise to address nutrition effectively in a clinical encounter, and might not know how to respond to broader issues around food availability in their community. This month on Ethics Talk, we talk about why clinicians should care about food ethics and what they can do to address nutrition in clinical and community settings. Our guests were Dr. Jessica Fanzo, Dr. David Katz, and Haley Swartz.