Agriculture and Food Issues
in the Bioethics Spectrum

By Paul B. Thompson

When Van Rensselaer Potter coined the term “bioethics” in 1970, he intended for it to include subjects ranging from human to environmental health, including not only the familiar medical ethics questions about the beginnings and endings of life, but also questions about humanity’s place in the biosphere. Today, we tend to think of bioethics primarily in terms of ­medicine and public health. Environmental ethics has matured into a somewhat separate subdiscipline where philosophers and ecologists ponder the imperatives of species conservation or ­population growth.

The emerging field of agricultural and food ethics straddles the dualism implicit in our contemporary mindset. On the one hand, agricultural and food ethics is concerned with a host of issues relating to risk and health, including nutrition and the potential for adverse health affects from pesticides or biotechnology. On the other hand, agriculture has obvious effects on the broader environment, and it is impossible to ignore questions about the moral standing of agricultural animals or the impact that food production has on wild nature.

Such topics will sound familiar to professionals working in medical as well as environmental ethics. Issues related to diet and health provide a natural link between agricultural ethics and medical humanities. Yet agricultural ethics has an additional focal point that looms over any discussion of food like the proverbial elephant in the room: farming has historically been deeply intertwined with culture and social organization. The last 250 years of Western history have been a steady transition from 80 to 90 percent of the population directly involved in farming to our present situation where that figure is less than 1½ percent.

Changes in the pattern of farming practice reverberate through our social life in profound and unexpected ways. Some of the most profound social issues of the 20th century have their roots in agrarian transition: urbanization and suburban sprawl (which may relate to nostalgia for the rural life); pressure on the institution of the nuclear family and a perceived decline in community ties; anxieties over the increasing rationalization of society and the “disenchantment of nature.” Unpacking and examining such phenomena defines entire careers in agricultural ethics. Within rural communities today, the sting of agrarian transition continues to be felt as a desperate need to prevent family farms from disappearing entirely.

There is much to be said in favor of the family farm. Traditional family farms had diverse and well-integrated work routines in which every family member made an evident contribution to the family’s well-being. Rural communities composed of family-based economic production units have loose (but essential) interdependencies that can foster a deep sense of solidarity and place. Diversified farms can foster sensitive and ecologically sustainable interactions with the broader environment. When all these aspects of family farming are working well, family farm communities satisfy important aspects of personal, social and ecological health.

But rural areas can also become a jungle of personal and social isolation, prejudice and xenophobia. Probing the linkages amongst personal, ecological and community health is a key topic for agricultural ethics. One relatively undeveloped link to medical ethics is the critical matter of rural health care. Medical practice has undergone its own agrarian transition, and the challenges posed by bringing the benefits of modern medical technology are considerable. Still, a more immediate tie to medical humanities comes through examining some of the questionable moves that have been made on behalf of the family farm, which connect up to more pervasive health issues.

Our political efforts to save the family farm have included farm subsidy programs that may have actually hastened the advent of today’s megafarms, while distorting the underlying economics of our food system beyond recognition. Subsidies for corn (and tariffs on cane sugar) have encouraged the development of cheap corn sweeteners, on the one hand, while encouraging low-cost confined animal production for meat and eggs, on the other. Our eagerness to save the family farm may have helped create the price system that made the fast food diet possible.

Studies persistently reveal that physicians are the public’s most preferred source for ­information on diet and health. Nutrition has only recently (and somewhat imperfectly) been incorporated into the formal training of physicians. Yet studies on the risk factors associated with obesity and the dietary basis of other degenerative diseases have made dietary advice into one of the staples of ordinary patient care. Perhaps the time is ripe for mainstream bioethics to take a hard look at food issues.

Philosophical issues arise within the domain of nutritional science itself. Human nutritional science has historical roots in colleges of agriculture, with one foot in home economics and the other in animal husbandry departments. Animal nutrition studies aimed to maximize growth and weight gain with little thought to the potential for long-term health effects. While human nutritional science has long since distanced itself from that tradition, it is still fair to say that nutritional studies tend to treat the human ­population as a homogenous whole. Until the 1980s, daily requirements for vitamins as well as for the relative balance of fats, protein and carbohydrate were based on aggregate populations that did not reflect important differences among human beings.

By the 1970s, nutritionists began to realize that the needs of women and children were markedly different from those of adult men. Gradually, nutritional studies have become more sensitive to differences in age, gender and level of physical activity, as well as recognizing special needs associated with pregnancy or disease. Nutritional science has yet to cope successfully with the potential for differences in dietary needs based on genetic variation. But many of the variables relevant to such differences that are inherently difficult to control. Nutritional research methods require long-term studies on relatively large populations, and the potential for confounding factors is ever present.

Given this background, it is not surprising that there have been frequent reversals in dietary recommendations based on nutritional research. Recommendations against salt and even sugar consumption have vacillated between mild and severe over the last forty years. Red meat and milk products were once highly recommended, and then became substances to avoid. Recent studies apparently vindicating the principles of low-carbohydrate diets have restored some of their acceptability. Nutritionists have also squabbled over the acceptability of vegetarianism. Health effects of foods, of food additives, and even of contaminants such as pesticide residue are difficult to study and remain controversial.

A philosophical analysis of nutrition science reveals the potential for problems when physicians and public health officials try to give dietary advice. Even where nutritional science has managed to attain consensus on general patterns indicative of healthy diets for the population as a whole, any particular piece of dietary advice may be useless or even counterindicated when given on an individual basis. This is not in itself an unusual situation in patient care. It does, however, suggest both a new domain of relevance for some familiar questions, as well as a few new ones:

• Are individuals made adequately aware of the uncertainties inherent in dietary advice, both when receiving advice from physicians or from other sources? Do they have means to evaluate such advice in light of their personal situation?

• Does the mass media promote a false picture of the current state of our scientific knowledge with respect to diet?

• How should medical professionals weigh the cultural, religious, social and psychological significance of food when giving dietary advice? Is it, for example, right to challenge dietary practices that may be important to family relations in pursuit of questionable health benefits?

• Does the impact of dietary advice on rural communities have any place in the ethics of medical practice?

This last question brings us back to the elephant sitting quietly in the corner, an elephant that agricultural ethicists have learned not to ignore.

The school lunch program, food stamps and the diet-health pyramid are all under the oversight of the U.S. Department of Agriculture. Consumer advocates have suggested that farm commodity groups have had adverse affects on American health through improper influence on these programs. Clearly health should not lose out to profit in the administration of these programs, but perhaps it is time to ask the correlative question: do healthcare professionals unethically whipsaw American farmers when they offer inadequately grounded dietary advice?

There is little question that dietary changes such as the fluctuations in red meat consumption have profound effects in rural areas. Farmers build structures and buy expensive equipment to produce specific commodities. Crops in the ground and animals on the hoof represent investment decisions that cannot be fully reversed. When arbitrary or capricious changes in food consumption patterns occur, these investments can become worthless. Small, family farms are especially vulnerable to such forms of economic caprice.

The emblematic case occurred in 1996 when vegetarian advocate Howard Lyman ­appeared on Oprah Winfrey’s television show describing some unsavory practices in food animal production. Winfrey’s spontaneous comment, “I’ll never eat a hamburger again,” precipitated a dramatic slump in U.S. beef prices and prompted an unsuccessful lawsuit to recover economic losses suffered by the Texas cattle industry. The economic effects of dietary advice dispensed by physicians and public health authorities are less immediate, but no less extensive and probably considerably more ­long-lived.

It must be recognized that there are legitimate personal and public health issues at stake in dietary planning, and that the likely health effects to human beings must be reckoned as the priority having the greatest moral weight. Nevertheless, it is arguable that at least two groups of factors should be given some moral weight in configuring dietary advice. One includes the cultural, social and psychological dimensions of food consumption, the practices that make food a carrier of group identity and a source of community solidarity. The other factors are those that affect the well-being, including the economic well-being, of rural people. The tendency of health care professionals to regard especially the latter group of factors as trivial, spurious and even improper cannot be justified on ethical grounds.

The time may be ripe for a more extended conversation between agricultural and medical ethics. Agricultural ethics is like a three-legged milking stool. One appendage rests in health, another in environment, and the third is planted firmly in the social, cultural and historical meanings of rural life. Medically-based dietary advice may be grounded in a concern for human health, but it has the potential for both cultural and environmental reverberations. Agricultural and food issues have a natural place in the bioethics spectrum, even when bioethics is conceived narrowly in terms of human health. But a
complete understanding of these issues will require insight from all three legs of the agricultural ethics stool.

Paul Thompson holds the W.K. Kellogg Chair in Agricultural, Food and Community Ethics at Michigan State University. He is the author of The Spirit of the Soil: Agriculture and Environmental Ethics (1995), and a contributor to the National Research Council Report The Environmental Effects of Transgenic Plants (2002).