In an interesting article, Mark Bittman, food writer for the New York Times, discusses a new book Nicholas Freudenberg, “Lethal but Legal: Corporations, Consumption, and Protecting Public Health.”
The article (and presumably the book, though I haven't read it yet) lumps together several major industries that use a similar framework to justify behaviors that inevitably result in worse public health outcomes. The industries - tobacco, food and beverage, alcohol, guns, pharma, and automotive - use a paradigm of "rights" to counter any assertions that they share responsibility in the widespread adoption of behaviors that are unhealthy (such as smoking).
It's an interesting article and one that I find particularly interesting in light of some conversations about ethics I've recently had with my students. We have been talking about which people might be most likely to be turned off by various public health promotion messages. For example, in discussing campaigns to get people to eat healthier, we have been talking about how shaming tactics may galvanize some people to change their behaviors, but that for others, particularly those who already experience marginalization based on multiple aspects of their identity, shaming tactics are unlikely to prompt behavior change and perhaps more likely to increase dysphoria and a sense of hopelessness.
Bittman's take on this book is centered on the food industry (which makes sense as he's a food writer) and the efforts that food and beverage corporations take to manufacture and market highly addictive and unhealthful food. In a NYT magazine article from about a year ago, The Extraordinary Science of Addictive Junk Food, the back room discussions that have led to some of these decisions were compellingly described. What I am concerned about from a public health standpoint is this pervasive use of "rights" language, when human rights can never be divorced from social protection and status.
In my work with former child soldiers, recently discussed in this beautiful article by Jean Friedman-Rudovsky in the Telegraph, it was clear that women did not feel entitled to access structures to protect their human rights until they felt social acceptance. For example, one woman shared how she had been beaten badly by her boyfriend. While the law protected her, she felt that she could not go to the police because the police would target her because of her past history. It was only after she had gained social acceptance in her community that when another incident occurred, she felt able to speak not yet to the police, but to the local chief who listened to her story and negotiated a settlement between her and her partner. Years later, perhaps she would go to the police. But change like this was incremental. So the "rights" may have been legally endowed, but because of her status and relationship with those who share the obligation to protect rights, she was unable to exercise her rights.
So when corporations that make guns or that sell cookies and soda talk about rights, I always wonder whose rights they are talking about? They say the rights of the consumers, but they mean corporate rights to sell what they want and earn as much money as they can. And whether those who are already likely to suffer worse health in our society because of our unjust history or because of continued social exclusion evident in all domains of our society are the ones most likely to consume these unhealthful products, who has the obligation to protect them? I guess that's where public health comes in.....