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对含糖饮料征税以改善公众健康的伦理问题。

The Ethics of Taxing Sugar-Sweetened Beverages to Improve Public Health.

机构信息

Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom.

Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.

出版信息

Front Public Health. 2020 Apr 16;8:110. doi: 10.3389/fpubh.2020.00110. eCollection 2020.

Abstract

The World Health Organization highlights fiscal policies as priority interventions for the promotion of healthy eating in its Action Plan for the Prevention and Control of Non-communicable Diseases. The taxation of sugar sweetened beverages (SSBs) in particular is noted to be an effective measure, and SSBs taxes have already been implemented in several countries worldwide. However, although the evidence base suggests that this will be effective in helping to combat rising obesity rates, opponents of SSBs taxation argue that it is illiberal and paternalistic, and therefore should be avoided. Bioethical analysis may play an essential role in clarifying whether policymakers should adopt SSBs taxes as part of wider obesity strategy. In this article we argue that no single ethical theory can account for the complexities inherent in obesity prevention strategy, especially the liberal theories relied upon by opponents of SSBs taxation. We contend that a pluralist approach to the ethics of SSBs taxation must be adopted as the only suitable way of accounting for the multiple overlapping, and sometimes, conflicting factors that are relevant to determining the moral acceptability of such an intervention.

摘要

世界卫生组织在其《预防和控制非传染性疾病行动计划》中强调财政政策是促进健康饮食的优先干预措施。特别指出,对含糖饮料(SSB)征税是一项有效措施,全球已有多个国家实施了 SSB 税。然而,尽管有证据表明,这将有助于遏制肥胖率的上升,但 SSB 税的反对者认为,这是不自由和家长式的,因此应该避免。生物伦理分析可能在澄清政策制定者是否应该将 SSB 税作为更广泛的肥胖策略的一部分方面发挥重要作用。在本文中,我们认为,没有单一的伦理理论可以解释肥胖预防策略中固有的复杂性,尤其是 SSB 税反对者所依赖的自由理论。我们认为,必须采用 SSB 税的多元伦理方法,因为这是唯一合适的方法,可以说明与确定这种干预的道德可接受性相关的多个重叠且有时相互冲突的因素。

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