Tuesday, August 26, 2014

Sin in the Secular Age: Smoking and Obesity

The Judeo-Christian concept of sin is an offence against capital-G God. It is going against His will or plan for us human beings. Some sins are considered minor (venial sins), others are major (mortal sins), but any type of sin carries with it not only consequences in this life, but in the life hereafter. Unless, of course, the sinner is sufficiently repentant, and in the cases of some religious sects, adhering to the correct faith.

We who hold a secular worldview today scoff at the concept of sin, and for a few good reasons.

First, while many behaviors traditionally regarded as sinful do harm (such as lying and stealing) others are not necessarily harmful and might even be beneficial to a person's well-being (such as having healthy sexual relationships outside of marriage.)

Second, inherent in the concept of sin is an additional punishment for supposed misdeeds. It is not enough that lying carries the risk of being caught and not trusted in the future, or that those who steal risk trial and punishment by law enforcement. There must also be the threat of either extra time in purgatory, or eternal torment in hell.

Third, the concept of sin tends to glaze over the reasons behind peoples' misdeeds and focus on punishment. Sin easily goes from being a verb (something a person capable of good or evil has done) to the noun sinner (a person whose fundamental nature is wicked.) When this happens, anger, righteousness and condescension trump humility and compassion. Punishment is emphasized over prevention or more constructive ways to modify harmful behaviors.

The thing is, these problems with sin are not exclusive to those of Judeo-Christian faith. Just as many people of faith emphasize compassion and forgiveness over self-righteous judgement, many secular people have adopted a sort of secular concept of sin.

One example of this is rising premiums on health insurance for smokers. The trend began a few years ago, and the Affordable Care Act does nothing to stop it.

All the problems with sin are present: These measures punish all smokers, even those who smoke in moderation and/or who suffer from no health problems directly connected to their smoking. It adds punishments in addition to the possible ill-effects of smoking (which disproportionately impacts those with lower income, who I might add are those more likely to smoke and have more difficulty quitting.) And instead of addressing the root causes of tobacco addiction and finding non-punitive ways of helping addicts who want to quit do so, it simply punishes them, hoping that these additional punishments will be the deterrent that finally works.

Let's look at a second, similar example: The rising cost of health insurance is driving many companies to pressure obese employees to meet arbitrary weight-loss goals and into participating in often humiliating weight-loss programs. Again, the Affordable Care Act does nothing to stop this discrimination against the obesity in the workplace.  

And again, all the problems with sin are present: These measures punish all (and only) obese people, regardless of any individualized assessment of their health and lifestyle, and while ignoring those who are thin but unhealthy for other reasons. It adds punishments in addition to the possible health problems that disproportionately impact many obese people (not to mention the social discrimination obese people face because they are outside mainstream measures of attractiveness.) Instead of addressing root causes of diseases correlated with obesity (such as diabetes and heart disease), it burdens and shames an entire class of people, hoping that will change their behavior and that those hypothetical changes will yield desirable outcomes.

Smokers and the obese do not need more arbitrary consequences from employers and health insurance companies. Either they are perfectly happy with their behavior choices, or they are not and already have enough motivation and challenges for modifying their behavior. In the case of the former, bug-off because we all have our personal indulgences which are nobody's damn business. In the case of the latter, people need encouragement when and from whom they request it.

While all of our day to day choices will never be 100% in line with our personal goals and values, we can always strive toward personal improvement. The benchmarks are different for different people based on circumstances. Not everyone's values are identical nor should they be. Knowing how much a person smokes or drinks or how much he or she weighs does not give a measure of how hard he or she is working toward personal improvement.

Perhaps some of you reading this post think smokers and obese people should be further punished for their behavior, either because their transgressions deserve it, or you are convinced (despite evidence to the contrary) that shaming people actually works. If that is the case, I implore you, go hang out with the Religious Right where you belong.

4 comments:

  1. I need to think deeper on this, but i think this may be conflating shaming with assessing risky behavior. Another example might be charging motorcyclists higher health care premiums, and those who choose to motorcycle without helmets even higher premiums. Can i hang out with progressive peeps while i consider the complexities..please!

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  2. Brian, are you suggesting that society at large can adequately assess an individual's behavior and deem it unacceptably risky and therefore needing additional, institutional consequences based on whether they smoke, their BMI, whether they ride of motorcycle, or wear a helmet while riding it?

    While you are thinking about that, ask yourself why are any of these factors up for singling out? Why aren't we suggesting a whole genetic and lifestyle assessment to determine cost of insurance and/or care? Does it matter that singling them out tends to put a greater burden on a poor and working class? And does it matter that in the case of insurance premiums, such policies provide a huge incentive for people to commit fraud by lying on insurance applications AND WORSE, to lie to their doctors.

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  3. On the motorcycle thing, so would a person's driving record matter? If so, will we look into the details (since in many motorcycle accidents involving a car, the driver of the car didn't see the motorcycle because the didn't expect to see one, and are more at fault.) How about their age (since statistically younger people are more likely to get in accidents.) How about their sex (since statistically men are more likely to get in accidents.) Should the fact that motorcycles are economical and more ecological (low emissions) be somehow factored in?

    You see how this can quickly start to spiral into something so complex, and no matter how many more elements we factor in to make it more fair and exact, we're still screwing over someone who doesn't really fit the offending profile and leaving out those who do. And we're also still adding additional punishment onto something that already had inherent risks that are taken into account by the person engaging in the behavior.

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  4. Complex indeed! We can agree upon that for sure.

    Foremost, I am convinced that Universal Health Coverage (single payer) is the best path for our nation and the world. Given that position, much of our disagreement is moot.

    Alas, we live in a world which does exact an economic price for choosing risky behaviors already. And so cigarettes are taxed, and should be taxed higher to fund said Universal Health Care! Perhaps junk food should also be taxed.

    Yes, this amounts to some level of social engineering. I think we want our leaders to implement sensible and cautious positive social engineering, and it's up to us to ensure it doesn't become a darker kind of social profiling.

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