More on health and virtue

[liv]

My post bouncing off the Alderman article has generated various bits of interesting discussion. The thread I want to follow further at this point is about the bold claim of the article title that There's no morality in exercise. yalovetz challenged that claim in a really thoughtful and interesting way:

No one is morally better than anyone else because of the amount of exercise they do. However, I, personally, am a better person for working out. I'm not better than anyone else, but I'm better as me-working-out than I am as me-not-working out. And that better does include a moral dimension [...] I feel like working out is a habit that allows me to develop many positive traits in myself - some physical, some intellectual, and some moral [...] it is a moral imperative for me personally, according to my own value system

I've been turning ideas round in my mind for a while about the idea of "being healthy", and how exercise fits as part of that. I think the core of it is that being healthy is often used to refer not to a state of being, but rather to (believed to be) correct actions which people may or may not perform.

Like, a young man who has no chronic conditions is probably quite healthy, in the sense that he doesn't experience any significant illness, pain or dysfunction. But if he smokes, spends most of his time playing video games, lives on a diet of nothing but fast food and takeaways, has no close relationships and is reticent to express emotions, etc, people would tend to describe him as unhealthy. And in some ways that's a shorthand for the fact that he has a high statistical risk of becoming unhealthy later in life, but that's only a probability. He's not performing what society generally holds to be the right actions in terms of diet, drug use, exercise, lifestyle and so on.

One of my posts I'm most proud of is this one on health and individual choice. It's rather telling that the post got a great reception here, but when somebody linked to it from Facebook there were lots of people in the comments who were very angry because they thought my principles would give people a justification to be lazy and unhealthy. I mean, in many ways that was exactly the point, I do think people are justified in being lazy and unhealthy. Or at least, they're justified in prioritizing their time and effort differently from the consensus of what's healthy. But the debate was another instance of the meme where there's assumed to be an obviously right, virtuous way to act and that's "healthy", and the only possible reason why someone would do anything else is because they're a bad person.

It's fairly clearly an overstatement of the case to say there's no morality in exercise. I'm not sure I believe there's any such thing as an activity which is completely morally neutral! But certainly, I do agree with yalovetz that if exercise makes you feel better and makes you better able to act rightly in the world than not exercising, then yes, it is morally better for you to exercise than not. I do hold that people have moral obligations towards themselves, and it's highly likely that exercise will in fact have long term health benefits for most people. But note that I started with a conditional: if exercise makes you happier and more virtuous, then it's morally right. I just don't believe this is universally true of exercise for everybody.

And I'm suspicious of the idea that exercise is moral because it's unpleasant. I mean, there's a false dichotomy between "doing regular exercise" and "sitting on the couch stuffing yourself with junk food and consuming mindless entertainment". Lots of people are not doing exercise because they're doing something else that either gives them more pleasure, or does more direct good in the world than working out. In those cases, excerise is not the moral choice. There absolutely are moral, including personal, benefits, in discipline. Setting up a habit of doing something regularly, even if it's less immediately appealing than something that does you less long-term good. But there are other ways to be disciplined other than doing exercise, and if exercise isn't in fact doing you long-term good, then why not get the benefits of being a disciplined, conscientious sort of person in some way that is directly beneficial as well? There's the question of opportunity costs which often gets left out of this sort of moral calculus as with economic planning: maybe in the abstract exercise is morally better than not, but it's not a choice between exercise and nothing, it's a choice between exercise and everything else you might be doing with that time, energy and money.

When I was discussing the Alderman post with jack, he came up with the excellent point that it's not so much that there's no morality in exercise, as that exercise is over-moralized in our current society. So in pushing back against that, people, including me quoting Alderman, can go to far in denying the moral component. Even if you accept that behaviours conducive to long-term health are always "right" behaviours, and that must be a priority in decision-making, well, lots of things contribute to health-related risk factors which are lot less moralized about than exercise (and not smoking and eating well). There are significant measurable health benefits to some form of regular meditative practice, whether that's overtly spiritual or not. But you don't get a lot of people on the internet pontificating about those terrible lazy people who don't pray or medidate regularly enough. One of the biggest factors in long-term health is having a strong intimate network, but making friends and building loving relationships can't be reduced to a simple formula like "spend 30 minutes five times a week doing aerobic exercise".

I expect someone like oursin would be able to explain this better than me (or find flaws in my analogy), but I am reminded of the fixation on hygiene in the nineteenth century. Yes, it's "better", both morally and practically, to be clean than not clean, personally and in terms of your habitation and environment. But there was an awful lot of handwringing going on a couple of generations back about how "The Poor" were dirty and unhygienic, and sometimes this was used to set up philanthropic programmes to help them be cleaner, but it was very much about how decent (ie middle-class) people are morally superior because of their better standards of cleanness. Without taking into account that it's a lot easier to be clean if you can afford to pay people to do the menial labour that cleaning takes and / or you have leisure time for focusing on fighting entropy, not to mention that if the only place you can afford to live is somewhere affected by industrial pollution, then of course you're going to be dirtier than someone who can afford to live in a more desirable place. It feels like there's a similar thing going on, those awful people over there are lazy because they don't "find time" to do regular exercise, and therefore their bad health is the fault of their bad habits. And not paying attention to the fact that if you're poor or disabled or have other systematic things going on, you have a lot less time and money available for said good habits.

So yes, I think in some ways exercise, and health-promoting behaviours in general, are moral. But it's not an absolute imperative to be healthy at the expense of absolutely everything else that moral people might care about. And actions that are statistically healthy might not be individually healthy anyway, and people might perform lots of healthy actions and still have bad health for reasons outside their control, but that's a different thing. I think it's very easy to fall into a Just World fallacy if you treat healthy behaviour as moral behaviour, though.

Comments

[redbird]

Like yalovetz, I think I am better as me for working out. But I'm not sure that has a moral dimension, unless we want to argue that any habit or situation that makes a person happy and/or healthy is intrinsically moral.

If someone is going to claim that working out is moral, either in general or specifically for me and Electricant, are they also going to claim that sleeping until I wake up, without using an alarm clock, is more moral than keeping a regular schedule in order to be at a job or class at a set time? I'm fairly sure that getting enough sleep is as valuable to my physical and mental well being as those sessions with the resistance machines.

Come to think of it, I could improve my statistically expected lifespan by doing something that would generally be considered self-indulgent: drinking about one glass of wine a day. I'm not avoiding it out of any idea of virtue in self-denial, or because tap water is cheaper: I just don't like wine. I am "avoiding" wine in the same sense as I am avoiding Brussels sprouts, and for similar reasons. But people who talk about food as moral tend to put sprouts and wine on opposite scales.

[liv]

Thank you, this is really interesting and thinky. I do feel that a lot of discourse about "healthiness" is implicitly relying on the assumption that habits that make you healthy are intrinsically moral, which is part of what I wanted to examine. I do take yalovetz's point though, that if your habit makes you not just happier but more able to do moral things, then that habit does have some moral aspects.

There's also a lurking idea that self-denial is intrinsically more moral than pleasure and indulgence, and your examples here connect to that false assumption. Honestly my impression of the evidence is that the health benefits of eating Brussels sprouts and drinking red wine are tiny enough that they mostly get lost in the statistical noise. So they're both a tiny bit better than neutral, health-wise, but you're right, there's a big difference in attitudes to the two foods.

Your sleeping naturally example is really interesting. I'd thought of putting something about sleep habits in my OP. I haven't actually run the figures on this, but it seems very likely to me that getting enough sleep and waking up in an unforced way, would have a pretty major beneficial effect on most people's health. But getting plenty of sleep is pleasurable, it isn't self-denial, so you rarely get health fanatics telling everybody that they should get more sleep, indeed quite the opposite, they're more likely to be extolling the benefits of getting up extra-early to exercise before work. So in isolation, I would say that sleeping naturally is better than forced waking, but in real life, for many people doing a job with fixed hours is also morally good, if only because it brings in the income they need to buy all the other things they need to be happy, healthy and productive. Same goes for exercise; in isolation, doing plenty of exercise may be better than being sedentary, but it might not be compatible with doing other things that are more important, whether that's jobs or whatever else.

[rmc28]

"getting enough sleep" is self-denial when you are going to bed early rather than doing other fun stuff, because you have to be up at a particular time. That's the other side of the health fanatic getting-up-early.

I think self-denial as something moral is about as shaky as "do something every day which scares you" - you have to be in a state where denial or fear isn't a feature of everyday life to start with to even consider it being a "good" thing to do.

[oursin]

Definitely yes on the issue about cleanliness - there was a strong moral element (working class women keeping a clean white apron to whip on when the district visitor knocked on the door!) - with a complex relationship to actually Doing Something about it like ensuring running water, indoor sanitation, etc, in dwelling places, or the provision of municipal laundries, bathhouses, etc. I forget who it was who riposted to the claim that it costs nothing to be clean, that soap, hot water, etc etc do not come free.

It is distressing to see still recurring the attacks on the food choices by the poor that were taken apart by The Fabian Women's Group in Round About A Pound A Week in 1913 - pointing out the constraints of resources (no running water, lack of storage, inadequate cooking facilities) and economic pressures (no good buying what was deemed healthy and nutritious if the children would not eat it).

Possibly related: Under my scholarly persona I once contributed a guest blog post on the similarities between early C21st obesity panic and C19th anti-masturbation mania.

Cleanliness

[(Anonymous)]

My late Mother was a community physician in Toxteth, Liverpool in the 1950s to 1970s. (For those who don't know the city, much of the housing of central Liverpool at that time which had survived the blitz was Victorian slums.)

As a doctor, my Mother always maintained that the rubbish collectors made a far greater contribution to public health than she did.

Southernwood

[nicki]

I think we spend too much time trying to enforce our personal opinions on others by framing them as a question of morality and that this creates a massively unhealthy society that is full of judgement, anxiety, cliques and exclusion. Do you feel better if you get some exercise? probably. Do you feel better if you perform other preferred leisure activities? probably. Do they sometimes interfere with each other? probably. My opinion is that framing exercise as a moral choice probably creates more problems than it solves.

[slashmarks]

I think the tendency to use disease as a metaphor for evil, and then at times forget that it's a metaphor, may come into play here. (There are various metaphors about the contagion or spread of evil or immoral behavior and corresponding reactions, and then there's the tendency to claim that taboo behaviors like sadism, or whatever else your society says that Normal People Don't Do, are a sign of mental illness and medicalize them.)

I definitely don't think that exercise can be said to be a 'moral' choice; it could theoretically be part of a moral choice, but only in the sense that pretty much anything that has consequences could theoretically be part of a moral choice. Then again, I also don't believe that taking care of yourself is a moral obligation; I think it's a very good idea, but I generally hold that people have the moral right to do whatever they want to themselves.

[naath]

Well, if you chose to, say, exercise by chasing down endangered animals on foot an then wrestling them to death... that would probably be an immoral choice. And of course perhaps choosing to spend my time (a lot of it) and money (no-negligable amounts) on my running hobby rather than, say, donating to an effective charity is also an immoral choice. I'm sure morality is not totally separate from these choices.

I agree though that the consequences of my actions *to my own health* do not have a moral dimension; it's my health and I think I should be able to choose how I risk/enhance it. I don't think I'm "morally obligated" to live as long and as healthily as possible (and even if I *was* then "as possible" is a different value for different people and different people find different things health-increasing).

I think running is fun. If I didn't I wouldn't do it. If other people think it's not fun then *more race entry places for me* is IMO a much better way to look at it :)

[slashmarks]

Yeah, that's what I meant when I said "any actions with consequences." Of course there are ways to exercise which can be immoral (exercising by beating random people up, say) but that's fairly separate from the question of exercise by itself being moral/immoral.

I think the question of whether the opportunity cost, where exercising is something you're doing instead of something actively good, is somewhat more interesting, but this is where taking care of yourself comes in. On a pragmatic level, people who don't do anything other than working towards the Cause, whatever that cause may be, burn out and become less effective. In any case, I don't exactly think that's the question of exercise specifically being moral. You could fill that time you aren't working towards the Cause with a lot of things. So again, it's not really about exercise.

[davidgillon]

I inevitably come at this from the disability perspective, with two patterns of behaviour sticking in mind.

The first is the tendency of people to see obesity as a cause of ill health or disability, rather than the consequence it generally is (and I heard about an absolutely appalling example of this from a care worker to a disabled person just this week). The reality is illness and disability, and the drugs we use to treat them, can cause people to very quickly pile on the pounds, I was gaining two pounds a month from the moment my GP made me switch to gabapentin, as soon as I stopped taking it I started losing two pounds a month, all with no other changes in my situation, and this is by no means an unusual experience.

The second is the tendency of the obesity-fanatics to aggressively police the perceived behaviour of other people, with one particular bugaboo being their attempts to establish using lifts or escalators as 'unhealthy' (and therefore morally deviant), with a prime example being a conference of obesity health specialists in Singapore last year that had the brilliant idea of turning off the lifts and escalators between sessions. Let's just say they didn't plan on being hammered by disability rights activists from around the world.

The interaction of these two things mean that disabled people often find themselves being painted as the architects of their own disability, and morally reprehensible, because of the limitations their disability imposes. We see this whenever obesity is brought up as a limiting factor in access to surgery, there was an example from North Devon PCT (or CCG?)with respect to knee surgery just a few months ago. Now given any knee specialist knows that any patient immobilised by needing knee surgery and on steroids in the meantime is going to be piling on the pounds for two separate reasons, we have to realise that there is actually more going on here, and that the reality is medical bureaucracies, under budget pressure, are choosing to impose an unjustifiable barrier on access to surgery, in order to artificially restrict the number of patient they are treating, and are painting the patients themselves as morally deficient in order to justify it and cover up their own culpability for what is really happening.

Given that reality, I tend to consider labeling exercise as morally virtuous, even when done with the best of intentions and not meant for general application, as reinforcing negative behaviour among the wider populace and inherently dangerous to disabled people.

[silveradept]

There are a lot of ways that we land in that particular fallacy when we start ascribing morality to actions to things that aren't necessarily moral on their face. Unsurprisingly, it tends to happen when we start imposing our morals on others. Which is a lot of where the talk about exercise comes from a position of.