New salt in a restaurant industry wound

Distribution of estimated usual intake of sodium (mg/day) among U.S. adults, by hypertension status* — National Health and Nutrition Examination Survey, 2009–2012

Scenario

The restaurant industry will have to stay salty about a New York City mandate imposed on high-sodium items on menus. An appeals court has affirmed that the city’s mandate — which requires menus to stick a salt-shaker symbol next to dishes that contain more than a day’s worth of sodium — was legal and well within the limits of the health department’s authority. The restaurant industry said that the menu symbols violated their right to free speech and could run the risk of confusing customers. The recommended daily limit of sodium is 2,300 mg. The CDC has estimated that around 90 percent of Americans, both adults, and children, take in too much sodium.

Reference: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6452a1.htm

Section 1

  1. Discuss the ethics of why the government should enact rules to safeguard society (even when society doesn’t know it needs protecting?)
  2. How does this mandate impinge on the restaurant industry’s right to free speech?
  3. How does this mandate impinge on the customers’ right to free speech?
  4. List some other stakeholders in this issue: 

Section 2

  1. Is the restaurant industry saying that an ignorant customer is better than a confused customer? Explain
  2. Why might a confused customer reading a menu with the suggested symbols be better than an ignorant customer? Explain
  3. How is giving subjects amounts of salt that could harm them, different from infecting people with malaria to find a possible cure?
  4. Which of the four behaviors is the restaurant industry showing?

Section 3

The American Heart Association recommends 2,300 milligrams a day and for people with high blood pressure 1,500 milligrams. BUT the average consumption in the U.S. is 3,500 milligrams a day. In an experiment, subjects would be given a range of salt from low to high (probably more than 3,500 mg/day.

  1. Is it ethical to give test subjects an amount that is likely to induce adverse health effects due to salt intake?
    1. It is ethical because:
    2. It is not ethical because:
  2. How else could we run the test to show the effects of high salt intake on humans?

Section 4

  1. Why might a population composed of prisoners be better for a study than a group of randomly selected individuals from the general population?
  2. Which would be an ‘inherently coercive environment’?
    1. Tell why.
  3. What safeguards should be part of the study?
  4. How should the results of the study be used?