Human Dignity and Bioethics

370 | Martha Nussbaum
government to push citizens into healthy lifestyles. I take issue with
him for the reasons given, reasons deriving from the equal respect we
owe to people’s choices of a comprehensive doctrine. 22
Although I reject Arneson’s argument, I myself make a significant
exception in the area of public humiliation. Here I observe that the
government could say to citizens, “If you pay ten cents, we’ll treat
you with respect. We’ll even give you the dime ourselves. But it’s
your choice. If you choose to use the dime for something else, we will
publicly humiliate you.” I say that offering choice in this area goes
counter to the entire purpose of the conception, for the whole idea is
that government should be showing equal respect to all citizens and
should offer humiliating treatment to nobody. Private humiliation
is a different matter, and I see no reason why government should
step in to prevent people from choosing a humiliating friendship, or
even marriage, short of recognized criminal violations. (Of course
to refuse to offer divorce on grounds of psychological humiliation
would make government an accomplice to the private humiliation
and would not be acceptable to me.)
All right, so what does this mean about health? It means that
the respectful government promotes health capabilities, not healthy
functioning. That is, it should make sure that all citizens have adequate
health insurance and access to good medical facilities. It should
also make sure that all citizens have access to healthy nutritional and
lifestyle choices, for example by focusing on building more parks and
recreational facilities in urban areas. It should also make sure that all
citizens have access to accurate health information. But it should not
penalize citizens if they prefer to live unhealthy lives. Policies that
would be supported by my program include bans on smoking in
public places, but only because of secondary smoke. They include the
extensive program of bicycle paths, underpasses, and sheds that Chicago’s
Mayor Daley has recently been constructing, many of them in
poorer neighborhoods, so that poor people can have what the rich
typically have already, access to the recreational facilities of the lakeshore,
and the ability to go to work on a bike. They include, further,
Mayor Daley’s deliberate construction of public parks that are interesting
and fun, so that people will actually want to go there and
walk around in them, rather than seeing them as boring displays of
opulence. And of course they include Chicago’s recent improvements