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SarahC comments on Diseased thinking: dissolving questions about disease - Less Wrong
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I like this because it dissolves the question quite effectively. I'm not sure the question should be dissolved, though ... what about the sister?
This is why I'm not a consequentialist all the way. We may regard it as obvious that cancer is undesirable, but there really may be some who disagree. There are some who disagree that obesity is undesirable. There are some who disagree that depression is undesirable. Health is one issue where most people (in our society) are particularly unlikely to take account of differences in opinion.
Praise and blame are not just alternate possible ways to treat a disease. Example: I personally think obesity is undesirable. If I know an obese person who's happy that way, though, I wouldn't dream of trying to "treat" her, because it's none of my business. Yet I'm still curious to what extent she's "blameworthy" or personally responsible. Judging someone's blameworthiness or praiseworthiness doesn't necessarily result in trying to improve her behavior; it has to do with what opinion I hold of her.
That's a libertarian deontologist view, yeah, but it's close enough to ordinary behavior that I think we should consider whether it's completely unreasonable.
Eating and survival are fundamental functions of life. Someone whose regulatory systems are so out of whack that they are eating/fasting themselves into an early grave, is probably subject to control dysfunctions which have inbuilt advantage over intellectual or social control.
Also, punishment is the trickiest of all behavioral modification techniques. It is very likely to backfire, which makes perfect sense. If punishment was very effective on a given individual, he/she would be a perfect slave. Being a perfect slave isn't so great from the perspective of the slave, though it is good for the master. Since human biology doesn't make it easy for a large population of slaves to be related to a master, it makes perfect sense that we'd evolve defenses against punishment.
For what it's worth, a member of my band is morbidly obese. He has taken extraordinary measures in terms of effort to lose weight. (Eschewing use of a car in Houston and walking everywhere instead.) His condition is not voluntary.
My point was not that obesity is voluntary, but that it's worth asking whether or not it's voluntary. I don't think you and I disagree, because you made the point that your band friend's condition isn't voluntary.
Yvain's post argues that such questions are not important. I think they may be.