Column: Talking Precisely About Sensitivities

Aug 17, 2017

Credit Courtesy / Abe Schwab

A couple of weeks ago I was sitting in a Starbucks doing my work. As I sat there, a young couple got their drinks, but one of the drinks was made incorrectly. The whipped cream was not supposed to be there. 

The young woman noted that she couldn’t have the whipped cream because she had allergy. But then, to my horror, she said that it would be okay if the barista just scooped the whipped cream off. 

I don’t know this young woman and so I don’t know if she has an allergy or not. If she does, she was taking an unnecessary risk. My guess, though, is that she has a sensitivity and not an allergy. 

Here’s why I think this. When someone is allergic to a type of food, ingesting this food, even in small amounts, will lead to an auto-immune response. The remnants of the scooped off whipped cream could give her an allergic reaction. That is, her immune system would treat the introduction of this food (dairy in this case, but for others it could be peanuts, eggs, shellfish, etc.) as a threat to the entire body and kick in to overdrive. In the most life-threatening of scenarios, this could lead to anaphylaxis where the throat swells shut and the individual will die without the use of epinephrine (and sometimes dies even with its use).

A sensitivity, however, does not engage the immune system. Instead it involves the gastro-intestinal system. The body is unable to digest or process the food in question. Ingesting food to which one has a sensitivity could lead to intestinal discomfort and other gastrointestinal complications, but does not involve the auto-immune system. It’s understandable why this young woman, if she has a sensitivity but not an allergy, might be willing to risk small amounts of dairy. She might have some discomfort, but she doesn’t risk an anaphylactic reaction.

A small amount of food to which one is sensitive may lead to regret, pain, and discomfort, but a small amount of food to which one is allergic could be life-threatening.

I don’t know if this young woman was risking her health by allowing the whipped cream to be scooped off, but she might have been. Regardless, if she’s going to claim she has an allergy, she should have asked them to remake it. Otherwise, I worry that she sends the message that individuals who have a food allergy (rather than a food sensitivity) will be okay if they have just a little of the food they are allergic to, even though just a little could kill them. 

Abraham Schwab is a Fort Wayne associate professor of philosophy and medical ethicist.

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