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Edge Express: A Balancing Act - Protecting Your Clients with Food Safety and Professional Ethics

By Jessy Sadler, SNS

This Ethis Connection CE article appeared in the 2024 April issue of Nutrition & Foodservice Edge Express. To view a PDF of this article click HERE.

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A Balancing Act: Protecting Your Clients with Food Safety and Professional Ethics

By: Jessy Sadler, SNS 

THE FOOD SYSTEM IS COMPLEX; not only does it affect the well-being of people’s lives, but also the organization itself. It encompasses the entire food chain—from operation management and personnel, to food production and consumption.

Food safety is a constant balancing act and when it comes to guidelines, there is no gray area. Research estimates that approximately 9.4 million foodborne illness episodes in the United States were caused by 31 major pathogens in 2006 (Scallan et al.). Government agencies play a big role in being responsible for providing the regulatory parameters, oversight, and infrastructure necessary to create, enforce, and maintain a safe and secure food system. Developed by the U.S. Food and Drug Administration, the FDA Food Code serves as the blueprint for food safety in the United States. This comprehensive framework establishes a set of guidelines and regulations that food establishments must follow to ensure the safe handling and preparation of food. While following best practices and adhering to regulations are crucial to ensuring a safe operation, navigating the complexities of determining what is ethically right or wrong in food production can be just as important.

In the legal context, according to the Legal Information Institute, an independently-funded project of the Cornell Law School, ethics is defined as how individuals choose to interact with one another. In a philosophical context, ethics defines what is good for the individual and for society. Simply stated, it’s a set of moral principles, values, and beliefs that guide an individual’s behavior.


In today’s fast-paced and ever-evolving world, food establishments and operations—including restaurants, grocery stores, and manufacturers—encounter a range of ethical decisions that may fall in that “gray area” when facing challenges and when making decisions to improve their processes and efficiency. However, the reality is that food safety is only as strong as its weakest link. This means that even when regulations are in place, ethical considerations arise when someone chooses shortcuts or ignores safety protocols.

What follows are a few scenarios you could face in your foodservice operation. Test your professional ethics IQ by choosing the best way to manage each situation.

Scenario 1: Beyond Appearance

The kitchen at Happy Haven Assisted Living is closed for the evening, but 96-year-old Mr. Garcia, who has a sweet tooth, has been asking for a snack. Jessica, a certified nursing assistant, decides to get him one.  As she reaches for his usual vanilla-flavored yogurt cup in the refrigerator, she notices the “use-by” date was four days ago.  Even though it looks and smells totally fine, should Jessica prioritize the resident’s immediate preference and serve the yogurt that appears acceptable, or should she not take a chance and discard the expired food, potentially causing frustration for Mr. Garcia?

Violation:  Serving food past its “use-by” date to a high-risk patient.

Food safety is top priority in every foodservice setting, but it becomes absolutely essential when serving a highly susceptible population. These individuals are more likely to experience serious complications from foodborne illness due to their age or underlying health conditions.

The 2022 Food Code identifies several groups as highly susceptible populations:

  • Immunocompromised individuals: those with weakened immune systems due to illness, medication, or medical treatments.
  • Both preschool-aged children and older adults: who have either developing or weakened immune systems.
  • Individuals in healthcare settings: anyone receiving services at facilities such as hospitals, nursing homes, assisted living centers, or kidney dialysis centers.

The Food Safety and Inspection Service (FSIS), an agency of the U.S. Department of Agriculture, is responsible for ensuring that meat, poultry, and egg products are handled, packaged properly, and correctly labeled. The FSIS states that the Use-By date is the “last date recommended for the use of the product while at peak quality” (Food Product Dating).  While the food might appear fine visually and by scent, after this date, the risk of foodborne bacteria multiplying rapidly increases. For a healthy person, a foodborne illness might cause mild discomfort. However, for someone with a weakened immune system, the consequences can be far more severe which can lead to hospitalization, delayed recovery, or even life-threatening complications.

Scenario 2: The Pressure to Please

John, a grill cook at Sunshine Retirement Home, is grilling some burgers for lunch.  Helga, an 85-year-old resident with a twinkle in her eye, leans forward and asks for her burger to be “nice and pink,” just how she likes it.  John hesitates for a moment but knows Helga has always ordered her burger rare. Even though he learned about the importance of cooking foods to their safe minimum internal temperatures, he wants to fulfill her wishes; he also remembered that Helga is undergoing cancer treatment. Can John satisfy Helga’s preference while prioritizing her safety?

Violation: Disregarding safe minimum internal cooking temperatures for at-risk patients.

According to the 2022 Food Code, cooked ground beef, regardless of preference, must reach a minimum internal temperature of 155°F (68⁰C) for at least 17 seconds to ensure the destruction of harmful bacteria like E. coli.  This is especially crucial for patients like Helga, who has a compromised immune system due to her age and cancer diagnosis.  Consuming undercooked ground beef significantly increases her risk of developing a foodborne illness, which could be life-threatening in her case. While respecting patient preferences is important, it cannot override their safety. Healthcare foodservice professionals have a responsibility to ensure the food they serve is safe for consumption, especially for vulnerable patients. Restaurants, on the other hand, may offer customers an option to order their burgers based on their preference; however, they are required to provide a consumer advisory to inform customers of the potential risks associated with consuming undercooked ground beef.

Scenario 3: More Than Just a Preference

It’s Saturday morning at Rise & Shine Bakery and Sara is rushing through breakfast orders when eight-year-old Josh makes a specific request: “A bagel with cream cheese, but hold the seeds please.” With a friendly smile, she inquires about a potential sesame allergy, and Josh nods in confirmation. Faced with a dilemma, Sara momentarily considers scraping off the seeds as the bakery just ran out of plain bagels. “Maybe just a few won’t hurt,” she thinks. However, she recalls in her food allergy training the potential gravity of a life-threatening allergic reaction. Should Sara take a chance and risk a potentially life-threatening allergic reaction or prioritize customer safety?

Violation:  Failing to accommodate a declared food allergy.

As of January 1, 2023, sesame was officially declared as the ninth major food allergen and must be labeled on packaged foods in the United States. According to a cross-sectional study, findings using self-reported surveys estimated that approximately 1.1 million people in the U.S. are affected by a sesame allergy (Warren et al.).

Foodservice professionals have a responsibility to take customer allergies seriously, regardless of age. Even a tiny amount of an allergen can trigger a serious reaction. But the danger isn’t limited to just what’s directly in a dish. Cross-contamination, the unintentional transfer of allergens from one food to another, can pose a hidden threat. Foodservice staff should be well-trained on recognizing and accommodating food allergies. This includes understanding the severity of potential reactions and the importance of avoiding cross-contamination. Disregarding Josh’s allergy could have serious consequences for his health.

Scenario 4: The Exhausted Chef

PrairieSun Manor, a healthcare facility known for its warm atmosphere and hospitality, is hosting its annual lunch catering on Wednesday for their own residents, along with residents from their neighboring sister-facility: a combination of post-surgical patients recovering from delicate procedures and elderly residents on specialized diabetic or low-sodium diets.

It’s early Wednesday morning, and Jessica, the dietary manager, receives a call that throws off her entire day.  Marcy, their only cook available for the crucial midday shift, has just tested positive for COVID-19 after a few days of sniffles, sinus drainage, and a mild fever.  With springtime weather changes, she assumed it was just allergies. Thinking of how the facility is already short-staffed, should Jessica ask Marcy to come in with a mask on just for a few hours or have her call in sick?

Violation:  Knowingly allowing a sick employee to handle food preparation.

People who are sick can easily spread bacteria and viruses to food through coughing, sneezing, or simply touching contaminated surfaces.  This can lead to foodborne illness in people who consume the contaminated food, especially highly susceptible populations.

The FDA Food Code established guidelines for safe food handling, specifically addressing the exclusion of food employees who exhibit symptoms of illness that can be transmitted through food.  Common symptoms that would trigger exclusion include:

  • Vomiting
  • Diarrhea
  • Fever
  • Jaundice (yellowing of the skin or eyes)
  • Sore throat with a fever (especially for those handling high-risk foods)

Foodservice facilities have a responsibility to protect public health by ensuring safe food handling practices.  Allowing a sick employee to prepare food creates a significant risk of illness outbreaks and could have serious consequences. Ignoring health department guidance and permitting a sick employee to handle food is a clear breach of this ethical obligation. While staffing shortages are a challenge, following these guidelines is crucial for maintaining a safe and ethical foodservice environment.


These example scenarios highlight the ethical complexities of food safety. There’s often a balancing act between convenience, cost, and potential consequences.  By understanding the ethical considerations, you can make informed decisions that prioritize the well-being of others and yourself.

The Food Code sets clear guidelines for hygiene, proper food handling, and preparation of food. It also sets clear protocols to prevent foodborne illnesses by covering aspects like safe food handling, storage, and temperature control. By following these guidelines and with continual staff training, food establishments can significantly reduce the risk of foodborne pathogens, helping to ensure safe food consumption.

Adhering to the Food Code goes beyond compliance. Would you serve this food to your family? This simple question emphasizes a crucial point: It’s about prioritizing every customer’s well-being and upholding ethical standards within the food industry. Using the scenarios in this article as a learning tool, determine what training methods can be implemented to better equip your staff with skills to make informed, ethical decisions regarding food safety in their daily work routines.

About the Author

Jessy Sadler, SNS

Jessy Sadler has worked in school food service for eight years and is currently the Nutrition Director in Urbandale, Iowa. She holds a School Nutrition Specialist (SNS) credential with a Master’s Degree in Nutrition Science from Eastern Michigan University and a B.S. in Nutrition and Dietetics with a minor in Wellness from Bradley University. Sadler is a certified ServSafe Instructor and Proctor, and provides food safety training to many professional groups such as schools, restaurants, and healthcare facilities.