Diana Cárdenas

Physician and philosopher. She is the intellectual architect of the Vienna Declaration on the Human Right to Nutritional Care (2022) and the person who, more than any other, has carried the argument that access to nutritional care is a human right through the clinical-nutrition field, from the Cartagena Declaration of 2019 to the ESPEN Practical Guideline of 2026.

Training

• MD, Universidad El Bosque (Bogotá), followed by internal residency in Santa Fe de Bogotá.
• Master 2 in metabolism and human nutrition, Université Paris-Diderot (Paris 7).
• Master in political science and international relations, Université Lumière Lyon 2.
• PhD in philosophy, Université de Franche-Comté, Besançon, 2016. Dissertation: La nutrition en médecine : approche épistémologique, problèmes éthiques et cas cliniques, published in 2020 by L’Harmattan (Paris, 334 pages, ISBN 978-2-343-20974-6). PhD director: Corine Pelluchon, who works at the intersection of phenomenology of food, ethics of vulnerability and animal / environmental ethics. Cárdenas is one of very few clinicians in the world to have written a dissertation on the philosophy of nutrition under a philosopher of Pelluchon’s stature. The Pelluchon filiation is the philosophical spine of the human-right-to-nutritional-care programme.

The Pelluchon filiation

Corine Pelluchon (Université Gustave Eiffel, formerly Paris-Est Marne-la-Vallée) argues that the act of eating is not a private preference but a foundational relation to the world, to the body of another and to the living substrate of the body. From that starting point she has developed an ethics of nourishment (Les Nourritures, Seuil 2015) that reworks the phenomenological tradition of Levinas and Merleau-Ponty against liberal contractualism. Cárdenas is the clinician who has taken that philosophical apparatus into the hospital and into the guideline machinery of the clinical-nutrition societies. Whenever the Vienna Declaration invokes dignity, vulnerability, the sick body’s fundamental right to be fed, it is Pelluchon’s argument that is being deployed.

The Latin American formation

Before her Paris and Besançon years, Cárdenas trained and practised in Bogotá and taught at Universidad El Bosque, a Colombian university with a strong bioethics tradition and a specific commitment to nutritional education for physicians. She was later responsible for the bioethics programme at the UNESCO regional office for Central America, based in San José, Costa Rica. That regional-UNESCO passage is decisive: it gives her the direct working knowledge of the UNESCO Universal Declaration on Bioethics and Human Rights (2005), whose Article 14 (social responsibility and health) she later cites as the philosophical anchor of the nutritional-rights argument.

She is currently a researcher in the Nutrition Unit at Institut Gustave Roussy (Villejuif, the largest cancer centre in France) and a professor at Universidad El Bosque (Bogotá).

The Cartagena Declaration and the coordination role

In May 2019, at the XVI FELANPE (Latin American Federation of Parenteral and Enteral Nutrition) Congress in Cartagena, the Cartagena Declaration was adopted. It was coordinated by Cárdenas and it contains, for the first time in an official text, the formulation that will structure the entire subsequent chain: nutritional care as a human right, inseparable from the right to food and the right to health. Published in the Revista de Nutrición Clínica y Metabolismo 2019;2(Sup.):14-23. The Cartagena Declaration is the Latin American test bed. What Vienna 2022 does is to translate its formulation to the intercontinental level and to have it signed by ASPEN, ESPEN, PENSA and EFAD alongside FELANPE.

In 2020, Cárdenas creates the International Working Group for Patients’ Right to Nutritional Care, bringing together the four continental clinical-nutrition societies under her coordination. That working group is the institutional vehicle of the Vienna Declaration, of the 2021 position paper, of the 2023 formal publications, of the 2025 resource-limited-settings paper, and of the 2026 ESPEN Practical Guideline.

The 2021 position paper

Cárdenas D., Correia M.I.T.D., Ochoa J.B., Hardy G., Kondrup J., Bermúdez C., Bertrand L., Cuerda C., Van Ginkel-Res A., Remijnse W., Gramlich L., Furst P., Barrocas A., Ljungqvist O., Cederholm T., Barazzoni R. Clinical nutrition and human rights. An international position paper. Clinical Nutrition 2021;40(6):4029-4036. DOI 10.1016/j.clnu.2021.02.039. Co-published in Nutrition in Clinical Practice 2021;36(3):534-544.

This is the foundational theoretical text of the whole programme. It deploys the entire apparatus: the human-rights-based approach, the tripartite duty of the state (respect, protect, fulfil), the foundational documents (UDHR 25, ICESCR 11 and 12, General Comment 14, UNESCO 2005), a table of the normative content of the right, a table of duty-bearers, a table of the practical implications for the clinician. Sixteen co-authors. The Vienna Declaration of 2022 is the declaratory translation of this paper.

Cárdenas’s own words, from the paper, are the argument in condensed form:

Ethics and human rights are guiding values for clinical nutrition practitioners… Human rights are based on the powerful idea of equal dignity for all people while expressing a set of core values, including fairness, respect, equality, dignity, and autonomy (FREDA).

The 2026 practical guideline

Cárdenas D. (first author), Burgos R., Barazzoni R., Cederholm T., Correia M.I.T.D., Gramlich L., Hardy G., Ljungqvist O., Ochoa J.B., Wischmeyer P.E., Druml C. (last author), ESPEN Practical Guideline on Ethical Aspects of Medical Nutrition Therapy, Clinical Nutrition, 1 May 2026. DOI 10.1016/j.clnu.2026.106622.

This is the first time the human-right-to-nutritional-care formulation enters an ESPEN prescriptive guideline rather than a declaratory text. The 2016 ESPEN ethical guideline (Druml first author) had operated in the Beauchamp-Childress principlist framework alone. The 2026 update, with Cárdenas at the head of the authorship, keeps Druml in the anchoring last-author position but adds the human-rights layer as the guideline’s normative foundation. It is the moment at which the argument enters the clinical practice standard.

Editorial role

Cárdenas is the Editor-in-Chief of the Revista de Nutrición Clínica y Metabolismo (the journal of the Asociación Colombiana de Nutrición Clínica), position she has held since 2017. She is also Associate Editor of Clinical Nutrition ESPEN. Editorial control of the Latin American journal is one of the mechanisms by which the argument was consolidated in the Spanish-language literature before its intercontinental take-off in 2022.

Why she matters here

Three points.

First, on filiation. She is the only figure in 2026 who combines a medical qualification, formal training in political philosophy under a philosopher (Pelluchon) whose work is directly relevant to a rights-based reading of nutrition, hands-on experience of the UNESCO bioethics apparatus, and institutional leadership of the international nutritional-rights programme. The physiological-rights argument developed in this resource shares its philosophical spine with hers; that spine has a name, and it is Pelluchon.

Second, on the specific gap. Cárdenas’s argument stops at the level of “nutritional care” and “disease-related malnutrition”. It does not descend to the individual micronutrient, to the specificity of the reference range, to the failure of serum tests to detect tissue depletion, or to the twenty-year latency between the scientific establishment of a physiological requirement and its reflection in public dietary guidance. The physiological-rights argument developed here extends her framework by one order of biochemical resolution. The philosophical apparatus she has built is the one that this resource inherits and specifies.

Third, on the bridge that does not yet exist. Neither Tlaleng Mofokeng nor Michael Fakhri nor Alicia Ely Yamin nor Katharina Ó Cathaoir has cited the Vienna Declaration or Cárdenas’s 2021 position paper. The clinical-nutrition-rights argument and the UN right-to-food and right-to-health apparatuses have proceeded in parallel and have not yet met. The physiological-rights argument developed here is one of the routes by which that bridge can be built; Cárdenas is the first person to whom that bridge should be proposed.

Contact: Institut Gustave Roussy, 114 rue Édouard-Vaillant, 94805 Villejuif, France; Universidad El Bosque, Bogotá, Colombia.