Public health ethics

Public health ethics is the branch of bioethics that is concerned with behaviours and policies affecting not only (or even not primarily or not at all) the health of any single individual, but also (or even primarily or indeed exclusively) the health of third parties or of the collective.

Public health ethics is about ethical values and ethical principles that should inform individual behaviour as well as collective and institutional action. These are often necessary to achieve certain public health goals, such as herd immunity against certain infectious diseases, or slowing down antibiotic resistance, or containing certain diseases by isolating infected individuals, or preventing diseases resulting from lifestyle choices such as tobacco and alcohol consumption. Thus, from a philosophical perspective, an important part of public health ethics concerns the mutual relationship between individual, collective, and institutional responsibilities for the health of the public.

Ethical values and principles that are relevant to public health ethics include, but are not limited to, promotion of overall wellbeing, individual liberties (e.g. in the form of parental autonomy), fairness, responsibility for health, and reciprocity. Tensions between these different values and principles give rise to some of the distinguishing questions of public health ethics, such as: what level of coercion may a state permissibly enforce to protect the health of the public? How should the burdens and benefits of public health promotion be distributed? Should individuals be compensated when they sacrifice some of their personal interests or rights for the sake of public health? Should responsibility for behaviours that are detrimental to one’s health or to public health affect allocation of scarce health resources?