198279 Paul Farmer frenzy: Praising the privileged to the detriment of global health?

Monday, November 9, 2009

Woods Nash, MA, MPH , Department of Philosophy, University of Tennessee, Knoxville, TN
In public health circles in the United States, Paul Farmer's moral stature is unparalleled. His esteemed position is due largely to both his strong scholarship and the groundbreaking work of Partners in Health (PIH), Farmer's organization described dramatically in the bestselling narrative Mountains beyond Mountains. There is little doubt that Farmer and PIH have done important work, from improved sanitation and health education to prevention and treatment of both tuberculosis and HIV/AIDS for thousands of people in various impoverished regions. Nevertheless, might there be cause for worry about Farmer's esteemed status and the ambitions that he inspires in U.S. public health students, practitioners, and policymakers? Farmer and popular acclaim for him fit neatly into an old and influential moral mythos—namely, that of the hero-descent of the Buddha and Jesus, of the privileged one who humbles to heal the masses. In contrast, without an influential mythos of what might be called the hero-at-home, the indigenous physicians, nurses, and other public health workers who labor alongside Farmer largely escape widespread notice and praise. What are the consequences of this selective moral attention? For example, in a sad irony, might Farmer's embodying the mythos of the hero-descent sometimes perpetuate the dependent status of the poor—a status that Farmer, of course, wishes to eliminate—insofar as the hero-descent discourages the poor from helping themselves in ever greater ways? If so, what might Farmer and his ilk do differently to contribute to the creation and elevation of the hero-at-home mythos?

Learning Objectives:
Describe the moral mythos of the hero-descent and the ways in which it informs our praise for Paul Farmer and his colleagues. Discuss ways in which the hero-descent mythos might perpetuate the dependent status of poor indigenous recipients of public health interventions. Identify strategic changes in public health practice that might contribute to the elevation of a hero-at-home mythos that could partially supplant that of the hero-descent, thereby averting the perpetuation of the poor's dependent status.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In addition to my having earned an MPH, I am a PhD candidate in Philosophy (with a concentration in clinical and public health ethics). I also have global public health experience in Haiti, Tanzania, and Cambodia.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Ethics SPIG Poster Session
See more of: Ethics SPIG