Ecological health and new frontiers for public health ethics

Today there is an ecological turn underway in the study of environmental health. Historically environmental health has focused on dangerous pollutants, but today broader perspectives on the relationships between health and the natural environment are emerging. Increasingly, health hazards come from multiple factors that undermine the functioning of complex holistic natural systems. For example, there is a growing awareness of the health effects of global climate change, a process that involves much more than atmospheric carbon dioxide “pollution.”

This paper will focus on this ecological turn and its implications for the study of public health ethics. It moves away from an individualistic human-centered perspective in which the environment is understood as an instrumental backdrop for human health. It is a turn toward a relational perspective in which the natural (and built) environment is understood as a context of complex systems, from which human behavior and health emerge.

The implications for public health ethics are significant. The stage and field of ethical agency and responsibility is shifting. If the conditions that undermine health and that promote it are systemic, institutional, and fundamentally global in scale, then an ethical response to these conditions cannot be focused on individual behaviors operating on local or small regional scales. Ethical theory is only beginning to develop systematic and global accounts of justice, cosmopolitan rights, and intergenerational obligations. Public health ethics—in tandem with bioethics and environmental ethics—can contribute to and draw from this innovative new form of theorizing.