Public Health Ethics as a Bridge Connecting Bioethics, Public Health, and the Environment

Public health ethics in the United States emerged from bioethics in the 1980s as a result of concerns outside the individual-and-provider relationship, such as organ transplantation, community-based prevention strategies, environmental influences on health, and increasing sensitivity to justice in health.  The field distinguished itself from clinical or medical ethics based on its broader focus on the determinants of health.  From 1980 through 2014, interest in public health ethics as a distinct field has gained traction as shown by the nearly 3800 articles published in the past 35 years.  In the medical and public health literature there was one article published on the topic of public health ethics in 1980, 403 in 2008, and approximately 200 in 2014.  Since the turn of the 21^st century, the fields of medicine and public health have begun to reengage with each other.  The wisdom of seeing an individual as more than a sum of their parts, of recognizing the financial and health gains stemming from prevention, and the recognition that our context—literally our environment—has an impact on our health across the lifespan, has led practitioners and ethicists to consider how the synergy from the fields of bioethics, public health ethics, and environmental ethics should be accessed.  As public health ethics is concerned with communities, individuals, and the environment (both natural and built), we will examine its role as a bridge connecting these three “fields” of ethics to promote a healthier planet.