Re-Conceptualizing Bioethics: Public, Individual, and Environment

What is the relationship between public health ethics and bioethics?  These two arenas of applied ethics seem to differ in numerous ways, including in terms of their normative commitments, practical emphases, and disciplinary interfaces, yet perhaps share some common purpose. In this presentation, I will articulate some of these conceptual and normative differences and then argue for the practical benefits of reframing public health ethics as a specialization of a reconceptualized and broader bioethics.

Individual welfare and rights are the normative focus of bioethics. Public health ethics, on the other hand, places priority on community-level concerns, including population health and just distribution of harms and benefits. Yet, the goals of public health work are not dualistically opposed to the goals of medical bioethics: the health of the public is integrally linked to the health of the individual members of the community populations that make it up. Yet public health ethics and bioethics remain largely distinct from each other in the disciplinary contexts related to health.

Engaging them together in service of better health outcomes requires their conceptual integration under the umbrella of a bioethics, overcomes the epistemic and ontological narrowness of current biomedical ethics. A commitment to this conclusion is supported by understanding bioethics etymologically as an ethics of life.  By returning to genealogical roots of the term as a broader ecologically-engaged concept in the works of German pastor Fritz Jahr and American cancer researcher Van Rensselaer Potter, I articulate some ways in which public health ethics can benefit from conceptually-coherent engagement with a broader range of bioethical concerns.  Reconstructed in this way, bioethics can help bridge existing gaps between issues in medical, environmental, and public health ethics.