Skip to main content

The Place of Solidarity in Public Health Ethics


When we consider the literature that has been produced exploring approaches to public health ethics, it is rare to find any mention of solidarity. One obvious conclusion is that solidarity is a meaningless or superfluous consideration. We suggest that this is not the right conclusion to draw, and that we must first understand what solidarity is and then consider what difference it might make to thinking about issues in public health ethics. In this paper we, first, outline some of the existing approaches to public health ethics and suggest that they often involve a set of questionable assumptions about the nature of social relations as well as a clear commitment to particular values. A failure of imagination in relation to solidarity is not, however, an argument against taking the concept seriously. Second, we propose a particular account of solidarity, suggest reasons why it is important for thinking about ethical issues in public health, and suggest how it relates to other relevant values. We argue that it is essential to engage with the issue of where we ought to place solidarity within our debates and frameworks for public health ethics.


  1. Donne J. Devotions Upon Emergent Occasions. Meditation XVII. The Works of John Donne. vol III. Henry Alford, ed. London: John W. Parker; 1839. pp.574–5.

  2. Gostin LO. Public Health Law: Power, Duty, Restraint (second edition). Berkeley (CA): University of California Press; 2008.

  3. Powers M, Faden R. Social Justice: The Moral Foundations of Public Health and Health Policy. Oxford: Oxford University Press; 2006.

    Google Scholar 

  4. Holland S. Public Health Ethics. London: Polity Press; 2007.

    Google Scholar 

  5. Coggon J. What Makes Health Public? A Critical Evaluation of Moral, Legal, and Political Claims in Public Health. Cambridge: Cambridge University Press; 2012.

    Google Scholar 

  6. Faden R, Shabaya S. Public health ethics. In: Zalta EN, (editor). The Stanford Encyclopedia of Philosophy (Summer 2010 Edition). Metaphysics Research Lab, CSLI, Stanford University; 2010. Available from URL: (Accessed 12 November 2013).

    Google Scholar 

  7. Nuffield Council of Bioethics. Public Health: Ethical Issues. London: NcoB; 2007.

    Google Scholar 

  8. Mill JS. On Liberty. London: John W. Parker and Son, West Strand; 1859.

    Google Scholar 

  9. Dawson A, Verweij M. (2008) The steward of the Millian state. Public Health Ethics. 2008;1(3):193–5.

    Article  Google Scholar 

  10. Prainsack B, Buyx A. Solidarity: Reflections on an Emerging Concept in Bioethics. London: NcoB; 2011.

    Google Scholar 

  11. Beauchamp T, Childress J. Principles of Biomedical Ethics (seventh edition). Oxford: Oxford University Press; 2013.

    Google Scholar 

  12. Gillon R. Ethics needs principles—four can encompass the rest—and respect for autonomy should be “first among equals”. J Med Ethics. 2003;29:307–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Upshur REG. Principles for the justification of public health interventions. Can J Public Health. 2002;93:101–3.

    CAS  PubMed  Google Scholar 

  14. Childress JF, Faden RR, Gaare RD, Gostlin LO, Kahn J, et al. Public health ethics: mapping the terrain. J Law Med Ethics. 2002;30:170–8.

    Article  PubMed  Google Scholar 

  15. Dawson A. Resetting the parameters: public health as the foundation for public health ethics. In: Dawson A, (editor). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge: Cambridge University Press; 2011.

    Chapter  Google Scholar 

  16. University of Toronto. Stand on Guard for Thee: Ethical considerations in preparedness planning for pandemic influenza. Toronto: University of Toronto’s Joint Centre for Bioethics; 2005.

    Google Scholar 

  17. North Carolina Institute of Medicine. Stockpiling Solutions: North Carolina’s Ethical Guidelines for an Influenza Pandemic. Durham, NC: North Caroline Institute of Medicine. 2007. Available from URL: (Accessed 12 November 2013).

    Google Scholar 

  18. Tong R. Shaping ethical guidelines for an influenza pandemic. In: Boylan M, (editor). International Public Health Policy and Ethics. Dordrecht: Springer; 2008. pp.215–232.

    Chapter  Google Scholar 

  19. Bioethics. 2012;27:ii, 357–410.

  20. ter Meulen R, Arts W, Muffels R, (editors). Solidarity in Health and Social Care in Europe. Dordrecht: Kluwer Academic Publishers; 2001.

    Google Scholar 

  21. Jennings B, Dawson A. (MS) Solidarity in the moral imagination of bioethics.

  22. Beauchamp DE. The Health of the Republic. Philadelphia: Temple University Press; 1990.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Angus Dawson PhD.

Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit

The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Dawson, A., Jennings, B. The Place of Solidarity in Public Health Ethics. Public Health Rev 34, 4 (2012).

Download citation

  • Published:

  • DOI:

Key Words