Skip to main content

Advertisement

The Place of Solidarity in Public Health Ethics

Abstract

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.

References

  1. 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. 2.

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

  3. 3.

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

  4. 4.

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

  5. 5.

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

  6. 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: http://plato.stanford.edu/archives/sum2010/entries/publichealth-ethics/ (Accessed 12 November 2013).

  7. 7.

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

  8. 8.

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

  9. 9.

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

  10. 10.

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

  11. 11.

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

  12. 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.

  13. 13.

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

  14. 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.

  15. 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.

  16. 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.

  17. 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: http://epi.publichealth.nc.gov/cd/fu/plan/AppendixO1_2008.pdf (Accessed 12 November 2013).

  18. 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.

  19. 19.

    Bioethics. 2012;27:ii, 357–410.

  20. 20.

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

  21. 21.

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

  22. 22.

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

Download references

Author information

Correspondence to Angus Dawson PhD.

Rights and permissions

Reprints and Permissions

About this article

Key Words

  • solidarity
  • public health
  • ethics
  • justice
  • frameworks