Introduction

In this chapter I introduce a number of different approaches to public health ethics. However, I do this in a deliberately provocative way. I argue that we need a revolutionary, rather than evolutionary, approach to the development of public health ethics: in other words, we ought to reset the parameters that frame this area of applied ethics. I attempt to argue for this conclusion in the three sections of this chapter. First, I outline and defend what I consider to be a necessary condition to be met by any adequate theory of public health ethics. Second, I suggest what I call the traditional liberal approach, currently dominant in much medical ethics, fails to meet this condition because of the primacy it accords the idea of non-interference. I also suggest that various proposed alternatives, although offering some welcome broadening to this traditional liberal position, ultimately remain restricted by their implicit or explicit acceptance of the parameters set by the liberal approach. Third, I briefly outline a range of areas where I argue that future work ought to be directed as a means of developing a sufficiently rich account of public health ethics: a substantive account that meets my condition. I suggest that such an account must accept a view of human interests as intrinsically social. My primary focus in this chapter is a general argument in favour of the re-orientation of the field of public health ethics.