Foundational values for public health

Lisa M Lee, Christina Zarowsky

The development of an agreed-upon set of foundational ethical values for the field of public health is ongoing. In this paper we outline key elements of recent convergence on some basic moral precepts that drive public health. We suggest that three elements are particularly useful for anchoring public health practitioners' reflections on public health ethics: 1) the notions of "common" and "professional" morality, 2) an understanding of the practice and content of modern public health and especially its practical, solution-focused orientation, and 3) an appreciation of the history of public health as integrally linked to evolving and contested views of the relationship between citizens, science, and the state. There is broad agreement that governments are stewards of their populations and are responsible for providing conditions that allow for its members to be healthy and productive. Given the role of policy and government in public health, the role of political philosophy likely has a substantial place as we seek a coherent system of ethical justification in our work. The aim here is not to align with one theoretical approach or another, rather, to consider the foundational values of public health practice order to identify the common moral governance of our work. Our profession's morality-the set of norms shared by all public health professionals-is determined by what public health is and what we think it should be. As our aspirations for public health evolve, it is incumbent upon us to engage in reflective discourse to reach a new equilibrium about our moral foundation.