By Stephanie Massot, Public Health Practicum Student at Health Nexus
This is the first blog post in a series on public health ethics. This post focuses on the importance of understanding your/your organization’s philosophical orientation.
One of my first year-long courses during my undergraduate degree in Health Education at the University of Victoria was Philosophy 100. I know I spent many hours poring over the writings of well-known philosophers but what seems to have stayed with me are disordered images of Waking Life, a film that captures a range of philosophical issues, and an overall feeling that philosophy was a ‘nice to know’ but not a ‘need to have’.
Fast forward 11 years later to the final academic term of my Master of Public Health at the University of Toronto and I am creating a course in Public Health Ethics, which has strong roots in philosophy. Since I worked in the nonprofit sector, I know that many decisions have ethical implications, such as resource allocation or selecting which organizations to collaborate with. You have an impact on the public health system if you or your organization puts any energy towards keeping people healthy and preventing injury, disease and premature death. For many of us this occurs by taking action on the living conditions that affect our community members. As members of a public health network, having an understanding of public health ethics and tools available will result in better decisions and improvements in the health and satisfaction of the people we serve.
Now how to take on ethical decisions in public health?
Whenever you have to make decisions, whether you are aware or not (typically therein lies the problem) you always come from a particular philosophical orientation. Since you may not be cognizant of your philosophical orientation, as a public health practitioner it is important to develop reflexivity and understanding of your orientation because if tough, moral decisions occur in your public health work (which they will) and especially if the decisions have to be made quickly, you want to be aware of where you and your colleagues stand.
Population and Public Health Ethics: Cases from research, policy, and practice is a useful resource for familiarizing yourself with philosophies that are particularly influential in the public health arena and to use case studies to expand your understanding. A quick summary is below and you can ask yourself, ‘in Canada, our governmental system is most aligned with which philosophy? Our neighbours down south?’
The answer for Canada is liberalism and for the United States it is libertarianism. Although these philosophical orientations sound similar, libertarianism is about having individual freedom through as little government involvement as possible whereas liberalism is basically about having individual freedom guaranteed by governments (see bolded text in the above chart). The context of your work (country, specific organization) should always be a consideration when you are thinking about ethics because context will influence your decisions.
I may not be able to quote you passages from Socrates and Plato, but I will aim to create a space for discussion where colleagues can co-inquire about values, assumptions and concepts that build a foundation for equitable decision-making and of course, ask more questions.