Does public health need virtue ethics?

So-called virtue ethics may seem too inward-looking to be of any practical use in a complex world. It focuses on good character traits of a morally virtuous person, such as courage, sincerity, compassion, humility and responsibility. It emphasizes how we should be rather than how we should act. How can we find effective guidance in such “heroic” ethics when we seek the morally correct action in ethically difficult situations, or the correct regulation of various parts of the public sector? How can such ancient ethics provide binding reasons for what is morally correct? Humbly referring to one’s superior character traits is hardly the form of a binding argument, is it?

It is tempting to make fun of the apparently ineffective virtue ethics. But it has, in my view, two traits of greatest importance. The first is that it trusts the human being: in actual situations we can see what must be done, and what must be carefully considered. The second is that virtue ethics thus also supports our freedom. A virtuous person does not need to cling to standards of good behavior to avoid bad behavior, but will spontaneously behave well: with responsibility, humility, compassion, etc. So a counter-question could be: What good will it be for someone to gain a whole world of moral correctness, yet forfeit themselves and their own freedom? – This was a personal introduction to today’s post.

In an article in Public Health Ethics, Jessica Nihlén Fahlquist discusses public health as a domain of work where moral virtues may need to be developed and supported in the professionals. Unlike medical care, public health focuses on good and equal health in entire risk groups and populations. Due to this more universal perspective of collective health, there can be a risk that the interests, rights and values ​​of individuals are sometimes overlooked. The work therefore needs to balance the general public health objectives against the values ​​of individuals. This may require a well-developed sensitivity, which can be understood in terms of virtue ethics.

Furthermore, public health is often characterized by a greater distance between professionals and the public than in medical care, where the one-on-one meeting with the patient supports a caring attitude in the clinician towards the individual. Imagination and empathy may therefore be needed in public health to assess the needs of individuals and the effects of the work on individuals. Finally, there is power asymmetry between public health professionals and the people affected by the public health work. This requires responsibility on the part of those who use the resources and knowledge that public health authorities possess. This can also be understood in terms of virtue ethics.

Jessica Nihlén Fahlquist emphasizes three virtues that she argues are needed in public health: responsibility, compassion and humility. She concretises the virtues through three ideals to personally strive for in public health. The ideals are described in short italicized paragraphs, which provide three understandable profiles of how a responsible, compassionate and humble person should be in their work with public health – three clear role models.

The ethical problems are made concrete through two examples, breastfeeding and vaccination, which illustrate challenges and opportunities for virtue ethics in public health work. Read the article here: Public Health and the Virtues of Responsibility, Compassion and Humility.

Jessica Nihlén Fahlquist does not rule out the importance of other moral philosophical perspectives in public health. But the three virtue ethical ideals (and probably also other similar ideals) should complement the prevailing perspectives, she argues. Everything has its place, but finding the right place may require good character traits!

If you would also like to read a more recent and shorter discussion by Jessica Nihlén Fahlquist on these important issues, you will find a reference below.

Jessica Nihlén Fahlquist, Public Health and the Virtues of Responsibility, Compassion and Humility, Public Health Ethics, Volume 12, Issue 3, November 2019, Pages 213–224, https://doi.org/10.1093/phe/phz007

Jessica Nihlén Fahlquist, Individual Virtues and Structures of Virtue in Public Health, Public Health Ethics, Volume 15, Issue 1, April 2022, Pages 11–15, https://doi.org/10.1093/phe/phac004

This post in Swedish

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