A revolutionary or what we might call a ‘substantive’ account of public health ethics will begin elsewhere: not with the individual and the assumption of liberty as our prime value, but with a set of values that try to capture the public nature of public health. This approach will begin with some defence of the different normative factors that might be used to take seriously what we share in common as human beings and social creatures.
This change in perspective will, in turn, set a clear agenda for the work of public health ethics. If we are serious about defending public health activities from the traditional criticisms drawn from the direction of medical ethics, then we need to think about how we can justify a more population- or community-orientated approach to ethics. However, this does not just mean an easy flip into some form of communitarianism.
Although communitarianism is one option, there are many other ways of attempting to capture the ‘publicness’ of public health through the exploration of a series of theoretical questions. In other words, reflection upon the nature of public health practice, and the ethical issues that arise there, is also likely to result in a welcome development of our moral theories. However, before we proceed any further, it is worth sounding two notes of caution.