Is public health just science? Values, politics and varied but collective practices to secure better health with justice

Abstract

Abstract This paper asks: Is public health just science? That question invites analysis from the field of public health ethics of how we might distinguish public health as being built simply on scientific evidence bases and its being founded on science and ideas of justice. In conducting the analysis, the paper explores the essentially political nature of public health as well as reasons why members of the public health community might aim not to ‘be political’ in their practice: in particular, considering professional competence/expertise, democratic legitimacy and the possibly damaging consequences of being seen as engaged in politics. Such considerations, while valid, do not stop public health from being political in nature and directed to the realization of ethical aims. The paper, therefore, then explores how members of the public health community might seek to realize the moral mandates of public health. Although that requires political outcomes, it does not mean there is an ethical requirement to be as directly politically engaged as possible. On the contrary, we find good reason to look to public health as a collective enterprise, with individual roles and activities within it being more or less directly activist.