For the past several years, it has been my privilege to attend the annual conference of the Florida Bioethics Network. As in prior years, this year’s conference showed the great range of topics that fall under the umbrella of bioethics. Topics included the so-called “Tattoo DNR,” a discussion of medical marijuana, the potential promise of an electronic and interactive informed consent document, and even a discussion of the role of clergy on ethics committees. Each of these topics could merit a blog post, but the one that grabbed my attention the most was the discussion of “Public Health” by Celeste Philip, Florida’s Surgeon General and Jeffrey Brosco, the Deputy Secretary of Children’s Medical Services for the Florida Department of Health.
In an increasingly divided country, the concept of public health seems more remote than ever before, yet the presenters made it clear that it is a goal worth pursuing. After all, “Your zip code is a better predictor of your health than your genetic code,” they argued. With the prevalence of the 23 & Me-style genetic testing, their statement took me by surprise. After giving it some thought, their point was clear. Addressing public health is an important function of government, they stated, and if the disparities between zip codes continue to grow, our health care system will be facing even more serious challenges than ever imagined. They claimed that the greater the inequality there is in income in a community, the greater the mortality – for everyone.
Both Drs. Philip and Brosco used the ethical concept of justice (which they used alongside “accessibility”) to underscore their case for a robust public health system. Understanding that there is an ongoing tension between community protection and individual autonomy, they made a case that “Public health ethics requires both identifying the values that underlie policy as well as optimizing the language we use to convey available options.” (If you haven’t seen this already, in 2010 The Robert Wood Johnson Foundation published an article entitled, “A New Way to Talk about the Social Determinants of Health.”
I found the presentation to be both thoughtful and thought-provoking, going beyond many of the typical bioethics conversations that I encounter on a day-to-day basis. Those committed to a Christian worldview would do well to engage in this discussion.