Philosophy, Public Health, and Liberal Education

Peer Review, Summer 2009 by Sankowski, Edward

The discipline of philosophy is among the oldest and most "traditional" liberal arts fields. Philosophy has changed in fundamental ways, however, and has reinvented itself often in different socio-cultural contexts - "Western" and non-"Western". In this article, I want to suggest some ways that the field can reinvent itself again to contribute productively to the goal of teaching public health to undergraduates. In attending to public health issues, the field can, in turn, strengthen itself as an engaged and compelling liberal arts field that teaches students broadly transferable skills and knowledge. The reinvention of philosophy needed for this transformation can draw on its own approaches in normative, often "applied" ethics, and "social epistemology," - the latter as represented by such philosophers as Alvin Goldman or Philip Kitcher - as well as by forging enhanced collaborations with the social and biomedical sciences, and other medical humanities.

The feasibility of such efforts depends on many considerations, including overall institutional mission, resources, openness to auricular innovation, faculty and student interest, the nature of an institutions general education program, and its receptivity to interdisciplinarity. These efforts, I believe, are worthwhile, especially in the area of values and ethics; the field of philosophy offers an approach to understanding public health distinct from approaches provided by other fields, including those in the social sciences.

CONCEPTIONS OF PHILOSOPHY

Philosophy as it functions in contemporary U.S. higher education institutions cannot entirely be confined to its typical philosophy department homeland. Nonetheless, I wish for some institutional definiteness to frame this discussion mainly in terms of how the philosophy department in a contemporary U.S. university might, with extensive collaboration across disciplinary boundaries, contribute to integrative education about public health in undergraduate liberal education. I want to argue that the philosophy department in some U.S. higher education institutions can and should contribute to undergraduate public health education while simultaneously and partly through these contributions continue to pursue a departmental mission as part of liberal education.

Just what philosophy is is itself a matter for controversy. Often, philosophy is identified with a canon of great works and auxiliary writings, but this conception is an oversimplification, and makes philosophy and public health work more difficult than problems oriented conceptions of the discipline.

HOW CAN PHILOSOPHY DEPARTMENTS ADVANCE PUBLIC HEALTH OUTCOMES?

A philosophy department could contribute to public health studies in its own degree programs for its majors and minors, and in philosophy courses for the general education of non-majors, as well as in more specifically dedicated philosophy courses chiefly intended for non-philosophy specialists in areas such as the biomedical sciences.

I think it is quite realistic, though not obviously feasible everywhere, for some philosophy departments to offer a philosophy major or minor with a philosophy and public health emphasis, or more modestly, some electives, alongside a more traditionally conceived major or minor. For reasons of limited resources and personnel, the courses might initially - or possibly for a long time - be expected to do double duty as courses for majors/minors and for the general undergraduate student population.

A philosophy department major/ minor with a public health emphasis would include at least one course in epistemology or philosophy of science with a focus on general issues about public health, or with a focus on more specific topics, such as case studies of public health problems in the United States or abroad, including AIDS, influenza, obesity, infant mortality, and sex education. While it is often difficult to keep factual and normative issues apart, such topics can be discussed with a greater emphasis on one or the other area. A required normative ethics or politics of public health course could also consider similar issues from the point of view of normative policy positions and their justification. One example of the latter might be a course about the often asserted right to health care in a U.S. or global context, a course or segment of a course about the normative politics of international and national governmental responses to AIDS, a course or segment about the ethics of biomedical research in less-developed countries, or a course or segment about moral obligations concerning assistance from richer countries about health care in poorer countries. Such a major/minor option should also preferably include auxiliary requirements in statistics and epidemiology, as well as a capstone course with a public health emphasis for the major option.

Philosophy departments could also collaborate with interdisciplinary programs devoted to education of undergraduates about public health; for example, in team-taught courses, philosophy faculty could co-teach with public health-related faculty about the sciences, or the normative ethics or legal policy, or the politics of public health areas. Such courses could include study of topics such as health insurance coverage, reproductive health, global health, epidemics, substance abuse, disaster responses, accidents, the pharmaceutical industry, medical informatics applied to populations, societal mental health, and environmental health issues. The academic discipline of philosophy could do all this without compromising its nature.