PUBLIC HEALTH FOSTERS PERSONAL FREEDOM VS. PUBLIC GOOD DEBATES
More than 200 years ago, when smallpox killed about 30 percent of its victims and left most others scarred for life, Dr. Edward Jenner’s pioneering use of less virulent cowpox as a vaccine excited scientists and politicians.
The public, however, was less enthused, says Dr. Ross Kauffman, assistant professor of public health at Bluffton University. "You shouldn’t be forcing us to do this," a fearful populace argued, according to Kauffman. "Don’t tell us what to do."
Two centuries later, that tension between public good and personal freedom remains a part of the discussion about vaccinations and other public health issues, such as pasteurization of milk, he told a campus audience March 27.
Kauffman’s talk was Bluffton’s annual civic engagement lecture, given in keeping with the university’s 2011-12 civic engagement theme, "Public Health: Promoting Wellness for Self and Community."
Smallpox vaccination, which eradicated the disease by 1979, was a public health "success story," said Kauffman, who holds master’s and doctoral degrees in epidemiology from The Ohio State University. And public health practitioners, he added, hold to the concept of "herd immunity," meaning that the spread of contagious disease is contained when most members of the population have been immunized.
But some parents, concerned that potential risks of vaccinations may outweigh the benefits, argue that they should be able to not have their children immunized against childhood diseases, he noted. The question then becomes, as posed by Kauffman: "Can I force you to take on that risk for the good of the community?"
A similar situation exists, he said, with milk—government-required pasteurization, which he called a "safety net," versus the right to drink raw milk, whose advocates cite health benefits and better taste.
The Eastern Mennonite University graduate cited several perspectives on how to think about the question of group gain versus individual cost. Among them, he said, are Jeremy Bentham’s utilitarianism, or the valuing of what brings "the greatest happiness to the greatest number"; 20th-century American philosopher John Rawls’ "veil of ignorance," a concept proposing that if everyone’s decisions were made without knowledge of their positions in society, they would agree upon principles that would most benefit the least well-off; and the Anabaptist theology of Robert Friedman, focusing more on the common, rather than individual, good.
Kauffman also noted Rawls’ contemporary, Robert Nozick, who, as a libertarian, believed individual liberty is more important than governmental efforts to "improve" society. Later in his career, though, Nozick softened his perspective, arguing that "no one perspective has all the right answers," Kauffman said. Instead, he continued, Nozick eventually held that progress came from the tension of different perspectives, pulled back and forth to move closer to the goal.
Urging his student listeners to recognize a range of perspectives as well, Kauffman advised making well-informed decisions about issues of public good versus personal freedom, then listening to—and challenging—others’ views. "Only when we have strong and well-supported views," he added, "can we have this debate."
Bluffton public relations, 3/28/12