The National Center for Bioethics in Research and Health Care at Tuskegee University (Bioethics Center) is uniquely positioned within a socio-historical and contemporary context that demands a unique approach to bioethics (Warren & Tarver, 2010).
The Bioethics Center focuses on spheres of ethics (i.e. bioethics and public health ethics), public health, and spirituality (Warren & Tarver, 2010). Public health is viewed as synonymous with social justice because “an integral part of bringing good health to all is the task of ameliorating patterns of systemic disadvantage that undermine the well-being of people whose prospects for health are so limited that their life choices are not even remotely like those of others” (Gostin & Powers, 2006). Public health and ethics seek to achieve the common good, so do religion and spirituality. Spiritually encompasses religion in that it addresses the individual’s acknowledgment of a power greater than themselves (Warren, 2008). Within the context of a sound spiritual foundation, religion and religious practices may be realized. Religion and ethics are often assumed synonymous, because most major religions have ethical teachings associated with them….the fundamental ethical tenets of virtually all societies are based on religious teachings (Bayer & Beauchamp, 2007). However, “there is no necessary connection between religion and ethics. A person can be ethical and be a non-believer” (Bayer & Beauchamp, 2007).
Mainstream bioethics focuses on bio/medical technology, rights of research subjects, the doctor-patient relationship and how changes in the healthcare system affect it—generally, medical ethics. Public health ethics focuses on the interest and health of groups, the social justice of the distribution of social resources, and the positive or social/humans rights of individuals (Bayer and Beauchamp, 2007). Integrative bioethics is the field of inquiry and practice that brings together and embraces the social, cultural, economic, religious, philosophical, political, legal, scientific and technical domains of knowledge to influence ethical decision-making in life activities (Sodeke, 2012; Rincic and Muzur, 2011).
Recognizing the tension between these spheres of ethics is extremely important because there is scientific validity to the scope and practice of mainstream and integrative bioethics as well as public health ethics. Holding these spheres of ethics in tension is what distinguishes the Bioethics Center from those who subscribe to a narrow view of bioethics which forces them to leave many issues that face vulnerable and susceptible populations unaddressed. As a result, these same populations’ life circumstances worsen.”
Because mainstream bioethics is limited in scope and practice, Tuskegee University has historically subscribed to an integrative approach to ethics, science, education, and training, and integrative bioethics as well as public health ethics are, therefore, important aspects of the Tuskegee “ethos”. Unlike mainstream bioethics, and in some ways like public health ethics, which is trans-disciplinary, integrative bioethics is interdisciplinary conceptually, methodologically multi-disciplinary, and trans-disciplinary in practice. It builds bridges and spans the boundaries of the social, cultural, economic, religious, philosophical, political, legal, scientific and technical domains of knowledge in order to query actions, and alert us of moral chasms and ethical issues that are often embedded in life activities. Its proper practice enhances our capacity to make decisions that can inform appropriate policy and law. Integrative bioethics is a deliberate attempt to capture the wholeness that is lacking from mainstream bioethics. Integrative bioethics is grounded in the philosophical assumption of “bringing life to ethics and ethics to life”; it is therefore understood to be all encompassing.
Public health ethics is somewhat akin in method to integrative bioethics with respect to being inter-disciplinary. Its translational nature has a specific focus. Public health ethics is population-based, targets health promotion, and is directed at preventing the adverse conditions that result in disease, dysfunction, disability and pre-mature death. The unique method of holding these spheres of ethics in tension allows the Bioethics Center to address broad bioethics and public health ethics issues and specific needs of vulnerable and susceptible populations with respect to optimal health and health care, of which the connection between food security and health disparities loom large.
Bayer, R., & Beauchamp, D.E., (2007) Public health ethics: Theory, policy, and practice. New York: Oxford University Press.
Gostin, L. & Powers, M. (2006) What does social justice require for the public’s health? Public health ethics and policy imperatives. Health Affairs 25 (4): 1053.
King, L.M., (2002) Development of authenticity in public health: A culturecology model as a culture critique. In: Chunn JC, Ed. The health behavioral change imperative: theory, education, and practice in diverse populations. New York: Kluwer Academic/Plenum Publishers.
Warren, R.C., (2008) The impact of horizontal and vertical dimensions of faith on health and health care. The Journal of the Interdenominational Theological Center 34: 71-85.
Warren, R.C.& Tarver, W., (2010). A foundation for public health ethics at Tuskegee University in the 21stcentury. The Journal of Health Care for the Poor and Underserved, 21(3).