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Public health and the common good
  1. Paolo Vineis
  1. Correspondence to Professor Paolo Vineis, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, London W2 1PG, UK; p.vineis{at}

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In modernity, the cultural rank of science was elevated by that epoch's most basic cultural presuppositions—not merely the presupposition of the superiority of theory to practice, but more importantly the elevation of the public over the private and the disinterested over the interested, and, more importantly still, the belief that … adherence to proper means is the best guarantee of a ‘truly good’ outcome. (…) Today, on the contrary, technology is the beneficiary and science the maleficiary, of our pragmatic-utilitarian subordination of means to ends, and of the concomitants of that predominant cultural presupposition, notably, disbelief in disinterestedness and condescension toward conceptual structure.1 To improve quality of life and eliminate health disparities, public health would (…) be well served by recommending that community members devote 30 to 45 minutes a day 4 to 5 times a week to building consensus on the just society (David Buchanan, Am J Public Health 2008)

Public health has to face great challenges and moral dilemmas. Among the challenges there are the narratives that sustain ongoing economic crises, globalisation, climate change and their effects on health. Moral dilemmas concern an increasing tendency to conceptualise health, including prevention, as a commodity to be privately pursued and enjoyed.

Transgenerational transmission of culture goes together with transgenerational transmission of (healthy) genes. The continuity between generations—between past, present and future—is something that is necessary for the transfer of knowledge, societal cohesion and moral values. Therefore, it implies for past and future generations the same respect we have for the present population. But is this happening? Utilitarian thinking has often put the emphasis almost entirely on those presently living, and the ethics of obligations towards future generations has not clearly emerged yet.

The leading concept in the moral philosophy of the last three centuries has been ‘the pursuit of happiness’ …

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  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.