Is Justice for One Justice for All? The Dilemma of Public Health Enforcement in an Interconnected World

Abstract

Few biblical stories capture the American penchant for individualism better than that of David versus Goliath. The American experience is inextricably linked to the celebration of individuals, who, like David, triumph against all odds. Virtually all aspects of American law are highly affected and shaped by a legal commitment to the principles of individualism. The United States Constitution, for instance, is heralded as the linchpin of American jurisprudence. This belief is based largely on the Bill of Rights and its commitment to protecting individual liberties. Beyond constitutional law, other fundamental areas of law also manifest a strong tradition of individualism. For example, tort law is rooted in concepts of equity, which demand that the wronged individual be provided with a remedy. Most American lawyers are staunch advocates of a legal system that extols, protects, and empowers the individual, and would view our commitment to personal liberties as the hallmark of American democracy. This principle is best reflected in American jurisprudence that supports the concept of justice through individual right. At the risk of being labeled a legal heresy, this essay posits the notion that our conception of individual rights may not be compatible with a broader vision of justice as a principle of social justice using the framework of public health. This essay argues that a community oriented enterprise, such as public health, is illustrative of how American views of individualism and justice compete. This piece utilizes two examples from public health to illustrate the tension between individualism and community: (1) drawn from the domestic arena: childhood immunizations; and (2) drawn from the international sector: defining the right to health. These vehicles show how an individualistic vision of justice may not easily equate to a broader notion of collective justice.

Keywords: health care and justice, justice and community, american justice, health care law

JEL Classification: I18, I11, K32