Resnik DB. Environmental health ethics. New York: Cambridge University Press; 2012. ISBN 9781107617896. 305 p. Paperback. INR 1994.

Ethics in the field of environmental health deals not just with dilemmas involving individuals and groups of people, but also between people and the rest of the natural world, compounding the challenges. Resnik’s Environmental health ethics is written to serve as a “starting point”, “calling attention to important issues…and dilemmas”, and to provide a framework for ethical decision-making on issues relevant to environmental health. On each of those grounds, the book delivers well and in a succinct manner. This is also probably the first book devoted exclusively to this important subject, moving as it does beyond the traditional boundaries of public health ethics. While the bulk of the book is on the application of the proposed ethical framework to issues concerning environmental health, ethical theory, too, is discussed. The author includes other environmental thinkers’ critique of his framework, thus displaying a good deal of transparency about his line of thought.

With regard to decisions that concern economic development on the one side and human and environmental well-being on the other, the author opines that some degree of mutual compromise is necessary. He holds that this can be the objective result of an ethical framework dealing with multiple competing values. His approach is based on an “enlightened form of anthropocentrism”, one that gives a higher value to human concerns but also gives independent value to concerns of animal welfare and the larger natural world. It is akin to a critical type of environmental pragmatism, encouraging discussion on deeper moral differences and avoiding quick-fix solutions (1). The principles on which the framework is based: human rights, utility, justice, animal welfare, stewardship, sustainability and precaution.

Resnik goes on to discuss the realistic options available in each case, scrutinising them using current evidence and his framework. The apparent short-term benefits are weighed against longer term consequences, and it is suggested that decisions be revisited in the light of new evidence. While recommending a balance between competing values, he adds that decisions should be consistent, withstand criticism from the public, and be based on distributive and procedural justice.

He starts with a familiar issue – vector control and the use of pesticides – in which the conflict between the health impacts of vectors against those of pesticides is apparent. Importantly, other issues such as population size or the consumption of meat, which are either relatively challenging or unfamiliar to the average public health professional, are included in this discourse.

Some of Resnik’s conclusions are debatable. For instance, questionably, he allows for the use of genetically modified foods (after “adequate measures” have been taken to mitigate and prevent risks) for their role in food security and economic growth. The inappropriateness of this technology for developing countries (2) and the threats posed (through direct and indirect mechanisms) to global food security and health are known (3). In that context, the author’s application of the principle of “precaution” also needs further discussion – which may be the most contentious part of the framework. Mainstream technology has assumed the guise of a saviour in dealing with social problems in developing countries, and the zeal for its promotion (4) has superseded any need for reflection, or for stringent checks and balances (5). There is a need to learn from previous developmental programmes which had disastrous consequences on biodiversity and communities (6).

In the author’s words, “much more work remains to be done”. Environmental health concerns range from individual well-being to the survival of life in general. More than any other time in history, we have reached a stage in which people are having a catastrophic impact on the global environment, and are also systematically oppressing groups of people and other species, in the name of efficiency, development and the greater good. It is very difficult to be aware of latent prejudices (7), and this may hold true in the context of how people perceive of the environment as well. It is possible and not unlikely that in the near future, the priority given to each of the competing ethical principles will be different, with several authorities already recommending an urgent paradigm shift in development thinking (8). The Sustainable Development Goals are potentially the first global step towards such a shift.

This book is relevant to practitioners and students of public health, the environmental sciences, engineering, the agricultural sciences and philosophy, as well as industrialists and policy-makers. It provides first-time readers with a technical input on the subject, and would serve to stimulate a debate among professionals. There is, indeed, a gigantic gap between ethics and decision-making, which necessitates discussion striving to narrow the gap.