Changing value priorities is not easy, for it means changing hearts and minds and outlooks on life. III Another aspect of moral responsibility for health that must concern us is that which gathers around the notion of public morality. By that term I do not mean public participation in the directions and priorities of medical practice, getting representatives of the public on committees and decision-making bodies. Nor do I mean simply the law. Since one acid test of law is feasibility, reducing public morality to the law could all too easily collapse it into the utterly pragmatic considerations that so often decide what is feasible.
Public morality is something quite different.
I would outline the notion by highlighting the fact that health-care delivery is increasingly mediated very heavily by institutions. We have group practice, insurance coverage, medication controlled by the FDA, Medicare, Medicaid, etc., hospitals built by government, and research supported and controlled by its agencies. All of this suggests that whenever other values are the legitimate concern of the mediators of health care, the good of the patient can easily become one of several values, in competition for attention and priority. This means that the individual is in danger of being subordinated to these values. Public morality is precisely the pursuit of these other values without violating individual rights.