An Ethics Debate for the Ages: American Individualism and the Dilemma of the Healthy Carrier

Many public health ethics debates are construed as the rights of the collective versus the rights of the individual. This essay demonstrates that in the context of diseases which are transmitted by healthy carriers, the issue is more complex than this. Instead of arguing about competing rights, this essay argues that such debates are first about competing visions of reality, in which the individual is asked to substitute a collective understanding of their body for their own personal experience of their body. Understanding this first layer of the ethics debate in such healthy carrier situations allows us to redirect persuasive energies, moving away from a beginning-point of compliance to one of understanding, which may ultimately find a more willing public audience.

Fighting Unions

This chapter focuses on the National Association of Manufacturers (NAM) as an explicitly anti-union organization with the stated goal of maintaining the “open shop”—or union-free workplaces. NAM's chief target was the American Federation of Labor (AFL), which, like NAM, sought to bring order and standardization to the field of labor, but on workers' terms. NAM fought the AFL using many of the same tactics the AFL deployed against employers: disciplined organization, injunctions, lobbying, and what it variously called “propaganda” or “education.” The battle between NAM and the AFL was epic, conceived by both as a struggle for control of the American workplace. Unions and industrialists—both wary of the state—fought one another for control. Neither the AFL nor NAM were truly representative of their alleged constituency (“workers” and “industry,” respectively), but they were the organizations most fully engaged in this battle, each vilifying the other as “the enemy,” both claiming to uphold American individualism.