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The Internet defines integrity as:
Being honest and showing a consistent and uncompromising adherence to strong moral and ethical principles and values—it is honesty and truthfulness or earnestness of your actions.
This points to a vision of integrity rooted in actions that are guided by values that are clear in one’s own mind. Throughout history, we have seen how certain figures and movements have lived in accordance with this vision, by aligning everything they did—actions big and small—with what they perceived as the highest possible good. We see this, for example, in Plato’s representation of Socrates. The integrity of Socrates was reflected in both his commitment to the highest ideals of truth and goodness and in the completeness of this commitment, which unified an engagement with ideals with other core virtues like intelligence, courage, and a willingness to act in pursuit of justice.
Socrates was undivided in his pursuit of the Good, an example of integrity in practice from which our civilization has learned for thousands of years. Such integrity was echoed in the words and deeds of Martin Luther King, Jr., whose integrity helped him to accomplish feats, in concert with the actions of many other people of similar integrity, which seem almost superhuman in hindsight, changing the world even in the face of violence and the threat of death.
I note that integrity does not mean, in my assessment, holiness, and neither does it lend itself to sanctimony. It suggests being very clear in one’s mind what values we hold dear, establishing a suite of values that should guide how we live and how we work, and that then enable us to do more than we perhaps think ourselves capable of. In the context of those who are committed to the health of populations, integrity is to act in accordance with ideals of fairness, justice, compassion, and courage in pursuit of a better world, leaving out none of the values that can support the best possible functioning of our field. This quality of leaving nothing out also reflects public health’s central commitment to creating a world where all can be healthy, leaving out none of the populations that can find themselves excluded from the conditions that create health.
Given the power of integrity to support progress at the individual and collective level, it seems worth considering integrity in the context of a post-war, practical philosophy of public health. These reflections are motivated by a belief that there is indeed integrity in what we do, that there can be clarity of the values that guide us, and that we are well served by that clarity and its application to our mission. I will anchor these reflections in three characteristics of integrity, drawing on the definitions mentioned: consistency, uncompromising adherence to values, and the centrality of action guided by these principles.
I will start with consistency. Consistency has been defined as “agreement or harmony of parts or features to one another or a whole.” While consistency is oft-criticized (hobgoblins and all that), I have often thought it to be a cardinal virtue. In the context of health, consistency means working to align all we do with the values we have embraced as the guiding principles of our field. At the same time, in addition to being aligned with our values, our work must be effective. This means our consistency should align pragmatically with what we are trying to achieve.
The second characteristic of integrity in our work is an uncompromising adherence to our values. Such adherence suggests that we put health at the heart of all we do, achieving a healthier world by any means necessary. This is, of course, complicated by the questions of what we mean by health, what it means to create a world that balances dignity and opportunity, and what values we will prioritize in getting to such a world—all questions I have addressed in these essays. In engaging with values, it is important to acknowledge that others may have different values and that what can seem at first like differences in interpretations of data—which is to say differences in intellectual methods—can reflect, more fundamentally, differences in values and should be addressed at this level.
This means that we should have a very narrow set of values we are uncompromising about, which here I have distilled as the dignity-opportunity space creation for all. Everything else we should be willing to compromise on. Such compromise does not contradict the integrity of our efforts if it means doing what best advances our work at a practical level. To do otherwise is to risk setting our work back, which cannot be said to reflect the integrity that supports our mission.
Finally, integrity informs and is reflected by our actions. Integrity is not merely sitting on our ideas; it is being effective in implementing them. Integrity, for Socrates, did not just mean talking about the ideas that lead to a good life and a good society. It meant living out their full implications with the courage of his convictions. The same should be true for our efforts in pursuit of health. This does not mean that we need to find ourselves on trial for our lives, like Socrates did, to live with integrity. But it does mean recognizing that embracing the values that support a radical vision has implications that may not always be comfortable.
While acting with integrity does not mean picking fights, it almost certainly means we will find ourselves in positions where we will be out of step with what is easy or professionally convenient. A willingness to be in these positions from time to time, then, is a prerequisite for living with integrity and getting to the better world this can lead to. To be able to act in ways that get us to this world, we need the courage of our convictions, even when this means seeming to move too slowly, or against the grain. Vision without execution is a hallucination, as the saying goes. To execute a vision for a healthier world, we need to balance consistency and uncompromising adherence to our core values with the actions that lend practicality to our efforts, even when doing so is hard, sustained by a vision of integrity that can support our efforts over the long haul.
A version of this piece also appears in Substack.
