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Feature

A Right to Bacteria?

By Gordon Hull, Director, Center for Professional and Applied Ethics,

Associate Professor Philosophy and Public Policy, UNC Charlotte

A rapidly accumulating body of research establishes that since natural ecosystems change over time. Restoration also faces
our health depends, in part, on the good health of our numerous practical difficulties. For example, when in a restoration
microbiome. The health of that microbiome, in turn, could a given species be re-introduced? In what order? What do
depends on the environment. So too, we know that the you do when a species has a range larger than the refuge? It seems

environment, broadly construed, has far-reaching implications for health to me that some of these questions become less important for

outcomes at the population level. These social determinants of health microbial restoration. Bacterial systems evolve so rapidly, and so

support a broad conversation about equity and justice in both direct health idiosyncratically, that the idea of restoring to a bacterial baseline or

outcomes and (more narrowly) in access to health care. If you put this the timeline for establishing certain species seems less important

together, you might conclude, as Suzanne Ishaq and co-authors argue in a than restoring some semblance of diversity. That said, experimental

recent PLOS Biology article, that there ought to be some sort of a right of work in New York suggests there are analogous complexities even in

access to the sorts of microbial diversity that support good health. designing systems to manage urban runoff.

The argument runs like this. Exposure to the right kinds of microbes This allows us to focus on questions of justice and morality. Recent

in a variety of contexts can be very good for human health. The most work suggests we might view environmental restoration projects on a

widely discussed of these probably is the so-called “gut microbe,” the model of restorative justice. In this way, they are part of acknowledging

various bacteria that live in our GI tracts and which make it possible wrongdoing and creating a viable path forward toward renewed moral

to digest food. The health implications of diversity of gut microbiota relations. It seems to me that microbial rewilding in this sense goes

are only beginning to be understood, but what we do know suggests some way toward answering Ishaq et al.’s call for a right to a diverse

that it is important for everything from brain health to obesity. Ishaq microbiome. In particular, to whatever extent we owe disadvantaged

et al. cite recent work showing the mechanisms of social determinants communities better access to a healthy environment and health care as

of health often are related to microbial diversity, such that “social matters of justice, efforts at local environmental restoration aimed at

inequality, which impedes access to macrobiodiversity, also impedes microbial diversity may well be part of that obligation.

access to microbiodiversity and the health benefits therein.” Ishaq et al.

accordingly produce a long list of social determinants of health, such as

the lack of maternity leave for low-income women, and then associates

them with microbial issues: the microbiota of formula-fed babies are less

diverse than breast-fed babies.

One fascinating case is the affect of urban environments on

microbial diversity, and the ways that living in a city can be bad for

you, independently of pollution. The best-known example is the CHARLOTTE AHEC COURSE OFFERINGS
relative increase in allergy and asthma rates in urban, as opposed to
rural, children. This likely is because the microbiome in rural house Charlotte AHEC is part of the N.C. Area Health Education Centers (AHEC) Program and Atrium Health.
dust is somehow protective against these conditions. Ishaq et al. cite
a paper by Jacob Mills and coauthors that assembles a literature MARCH 2020
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There’s an environmental ethics literature on ecological 3/21 Medicine 13th Annual GI/HPB Conference
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restoration, and it seems to me that microbial rewilding could be
usefully viewed in this regard. Philosophers who have worked

on ecological restoration often have pointed to its limitations; a For more information or to register for these courses, call 704-512-6523
damaged landscape never can be fully repaired or restored to its or visit www.charlotteahec.org.
original state. Indeed, it is not even clear what that state would be,

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