Events

Wastewater surveillance is an emerging technology that has traditionally been utilized for detecting infectious diseases. However, its potential future uses may bring a staggering and unpredictable amount of information that could be used for a wide variety of purposes, both health and non-health related. Wastewater-based technologies are in a period of development similar to artificial intelligence in that: 1) its potential uses in the near future are staggering; 2) there is uncertainty regarding what is technically feasible vs what is science fiction; and 3) its use is rapidly expanding, with bioethical analysis struggling to keep pace. Currently, the U.S. Department of Defense (DoD) is beginning to establish wastewater surveillance capacities to support public health, national security, and force health protection. The DoD’s presence and potential wastewater surveillance activities also reach far beyond military installations and are global in scale. Furthermore, the military is a unique context. It serves an inimitable role for its country and its citizens, and it exercises significant levels of control over its service members compared to civilian organizations. As such, there arise unique ethical considerations that must be accounted for to ensure militaries such as the DoD implement wastewater surveillance in a manner that is both impactful in supporting public health and appropriate to the scope and population under surveillance. In this talk, Dr. Smith explores important ethical features of and offers recommendations for conducting wastewater surveillance that are both specific to the military experience and applicable for wider public health interests. He concludes by discussing the importance of tailoring bioethics messaging to the intended audience for practical applications and meaningful action.

Army Maj. Hunter Jackson Smith, M.D., M.P.H., M.B.E. is a Major in the U.S. Army Medical Corps and the Focus Area Lead for Antimicrobial Resistance, Sexually Transmitted Infections, and Enteric Infections at the Department of Defense Global Emerging Infections Surveillance Branch in Silver Spring, Md. In this capacity, he oversees many of the DoD’s disease surveillance efforts across the globe in these pathogen domains.

Maj. Smith is an Assistant Professor for the Uniformed Services University in the Department of Preventive Medicine and Biostatistics where he teaches preventive medicine, epidemiology, and emerging infectious disease topics. He is an Adjunct Assistant Professor at the Johns Hopkins Berman Institute of Bioethics where he teaches bioethics, and he also serves as a subject matter expert for the Department of Defense Medical Ethics Center. He practices travel medicine at the Walter Reed National Military Medical Center.

Dr. Smith serves on the Board of Governors of the American Journal of Preventive Medicine (AJPM) and Editorial Board of AJPM Focus. He is also an enthusiastic member of the American College of Preventive Medicine (ACPM) and volunteers on several of the College’s leadership committees, including his current role as the Chair of the Preventive Medicine 2024 Conference. He is a recipient of the ACPM’s Donald Gemson Resident Award.

Dr. Smith is board certified in General Preventive Medicine and Public Health. He graduated from Tulane University with a BA in Philosophy. He couldn’t stay away from the crawfish etouffee, so lived in New Orleans four more years to earn his Doctor of Medicine and Master of Public Health in Epidemiology from Tulane University. Dr. Smith completed his intern year at Tripler Army Medical Center in Honolulu, Hawaii where he met his amazing wife, Joy. He went on to complete his residency training in General Preventive Medicine and Public Health at the Uniformed Services University, during which time he earned Master of Bioethics from the Johns Hopkins Bloomberg School of Public Health.

His scientific research interests include emerging infectious diseases, tropical medicine, and pain epidemiology. His bioethics research interests include social determinants of health, obesity, infectious diseases, opioids, and military medicine.