The concepts and methods of poststructuralism are emerging as useful t
ools to increase our understanding of public health. This paper discus
ses poststructuralism within the context of a metaphoric 'evolutionary
ecology' of knowledge (an epistemecology). It argues that claims for
the importance of any programs (such as poststructuralism) are problem
atic. Using evolutionary and ecological metaphors, it suggests that pu
blic health may benefit from its advocates fostering the recombination
of elements of knowledge to produce epistemes which adapt us congruen
tly to the general and specific goals of public health, which should i
nclude a primary aim of minimising suffering. Choosing to act in an et
hical way in regard to our construction and use of knowledge may be on
e way of achieving those aims. The term 'ethical fitness' is a way of
conceptualising an evolving epistemic ethic.