The concepts and methods of poststructuralism are emerging as useful tools to increase our understanding of public health. This paper discusses 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 problematic. Using evolutionary and ecological metaphors, it suggests that public health may benefit from its advocates fostering the recombination of elements of knowledge to produce epistemes which adapt us congruently to the general and specific goals of public health, which should include a primary aim of minimising suffering. Choosing to act in an ethical way in regard to our construction and use of knowledge may be one way of achieving those aims. The term 'ethical fitness' is a way of conceptualising an evolving epistemic ethic.
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