March 19, 2017
In the United States, we value freedom andthe legal extensionthese freedom rights. That means theTee-PartyResisting the agenda of Barack Obama and theburgeoning progressive resistanceWhile they have little in common ideologically for the Trump administration, they are united by their reverence for the right and their concern at losing it. In the case of the Tea Party, these rights include, but are not limited tothe right to bear arms, and rightmeet and chat freely; On the left, the focus was on issues such as the right tosafe reproductive carejpay equity, Ofthe right of workers to organize in unions. In particular, all of these rights are “A” rights, i.e. H. they represent our freedom to perform an action or access a resource that benefits us, and in most casesbut not allCases enriches our civil society. But there is another kind of right: rights based on freedom “from”. This includes the right to live free from socioeconomic insecurity or risk of environmental disaster or risk of preventable injury and disease. Promoting freedom “from” is largely the task of public health. However, sometimes we are blamedpaternalism, freedom "for" violating the rights of others. With that in mind, a note on these two notions of freedom and how public health can help ensure that freedom “from” becomes as integral a part of our society as freedom “to”.
What can our history teach us about our collective emphasis on freedom "to"? How did this emphasis develop? Perhaps the most important record of American freedoms, the Bill of Rights contains several famous "a" freedoms. These include the right to freedom of expression and association, the right to bear arms, due process, a speedy and public trial and a jury trial. The remaining five amendments are clearly freedoms “from” (freedom from unreasonable search and seizure, from having to quarteree soldiers in time of war, from excessive bail and from cruel and unusual punishment) or, in the case of theNonajtenthThe reforms relate to the Constitution itself. In addition to the "to" freedoms listed in the Bill of Rights, which represent the fundamental privileges of an American citizen, the Constitution has catalyzed our emphasis on the "to" freedom in another fundamental way . Because the document was written at a time when many groups, especially African Americans and women, were excluded from the full scope of its protections, a central theme of American history has been these groups' struggle to gain the freedoms they were initially denied. . . . The drama of this struggle often revolved around freedoms “for”:poll;have access to the same kitchens, schools and public spaces as their fellow citizens; Ömarry. These achievements have become central to our country's history and have shaped the way we view ourselves and our freedoms, with the freedom of "to" arguably holding a place of honor in the American psyche.
This emphasis on the freedom to “do” has shaped our political reality both positively and negatively. The freedom to “cough” enshrined in the Bill of Rights laid the foundation for a free press, an open society, and a judicial system that strives at best for an ideal of justice. If we fall short of these ideals, the struggle for liberty—for civil rights, equal protection from the law, and a more equal society where all have access to the same rights regardless of race, gender, or sexual orientation—has done much to improve conditions, which led to decades of social and political progress. These efforts have also stimulated the creation of influential civic organizations dedicated to upholding these hard-won rights and increasing the number of people who can enjoy them.family planning, IsAmerican Civil Rights Union, IsNational Association for the Advancement of Colored People, it's himSouthern Poverty Law Centerare examples of such organizations. We have also seen how an emphasis on the freedom to "do" can compromise the health and safety of citizens. The problem of armed violence is an example of this. In the centuries since the Second Amendment was written, has the right to bear arms,for a small but vocal minority of Americans, meant the right tounrestricted access to firearmsat any time, in any place,to all types of weapons. The annual number of firearm deaths in the United States –more than 30,000 people a year-esa direct resultthis interpretation, an interpretation promoted by powerful interest groups, notably the National Rifle Association,who fought backEfforts to curb gun violence. We also saw resistance to everythingseat belt laws, APortion controls for sugary drinks, AIndoor smoking bans. While all of these measures represent advances in public health, theirs areimplementationIt has been difficult in a society that tends to see freedom primarily in terms of what a person can do and own.
What is the alternative view of freedom, i.e. freedom “from”? What does freedom "from" mean in the context of social and political systems? A central expression of this freedom can be found inThe Universal Declaration of Human Rights. The declaration states in its preamble that "the liberation from fear and want has been proclaimed as the supreme aspiration of the common people". This is the core responsibility of public health and the central challenge we face in all of our work. In the struggle for these goals, we often encounter opposition from those who focus on freedom “towards,” who see the pursuit of freedom “from” as a threat to individual freedom. This happens when the existing institutions and policies designed to protect the rights of populations to live free from the dangers of economic insecurity and disease are misinterpreted as violating the rights of individuals. 1789 conservative political philosopherEdmund Burkeaddressed this issuein a letter, where he described what he saw as the best way to promote freedom:
“The freedom I am referring to is social freedom. It is that condition in which liberty is assured by equality of constraints. A state of affairs in which the liberty of no man, group of men, and number of men can find ways to exceed the liberty of any person or any description of persons in society. That kind of freedom is really just another name for justice; determined by wise laws and secured by well-built institutions".
Burke's support for shaping the legal and social institutions necessary to protect liberty is well captured by his phrase "the equality of constraint," which suggests the role of these institutions in creating an environment in which liberty can flourish. In presenting this case, Burke makes it clear that these institutions are necessary to ensure that unrestricted individual liberty does not violate anyone's liberty, and that such a violation is in fact an injustice. For Burke, freedom from this interference—beyond the exercise of any freedom “to”—is the essence of freedom; a strong affirmation of the importance of freedom “from” for a healthy civil society.
What should ideally be a conversation about the social, economic and environmental conditions that shape population health often turns into a debate about whether public health work mattershurtful em the rightthese populations. Such arguments often confront us with a narrow definition of liberties "for"; Not thinking about how to live a healthy and productive life is not faira right in itselfbut also a necessary condition for our ability to enjoy other rights, including our rights toLife, liberty and the pursuit of happiness. Instead of accepting the terms of this debate, we need to change the context in which the conversation is taking place and address itour common constitutional heritage, regards it as the basis of many different kinds of freedom. This means arguing that both freedom “from” and freedom “to” are equally valid and essential characteristics of a society that prioritizes health and human rights for all populations, and generating a recalibration of our national conversation in which freedom from Sickness, healthy living – is a key freedom aspired to that should have the same place as “for” freedoms in the national debate. Contemporary human rights doctrine sums up the argument concisely: there is no hierarchy of human rights in which civil rights take precedence over economic and social rights; All human rights are interrelated and essential for the thriving of humanity. This is partly our responsibility as a public health school; to create the space for this conversation in our community, locally, nationally and globally.
I hope everyone is having a great week. Until next week.
a warm greeting,
Sandro Galea, MD, DrPH
Professor Dean und Robert A. Knox, Boston University School of Public Health
Acknowledgments: Thanks to Professor George Annas and Eric DelGizzo for their contributions to this Dean's Note.
The Dean's past notes are archived at:https://www.bu.edu/sph/tag/deans-note/
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