An "Epidemic" Of Awakening?
Well, well.
It appears that awareness and understanding of the inherently totalitarian nature of the Health Promotion industry is spreading out, from obscure forums and blogs like this one to publications with substantial and diverse readership. The revelations about Public Health/ Health Promotion/ Population Health Promotion voiced by our own Ron Thomlinson several years ago seem to be reflected in an "epidemic" (teehee) of awakening by commentators of larger and larger readership all the time.
Hooray! for Jacob Sullum of Reason magazine, for his erudite and insightful analysis in the May edition of that publication: "An Epidemic Of Meddling - the totalitarian implications of public health"
Jacob Sullum article
Sullum's perspective is American, and he doesn't mention the Ottawa Charter for Health Promotion and its implications, nevertheless he seems to have independently drawn parallel conclusions to what we've been saying about the necessarily totalitarian nature of the modern Public Health and Health Promotion industries. After you sift through the fog of social marketing propaganda and epidemiological pseudo-science surrounding this topic, a frightening conclusion becomes inescapable - the true underlying "cause" of "lifestyle-related" illness is our freedom to place our health at risk, and the mission of public health promotion is to progressively strip us all of the liberty to make choices and decisions in our own behalf - in every sphere of our lives.
Sullum says:
"What do these four “public health” problems—smoking, playing violent video games, overeating, and gambling—have in common? They’re all things that some people enjoy and other people condemn, attributing to them various bad effects. Sometimes these effects are medical, but they may also be psychological, behavioral, social, or financial. Calling the habits that supposedly lead to these consequences “public health” problems, “epidemics” that need to be controlled, equates choices with diseases, disguises moralizing as science, and casts meddling as medicine. It elevates a collectivist calculus of social welfare above the interests of individuals, who become subject to increasingly intrusive interventions aimed at making them as healthy as they can be, without regard to their own preferences."
"In the past, public health officials could argue that they were protecting people from external threats: carriers of contagious diseases, fumes from the local glue factory, contaminated water, food poisoning, dangerous quack remedies. By contrast, the new enemies of public health come from within; the aim is to protect people from themselves—from their own carelessness, shortsightedness, weak will, or bad values—rather than from each other."
"For the most part, Americans are dying of things you can’t catch: cancer, heart disease, trauma. Accordingly, the public health establishment is focusing on those causes and the factors underlying them. Having vanquished most true epidemics, it has turned its attention to metaphorical “epidemics” of unhealthy behavior."
Sullum observes that, when public health promotion began to focus on "lifestyle factors" alleged to contribute to various illnesses, there seemed to be a widespread - albeit naive - belief among public health practitioners that "...people engage in risky behavior because they don’t know any better. Once they realize the risks they are taking, they will change their ways", and that there really were dramatic changes to certain patterns of behaviour brought about by aggressive public education campaigns on subjects such as smoking.
However, over time it must have become evident to these same practitioners that - even when fully aware of and educated about potential risks to health posed by various activities, behaviours and lifestyle choices - some people will still choose to place their health at risk because they value something else more highly than living as long as possible.
"Still, some people, even after they understand the risks they’re taking, obstinately continue to take them. To Richard Carmona, it may be obvious that “every American needs to eat healthy food in healthy portions and be physically active every day.” But what if some Americans, or many, or most, refuse to get with the program?"
"Maximizing health is not the same as maximizing happiness. The public health mission to minimize morbidity and mortality leaves no room for the possibility that someone might accept a shorter life span, or an increased risk of disease or injury, in exchange for more pleasure or less discomfort. Motorcyclists, rock climbers, and sky divers make that sort of decision all the time, and not all of them are ignorant of the relevant injury and fatality statistics. With lifestyle choices that pose longer-term risks, such as smoking and overeating, the dangers may be easier to ignore, but it is still possible for someone with a certain set of tastes and preferences to say, “Let me enjoy myself now; I’ll take my chances.” The assumption that such tradeoffs are unacceptable is the unspoken moral premise of public health."
"Needless to say, people make mistakes—sometimes expensive, hard-to-correct mistakes—in many areas of life. If that fact is reason enough for the government to second-guess their decisions about dangerous activities such as smoking cigarettes and riding motorcycles, why on earth should the government let people make their own choices when it comes to such consequential matters as where to live, how much education to get, whom to marry, whether to have children, which job to take, or what religion to practice? These decisions are at least as important, and the government is at least as well equipped to make them as it is to decide which health risks are acceptable."
"Because the public health field developed in response to deadly threats that spread from person to person and place to place, its practitioners are used to enlisting the state in their cause. Writing in 1879, John Shaw Billings put it this way: “All admit that the State should extend special protection to those who are incapable of judging of their own best interests, or of taking care of themselves, such as the insane, persons of feeble intellect, or children; and we have seen that in sanitary matters the public at large are thus incompetent.”
"Billings was defending measures aimed at traditional public health targets, such as infectious diseases and toxic pollution. It’s reasonable to expect that such efforts will be welcomed by the intended beneficiaries once they understand the aim. The same cannot be said of public health’s new targets. Even after the public is informed about the relevant hazards, many people will continue to behave in ways frowned upon by the public health establishment. This is not because they misunderstood; it’s because, for the sake of pleasure, utility, or convenience, they are prepared to accept the risks. When public health experts assume these decisions are wrong, they do indeed treat adults like children."
Sullum notes that this "obstinate" trait common to much of the population - the tendency to insist on making fully informed choices and decisions that fail to conform to the advice of public health practitioners - eventually leads some of those practitioners to conclude that the freedom to be autonomous, to make choices and decisions for ourselves, is itself the biggest risk factor for the development of chronic illnesses in our society today.
"Some public health theorists explicitly recognize that their aims are fundamentally collectivist and cannot be reconciled with the American tradition of limited government.In 1975 Dan Beauchamp, then an assistant professor of public health at the University of North Carolina, presented a paper at the annual meeting of the American Public Health Association in which he argued that “the radical individualism inherent in the market model” is the biggest obstacle to improving public health. “The historic dream of public health that preventable death and disability ought to be minimized is a dream of social justice,” Beauchamp said. “We are far from recognizing the principle that death and disability are collective problems and that all persons are entitled to health protection.”
"Not only are all persons entitled to health protection, but they’re going to get it, whether they want it or not. Beauchamp rejected “the ultimately arbitrary distinction between voluntary and involuntary hazards” and complained that “the primary duty to avert disease and injury still rests with the individual.” He called upon public health practitioners to challenge “the powerful sway market-justice holds over our imagination, granting fundamental freedom to all individuals to be left alone.” So the right to be left alone—the right Supreme Court Justice Louis Brandeis considered “the most comprehensive of rights and the right most valued by civilized men”—turns out to be the leading risk factor for disease and injury".
And thus we find ourselves in our current social circumstances, wherein the greatest threat to our liberty & freedom comes not from some malevolent foreign power but from benevolent, internal, health nannies.
It appears that awareness and understanding of the inherently totalitarian nature of the Health Promotion industry is spreading out, from obscure forums and blogs like this one to publications with substantial and diverse readership. The revelations about Public Health/ Health Promotion/ Population Health Promotion voiced by our own Ron Thomlinson several years ago seem to be reflected in an "epidemic" (teehee) of awakening by commentators of larger and larger readership all the time.
Hooray! for Jacob Sullum of Reason magazine, for his erudite and insightful analysis in the May edition of that publication: "An Epidemic Of Meddling - the totalitarian implications of public health"
Jacob Sullum article
Sullum's perspective is American, and he doesn't mention the Ottawa Charter for Health Promotion and its implications, nevertheless he seems to have independently drawn parallel conclusions to what we've been saying about the necessarily totalitarian nature of the modern Public Health and Health Promotion industries. After you sift through the fog of social marketing propaganda and epidemiological pseudo-science surrounding this topic, a frightening conclusion becomes inescapable - the true underlying "cause" of "lifestyle-related" illness is our freedom to place our health at risk, and the mission of public health promotion is to progressively strip us all of the liberty to make choices and decisions in our own behalf - in every sphere of our lives.
Sullum says:
"What do these four “public health” problems—smoking, playing violent video games, overeating, and gambling—have in common? They’re all things that some people enjoy and other people condemn, attributing to them various bad effects. Sometimes these effects are medical, but they may also be psychological, behavioral, social, or financial. Calling the habits that supposedly lead to these consequences “public health” problems, “epidemics” that need to be controlled, equates choices with diseases, disguises moralizing as science, and casts meddling as medicine. It elevates a collectivist calculus of social welfare above the interests of individuals, who become subject to increasingly intrusive interventions aimed at making them as healthy as they can be, without regard to their own preferences."
"In the past, public health officials could argue that they were protecting people from external threats: carriers of contagious diseases, fumes from the local glue factory, contaminated water, food poisoning, dangerous quack remedies. By contrast, the new enemies of public health come from within; the aim is to protect people from themselves—from their own carelessness, shortsightedness, weak will, or bad values—rather than from each other."
"For the most part, Americans are dying of things you can’t catch: cancer, heart disease, trauma. Accordingly, the public health establishment is focusing on those causes and the factors underlying them. Having vanquished most true epidemics, it has turned its attention to metaphorical “epidemics” of unhealthy behavior."
Sullum observes that, when public health promotion began to focus on "lifestyle factors" alleged to contribute to various illnesses, there seemed to be a widespread - albeit naive - belief among public health practitioners that "...people engage in risky behavior because they don’t know any better. Once they realize the risks they are taking, they will change their ways", and that there really were dramatic changes to certain patterns of behaviour brought about by aggressive public education campaigns on subjects such as smoking.
However, over time it must have become evident to these same practitioners that - even when fully aware of and educated about potential risks to health posed by various activities, behaviours and lifestyle choices - some people will still choose to place their health at risk because they value something else more highly than living as long as possible.
"Still, some people, even after they understand the risks they’re taking, obstinately continue to take them. To Richard Carmona, it may be obvious that “every American needs to eat healthy food in healthy portions and be physically active every day.” But what if some Americans, or many, or most, refuse to get with the program?"
"Maximizing health is not the same as maximizing happiness. The public health mission to minimize morbidity and mortality leaves no room for the possibility that someone might accept a shorter life span, or an increased risk of disease or injury, in exchange for more pleasure or less discomfort. Motorcyclists, rock climbers, and sky divers make that sort of decision all the time, and not all of them are ignorant of the relevant injury and fatality statistics. With lifestyle choices that pose longer-term risks, such as smoking and overeating, the dangers may be easier to ignore, but it is still possible for someone with a certain set of tastes and preferences to say, “Let me enjoy myself now; I’ll take my chances.” The assumption that such tradeoffs are unacceptable is the unspoken moral premise of public health."
"Needless to say, people make mistakes—sometimes expensive, hard-to-correct mistakes—in many areas of life. If that fact is reason enough for the government to second-guess their decisions about dangerous activities such as smoking cigarettes and riding motorcycles, why on earth should the government let people make their own choices when it comes to such consequential matters as where to live, how much education to get, whom to marry, whether to have children, which job to take, or what religion to practice? These decisions are at least as important, and the government is at least as well equipped to make them as it is to decide which health risks are acceptable."
"Because the public health field developed in response to deadly threats that spread from person to person and place to place, its practitioners are used to enlisting the state in their cause. Writing in 1879, John Shaw Billings put it this way: “All admit that the State should extend special protection to those who are incapable of judging of their own best interests, or of taking care of themselves, such as the insane, persons of feeble intellect, or children; and we have seen that in sanitary matters the public at large are thus incompetent.”
"Billings was defending measures aimed at traditional public health targets, such as infectious diseases and toxic pollution. It’s reasonable to expect that such efforts will be welcomed by the intended beneficiaries once they understand the aim. The same cannot be said of public health’s new targets. Even after the public is informed about the relevant hazards, many people will continue to behave in ways frowned upon by the public health establishment. This is not because they misunderstood; it’s because, for the sake of pleasure, utility, or convenience, they are prepared to accept the risks. When public health experts assume these decisions are wrong, they do indeed treat adults like children."
Sullum notes that this "obstinate" trait common to much of the population - the tendency to insist on making fully informed choices and decisions that fail to conform to the advice of public health practitioners - eventually leads some of those practitioners to conclude that the freedom to be autonomous, to make choices and decisions for ourselves, is itself the biggest risk factor for the development of chronic illnesses in our society today.
"Some public health theorists explicitly recognize that their aims are fundamentally collectivist and cannot be reconciled with the American tradition of limited government.In 1975 Dan Beauchamp, then an assistant professor of public health at the University of North Carolina, presented a paper at the annual meeting of the American Public Health Association in which he argued that “the radical individualism inherent in the market model” is the biggest obstacle to improving public health. “The historic dream of public health that preventable death and disability ought to be minimized is a dream of social justice,” Beauchamp said. “We are far from recognizing the principle that death and disability are collective problems and that all persons are entitled to health protection.”
"Not only are all persons entitled to health protection, but they’re going to get it, whether they want it or not. Beauchamp rejected “the ultimately arbitrary distinction between voluntary and involuntary hazards” and complained that “the primary duty to avert disease and injury still rests with the individual.” He called upon public health practitioners to challenge “the powerful sway market-justice holds over our imagination, granting fundamental freedom to all individuals to be left alone.” So the right to be left alone—the right Supreme Court Justice Louis Brandeis considered “the most comprehensive of rights and the right most valued by civilized men”—turns out to be the leading risk factor for disease and injury".
And thus we find ourselves in our current social circumstances, wherein the greatest threat to our liberty & freedom comes not from some malevolent foreign power but from benevolent, internal, health nannies.
posted by son of gaia at 12:36 AM
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