Freedom “to” vs. Freedom “from”.

In the United States, we place a high premium on freedom, and on the legal extension of that freedom—rights. It is telling that the Tea Party resistance to the agenda of Barack Obama, and the burgeoning progressive resistance to the Trump administration, while sharing little in common ideologically, are united by their reverence for rights, and by their concerns about losing them. In the case of the Tea Party, these rights notably include the right to bear arms, and the right to assemble and speak freely; on the left, the emphasis has been on issues like the right to safe reproductive care and pay equity, and the right of workers to unionize. Notably, all of these rights are rights “to”—this is to say, they represent our freedom to perform an action or access a resource that benefits us, and, in most but not all cases, enriches our civil society. But there is another kind of right—rights that are founded on the basis of freedom “from.” These include the right to live free from socioeconomic insecurity, or from the threat of environmental disaster, or the hazard of preventable injury and disease. Promoting freedom “from” is, in large part, the work of public health. In doing so, however, we sometimes find ourselves accused of paternalism, of infringing on the freedom “to” rights of others. With this tension in mind, a note on these two notions of freedom, and how public health can work to ultimately make freedom “from” just as integral to our society as freedom “to.”

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“The liberty I mean is social freedom. It is that state of things in which liberty is secured by the equality of restraint. A constitution of things in which the liberty of no one man, and no body of men, and no number of men, can find means to trespass on the liberty of any person, or any description of persons, in the society. This kind of liberty is, indeed, but another name for justice; ascertained by wise laws, and secured by well-constructed institutions.”

Burke’s support for shaping the legal and social institutions necessary to safeguard liberty is well captured by his phrase “the equality of restraint,” which suggests the role of these institutions in creating an environment where liberty can flourish. In making this case, Burke clarifies that these institutions are necessary to ensure that unfettered individual liberty does not trespass on the liberty of anyone else, and that such a trespass is, in fact, an injustice. To Burke, freedom from this encroachment—beyond the exercise of any single freedom “to”—is the essence of liberty; a powerful endorsement of the importance of freedom “from” to a healthy civil society.

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I hope everyone has a terrific week. Until next week.

Warm regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor, Boston University School of Public Health
Twitter: @sandrogalea

Acknowledgement: I am grateful to Professor George Annas and to Eric DelGizzo for their contributions to this Dean’s Note.

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