The medicalization of freedom

[Niemand]

These people... no mention of how some of these things are not scientific nor a number of other things.

https://www.nature.com/articles/s41591-021-01640-y

Published: 07 February 2022
The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it
Jerel M. Ezell
Nature Medicine volume 28, page219 (2022)Cite this article

To the Editor — Looking back, the initial spread of COVID-19 in early 2020 illustrates that clinicians, epidemiologists and behavioral scientists around the world greatly underestimated the scope and intensity of resistance to mitigation measures that would follow. Many in the medical community have remained wedded to the view that direct observation of the soaring volume of death and morbidity associated with coronavirus infections will convert most people into adherents of mitigation measures. Hence, most public health communications on mask-wearing, social distancing, and vaccination stubbornly focus on and attempt to leverage efficacy data, patient testimonies, and the clout of clinicians, politicians, athletes and social media influencers, to increase public uptake1.

Grappling with the nature and scale of resistance to COVID-19 mitigation measures requires an intimate and nuanced understanding of personal and medical autonomy. This reckoning must acknowledge the fusion between anti-science and personal liberty movements that can be described as the ‘medicalization of freedom’.

COVID-19 is currently ensnarled in the most consequential culture war of our times. At the heart of this social flashpoint is a thorny question on the nature of freedom: what it is, who it belongs to and how to preserve it. Freedom, as an ideal and social aspiration, has long occupied a virtually unimpeachable — and axiomatic — position in Western society.

Resistance to COVID-19 mandates fits in a lineage of freedom in Western society, where freedom has always had a subjective, shapeshifting quality. Global so-called freedom movements have considerably undercut efforts to disrupt the pandemic, as public health advocates have wrestled with how to get upstream of a deluge of anti-science while addressing downstream outcomes of increased infections and the need to preserve institutional legitimacy.

Arguments against COVID-19 mitigation protocols are enmeshed in freedom ideology and are invoked as a way to maintain, or promote, the ‘health’ of an individual’s freedom. Arguments against mitigation protocols include: stay-at-home policies to curtail the movement of individuals to otherwise accessible and desirable spaces; business shutdowns or restrictions that severely limit economic activity and recovery potential; mask mandates that violate personal standards for ease and comfort (and may operate inefficaciously); and vaccine mandates that are an assault on the body and the notion of bodily autonomy (and may present an undue health risk or inconvenience).

Freedom can be seen as an extension of an individual’s psyche — psyche being a psychological state reflecting a feeling of (looming) social or medical vulnerability. As such, the medical community should consider how freedom can best be problematized as a medical phenomenon and how its manifestations can be treated. There are four primary steps needed to effectively address this medicalization of freedom as part of clinical engagement and public outreach efforts.

First, bring conversations of freedom into clinical and public outreach spaces, treating freedom as a healthcare paradigm. Clinicians and public health advocates should not shy away from discussions on freedom and the process of medicalization that it is undergoing. Additionally, clinicians should actively encourage discussions of freedom and its meanings when discussing the importance of mitigation options with patients. Freedom should be codified as a discrete health concern, such that certain beliefs around it are situated as a potential risk factor for healthcare disengagement.

Second, seek to understand where precisely the focus on freedom has its genesis and when it manifests. Most centrally, the craving for freedom derives from a sense that one has been wronged or that being wronged — socially, economically, medically or otherwise — is imminent. Hence, the focus on freedom comes from a place of perceived vulnerability and thus operates in both a defensive and offensive context. In this regard, although vulnerability is very much relative, the desire for freedom is a ‘future-oriented’ emotion2, meaning that it is likely most pronounced and resilient when uncertainty is elevated.

Third, recognize the socioeconomic and intersectional richness of freedom in a culturally humble manner, treating it as a social determinant of health. Freedom means different things to different people, prompting the need for cultural humility. For many white people, freedom is perhaps most salient in colonial terms and as a direct means of enshrining personal preferences, expressed as freedom of religion, freedom of assembly, freedom of speech, and so on. By contrast, the freedom of racial or ethnic minorities and low-income people are highly connected to historical trauma; for example, resistance to COVID-19 vaccination can be understood as a tactical response to generations of structural oppression including acts of land dispossession, forced assimilation, genocide and systemic racism3.

Fourth, align the freedom mentality with a humanistic COVID-19 mitigation mentality. Freedoms are most intimately and persistently felt as, and equated with, human rights. However, without strategic integration, freedom becomes an individualistic paradigm focused on personal gain, disengaged from collectivist public health efforts. The embrace of mitigation should be promoted as an expression of freedom and support of human rights, a communal paradigm focused on maintaining personal health and dignity.

The medical community must take seriously the medicalization of freedom and start problem-solving around it to stop the spread of the anti-science movement. Without action, there will be further distrust of the medical establishment, allowing for deepening politicization of other aspects of public health.

References
Bekalu, M. A. et al. Health Educ. Res. 36, 178–191 (2021).

Article

Google Scholar


Barbalet, J. M. Int. J. Sociol. Soc. Policy 16, 75–96 (1996).

Article

Google Scholar


Ravi, S. J. et al. Health Secur. 19, S1 (2021).

Article

Google Scholar


Download references

Author information
Affiliations
Africana Studies and Research Center, Cornell Center for Health Equity, Cornell University, Ithaca, NY, USA

Jerel M. Ezell

Corresponding author
Correspondence to Jerel M. Ezell.

Ethics declarations
Competing interests
The author declares no competing interests.

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Reprints and Permissions

About this article
Verify currency and authenticity via CrossMark
Cite this article
Ezell, J.M. The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it. Nat Med 28, 219 (2022). https://doi.org/10.1038/s41591-021-01640-y

[BroJones]

These people... no mention of how some of these things are not scientific nor a number of other things.

https://www.nature.com/articles/s41591-021-01640-y

Published: 07 February 2022
The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it
Jerel M. Ezell
Nature Medicine volume 28, page219 (2022)Cite this article

To the Editor — Looking back, the initial spread of COVID-19 in early 2020 illustrates that clinicians, epidemiologists and behavioral scientists around the world greatly underestimated the scope and intensity of resistance to mitigation measures that would follow. Many in the medical community have remained wedded to the view that direct observation of the soaring volume of death and morbidity associated with coronavirus infections will convert most people into adherents of mitigation measures. Hence, most public health communications on mask-wearing, social distancing, and vaccination stubbornly focus on and attempt to leverage efficacy data, patient testimonies, and the clout of clinicians, politicians, athletes and social media influencers, to increase public uptake1.

Grappling with the nature and scale of resistance to COVID-19 mitigation measures requires an intimate and nuanced understanding of personal and medical autonomy. This reckoning must acknowledge the fusion between anti-science and personal liberty movements that can be described as the ‘medicalization of freedom’.

COVID-19 is currently ensnarled in the most consequential culture war of our times. At the heart of this social flashpoint is a thorny question on the nature of freedom: what it is, who it belongs to and how to preserve it. Freedom, as an ideal and social aspiration, has long occupied a virtually unimpeachable — and axiomatic — position in Western society.

Resistance to COVID-19 mandates fits in a lineage of freedom in Western society, where freedom has always had a subjective, shapeshifting quality. Global so-called freedom movements have considerably undercut efforts to disrupt the pandemic, as public health advocates have wrestled with how to get upstream of a deluge of anti-science while addressing downstream outcomes of increased infections and the need to preserve institutional legitimacy.

Arguments against COVID-19 mitigation protocols are enmeshed in freedom ideology and are invoked as a way to maintain, or promote, the ‘health’ of an individual’s freedom. Arguments against mitigation protocols include: stay-at-home policies to curtail the movement of individuals to otherwise accessible and desirable spaces; business shutdowns or restrictions that severely limit economic activity and recovery potential; mask mandates that violate personal standards for ease and comfort (and may operate inefficaciously); and vaccine mandates that are an assault on the body and the notion of bodily autonomy (and may present an undue health risk or inconvenience).

Freedom can be seen as an extension of an individual’s psyche — psyche being a psychological state reflecting a feeling of (looming) social or medical vulnerability. As such, the medical community should consider how freedom can best be problematized as a medical phenomenon and how its manifestations can be treated. There are four primary steps needed to effectively address this medicalization of freedom as part of clinical engagement and public outreach efforts.

First, bring conversations of freedom into clinical and public outreach spaces, treating freedom as a healthcare paradigm. Clinicians and public health advocates should not shy away from discussions on freedom and the process of medicalization that it is undergoing. Additionally, clinicians should actively encourage discussions of freedom and its meanings when discussing the importance of mitigation options with patients. Freedom should be codified as a discrete health concern, such that certain beliefs around it are situated as a potential risk factor for healthcare disengagement.

Second, seek to understand where precisely the focus on freedom has its genesis and when it manifests. Most centrally, the craving for freedom derives from a sense that one has been wronged or that being wronged — socially, economically, medically or otherwise — is imminent. Hence, the focus on freedom comes from a place of perceived vulnerability and thus operates in both a defensive and offensive context. In this regard, although vulnerability is very much relative, the desire for freedom is a ‘future-oriented’ emotion2, meaning that it is likely most pronounced and resilient when uncertainty is elevated.

Third, recognize the socioeconomic and intersectional richness of freedom in a culturally humble manner, treating it as a social determinant of health. Freedom means different things to different people, prompting the need for cultural humility. For many white people, freedom is perhaps most salient in colonial terms and as a direct means of enshrining personal preferences, expressed as freedom of religion, freedom of assembly, freedom of speech, and so on. By contrast, the freedom of racial or ethnic minorities and low-income people are highly connected to historical trauma; for example, resistance to COVID-19 vaccination can be understood as a tactical response to generations of structural oppression including acts of land dispossession, forced assimilation, genocide and systemic racism3.

Fourth, align the freedom mentality with a humanistic COVID-19 mitigation mentality. Freedoms are most intimately and persistently felt as, and equated with, human rights. However, without strategic integration, freedom becomes an individualistic paradigm focused on personal gain, disengaged from collectivist public health efforts. The embrace of mitigation should be promoted as an expression of freedom and support of human rights, a communal paradigm focused on maintaining personal health and dignity.

The medical community must take seriously the medicalization of freedom and start problem-solving around it to stop the spread of the anti-science movement. Without action, there will be further distrust of the medical establishment, allowing for deepening politicization of other aspects of public health.

References
Bekalu, M. A. et al. Health Educ. Res. 36, 178–191 (2021).

Article

Google Scholar


Barbalet, J. M. Int. J. Sociol. Soc. Policy 16, 75–96 (1996).

Article

Google Scholar


Ravi, S. J. et al. Health Secur. 19, S1 (2021).

Article

Google Scholar


Download references

Author information
Affiliations
Africana Studies and Research Center, Cornell Center for Health Equity, Cornell University, Ithaca, NY, USA

Jerel M. Ezell

Corresponding author
Correspondence to Jerel M. Ezell.

Ethics declarations
Competing interests
The author declares no competing interests.

Rights and permissions
Reprints and Permissions

About this article
Verify currency and authenticity via CrossMark
Cite this article
Ezell, J.M. The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it. Nat Med 28, 219 (2022). https://doi.org/10.1038/s41591-021-01640-y

--> The British journal NATURE is probably the world's premier science journal. For them to publish this article is remarkable and noteworthy.

And disturbing.

Note the interweaving of "freedom" and "racism" in this article:
"For many white people, freedom is perhaps most salient in colonial terms and as a direct means of enshrining personal preferences, expressed as freedom of religion, freedom of assembly, freedom of speech, and so on. By contrast, the freedom of racial or ethnic minorities and low-income people are highly connected to historical trauma; for example, resistance to COVID-19 vaccination can be understood as a tactical response to generations of structural oppression including acts of land dispossession, forced assimilation, genocide and systemic racism3."

Note also the stance that notions of freedom are to be "medicalized" and considered an obstacle to be treated medically:

"The medical community must take seriously the medicalization of freedom and start problem-solving around it to stop the spread of the anti-science movement. Without action, there will be further distrust of the medical establishment, allowing for deepening politicization of other aspects of public health."

Wow.
I have had experiences with Nature, published there at least three times.
This takes the cake.

[Niemand]

resistance to COVID-19 vaccination can be understood as a tactical response to generations of structural oppression including acts of land dispossession, forced assimilation, genocide and systemic racism

This is post-structuralist garbage, a classic example of some right questions with wrong answers. A lot of Africans are rightly suspicious of the motives of Bill Gates and Pfizer, since previous vaccine injuries are a well known fact there.

As I point out here:
viewtopic.php?f=1&t=63439

In 2007, the Nigerian federal government and Kano State government filed criminal and civil suits against Pfizer and eight other defendants, asking for $7 billion in damages. The suit charged that the company had tested an unapproved and experimental drug on children with neither informed consent from parents nor approval from the Nigerian government. Pfizer countered that such approval wasn’t necessary. In 2001, an investigation by the Washington Post had uncovered that a document Pfizer claimed to prove ethical approval by Nigerian authorities for the trial appeared to be falsified and back-dated.

[JuneBug12000]

These people... no mention of how some of these things are not scientific nor a number of other things.

https://www.nature.com/articles/s41591-021-01640-y

Published: 07 February 2022
The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it
Jerel M. Ezell
Nature Medicine volume 28, page219 (2022)Cite this article

To the Editor — Looking back, the initial spread of COVID-19 in early 2020 illustrates that clinicians, epidemiologists and behavioral scientists around the world greatly underestimated the scope and intensity of resistance to mitigation measures that would follow. Many in the medical community have remained wedded to the view that direct observation of the soaring volume of death and morbidity associated with coronavirus infections will convert most people into adherents of mitigation measures. Hence, most public health communications on mask-wearing, social distancing, and vaccination stubbornly focus on and attempt to leverage efficacy data, patient testimonies, and the clout of clinicians, politicians, athletes and social media influencers, to increase public uptake1.

Grappling with the nature and scale of resistance to COVID-19 mitigation measures requires an intimate and nuanced understanding of personal and medical autonomy. This reckoning must acknowledge the fusion between anti-science and personal liberty movements that can be described as the ‘medicalization of freedom’.

COVID-19 is currently ensnarled in the most consequential culture war of our times. At the heart of this social flashpoint is a thorny question on the nature of freedom: what it is, who it belongs to and how to preserve it. Freedom, as an ideal and social aspiration, has long occupied a virtually unimpeachable — and axiomatic — position in Western society.

Resistance to COVID-19 mandates fits in a lineage of freedom in Western society, where freedom has always had a subjective, shapeshifting quality. Global so-called freedom movements have considerably undercut efforts to disrupt the pandemic, as public health advocates have wrestled with how to get upstream of a deluge of anti-science while addressing downstream outcomes of increased infections and the need to preserve institutional legitimacy.

Arguments against COVID-19 mitigation protocols are enmeshed in freedom ideology and are invoked as a way to maintain, or promote, the ‘health’ of an individual’s freedom. Arguments against mitigation protocols include: stay-at-home policies to curtail the movement of individuals to otherwise accessible and desirable spaces; business shutdowns or restrictions that severely limit economic activity and recovery potential; mask mandates that violate personal standards for ease and comfort (and may operate inefficaciously); and vaccine mandates that are an assault on the body and the notion of bodily autonomy (and may present an undue health risk or inconvenience).

Freedom can be seen as an extension of an individual’s psyche — psyche being a psychological state reflecting a feeling of (looming) social or medical vulnerability. As such, the medical community should consider how freedom can best be problematized as a medical phenomenon and how its manifestations can be treated. There are four primary steps needed to effectively address this medicalization of freedom as part of clinical engagement and public outreach efforts.

First, bring conversations of freedom into clinical and public outreach spaces, treating freedom as a healthcare paradigm. Clinicians and public health advocates should not shy away from discussions on freedom and the process of medicalization that it is undergoing. Additionally, clinicians should actively encourage discussions of freedom and its meanings when discussing the importance of mitigation options with patients. Freedom should be codified as a discrete health concern, such that certain beliefs around it are situated as a potential risk factor for healthcare disengagement.

Second, seek to understand where precisely the focus on freedom has its genesis and when it manifests. Most centrally, the craving for freedom derives from a sense that one has been wronged or that being wronged — socially, economically, medically or otherwise — is imminent. Hence, the focus on freedom comes from a place of perceived vulnerability and thus operates in both a defensive and offensive context. In this regard, although vulnerability is very much relative, the desire for freedom is a ‘future-oriented’ emotion2, meaning that it is likely most pronounced and resilient when uncertainty is elevated.

Third, recognize the socioeconomic and intersectional richness of freedom in a culturally humble manner, treating it as a social determinant of health. Freedom means different things to different people, prompting the need for cultural humility. For many white people, freedom is perhaps most salient in colonial terms and as a direct means of enshrining personal preferences, expressed as freedom of religion, freedom of assembly, freedom of speech, and so on. By contrast, the freedom of racial or ethnic minorities and low-income people are highly connected to historical trauma; for example, resistance to COVID-19 vaccination can be understood as a tactical response to generations of structural oppression including acts of land dispossession, forced assimilation, genocide and systemic racism3.

Fourth, align the freedom mentality with a humanistic COVID-19 mitigation mentality. Freedoms are most intimately and persistently felt as, and equated with, human rights. However, without strategic integration, freedom becomes an individualistic paradigm focused on personal gain, disengaged from collectivist public health efforts. The embrace of mitigation should be promoted as an expression of freedom and support of human rights, a communal paradigm focused on maintaining personal health and dignity.

The medical community must take seriously the medicalization of freedom and start problem-solving around it to stop the spread of the anti-science movement. Without action, there will be further distrust of the medical establishment, allowing for deepening politicization of other aspects of public health.

References
Bekalu, M. A. et al. Health Educ. Res. 36, 178–191 (2021).

Article

Google Scholar


Barbalet, J. M. Int. J. Sociol. Soc. Policy 16, 75–96 (1996).

Article

Google Scholar


Ravi, S. J. et al. Health Secur. 19, S1 (2021).

Article

Google Scholar


Download references

Author information
Affiliations
Africana Studies and Research Center, Cornell Center for Health Equity, Cornell University, Ithaca, NY, USA

Jerel M. Ezell

Corresponding author
Correspondence to Jerel M. Ezell.

Ethics declarations
Competing interests
The author declares no competing interests.

Rights and permissions
Reprints and Permissions

About this article
Verify currency and authenticity via CrossMark
Cite this article
Ezell, J.M. The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it. Nat Med 28, 219 (2022). https://doi.org/10.1038/s41591-021-01640-y

The fact that this is thought is astounding. The fact that it was written is horrifying. The fact that it was printed. . . I have no words.


Part of me wants to write a response to each wrong statement, and I did start. But my response would be so much longer than the article.

[Dusty Wanderer]

...

Part of me wants to write a response to each wrong statement, and I did start. But my response would be so much longer than the article.

Suppose that supports the old adage, "A lie will go round the world while truth is pulling its boots on".

[Christianlee]

From social distancing to lockdowns to face masks to mRNA shots none of their mitigation efforts worked. To say otherwise is simply an authoritarian lie. Beyond that, the mRNA shots caused a small percentage, but still significant, number of deaths and injuries. Where there is risk there must be freedom. Lockdowns favored big corporations over small businesses. Who knows what the long term effect of forcing masks on school children will be? The cult of Covidstan was anything but science.

[Serragon]

The medical arena is just the latest place where your freedom to determine risk and make decisions is being hijacked by those who wish to rule you and make those decisions for you.

You are completely free in the USA. Except for a few tiny little things where your betters need to get involved. Little things like who you associate with, personal property, trading, etc. You still get to decide all the important things like what you will watch on netflix tonight.

Enjoy your freedom. And rejoice that your betters are making all the tough decisions for you. Their sacrifice on your behalf is truly inspiring. Without that sacrifice, you would be enslaved by the responsibility of those decisions and never be truly free.

[JuneBug12000]

The medical arena is just the latest place where your freedom to determine risk and make decisions is being hijacked by those who wish to rule you and make those decisions for you.

You are completely free in the USA. Except for a few tiny little things where your betters need to get involved. Little things like who you associate with, personal property, trading, etc. You still get to decide all the important things like what you will watch on netflix tonight.

Enjoy your freedom. And rejoice that your betters are making all the tough decisions for you. Their sacrifice on your behalf is truly inspiring. Without that sacrifice, you would be enslaved by the responsibility of those decisions and never be truly free.

AMEN! That is the part that bothers me the most.

When people speak of maintaining freedom, they don't realize how little they have. Worse, they believe they have had it in their lifetime and just want it back.

Freedom has not been had by any for longer than I have been alive and then a lot more.

You find where the lines are when you try to cross them.

I was born on Earth, placed here by God.

As a child of God I am -commanded- to multiply and replenish the Earth. I am commanded to subdue the Earth. I am commanded to have dominion over the animals.

If I should reject the governments of the world and live free as God intended: sheltering, eating, living by the sweat of my brow all my day: I would break so many laws in such a short time, that if prosecuted I would find myself in prison for life.

To build a shelter on the land God made. (Where is deed? Public lands are all our lands" so you need government permission to use them." Meaning of course that you can't use them. Lots of codes, laws, and restrictions. Nothing too simple or plain, not legal in most places. You can't just cut down trees, you need a permit. )
Killing an animal to eat? (Do you have a license? Is it the right season? Are they protected?)
Domesticating animals (You'll kill the Earth! You may only do this with permission and not too many and only certain kinds.
Want to burn wood for heat or cooking. (Might need to buy some carbon credits.)
Making clothing from animal skins. (Cruelty to animals. Not sustainable.)
And on and on.
You can't even pee and poop just anywhere in the woods or on your own property without getting permission that you might not get. (No more outhouses. We need complex systems to manage our poop!)
Want to dig a well for water? (Do you have a legal "right" you may need to buy one, if one is even available to buy.)
Surface water? (Depends on the local laws and if someone downstream claims it or upstream stops it. )

Maybe you agree with all those, basic civilization and all.

What about how you raise your kids? What you think is important to educate them in or protect them from.
What clothes you choose to wear? We wore hand me downs and used patches on our jeans when I was a kid. I got flak for trying to do patches for my kids. People think you aren't taking care of them well enough. Easier/safer to just buy new jeans.

And all of that comes before medical procedures like vaccines, cancer treatments, etc.

And yet, there are still many who do not want us to choose as evidenced by the last two years for any who were still asleep.

[EvanLM]

these ideas of freedom and harm came from perceptions? oh no, not only no but _______ no. It came from watching the medical profession constantly mess up, kill people, harm people and never admit it.

I taught kids that had brain damage, cerebral palsy and were blind . . . . brain damage and cerebral palsy from lack of oxygen at birth . . .then blind from too much oxygen at birth . . . what a doctor, then parents and the child deal withthis the rest of their lives . . . I could go on . . . .

[Fred]

The doctors, clinics, and hospitals, that preached masks and shots will soon discover the error of their ways. Or maybe not. Lucifer still thinks he was right. I'm betting my life on God's immune system. I've wondered how the medical community can live with themselves knowing there is no science behind it at all. They are finding out just how very little they actually know about mRNA and such. Every doctor that has a mask sign or that encourages shots is a disciple of satan. Every last one.

[BroJones]

If "freedom" is a medical issue/problem, then perhaps they'll find a medication to treat the problem...

Is there a med that takes away one's sense of freedom? I hope not.

[NeveR]

If "freedom" is a medical issue/problem, then perhaps they'll find a medication to treat the problem...

Is there a med that takes away one's sense of freedom? I hope not.

I think there are several that take away your desire for freedom and the mental capacity to recognize you are a prisoner.

[Niemand]

If "freedom" is a medical issue/problem, then perhaps they'll find a medication to treat the problem...

Is there a med that takes away one's sense of freedom? I hope not.

Antidepressants etc?