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Within Reason
A Liberal Public Health for an Illiberal Time
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Sandro Galea
Language:
English
Published/Copyright:
2023
About this book
A provocative chronicle of how US public health has strayed from its liberal roots.
The Covid-19 response was a crucible of politics and public health—a volatile combination that produced predictably bad results. As scientific expertise became entangled with political motivations, the public-health establishment found itself mired in political encampment.
It was, as Sandro Galea argues, a crisis of liberalism: a retreat from the principles of free speech, open debate, and the pursuit of knowledge through reasoned inquiry that should inform the work of public health.
Across fifty essays, Within Reason chronicles how public health became enmeshed in the insidious social trends that accelerated under Covid-19. Galea challenges this intellectual drift towards intolerance and absolutism while showing how similar regressions from reason undermined social progress during earlier eras. Within Reason builds an incisive case for a return to critical, open inquiry as a guiding principle for the future public health we want—and a future we must work to protect.
Author / Editor information
Sandro Galea is the dean and Robert A. Knox Professor at the Boston University School of Public Health. He is the author of several books, including The Contagion Next Time and Well: What We Need to Talk about When We Talk about Health.
Reviews
“Powerful, erudite, and immersive—an essential treatise on our needed reformation in public health.”
— Alonzo Plough | Robert Wood Johnson Foundation“With equal dose of empathy and examination, Sandro Galea challenges us to undertake a deep exercise of self-reflection: how our hard-won political beliefs may betray us in the hope for a greater good. Within Reason is critically relevant for each of us—and all of us.”
— Julio Frenk | University of Miami"Despite remarkable successes, Galea argues, public health succumbed to a disturbing strain of illiberalism during the pandemic. . . .Galea makes a powerful case that to carry the worst illiberal outcomes from the pandemic into the next crisis would be a devastating mistake."
— Pamela Paul, The New York Times"Galea is a good companion in navigating readers through the political thickets in which public health now operates. [Within Reason] is not about COVID-19, but the pandemic was an enormous stress test of public health and thrust public health into the center of politics and media attention."
— The Lancet"In Within Reason, Galea provides a collection of his own essays to explore how the pandemic impacted public health in the US, alongside other general issues the pandemic exposed. In addition to providing incisive analysis on this topic, Galea’s essays provide a powerful and thought-provoking look at the trends in public health that were accelerated due to the pandemic."
— Choice"Galea’s book certainly covers many of the issues facing public health today and as such is required reading for those in the discipline or even those dependent on it for policy formation. . . . Galea is trying to resurrect the public health discipline from the illiberal quagmire of its ideological politicalization by re-founding it on liberalism. The question is whether public health, and to some extent science itself, can be resurrected within reason."
— Metascience"Within Reason provides a lucid examination of how the pandemic set in motion a gradual disenchantment with many of the liberal values that underlie the work of public health. For readers who are receptive, the book delivers a thoughtful set of ideas for moving forward while, at the same time, reclaiming a liberal approach to public health policy."
— Health Affairs"Erudite, well written and thought-provoking."
— The Spinoff Review of Books"[Within Reason] considers the case for a liberal public health policy, presenting reflections on the issues facing the field of public health in the United States and the efforts to establish and sustain a liberal public health policy. Examines the structural forces that shape health and how they have been shaped by the illiberalism of the contemporary political sphere."
— Journal of Economic Literature"Accessible. . . Galea has the style of a tutor who doesn’t heap his readers with unwarranted show-and-tell sympathy. When it comes to complex issues such as the economy, ideas, inequality, health, technology, policy, and politics, he is there, engaging the audience with parables. It is not difficult to be on board with him."
— The Hindustan TimesTopics
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Frontmatter
i -
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Contents
vii -
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Introduction
1 - Foundations
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What Stories Will We Tell about COVID-19?
15 -
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Liberty and Health?
22 -
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Fear
27 -
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The Economics of Illiberalism
32 -
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How to Get Healthier and Wealthier during a Crisis
36 -
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Decision-Making in an Age of Social Media
41 -
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Borders in an Age of Pandemics
46 -
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UFOs, COVID-19, and the Return of Radical Uncertainty
52 -
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Why Do We Tell the Stories We Tell?
57 -
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The History of Soccer, the Butterfly Effect, and Public Health
62 -
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The Ongoing Challenge of Race
66 -
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Not in the Name of Public Health
73 -
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Health and the Opportunity to Think Freely
78 -
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Thinking in Groups or Thinking for Ourselves: In Praise of Iconoclasm
83 -
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The Challenge of Slow-Burning Threats
88 -
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The Ineluctable Role of the Faceless Bureaucrat
93 -
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Sectarianism and the Public’s Health
98 -
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Health in an Era of Resurgent Great Power Conflict
103 -
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“For Our Own Good”
109 - Heresies
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Why Health?
117 -
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The Spherical Cow Problem
121 -
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Public Health and the Temptations of Power
126 -
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Not Our Place
131 -
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The Radical Importance of Acknowledging Progress
135 -
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Who’s Left?
139 -
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Too Far, or Not Far Enough?
144 -
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A Case against Moralism in Public Health
149 -
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Resisting the Allure of Moral Grandstanding
154 -
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Resisting Our Suburban Impulses
159 -
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Resisting Our Suburban Impulses
164 -
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We Need to Talk about Class
171 -
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Public Health and Tradition
176 -
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My Bias in Favor of Living
180 - Hopes
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Mercy and Our Present Moment
185 -
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A Case for Good Faith Argument
192 -
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“One Does Have Joys”
197 -
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Playbook for Balancing the Moral and Empirical Cases for Health
201 -
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The False Choice of Diversity and Inclusion versus the Pursuit of Excellence
206 -
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Our Place in the Natural Order of Things
211 -
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What Do We Want from Our Political System?
215 -
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The Role of Experts and Community Voices Both
220 -
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The Aesthetics of a Healthier World
224 -
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Intellectual Cross-Training toward a Healthier World
229 -
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The Incredible Potential of New Technology
233 -
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The Consent of the Governed
237 -
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Spending Smarter
242 -
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A Populist Public Health
247 -
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In Praise of Objective Reality
252 -
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The Next Generation: The Kids Are (Probably) All Right
256 - In Conclusion
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Toward a Liberal Public Health
261 -
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Acknowledgments
267 -
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Index
269
Publishing information
Pages and Images/Illustrations in book
eBook published on:
December 12, 2023
eBook ISBN:
9780226828862
Pages and Images/Illustrations in book
eBook ISBN:
9780226828862
Audience(s) for this book
For an expert adult audience, including professional development and academic research
