Within Reason: A Liberal Public Health for an Illiberal Time

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.

Table of Contents:
Introduction Foundations What Stories Will We Tell about COVID-19? Liberty and Health? Fear The Economics of Illiberalism How to Get Healthier and Wealthier during a Crisis Decision-Making in an Age of Social Media Borders in an Age of Pandemics UFOs, COVID-19, and the Return of Radical Uncertainty Why Do We Tell the Stories We Tell? The History of Soccer, the Butterfly Effect, and Public Health The Ongoing Challenge of Race Not in the Name of Public Health Health and the Opportunity to Think Freely Thinking in Groups or Thinking for Ourselves: In Praise of Iconoclasm The Challenge of Slow-Burning Threats The Ineluctable Role of the Faceless Bureaucrat Sectarianism and the Public’s Health Health in an Era of Resurgent Great Power Conflict “For Our Own Good” Heresies Why Health? The Spherical Cow Problem Public Health and the Temptations of Power Not Our Place The Radical Importance of Acknowledging Progress Who’s Left? Too Far, or Not Far Enough? A Case against Moralism in Public Health Resisting the Allure of Moral Grandstanding Resisting Our Suburban Impulses Checking Our Blind Spots We Need to Talk about Class Public Health and Tradition My Bias in Favor of Living Hopes Mercy and Our Present Moment A Case for Good Faith Argument “One Does Have Joys” A Playbook for Balancing the Moral and Empirical Cases for Health The False Choice of Diversity and Inclusion versus the Pursuit of Excellence Our Place in the Natural Order of Things What Do We Want from Our Political System? The Role of Experts and Community Voices Both The Aesthetics of a Healthier World Intellectual Cross-Training toward a Healthier World The Incredible Potential of New Technology The Consent of the Governed Spending Smarter A Populist Public Health In Praise of Objective Reality The Next Generation: The Kids Are (Probably) All Right In Conclusion Toward a Liberal Public Health Acknowledgments Index

About the Author :
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.

Review :
"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." "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." "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." "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." "Erudite, well written and thought-provoking." "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." "[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." "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." “Powerful, erudite, and immersive—an essential treatise on our needed reformation in public health.” “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.”