What is the history of thought around social welfare and how does it fit with free speech theory in our modern world?
Because the fields of science and medicine are relatively young, we can't look as far back in human history at theories of public health as we can for free speech. That said, the act of caring for others is as old as humanity, itself. Equal and reciprocal care for members within a societal group has not always been guaranteed, though, and–to the surprise of some–hasn't always seen continual progress.
While it's impossible to know what the earliest humans philosophized about this (or if they thought about it at all), hunter-gatherer societies were uniquely egalitarian and centered around collective good. Their survival depended on it. With the advent of pastoralism, however, societies became more nomadic, managing herds of domesticated animals. This caused increased conflict over lands and resources. The practice of making slaves of conquered tribes began, decreasing egalitarianism. Unfortunately, as the societies "progressed" in terms of food production (i.e. turning to agriculture) and civilization (i.e. building cities, governments, etc.), egalitarianism and collectivist frameworks faded away. Societal hierarchies were born. Those in power needed cheap labor. The basic provisions of social welfare were anything but guaranteed unless you were powerful, wealthy, and connected.
In the era of King Hammurabi in Babylon (around 1792 BCE), the tides began to shift again slightly. The first code of laws–the same codes that got you flogged for slandering a married woman–declared protection for widows, orphans, and the weak against the strong. While this was a far cry from a social security safety net, it was a start.
Over the following centuries, the birth of new religions and philosophies explored our responsibilities to one another. Philosophies tended to center motivations in societal progress, while religions focused on divine rules or the promise of a certain afterlife. Buddhism was born in the 6th century BCE and taught that the highest form of righteousness was love and charity. In the 5th century BCE, the Talmud–a vast collection of oral Jewish laws–described how charitable funds should be collected and distributed. Aristotle, for his part, in the 3rd century BCE, recognized that humans must cooperate with and assist each other for societies to continue to exist. The teachings of Jesus, around 30 AD, revolved around treatment of the poor, disabled, and dispossessed. In 622 AD, the Koran–Islam's guiding text–prescribed the generous giving of alms. Unfortunately, throughout much of the Dark Ages (about the 5th-14th centuries) in Europe, a fusion of Christian church and state ensued, characterized by a type of religious extremist, monarchal fascism. Poverty was criminalized, but so were efforts to rise from it. This is widely viewed as a period of economic, intellectual, and cultural decline, but public health and free speech suffered dramatically as well.
As the American colonies developed in the 17th and 18th centuries, attitudes towards public welfare reflected English law (still largely criminalizing poverty) and the uniquely American settler belief in pulling oneself up by the bootstraps. Poverty was addressed through indentured servitude and orphanages. The U.S. Public Health Service was established in 1889 to address illness and injury among military and new immigrant communities. Though science and medicine was beginning to flourish in Europe, America generally resisted these frameworks until the early 1900s–roughly corresponding with the establishment of germ theory. Despite this new understanding, attitudes and policies toward and disease were driven more by racism and classism than by science. This was all to change with World War II and the Holocaust.
After the traumatic end to World War II and global realizations of the atrocities of the Holocaust, the World Health Organization was established as the first specialized agency of the United Nations. Its constitution was the first international declaration enshrining health as a human right in 1946. Following this, in 1948, the UN General Assembly unanimously adopted the Universal Declaration of Human Rights (UDHR).
“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” ~ Article 25(1), UDHR
In the decades following the UDHR's adoption, the UN attempted to translate the declaration into a binding treaty under international law with the International Covenant on Economic, Social, and Cultural Rights. Unfortunately, an era of staunch anti-communist ideologies was also ensuing in the U.S., causing it to take a hard line against anything remotely affiliated with socialized medicine. The treaty was ultimately signed in 1977, but has never been ratified by the United States Senate. If it were ever ratified, the country would be required to take steps towards providing universal health care to its citizens.
Conflict Between Theories of Free Speech and Public Health in the Modern World
Whether we view health and health care as a right or as an ethical obligation, ensuring it can sometimes be at odds with theories of the right to free speech. In John Stuart Mills framing, free speech is a requirement for progress in democratic societies. Because his ideas influence our current interpretation of this liberty so profoundly, let's define how they fall short in today's times (he was born in 1806!)–particularly with the advent of the internet and social media.
Problem 1: Mills assumed that people are rational and that the intention of free speech is to improve society
These are two very big assumptions that are often not true at all.
The idea that people speak and act out of rational thought, setting emotions aside, has never been true. To assume otherwise is disconnected with the realities of humanity. Heuristics, emotions, and biases are always part of our behavior. To ignore their existence gives them more power, not less.
Particularly when negatively influenced by these things, some people will use their speech to forward their own agenda despite distinct societal harm.
“To properly address the wrongs done to victims of destructive cults and other extreme exploitation situations, the justice system needs to understand and incorporate research on human development and undue influence.” ~ Hassan, Gutheil & Shah (2022)
Problem 2: Original concepts of free speech didn't account for social media algorithms that prioritize financial gain over societal progress
In early eras of human existence, communication was constrained to speech directed towards others in your immediate vicinity. Without forms of mass communication or modernized transportation, the sharing of ideas was very limited. Over time, with the invention of paper, print media, radios, telephones, and televisions–these channels expanded significantly. In all of these, though, messages were typically controlled by large organizations.
The advent of widely available internet and social media, though, brought about an explosion in the marketplace of ideas. In fact, the marketplace is so bustling that it's been monetized by companies who are uninterested in using their platforms for societal progress. Rather than structuring rules and algorithms that encourage a helpful exchange of ideas and information, their focus is to drive individual user engagement with the platform itself–often with the goal of increasing profit.
“Research on Twitter has found that false news is about 70% more likely to be shared than true news, and it takes true news 6 times longer than false stories to reach 1,500 people.” ~ Sander van der Linden (2022)
Problem 3: Original concepts of free speech didn't account for foreign actors attempting to disrupt society and political culture
Historically, with the exchange of ideas, the author of the ideas was usually known. On social media platforms today, authorship can be completely anonymous and bring no personal repercussions. A organization–even the government of a foreign country–can push its interests on a far flung culture through the creation of fake (or, bot) accounts. As they are often run by computer programs, they are able to push out content at a superhuman pace–drowning out authentic thought by real humans.
References:
Alexander, C. A. (n.d.). Distinctive dates in social welfare history. Unpublished document. Retrieved from http://www-personal.umich.edu/~mdover/website/Social%20Welfare%20Policy%20Main%20Folder/DistinctiveDates.pdf
Hassan, S., Gutheil, T. G. & Shah, M. J. (2022). Responding to authoritarian cults and extreme exploitations: A new framework to evaluate undue influence. PsychiatricTimes.com. Retrieved on June 19, 2022, from https://www.psychiatrictimes.com/view/responding-to-authoritarian-cults-and-extreme-exploitations-a-new-framework-to-evaluate-undue-influence
Meier, B. M. (2013). The political evolution of health as a human right. In A. Mold & D. Reubi (Eds.), Assembling Health Rights in Global Context (1st Ed.). Routledge.
Schweikart, S. J. (2021). How to apply the Fourteenth Amendment to the Constitution and the Civil Rights Act to promote health equity in the US. AMA Journal of Ethics, 23(3), E235-239. https://doi.org/10.1001/amajethics.2021.235
TimeMaps (n.d.). Early pastoralists. TimeMaps.com. Retrieved on June 19, 2022, from https://www.timemaps.com/encyclopedia/pastoralists/
van der Linden, S. (2022). Misinformation: susceptibility, spread, and interventions to immunize the public. Nature Medicine, 28, 460-467. https://doi.org/10.1038/s41591-022-01713-6
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