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COVID-19 and the Consent of the Governed

What the vaccine debate reflects about the social compact.

Key points

  • Public consent is key to effective policies. Without consent, governments face an uphill battle in implementing successful measures.
  • According to John Locke, the basis for consent comes from surrendering some rights to a government in exchange for some safeguards.
  • Building healthy behaviors through a social contract requires trust, transparency and a delicate balance between sacrifices and benefits.

Over the last year or so, there has been much criticism of leadership in the U.S. for the state of affairs in this country. Government at the local and national level has been criticized for failures in mitigating COVID-19 and for challenges in addressing any number of the problems we collectively face.

Such criticism is often warranted, helpful even. Power needs accountability so that it can be used most effectively to support the common good (see prior thoughts on how accountability can help ensure effective functioning within bureaucracies). However, it strikes me that in much of this criticism there is an implicit belief that people in positions of leadership have more power than they actually do to sway events. We seem to believe that there is somewhere a magic wand that can be waved to solve our problems, and that it is only some kind of obstinacy that stops those in power from waving it.

This belief reflects a lack of understanding, on our part, of the extent to which the capacity of leadership to do, well, anything, depends on us—on the consent of the governed. In my writing, including in my upcoming book, The Contagion Next Time, I have found myself returning to a telling quote from Abraham Lincoln, “[P]ublic sentiment is everything. With public sentiment, nothing can fail; without it, nothing can succeed.” The power of public opinion is such that even a relatively low level of public engagement can be enough to reshape society. Research has suggested that it takes about 3.5 percent of a population actively engaging in political protests to bring about real political change.

Given this power, if the public withholds its consent from a given measure, governments face a steep uphill climb towards the measure’s successful implementation. It does not matter how much good the measure might do; without the consent of the governed, it cannot take effect to any significant degree. When this ineffectiveness occurs, it can look like it is solely the fault of incompetent leadership, when, in fact, leadership may be doing all it can within the confines of withheld public consent.

The Social Contract

This consent is more than just the linchpin of effective policy. It is, arguably, the cornerstone of the entire philosophy of liberal governance, refined during the Enlightenment notably by the political philosopher John Locke, which forms the basis for our political system in the U.S. According to Locke, the basis for this consent was the understanding that the people would willingly surrender some of their rights to the government in exchange for that government safeguarding life, liberty, property rights, and the public good. This arrangement was regarded as provisional, reserving for the people the right to resist any government that did not uphold the social contract.

We see reflections of this contract throughout our society. Take the example of traffic laws, in which we surrender to these laws our ability to navigate the open road at whatever speed we wish, with the understanding that doing so will keep us, and those around us, safer. The power of this social contract is well-reflected by the way we abide by it even in the absence of heavy-handed enforcement mechanisms. How often, for example, do you sit at a stoplight at night, with no one around? Why do you not speed through it? The answer is likely, in part, because you believe that consenting to the rules is better for all of us, that the system of regulations of which the stoplight is a reflection helps support a better, healthier world in clearly tangible ways.

But what if we stop believing this? What do challenges to the social contract, and to the consent of the governed, teach us about how we should talk about health, to encourage healthy behaviors in the years to come?

Supporting a Social Contract for Better Health

First, they teach us the importance of trust. For populations to consent to measures meant to improve public health, they must trust the people who are recommending them. For those of us trying to promote these measures, this means, frankly, being trustworthy. This does not just mean not telling lies, it means not giving the appearance of telling lies by being evasive, unclear, or inconsistent in our communication. During COVID, for example, it could sometimes seem like some of us used our mandate to follow the data as a crutch for inconsistent communication. If we contradicted ourselves, we could simply say we did so because the data changed. Now, sometimes the data really did change. Other times, however, it did not, but perhaps the political or social incentives had, causing us to reverse a position or walk back prior statements. Regardless of whether or not we were justified in claiming changing data as the reason for these reversals, such behavior can seem dishonest, eroding the consent on which we rely for our message to resonate.

Second, we should take care not to overplay our hand when it comes to what we ask of the public. In politics, the consent of the governed depends on a delicate balance, with the people making sacrifices with the expectation of clearly defined benefits. Such a balance also defines public health. We ask populations to make certain sacrifices, and to accept our coordination of these sacrifices at the institutional level, so that they might gain the benefit of better health.

We are at our best in this context when we are clear with the public about why we are asking what we are asking, about how long we are asking it for, and about why this duration is necessary. When we are unsure about any of this, we have a responsibility to be honest about it, even if we feel this might undercut our authority—if it does, it will surely not do so more than if we seem to be dishonest or unduly political in our recommendations.

At the core, supporting a social contract that relies on the consent of the governed means prioritizing engagement with the needs and perspectives of the populations we serve—something which should be guiding our efforts at all times. Encouraging healthy behaviors requires transparency about why these behaviors are necessary, and the understanding that the public’s buy-in is always provisional and should not be taken for granted or abused. For the public to uphold their end of the contract, we must uphold ours, working collaboratively and respectfully towards a healthier world for all.