What kind of freedom are we fighting for?

Echoing the rhetoric of President Donald Trump’s war on Diversity, Equity and Inclusion (DEI), philosophy professor Andrew Irvine defended his court actions against the University of British Columbia for “engaging in DEI and other political activity” in an opinion piece in the National Post. “Simply put, this is a case about academic freedom,” he stated.

As all sides seem to be fighting for our “freedom” these days, we must ask ourselves: What kind of freedom are we fighting for? The freedom to harm and dominate others or the freedom from such harm?

“Universities need to be places where faculty can follow the evidence where it might lead,” Irvine argued. As a psychiatrist and professor of medicine at UBC myself, I couldn’t agree more. The evidence across disciplines clearly shows that upholding the dynamics of domination in society harms everyone.

From Indigenous studies and ecology to economics and medicine, health is defined as balanced systems. We recognize the reality of our mutual interdependence, in which altering any one part or linkage in our system impacts the whole in myriad ways. When one of the interconnected parts dominates over the others – whether our body systems, social systems, geopolitical systems or ecosystems – the entire system dysregulates.

While our systems are resilient to short bouts of disruption, if stressed too much or for too long, the system collapses. We only have to look at the chaos from Trump’s unilateral tariffs to see that when the U.S. exerts its dominance over other countries, the entire global economy dominoes toward financial collapse.

For this reason, healthy systems are governed by feedback loops that sense disruption and then right themselves back into balance. In this way, our social systems require governance with regulations – such as human rights standards, DEI, unions and trade agreements, public health policies and environmental protections – to sense imbalances and then take actions to return back to health.

In our bodies, when cells disregard these regulations by dominating over others, we diagnose the pathology as cancer. Cancer cells are colonists who rule by supremacy, unregulated capitalists who follow the misguided principle of unlimited growth, anti-diversity activists who don’t understand the death sentence of only sustaining cells that are clones of themselves. Their marked individualism robs them of the foresight that they are trashing their own home. As they intrude on the delicate balance of their environment by extracting more than their share of resources, all the starved and displaced non-cancerous cells can no longer function to keep the system alive. Until the cancer is contained, no amount of self-care from the other body cells is going to save their lives.

The fallacy of our competitive brand of individualism, with its divide-and-conquer approach to victory, is that even when we “win” by exerting power over other members of our living systems, everyone still loses. As the victors are part of the collective that they’ve defeated, their actions are suicidal, and they’re taking everyone else down with them.

While the exquisite harmony of the trillions of cells that come together to function as our bodies can be defeated by a few power-crazed cancer cells, the other systems we inhabit are equally vulnerable to the same disease process. This time, the dynamics of dominance in humans are the cancer.

While the United States is one of the wealthiest nations in the world, with health-care spending far exceeding any other country, Americans experience more injuries, worse health and shorter lives than people living in other high-income countries, both a recent study in the New England Journal of Medicine and the US National Research Council (NRC) and Institute of Medicine report.

While these health disparities most inflict people from marginalized groups, even advantaged Americans – those with healthy behaviours and from non-racialized, insured, college-educated and high-income groups – have worse health outcomes than less privileged people living in comparison countries.

British social epidemiologists Richard Wilkinson and Kate Pickett studied the health of countries for decades. They discovered that the biggest predictor of poor health is the country’s level of inequities.

If the United Kingdom reduced its income disparities to the low rates of Denmark, Finland, Belgium, Norway and the Netherlands, it could save more than £128 billion a year as a result of its citizens living more years in full health, better mental health and reduced rates of homicide and incarceration, Wilkinson and Pickett calculated.

Simone Schenkman and Aylene Bousquat, researchers at the School of Public Health at Universidade de São Paulo, similarly found in their large 2021 study that countries with not only the most inequities in income but also in education and health care had the worst health outcomes – regardless of the country’s wealth.

Social inequities lead to poor physical health, higher levels of stress, mental illness (three times the rate of more equitable countries), substance use, crime, incarceration, segregation, social distrust, disrespect, violence and lack of innovation and social cohesion, Schenkman and Bousquat found.

The evidence is clear: Regulations that prevent the diseased dynamics of domination and inequities aren’t a partisan preference: They are fundamental principles to ensure our survival.

But while healthy systems require regulations to keep them in balance, they don’t require conformity – as long as our actions aren’t harming the collective. In fact, we need diversity for our systems to survive.

We need diversity for our systems to survive.

Systems become most resilient by increasing the diversity of its individual parts, with each functioning in different yet overlapping ways. We optimize our collective’s health when we maximize both the diversity of the different species in our ecosystem and the specific traits of individuals within each species.

This is why despite the addition of a thriving carbon-copy cancer cell population to our body, we can’t survive without the diversity of all our other cells from different body systems that the cancer has starved of resources. It’s also why most collectives regulate against incest. When two genetically alike individuals inbreed, their offspring are susceptible to a large host of diseases caused by having too similar a genetic make-up. But mating with a person who’s different creates higher odds of having an adaptive gene to overcome less adaptive ones.

Research in numerous fields clearly shows that diversity in a system improves it. Even in the financial realm, the 2023 McKinsey Diversity Matters report evaluated data from 1,265 companies in 23 countries from six global regions and confirmed that companies committed to diversity perform best. Teams scoring high in ethnic diversity had a 39 per cent greater likelihood of outperforming the competition; so did teams scoring high in gender diversity.

“Supporting diversity is not only the right thing to do, but the smart thing to do,” Michelle Bachelet, the first female president of Chile and past United Nations High Commissioner for Human Rights (CSW), shared with our group of delegates at this year’s UN Commission on the Status of Women. Loyalty is not about agreeing with your point of view, Bachelet explained. To succeed, we need to trust others to help us see beyond our limited lenses.

Social psychologists identify the problem of groupthink, where a group chooses the comfort of conformity and false certainty over the independent thinking and disruptive innovation required to solve new problems. It plays out in our divisive politics as online communication isolates us even further into echo chambers of confirmation bias, only listening to ideas consistent with our in-group while villainizing and dehumanizing those we deem different.

When this division and infighting happens in our body system, we diagnose autoimmune disease, when the body’s immune cells get confused and begin attacking the other cells that it depends on for life. When it happens in our social systems, the more we split off and attack what we falsely believe to be “not us,” the more we’re hurting ourselves. As we retreat to our own corners and dehumanize other members of our collective, it’s easy to support the types of “freedom” and agendas that dominate over, divide and thus destroy us all.

Irvine’s small group of non-racialized men argue against the “specific political beliefs” that individuals, institutions and societies are patriarchal, colonialist and racist. Denying these realities is common in people in positions of dominance who feel entitled to emotional comfort and control while refusing to hear information they don’t like.

Had these academics included others who lived diverse experiences to them – especially from non-dominant social positions – they could learn how patriarchy, racism, colonialism and inequities are real and require governance to protect our social system from their harm, even if they themselves haven’t been marginalized. It’s easy to “not see race,” believe in meritocracy or that a country isn’t racist, or deny the need for diversity, equity and inclusivity in our organizations when we’re in the dominant group.

Yet “freedom” itself is often used as an argument to forgo these protections. While removing regulations is tempting, abdicating governance only allows the most cancerous members to continue their dynamics of domination. We don’t want our groups to be at the mercy of the least healthy members who hoard power and privileges while disrupting everyone’s health.

The kind of freedom we need is not the freedom to harm the people and ecosystems that we depend on to survive. We need the freedom from harm. And the freedom to live to our fullest potential so we can cultivate our diverse strengths to best support the health of our collective.

Caring for our collective doesn’t take away from our freedom as long as our actions aren’t causing harm. We’re simply recognizing that we belong to something bigger than ourselves and honouring all our important differences and relationships to this web of life, so that we can be healthy because our systems are healthy.

While Trump and Irvine want us to “stay in our lane” and away from politics to maintain the comfort and control of their dominance, our health depends more on public policy and practices that protect the health of our systems at a population level than our individual practices.

We doctors take an oath to honour the health of those we serve, prevent illness whenever we can and first do no harm. These values aren’t a political preference; they’re enduring, evidence-based principles of healthy systems. Now, more than ever, “engaging in DEI and other political activity” is our lane.