The Virtue of Practicing Restraint in the Pursuit of Health

I have been thinking more and more lately about the value of restraint and how it can help guide our efforts in public health. I have long liked the aphorism, “See everything, overlook a great deal, correct a little.” I have always found this a useful summing up of how to navigate from a position of leadership the work of trying to improve systems. We may wish to correct much, but restraint helps us to recognize how trying to do everything at once could, in fact, be self-defeating. In doing less, we help ensure that the actions we do take are most effective.

Restraint has long been recognized as a key component of well-balanced individuals, leaders, organizations, and societies. Among the four cardinal virtues cited by classical philosophy, temperance—which could be read as moderation or self-restraint—is a pillar for sustaining a virtuous life. The value of restraint also appears in literature. Shakespeare wrote, “[I]t is excellent / To have a giant's strength; but it is tyrannous / To use it like a giant.”¹

This is to say it is not wrong for us to develop power and influence in pursuit of a worthy goal like healthy populations. Indeed, it is necessary. But in acquiring “a giant’s strength” we have a responsibility to avoid using it “like a giant”—capriciously, crudely, without regard for those we might inadvertently trample in striding towards our goals.

Restraint, then, is not about doing what one cannot do. It is about not doing what one could do, when such an action may prove unjust or counterproductive to the long-term success of our mission.

How are we to know when restraint is called for and when we should take decisive, immediate action? The following considerations could help guide reflection on whether a given action really does serve our long-term goals.

We should practice restraint in order to pave the way for larger action, avoiding taking small steps that could undermine our capacity to take bigger ones later on.

We live in an age of instantaneous everything, in which the quality of an action is often defined by the speed at which it is performed. Yet the better action is sometimes the one which has been seasoned by delay.

When we are hungry, we may be tempted to eat some fruit before it is ripe. If we do, however, the fruit may not taste as good. It is occasionally better to wait a little, to maximize our action when it is taken. We also see this in public health’s frequent engagement with politics, a field full of examples of the importance of sometimes delaying action until the proper time. Former House Speaker Nancy Pelosi is said to have a maxim: “You get the votes and you take the vote.” The implication is that you do not take the vote until you have in hand the votes needed to win—timing is everything. This suggests the importance of restraint, of waiting until the moment is right.

We should practice restraint when doing so is necessary for keeping public opinion on our side.

Throughout history, we have seen how public opinion can be slow to support certain policies, even when these policies, like universal healthcare, seem self-evidently beneficial to all. Yet when the public is finally behind an issue, change can be quick and durable. It is necessary, then, to respect the public’s deliberative process, frustratingly slow as it can be. This means taking care not to say or do anything that could turn the public away from our side.

This kind of restraint can take deep self-reflection and a willingness to listen to alternative points of view. It can be easy to convince ourselves that our favored policies are more popular than they are, which can cause us to act before the wind of public opinion has fully filled our sails. We need to try to see beyond the bounds of our ideological bubbles, to cultivate a sense of when the public supports a given action and when restraint is called for as public opinion takes the time it needs to coalesce.

We should practice restraint when there may be some who would like to support our efforts but are not yet ready to fully commit and premature action might destabilize their willingness to join us.

When engaging with public opinion, it is important for us to be mindful of two categories of potential allies. First, there are those who have not thought much either way about public health. The work of engaging with these people is largely still to come. Then there are those who have already thought much about our efforts and who may be close to supporting us, even as they are not yet completely in our camp. For this class of potential allies, it is particularly necessary to engage carefully.

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There is a saying I have heard attributed to Napoleon: “Never interrupt your enemy when he is making a mistake.” We might modify this to: “Never interrupt your potential ally when they are coming around to your point of view.” This means exercising restraint. There may be, for example, many with whom the environmentalist case for regulating pollutants has resonated. Perhaps they never considered themselves to be environmentalists, but they have been listening to the case for addressing climate change and they have seen the effects of respiratory illness in their community, and they are now newly open to federally directed solutions. In this context, restraint could go a long way towards making those who are close to being with us take those final steps.

Throughout its history, public health has enjoyed periods of power and influence. We are arguably in one of those periods now. The pandemic saw us amass great sway within government and key institutions, and our recommendations have led to sweeping actions at the policy level affecting millions of lives. At the same time, we have seen examples of overreach and backlash, as we have not always acted with restraint. It seems to me that public health is well-served when it tempers its power with restraint, so we can better support the long-term efficacy of our field and the health of the populations we serve.

This piece also appears on Substack.