National Nurses United

must have made poor choices, the wrong choices, because you did not exert enough willpower and self control. MAHA says, there- fore, you are bad and undeserving of health. If you are undeserving of health, MAHA leaders believe that government and society have no obligation to provide you health care services or other social programs, such as housing and food assistance, that we know significantly shape health. If you are unde- serving of health, MAHA believes that it is acceptable or even in the natural order of things for you to die; society should not care or should even celebrate the dying off of "the weak"—a view that scarily smacks of eugenics and runs directly counter to nurses' values. For example, in a CBS News interview last April, RFK, Jr. said, "If you want to eat donuts all day or drink sodas, that's your choice … but in terms of, should you then expect society to care for you when you predictably get very sick." He said these weren't just "moral" but "pragmatic" questions. And, last year, we saw evidence of RFK, Jr. and Trump's answer to this question when they worked with Con- gressional Republicans to pass H.R. 1, also known as the "One Big Beautiful Bill Act," which, among other things, will devastate Medi- care and Medicaid to fund tax cuts for billionaires. Some 17 million people will lose their health insurance and it's estimated 51,000 more people will die unnecessarily each year because of these cuts. MAHA messaging played a key role in passing H.R. 1. Amy Erb, an intensive care unit RN and National Nurses United vice president who also took the CE class, has a more nuanced view of "choice." "For me I think that, yes, of course personal choices matter, but those choices are not made within a vacuum—they are made within a society that has a certain set of constraints: within institutions, within a certain health care system, in a country that already doesn't have paid leave, and strong social supports. Choices are made within these social determinants of health. These determi- nants are powerful and they are not things that we choose. It's so much easier to look down on and shame people for their choices and behaviors instead of taking a look at these systems in which every- one is making these choices." This championing of individual choice is a fundamental tenet of MAHA ideology and, carried out to its logical conclusion, means that individual preferences and opinions matter more than what is good for the collective, and more than what the scientific and medi- cal community agrees is good for public health. In MAHA world, the individual's internet searches or belief in "trusted" social media influencers overrides the conclusions and advice of medical experts and scientists. As a result, MAHA leaders take anti-public health positions, such as believing that vaccination against infectious diseases should not be recommended by the government, and that everybody should individually choose whether to get them or not—never mind that decades of medical research shows that mass immunization—at very low risk to the overall population—has dramatically reduced rates of these diseases and almost completely eliminated others. This lack of confidence and trust in science and the medical establishment has also prompted the Trump administration, through RFK, Jr., to decimate and dismantle our national public health infrastructure. Since Trump and RFK, Jr. have taken office, they have slashed the staff, budgets, and work scope of the Centers for Disease Control and Prevention, HHS itself, the National Insti- tutes of Health, the Environmental Protection Agency, the Food and Drug Administration, and the U.S. Department of Agriculture; fired all the qualified experts from the vaccine advisory committee; and stopped collecting and publishing data on a host of public health markers that the United States has historically recorded for genera- tions. In their eyes, there's no need to do science if individual beliefs and preferences are all that matter. It's important to note here that authoritarian and fascist forms of government often denigrate and suppress science and scientific experts because the practice of science and the scientific method is inherently democratic. Science encourages the asking of questions, of O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 5 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 19 "Yes, of course personal choices matter, but those choices are not made within a vacuum— they are made within a society that has a certain set of constraints: within institutions, within a certain health care system, in a country that already doesn't have paid leave, and social supports."

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