Utilitarian Bioethics, Medical Socialism, and the State: The Path to Medical Totalitarianism, By Brian Simpson and Chris Knight (Florida)

The politicisation of the U.S. Centers for Disease Control and Prevention (CDC) and the broader Public Health Service (PHS) has reached a critical juncture. Those defending the status quo accuse reformers of politicising "The Science," yet it is they who cloak their resistance in the garb of scientism, a dogmatic reverence for scientific authority that masks deeper cultural and ethical shifts. These shifts, rooted in utilitarian bioethics and a creeping medical socialism, threaten to erode individual autonomy and pave the way for state-driven medical totalitarianism. The CDC's mishandling of public health during the COVID-19 crisis, coupled with its embrace of diversity, equity, and inclusion (DEI) over merit-based systems, has exacerbated a decline in public trust, health outcomes, and economic stability. We critically examine how utilitarian bioethics, under the guise of promoting "the greatest happiness for the greatest number," is reshaping public health into a tool for state overreach, undermining the foundational principles of individual liberty.

The Cultural and Ethical Decay of Public Health

At the heart of the CDC's dysfunction lies a cultural transformation that adopts ideological agendas over competence and merit. During the Obama and Biden administrations, the CDC and PHS became deeply invested in DEI policies, which opt for equality of outcomes over equality of opportunity. While ostensibly aimed at correcting historical inequities, these policies have led to questionable hiring and promotion decisions, with disastrous consequences for public health. A striking example is the appointment of an individual openly practicing sadomasochism and satanism as a senior advisor to CDC Director Rochelle Walensky during the COVID-19 crisis. This individual also served as the White House's monkeypox czar and oversaw vaccine safety monitoring, roles critical to public health that were mismanaged amid politicised decision-making. The elevation of such a figure, whose personal beliefs and practices are at odds with the values of most Americans, underscores the pitfalls of DEI-driven policies that value representation over qualifications.

Sadomasochism, defined as deriving pleasure from pain or humiliation, and satanism, the veneration of a figure embodying evil in Christian theology, are incompatible with the moral and ethical standards expected of public health leaders entrusted with safeguarding the nation's well-being. This is not a matter of private personal choices, but of public propriety and competence. The decision to place such an individual in a leadership role reflects a broader cultural shift within the CDC and PHS, where ideological conformity has superseded merit. A 2024 report by the Heritage Foundation noted that DEI policies in federal agencies have often led to the promotion of individuals lacking the expertise required for high-stakes roles, contributing to institutional failures during crises like COVID-19. The results, unscientific mandates, eroded trust, and harm to vulnerable populations, particularly children, speak for themselves.

Utilitarian Bioethics: The Camel's Nose Under the Tent

Beneath the surface of DEI lies a more insidious force: the rise of utilitarian bioethics, a philosophy that justifies state intervention in healthcare under the banner of maximising collective well-being. Utilitarian bioethics, rooted in the principle of "the greatest happiness for the greatest number," evaluates actions based on their consequences rather than inherent moral principles. While seemingly pragmatic, this approach sacrifices individual autonomy for perceived societal benefits, opening the door to bureaucratic overreach and medical socialism.

In public health, utilitarian bioethics manifests in policies that accept population-level outcomes over individual rights. For example, mandatory vaccinations and quarantine measures during pandemics, are often justified as necessary to protect the collective, even at the expense of personal freedom. A 2023 analysis by the American Enterprise Institute highlighted how such policies, while defensible in extreme circumstances, can slide into authoritarianism when unchecked. The COVID-19 crisis exemplified this, with the CDC and PHS imposing sweeping mandates, such as mask requirements and vaccine passports, that lacked robust scientific backing and ignored individual risk profiles. These measures, driven by utilitarian logic, disproportionately harmed children, small businesses, and marginalised communities, contributing to a 2025 CDC report noting a rare increase in childhood mortality.

The danger lies in the incremental expansion of this logic. As the parable goes, allowing the camel's nose under the tent soon invites the entire beast. Utilitarian bioethics, combined with modern tools of state influence, such as "nudge" technologies, digital propaganda, and psychological warfare, enables the state to manipulate public behavior on an unprecedented scale. A 2024 study by the RAND Corporation warned that these tools, often justified as promoting public safety, are increasingly used for social engineering, advancing socialist ideologies under the guise of public health. The World Health Organization's 2023 pandemic treaty proposal, which sought to centralise global health authority, exemplifies this trend, prioritising supranational control over national sovereignty and individual rights.

Medical Assistance in Dying: The Slippery Slope to Dystopia

The most alarming manifestation of utilitarian bioethics is the expansion of Medical Assistance in Dying (MAID), particularly in Canada, where it serves as a chilling case study. Initially introduced to alleviate suffering in terminally ill patients, MAID has evolved into a state-sanctioned solution for a broad range of issues, from chronic pain to mental health struggles. A 2025 report by the Canadian Medical Association revealed that MAID was offered to individuals citing vaccine injuries, economic hardship, or social isolation as reasons for seeking death. This expansion reflects a utilitarian calculus: if an individual's suffering outweighs their societal contribution, their death is framed as a net positive for the collective.

This logic has dystopian implications. In Canada, MAID is increasingly normalised as a "treatment" option, with state propaganda promoting it as a compassionate choice. A 2024 investigation by The Globe and Mail uncovered cases where elderly patients were pressured into MAID due to resource constraints in healthcare systems, raising ethical questions about coercion. The program's financial incentives, reducing healthcare costs and enabling organ harvesting, further align with utilitarian principles, choosing economic efficiency over human dignity. In a 2025 policy brief, the Fraser Institute warned that MAID's expansion risks creating a culture where the state defines "productivity" and encourages death as a civic duty for the elderly or infirm.

The United States is not immune to this trend. While MAID remains limited to a few states, the CDC's embrace of utilitarian bioethics lays the groundwork for similar policies. The agency's 2023 guidelines on "equitable resource allocation" during pandemics, for instance, chose certain groups based on perceived societal value, echoing the logic that underpins MAID. If left unchecked, this philosophy could justify state interventions that erode bodily autonomy, from mandatory medical procedures to incentivised euthanasia.

The Incompatibility with Individual Liberty

Utilitarian bioethics is fundamentally at odds with the principles enshrined in the U.S. Constitution, particularly the Bill of Rights. The First and Fourth Amendments protect individual freedom and bodily autonomy, yet the CDC and PHS have increasingly asserted state authority over personal medical decisions. The 2021 vaccine mandates, upheld by the Supreme Court despite shaky scientific justification, set a precedent for further encroachments. A 2024 Cato Institute survey found that 62% of Americans now distrust federal public health agencies, a direct consequence of such overreach.

The solution lies in a radical reformation of the CDC and PHS, rooted in a cultural and ethical realignment. Merit-based hiring must replace DEI-driven policies to restore competence and trust. More critically, the agencies must reject utilitarian bioethics in favor of a framework that adopts individual rights. This means reinstating the primacy of the patient-provider relationship, free from state or corporate interference. It also requires dismantling the infrastructure of "nudge" technologies and propaganda that manipulate public behavior, as documented in a 2025 MIT study on digital influence campaigns.

Conclusion: Freedom Over Collectivism

The rise of utilitarian bioethics within the CDC, PHS, and broader medical establishment represents a dangerous slide toward medical totalitarianism. By valuing collective well-being over individual autonomy, this philosophy justifies state overreach, from coercive mandates to the normalisation of euthanasia. The consequences, eroded trust, declining health outcomes, and the loss of personal freedom, are already evident. Reforming these institutions requires more than policy tweaks; it demands a cultural transformation that reaffirms the sanctity of individual rights. As history has shown, when the state subordinates personal liberty to the "greater good," the result is not happiness, but oppression. The fight to preserve freedom in healthcare is a fight for the soul of a free society. Because freedom is the fundamental value of democracy.