Deaths of Despair (DoD), or mortality resulting from suicide, drug overdose, and alcohol-related liver disease, have been rising steadily in the United States over the last several decades. In 2020, a record 186,763 annual despair-related deaths were documented, contributing to the longest sustained decline in US life expectancy since 1915–1918. This forum feature considers how health humanities disciplines might fruitfully engage with this era-defining public health catastrophe and help society better understand and respond to the crisis.

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Scholars of political thought often view Plato as a ‘political moralist’, or a ‘utopian’ partly due to the Republic’s emphasis on ‘justice’. But in the Republic, Plato offers a distinctive theory of legitimacy, one that grounds legitimacy on an interdependent relationship between justice and moderation. Justice requires that the principle of specialisation be respected, while moderation requires that citizens agree about who should rule. But citizens will only agree if their ‘necessary’ desires are satisfied. Conversely, the ‘necessary’ desires can only be satisfied when the principle of specialisation is maintained. In this way, justice requires moderation, and moderation requires justice, and both are necessary for legitimacy. Plato’s theory of legitimacy is positioned in relation to existing accounts, especially those of John Rawls and Bernard Williams. It is shown that Plato’s theory is a genuine theory of legitimacy, not a theory of acquiescence. In the concluding section, Rawls’ theory is subjected to a critique based on Plato’s theory.