The Ethical Dilemmas – And DILEMMA – of COVID-19

The OLD Philosopher – John M. Miller

 

The coronavirus lockdown of 2020 is unique to the experience of every living American. Indeed, it is unlike anything any citizens of all other developed nations in the world have ever known.

Since the end of January, the non-Fox American news media have become understandably obsessed with reporting almost exclusively news about the pandemic. After all, we have had far more cases and far more deaths than any other country. In only two and a half months we have become collectively consumed by one thing: a novel coronavirus (however novel this one is), the coronavirus, COVID-19. Three months ago a few hundred or perhaps a few thousand people knew who Dr. Anthony Fauci is, but now, anyone who does not know who he is does not know what is going on in America.

The U.S. Constitution unwittingly created a major pandemic political brouhaha. In a situation such as this, who is in charge? Is it the president, or is it the governors and/or the mayors? Legally and ethically, who should be giving the orders? The murky answer has turned out as follows: all of the above, but few of them in a coordinated manner.

Depending on where we live, we are in varying degrees of lockdown. The citizens of New York City have faced perhaps the highest degree of personal confinement, because NYC has been the hottest “hot spot” in the nation. People in Wyoming and North Dakota are still fairly footloose and fancy free. But by now, most of us are feeling increasingly incarcerated, and the natives are getting restless.

 Individually the lockdown has posed a number of issues for everyone. Should we “shelter in place” 100% of the time? Must we always maintain “social distance?” What, really, should social distancing entail? Despite what we are told, is it ethically acceptable to visit elderly parents or a sick spouse or a stricken sibling? Must we refrain from speaking openly to neighbors, or if we do, for how long, and with or without a mask?

These are not simply practical questions. They are also ethical questions. What are the right or wrong things to do in a situation such as this? For example, should religious groups be prevented from worship or community service, or should they have a special governmental dispensation to gather is larger numbers than are otherwise allowed, in order to praise the God whom they worship and whose assistance they want to implore together in a newly unique and existential way? The vast majority of congregations have obeyed the orders not to meet, but a few have chosen to gather in opposition to the new norms. Is that ethical?

At present, after only two months of serious restrictions, two questions have risen most powerfully to the surface. When shall the restrictions be lifted, and how, specifically, shall it be done? Nobody, including the experts, knows for certain what to do, because COVID-19 has never assaulted the world before. It is the pace of the parole which has become the main question, but we all know we cannot be instantly freed to go back to the old normal.

Two months ago, a very small percentage of “experts” were saying we were only weeks away from parole, but the vast majority were insisting it was impossible to say when we could get back to normal. And of that majority, many were saying the new normal may be months away or not until 2021 or 2022. They tell us it will be nothing like the old normal under which we happily lived BCV - Before the CoronaVirus. Furthermore, there is no unanimity among the experts about how we should ease out of the highly circumscribed life that the virus has thrust upon us.

There appears to be no doubt that the pandemic has already created a very troubling economic recession, and that if the lockdown continues for many more months or two or more years, we will be in a depression far deeper than the world has ever known. So the political, economic, and ethical issues now appear to be these: How much longer must we be forced to maintain the present mode, how much longer can we tolerate the present mode, and what will a new mode for ordinary living look like?

All health officials seem to agree that a vaccine is the only answer to defeating the virus, as do most sensible government officials. Politically and ethically, therefore, should the federal government pour billions of dollars into research for every institution that reasonably should be granted such funds? The CARES Act authorized $2.2 trillion to help corporations, medical institutions, and most individual Americans to weather these hard times. Should legislation provide several more billions of dollars to find a vaccine as soon as possible, rather than the year or two the experts are telling us will transpire before the vaccine will be produced? Should millions more test kits be manufactured ASAP by any corporations capable of manufacturing them? We will need many millions, because millions of Americans will need to be tested, and perhaps yet again. Tens or hundreds of thousands of people will need to be trained to analyze those tests. Ethically, what ought to be done, and how will the costs be paid?

* * * *

The most pressing political question is how long must the economic lockdown continue before we can safely try to adjust to the new normal? Some politicians, the most vocal one in particular, want to do that immediately if not sooner. Those people, and they are mostly men, are ideologically committed to the notion that the business of America is business. That was an observation made by that universally recognized intellectual giant of a political philosopher, Calvin Coolidge.

 When President Coolidge said that in the uber-capitalistic Roaring Twenties, he was moderately correct. A higher percentage of Americans were then employed by businesses of one sort or another. However, less than half of the American population is now employed in any kind of “business.” Nevertheless, it is true that many businesses cannot avoid bankruptcy if they are locked down for a prolonged period. Furthermore, many of the millions of people who presently are unemployed are even less likely to escape bankruptcy if all of us are forced to shelter in place for many months longer.

And that leads into the most pressing ethical question, which is by far the most important and the hardest question the American people and their leaders must try to answer. At its most basic and terrifying level, what is the highest number or percentage of deaths that America is willing to tolerate in order to begin to emerge from our current level of lockdown?           

Up to now, we have been doing our best to mitigate the virus. We are still a long way from containing it. We know that it is impossible to eradicate it within the next few months or so. But are we collectively willing to withstand our present level of social distancing and nearly total lockdown?

There have been relatively few reports of doctors or nurses have to make agonizing triage decisions about withholding treatments from people who are likely to die. But if the whole American health care system is stretched to the breaking point, what policies should be followed? Should the elderly be precluded from being connected to ventilators? If so, what age constitutes “elderly”: 70? 75? 80? Blacks are dying in higher percentages than any other group of Americans. Shouldn’t they therefore be given more assistance than others? What about children as compared to young adults? Who should receive triage priorities? 

Health leaders have largely determined our national or state coronavirus policies up to the moment. As the populace gets more restless, the health experts shall lose their command of the discussion to other more strident voices, especially voices from the business community and certain kinds of politicians.

Numbers have been flying across the airwaves like migrating birds headed north in the spring. Every day the numbers go up geometrically for how many have contracted or have died from COVID-19. It took a few weeks to go from the first patient who died in the state of Washington in January until a total of 2500 had died. Nearly 2500 died just on Thursday, April 16. By the past weekend (April 18-19), over 750,000 Americans had have been struck by the pandemic, and 45,000 perished from its merciless spread.

Widely varying estimates have been made about how many Americans will become contagious. They range from a few million to as many as fifty to a hundred and fifty million people, by one expert’s guesstimate. The disparity in those figures does little to build trust in the health experts, or in the politicians who, for reasons of their own, parrot all these disparate numbers.

Ethically, we must begin to give much more thought to the many other disasters which inevitably will result from this pandemic. The virus itself has commanded so much of our attention that we have ignored other major side effects of this huge epidemic.

The longer this goes on, how many millions of personal or corporate bankruptcies are we willing to tolerate? Two million? Five million? Twenty five million? If most workers do not get back to work soon, the rapidly rising graph of bankruptcies will begin to look like the rapidly escalating graphs for the virus.

How many committals to mental institutions can we bear? That graph will not rise nearly as quickly, but it is bound to rise with rapidly escalating numbers.

How many divorces or family breakups or abuse trials is the American system able to absorb? How many people who become permanently unemployable can the system support? Beyond what number are increasing suicides too many? What percentage of homelessness can the USA, which is definitely not a welfare state, manage? How many more addicted people can our health system contain? If ten thousand Americans starve in the next year, is that an acceptable number? How about twenty five thousand, or a hundred thousand, or a quarter of a million?

How many will blame God for this pandemic, and drop out of the greatly varied ecumenical community of faith? How many more will ask God than have already asked, “God, how can you allow so much suicide, death, starvation, poverty, sickness, and social disintegration?” Natural disasters prompt those kinds of queries. This is the largest national natural disaster this country has faced since the Spanish flu epidemic in 1918-19. In those years, it is claimed by some that sixty million people around the world died. People who are not well grounded in the nature of faith might become committed agnostics or atheists overnight if such numbers were to be repeated.

The Great Depression lasted from 1929 to the early years of World War II. How far will we allow the COVID Depression to reach in its initial stages?

* * * *

Utilitarianism was a theory of ethics whose two primary proponents were the English

 philosopher Jeremy Bentham (1748-1832) and the Scottish philosopher John Stuart Mill (1806-1873). They promoted what they described as the greatest level of happiness possible for all of humanity. By “happiness,” however, they did not mean what we understand by that word. They meant what Thomas Jefferson and the signers of the Declaration of Independence meant when they spoke of “life, liberty, and the pursuit of happiness.” They believed the highest ethic was to seek the highest possible degree of personal fulfillment for every person on earth.

     Jeremy Bentham wrote that we should all strive for “the greatest good for the greatest number.” In our battle with the coronavirus, are we really attempting to establish the greatest good for the greatest number if our only criterion is to prevent people from becoming contagious, and especially from dying? If we concentrate only on that, or mainly on that, will we not damage the wellbeing of the large majority of people who will never be afflicted by the virus, but whose lives will be greatly diminished in other ways because of our fierce fight against the pandemic? Can we safely imprison three hundred thirty million people for several more months?

     Thus far, the coronavirus has not shown itself to be nearly as lethal as many previous pandemics. As previously mentioned, the Black Death, other historic outbreaks of the bubonic plague, the death of nearly 90% of the native-American populations in North, Central, and South America in the 16th through the 19th centuries, and the Spanish flu epidemic, are examples. As of this date, about ¼ of 1% of Americans have been infected by COVID-19, although the figure may be twice that large or more. Of those who are infected, 2 to 3% are dying from it. This is a pandemic, but almost certainly it is not the one about which epidemiologists have been warning us for decades.

     Let us suppose that 3% of our populace will ultimately become contagious. That is 10,300,000 people. At the current death rate, let us further suppose that 2% of the stricken shall die. That is 206,000 people, which is a huge number, but it  is less than 1% of the total population. However, it would be 7% more than the number of Americans who will die in 2020 anyway.

     Seventy-five thousand workers were involved in the construction of the Panama Canal. Twelve thousand of them died in the effort, most from malaria and yellow fever. That was 16% of all the workers. That was a major pandemic.

     James Stanley Gilbert was one of those workers. In his best-selling book about those terrible and glorious years, called Panama Patchwork, he included this sardonic poem:

                                    Close the door --- across the river

He has gone.

                                    With an absess on his liver

He has gone.

                                    Many years of rainy seasons

                                    And malaria’s countless treasons

                                    Are among the many reasons

                                                Why he’s gone.

     Pandemics happen. There are epidemiological reasons why they happen, but when they happen and where they happen are ultimately mysteries. Our pandemic is worldwide, unlike most other pandemics.

     President Trump is right in wanting to get the economy up and running again, but he is completely wrong in his motivation for wanting to do that. To him, business is truly the only “business” of America, because he believes business is our economic engine, and making money is what mainly drives him and many other businessmen. He does not want to be remembered as the president who was in office when the stock market took its most drastic dip. He wants to avoid being the president who was in office when a depression greater than the Great Depression began. Most of all, perhaps, he is well aware that Fox News abhors strong federal leadership in anything other than bailing out big business.

     Henry II was the king of England in a very tense time, much like the period in which we now find ourselves. The king felt under heavy political pressure from all sides. One of his best friends and most trusted advisers, Thomas a’ Becket, the Archbishop of Canterbury, had turned against him because of one of Henry’s most ill-considered decisions.

     One day at court, the king blurted out in pained exasperation, “Will no one rid me of this troublesome priest?” Two of his knights took that to mean that they should assassinate the archbishop, which they dutifully did, when Becket was at the high altar in the Canterbury Cathedral. Writing about this infamous incident, T.S. Eliot in Murder in the Cathedral said, “The last temptation is the greatest treason: To do the right deed, but for the wrong reason.”

     It is the entire country which is being adversely affected by this plague; it is not just the business community or the entire economy. The national debt increased by twenty percent in a congressional spending bill that was debated for merely a few days. The long-term effects of that decision are enormous, but most of them have nothing directly to do with the coronavirus.  

     Because of our irrational fear of COVID-19, we are trying almost exclusively to contain the pandemic while at the same time paying far too little attention to what the emphasis on containment is doing to the rest of the body politic. To seek the greatest good for the greatest number, we must consider all aspects of how the pandemic is affecting us, and not just the sickness and death which it is causing.

     Even though the president is wrong in why he is so eager for the economy to be liberated from its restraints, he is doing the right deed, although for the wrong reasons. The epidemic affects everyone, not just those who are made sick or who die from its remorseless spread. Besides those who are afflicted by the virus, we must also be looking out for the unemployed and newly impoverished and the seriously mentally depressed and suicidal, for those who require the mundane but magical touch of community, for the desperately lonely who can be relieved only by re-connecting once again with the people they rely on for daily personal, mental, and spiritual sustenance.

     The greatest good for the greatest number is much broader than the several million Americans who are likely to experience the assault of COVID-19 before it is either extinguished or dies its natural death. All of us are affected by it, but most of us will not be afflicted by it.                                                                                   - April 19, 2020

 

John Miller is the 81-year-old Pastor of The Chapel Without Walls on Hilton Head Island, SC. He writes frequently about religious, political, and ethical issues. More of his writings may be viewed at www.chapelwithoutwalls.org.