For most of
Modern medicine along with its incalculable benefits also raised end-of-life questions our ancestors never had to ask. If the difference between dying at 90 or 95 is a life savings that could be left to one’s children, do we spend it? Until recently these questions weren’t even acknowledged in polite company. This is a case of technology evolving faster than our cultural values. Catching up only happens through many people honestly struggling with difficult questions.
The COVID-19 pandemic presents us with this kind of choice but on a global scale. The ability to forecast a pandemic and the institutions capable of a coordinated response are things we still struggle to understand scientifically. But that newness also raises moral questions we find deeply uncomfortable to face.
Spend more, sacrifice more, disrupt and damage society more, and save more lives. When New York Governor Andrew Cuomo said any efforts at shutdown and distancing were worth it to save just one life, it came from a place of human decency. Suggesting otherwise is chastised as putting the economy ahead of human lives.
Adam Smith taught us that moral sentiments emerge from the bottom up rather than being handed down from on high. Were the questions raised by our response to COVID-19 an aberration, we might not need to ask as many hard questions. But the truth is these questions are all around us and honestly recognizing them is uncomfortable but overdue.
The Movie That Won’t Stop Playing
Consider the following debate:
Group A forecasts major human tragedy that can only be addressed by vastly expensive or transformative changes to society. The choice is often presented as binary–maximum change versus fiddling while Rome burns. What a coincidence that what we must do often resembles politically controversial ideas already favored by Group A.
Group B doesn’t like those changes and sees through the all-or-nothing mentality but is reluctant to directly push back at the understandably uncomfortable life-or-death issues. Instead they allege Group A’s forecast, whether by honest mistake or manipulation, is wrong. We lack the moral vocabulary to look at the issue as anything but all-or-nothing, and assail each other’s intentions instead.
This dynamic, rather than being new, has poisoned a generation of public debates. Climate change, gun control, surveillance of U.S. citizens, torture of high-value terror suspects, preemptive wars, and at least to some extent the more recent populist friction points on both the left and right fall victim to this tension.
Most people have likely found themselves in both groups on different issues. When faced with complex uncertain problems with moral components, we find shelter in the place where our worldview makes us most comfortable. All of us.
Rules Destroy, People Redeem
What about our currently ticking clock? We must understand that economic harm itself does lead to loss of life and suffering, as many have made clear. This must be part of our discussion, but not all of it. Take the following not as a proposal but as an invitation to think differently, something we seem to do less and less.
We suspect most people will experience COVID-19 not that differently from a nasty flu, but were it to rip through the population all at once, the strain on hospital resources from the still-large number of people whose lives likely would need saving would create its own unspeakable tragedy. The enormous costs in this formulation are in the service of the laudable goal of actually letting our medical system save the lives it can.