Monday, 25 May 2020

Trading Lives Without Anger

Heinrich Hoerle, 1930, Monument to the Unknown Prosthesis
 Posted by Allister Marran
The COVID-19 crisis has brought into sharp focus modern man’s ideological belief that he has mastered science and medicine, and has so defeated—or at least delayed—the intrusions of the Grim Reaper.  Our misplaced belief that medical science can cure any ailment means we want to try to save everyone—and when we cannot, there is dismay and fury.
Centuries of loud, proud pronouncements from researchers, scientists, and the medical community, of sound progress being made in the battle against age-old enemies like cancer, malaria, tuberculosis, and innumerous mortal ailments has lulled us into a false sense of security—a perception of invulnerability and ultimately immortality.

What happens, then, when death becomes an inevitable choice?  What if the choices set before us are choices which must choose death in any event?

Whilst the achievements of medical science cannot be overstated, and are undoubtedly impressive, our somewhat conceited overestimation of our ability to stave off death indefinitely has led us to a crossroads today which opens up the social, spiritual, and philosophical question of where to draw the line, who to try to save, and at what cost—if death is indeed inevitable.

At logical extremes, there are two distinct, divergent—apparently incompatible—viewpoints that could be held and debated. In the context of the coronavirus, or COVID-19:
Firstly, that we should lockdown indefinitely, or until a treatment or vaccine is found, saving every life we can at any cost.

Alternatively, when the cost becomes too high, to start trading the lives of the old and the sick for that of the starving young and poor.
There have of course been many pandemics, and COVID-19 is just be the latest contagion in a long line of similar illnesses that have ripped through the human population over the last hundred or so yearsstarting with the Spanish Flu in 1918, and continuously assaulting us before retreating and coming back again in different forms and kinds.

There is a difference this time, however.  The connected world and social media has allowed the world to track the progress of the disease and monitor its devastation, and the real-time outrage has been swift, palpable, and highly publicised.

A minister who has presided over countless funerals told me recently that there has been a perceptible change in the emotions expressed when family and friends come together to bury loved ones.  The old markers of grief and the grieving process are replaced with anger and fury today. 

But our fury has no object; it is just the way things work.  There must be a middle road—to save who you can, but allow those whose time has come to leave.  A realisation and philosophical embracing that our time on earth is finite, which in turn adds value to the little time we do have.  To say goodbye without anger or pain or fury, because after all, shouldn’t your last memory of a departed one be tinged with memories and feelings of love, not hate?


Keith said...

Much to ponder here, Allister, of an ethically consequential nature.

I sense, based on several comments, that perhaps you’re drawn to a utilitarian basis for ethical choice-making.

Utilitarian theory aside, you’ve raised scenarios that seem to require someone, or something, in society to give a thumbs-up or -down on human life.

First, here are just three of those scenarios, pulled from the essay (then my question afterwards):

‘To start trading the lives of the old and the sick for that of the starving young and poor’.

‘Where to draw the line, whom to try to save, and at what cost’.

‘To save whom you can, but allow those whose time has come to leave’.

Sounds somewhat like the culling of society: who’s worth more, who’s worth less.

Here’s my question, tied to all three pulled quotes: Who, or what, in society gets to make those heady life-or-death choices?

Allister said...

It is not a choice that anyone wants to make, but a choice must be made. If our leaders choose to do nothing at all, and let the virus run its course naturally then the weak and the vulnerable are placed at risk. If they choose to do a full and indefinite economic and physical lockdown then the young and the healthy face economic ruin and starvation. There is a real cost to both choices, and I do not have any answers I am afraid. I am very happy I dont have to make the choice that will seriously damage peoples lives either way. And once this is all over, let's hope it's another hundred years or more until we need to make that same choice again. But if nobody makes the choice, nature will make it for us and "cull" the weak and sick as it would have in a time before medicine and science. Obviously the answer lies somewhere in the middle, save as many lives as you can with the least economic devastation as possible, but it's a tightrope walk or balancing act that nobody knows how to perform as this is a fairly unique situation we have found ourselves in. We can only hope that we can learn from this and apply our learning in the future.

Thomas Scarborough said...

Allister incidentally lives in Africa, where the choices are pressing indeed, moreso in his region than in other parts. Yes, there is the danger that we 'play God', and effectively cull certain members of society. This has always been the 'utopian nightmare'.

Yet I see Keith's comment as being simplistic. He assumes that we have a choice. We have already made the choices, which were driven by cultural presuppositions and priorities. It began with a fixation with deaths and cases, and took months to advance beyond that debate, skewing all of our thinking. What we did and now do reflects our society's ethos, through and through. This is, needless to say, a huge debate on its own (our rationality).

I saw Allister as saying the opposite to what (I think) Keith sees. Keith is talking about a 'thumbs-up or -down on human life'. Allister is talking about a greater acceptance of the natural order. This is a more holistic approach. 'Who or what gets to make the choices?' does not seem to be Allister's thinking or Allister's question, to me. Allister can correct me.

We are still not thinking holistically now, and we are certainly not feeling at peace about what we are doing. I disagree with Allister though that we have 'a balancing act that nobody knows how to perform'. By and large, I think we know, but we are confused by cultural inheritances.

Keith said...

As you point out, Allister, ‘There is a real cost to both choices’.

Indeed; an understatement. Those very choices you’ve expressed in your comment above cause me concern.

As you say, if society were to go in one direction — that is, ‘let the [corona]virus run its course naturally’ — then, as you say, ‘the weak and vulnerable are placed at risk’.

On the other hand, if society were to go in a different direction — that is, ‘choose to do a full and indefinite economic and physical lockdown’ — then, as you say, ‘the young and the healthy face economic ruin and starvation’.

But maybe the situation — the implied tradeoff — isn’t, in actuality, as binary as you propose.

The rub is that as epidemiologists, virologists, medical researchers, and public health specialists around the world continue their inquiries, they are finding that the lines of vulnerability to the pandemic among various groups in society are alarmingly blurring.

As the picture of who’s at risk has become clearer, the elderly; lower-income individuals and families; racial and ethnic minority groups; the young and middle aged but with underlying conditions; infants and children; people with compromised immunity; and so forth are all susceptible.

The coronavirus’s scythe swings wide.

One other rub is that the core tradeoff separating the two scenarios you’ve presented is between higher infection/death rates (‘let the virus run its course’) and lower infection/death rates (‘do a full and indefinite economic lockdown’).

Although economics must be factored into nations’ choices among emergent strategies for tackling the pandemic, I shudder that economics might trump, or even seriously outweigh, matters of health, and life and death.

I hope that humanity would rise above adopting what I’d call an ‘actuarial’ approach to values and ethics.

Where we agree, Allister, is not envying policymakers charged with ‘walking the tightrope’. Yet the tightrope must be walked!

Keith said...

I’d like to briefly touch upon the point, Thomas, that “Allister is talking about a greater acceptance of the natural order. . . . ‘Who or what gets to make the choices?’ does not seem to be Allister’s thinking.” Allister can, of course, clarify, but. . .

Either way, the option of humankind — more prosaically, the option of nations’ policymakers — to let nature take its course still amounts to a decision. A freely made choice, presumably; there is no nondecision. Put a slightly different way, ‘to defer to the natural order’ is, I suggest, the same as making a conscious choice, involving picking deliberately from among alternatives.

I would argue, therefore, that there is no getting around the fact that societies will have to make choices regarding this pandemic — whether that’s ‘choosing to defer (default) to the natural order’ and letting the virus cut a swath or, alternatively, ‘choosing to intervene and try to change the trajectory of covid-19 infections and casualties’. Either way, surely it’s a choice.

Allister said...

I believe that ultimately nature decides the natural order of things, and we try to intervene to prolong human life unnaturally, often at the expense of nature.

Nature has no malevolent intent. When we view a shark going on a feeding frenzy or a snake eating a baby bird, or watch an asteroid streaking towards earth, our human instinct is to stop these things happening because it horrifies us and we see the protagonists as being nasty or evil, but these are human emotions and notions we are ascribing to apathetic actors who are simply a part of a greater force that acts without conscience or duty. And they are important role players that serve a purpose, which have lead to us being here (as a species) in the first place. The circle of life or comets brining water to earth are all violent natural occurrences which has driven evolution to the point that man stands head of the food table today.

Carona Virus too has no evil intent, it has no hidden agenda, it has no world dominating ambitions. It just is.

As human beings our fault might lie in the fact that in our own arrogance we have claimed dominance over nature and all we observe (and don't observe in this case) and so in our folly we believe we can beat back death by defeating an invisible enemy that is extremely nimble and has no modus operandi, no conscience and no weakness (for now).

We get angry at it, at all those it has taken and will take from us but it's perhaps our lack of humility and our arrogance that makes us believe we can stop it.

Nature has humbled us many times and will do so many times in the future, this is not a failure of the progress or intelligence of mankind, we are still a highly impressive species, but it makes us fallable and this frailty to my mind makes us more human, not any less human.

We have chosen to interfere and lockdown and we are trying to stop the natural spread of a virus, which is an admirable human quality as we as mankind always try to shield our sick and old and vulnerable from danger, but in doing and trying to steer the course of life against the natural flow of nature we may be breaking a cardinal rule of survival, and that is we are exposing our flanks to attack by not protecting the younger, fitter members of the species who don't need direct intervention to see out this pandemic.

Not allowing those not affected to work, to eat, to live may well cost us dearly down the line.

I agree totally that it's not a dichotomous binary decision, but we are possibly fighting a losing battle because the virus spreads without prejudice or malice, but we are fighting it with emotion and human ideals.

The virus is not evil or self aware. But it may just humble us nonetheless, brining on a realization that nature is more powerful than mankind.

People are angry. People are furious that we cannot save everyone. People want answers and interventions and investigations. But that's because people have been lead to believe that mankind can cure anything, that we are above the food chain, above nature, that we have conquered even death.

We have not conquered death. The circle of life still rolls on, nature will one day be done with us too and replace us with another apex predator as it did countless times before, when one species becomes too dominant it is replaced by another. We can look to the dinosaurs for proof of that.

I think perspective is everything in a crisis, and we have lost perspective.

Martin Cohen said...

Thank you for this thought-provoking post, Allister! I agree with you that our collective response to the cornoa virus is distorted by an idea that we can control everything. This is a new folly created by our invetions in terms of such tings as electorn microsocopes - now we can SEE the virus! - and computer models - now we can SEE the future!

That is leaving aside the questino of whether human's actually create such viruses, nowadays in laboratories, though splicing togehter bits of genetic code, as some have said might be the origin of the cornona virus.

Our response has been all about "control" and I agree with Allister, that this becomes a kind of hubristic folly. Experts and political elites want to control the spread, by controlling who meets who, by controlling the daily routines of millions of people. They tell us we cannot see loved ones who are ill before they die - or sit on the beach. Billions of our dollars are diverted towards this policy of control - through subsidies to businesses put on hold, or individuals put out of work - and to billinaires with their intersts in developing vaccines.

As to vaccines, which may fit with what Allister is aying, it is interesting to note that historically the ilnesses they are credited with curing, have been well ast their peaks at the time the vaccines started to be used. Things like measles and smallpox seem to have killed millinos of people because of social problems like poor sanitation and diet, and to have dwindled dramatically as these largescale problems have been addressed, and only very marginally after the development of vaccines.

So, in such cases, we have human agency indeed causing and curing illnesses, but not in the high-tech, almost magical way, that is proposed for the corona virus. The lessons of medical history should lead us to think more carefully about the figures for the virus, which show time and again that yes, it is killing many people, but in most cases they are people with "co-morbodities", other illnesses and advanced age. Old people die from viruses, that society tolerates, like colds and flu - so is, as Allister says, the anger and horror at them dying from this one appropriate? Of course, we can be angry at the careless introduction of any virus into an old people's home, but to stop old people leaving their houses for months and months on end? To stop them having any human company? This is, to my mind, both a folly and a wickedness.

Thomas Scarborough said...

Thank you Keith for your 26 May comment. I am saying that the reaction to COVID-19 was cultural, and insofar as it was cultural, it was badly skewed. It was skewed not so much through what one chose to focus on first (cases, deaths, and so on), but in what this excluded. A powerful collective blindness. With this in mind, I see Allister's post as a more inclusive and holistic approach, which tends more to overcome cultural biases.

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