An Ethical Crisis: COVID-19 and the Valuing of Human Lives

by Alexandra Morrison, Assistant Professor of Philosophy

 

The COVID-19 pandemic will surely contribute to the stock of “case studies” used in undergraduate ethics classes. Frequently mentioned have been the situations in which doctors are compelled to choose which patients will get access to possibly life-saving ventilators and ICU beds. Then there are the dilemmas of health care providers who have had to decide to postpone the cancer treatments or elective surgeries of non-COVID patients in order to free up critical hospital beds and personal protective equipment. These are indeed the kinds of dilemmas for which training in the study of ethics can be a crucial preparation. But focusing on such isolated moments of decision can also obscure some of the deeper moral dimensions of these distressing situations, dimensions for which mature moral agents must also be able to assume responsibility. While thinking about ethical responsibility in individual terms is important, we must remember that the decisions we make as individuals occur within complex social and historical contexts that often predetermine what we see, and what we often fail to see, when we are actually confronted with a decision. 

It’s natural to assume that ethics is simply about informed, logically sound, decision-making that aims either to reduce harms or to realize some good. This view of ethical life is an inheritance of an influential current in the philosophy of the European Enlightenment according to which the defining features of human beings were the capacities for abstract thinking and rational choice. While this philosophical tradition is important for many reasons, not least for its connection to the emergence of modern science and democratic politics, its singular focus on the faculty of cognition obscures critical aspects of human experience foundational for ethics. Recent work in philosophy has drawn our attention to its limitations.

While of course moral responsibility demands that we think about moral problems, the dimension of feeling, or caring, often sets the terms for our thinking and doing. It subtly illuminates the things that will matter to us. We are ethical beings, then, precisely insofar as we are not just brains. We care about ethics because we are also bodies that are vulnerable to disease and death and to other persons, whether through acts of violence or of kindness. It is also in virtue of our embodiment that we are alive to the suffering of others. This is why ethical reasoning can’t be reduced to an algorithm: ethical judgments are responsive to the world and to others in virtue of our embodied, mortal exposure. It is this exposure that lets situations matter to us. 

The problem is that how we feel about, and perceive, situations is often a function of inherited frameworks of interpretation that remain opaque or even invisible to us. They only show up through the way they structure our felt experience of the world. This is a problem for ethics. How are we to hold ourselves morally responsible for the way we feel about situations? It is perhaps insofar as it provides occasion to reflect on this problem, more than for its examples of urgent ethical decision-making, that the COVID-19 pandemic is a singularly illuminating ethical case study.  

When we were first urged to stay at home to “flatten the curve” so that hospitals wouldn’t be overwhelmed, we were informed that we were doing so in order to protect those who were more vulnerable to the effects of the disease—the elderly, those with underlying conditions. At a certain point, though, it became apparent that shutting down businesses and institutions would take an enormous toll on the economy. Then the fact that the disease tended to affect different groups of people in different ways began to take on a different meaning. An increasing tone of urgency regarding the need to restart the economy was accompanied by reassurances that the young and healthy did not have so much to fear from the disease. Media commentators expressed shock when Texas Lieutenant Governor Dan Patrick went so far as to suggest that it was fine, even moral and honorable, for vulnerable people to die for the sake of the economy, but the truth is that this calculation was already implicit in the decision to reopen in states where infection rates were still on the rise. History shows us that vulnerable groups have long been routinely subjected to this kind of calculus, and to the quiet enactment in policy of what the Lieutenant Governor had dared to say out loud.

In this connection, the American philosopher, Judith Butler, has recently reflected on what she terms the “differential distribution of grievability.” She claims that grievability, the quality of a life whose loss would really matter, is unequally “distributed,” as though in a kind of “economy.” She makes this striking claim in the context of reflections on representations of war, for example, in art, or in the media. Images have a sense of immediacy that allows them to appeal directly to our sensibility; they often provoke in us a felt response to what they show us. But in reflecting on this power of images, Butler draws our attention to our felt evaluations concerning which lives matter, and which do not, and to the fact that these responses are thus structured in ways of which we are not typically conscious. This is why Butler says that the distribution of grievability is a function of “frames”: a frame limits and organizes an image precisely by not appearing in it. The point is that consequential calculations concerning which lives really matter are rarely voiced in explicit statements about different groups of people; they are subtly embodied in actions, or failures to act, in visual images, cultural artifacts, laws, practices, policy decisions, the design of spaces that separate poor from affluent communities. These are all modes of framing, and they structure the way in which we register the moral dimensions of our world. They are also open to critical reflection, and the capacity for such critical reflection is no less crucial to the moral life than the capacity for reasoning and calculation in the face of moral dilemmas.

The differential distribution of grievability is at issue when health care providers have to decide which groups of people to prioritize. But it is also more subtly at issue when each of us is faced with the decision to commit to wearing masks to protect others, or when we have to decide who is an “essential” worker, or when we have to decide about opening businesses and schools. As of June 17, 120,000 Americans have died because they contracted COVID-19 and this number continues to grow. While the virus is indiscriminate, it seems so far to have mostly killed people whose vulnerability was already heightened, often by years of policy decisions about health care, pollution regulation, food security, housing, education, and policing. The CDC now has data to corroborate what many already suspected: that black and Hispanic/Latinx people are much more likely than to die if they contract the virus than whites across all age groups. When we have to commit to new behaviors of social distancing, or decide when it is safe to reopen businesses and schools, these facts are in the background; as responsible ethical actors, we must attend to the unequal distribution of grievability that frames our choices. 

Viewed in this light, the recent outpouring of grief and outrage in the aftermath of the death of George Floyd is perhaps another manifestation of the same crisis. The horrifying video of that death has exposed the frame. The unequal distribution of grievability has been brought into the open, and has become a scandal in a society claiming to have been founded on the proposition that all human beings are created equal. There is a simple injunction scrawled onto many signs carried in hundreds of street protests in recent weeks: “Say Their Names!” This is an eloquent protest against the mechanism that apportions grievability to some lives, and not to others. To say the names of George Floyd, Eric Garner, Michael Brown, Tamir Rice, Walter Scott, Alton Sterling, Philando Castile, Stephon Clark, Ahmaud Arbery, Breonna Taylor, is to insist that each one of these lives mattered. But this is only the beginning of an ethical task in which each of us must have a part. Our outrage against racist violence or racially motivated indifference must go beyond condemnation of individual acts and choices, it must strike at the frames—embodied in media representations, laws, monuments, institutional practices--that support what is rightly called “structural racism.” These structures set the terms for individual choices. And though these frames are, for each of us, a kind of inheritance that we often take on unconsciously, it behooves each of us as ethical adults to free ourselves of their claim.