perspective

Pandemic Dilemmas

(A note: sometimes posts for our blog sit on the backburner. There’s all kinds of reasons for this. The post below was written in April 2020.  It has lived in the drafts folder ever since.  Current news and trends brought it back to mind these past couple of weeks, and it seems as relevant as it was then, if not more so. The resources I worry about most now are our health care workers, but as you can read, those worries were already bubbling up last April.)

It was the classic problem.

Hans has a sick child.  Hans is poor and can’t afford the medicine his child needs to live.  Is Hans morally wrong for stealing the medicine his child needs to survive?

In the eyes of the law, sure he would be wrong.  Stealing is a crime. He doesn’t have the right to take what belongs to someone else.  But is he blameworthy?  If he does it, should he go to jail for it?  If he doesn’t steal it, isn’t there a different kind of penalty?

I was a philosophy major in college, specializing in ethics, or figuring out right / wrong / morality. I shouldn’t say figuring it out, since we rarely if ever got to the bottom of anything.  But we spent a lot of time thinking about Hans and these sticky situations, where different people have different rights and those rights cross or conflict.  Moral dilemmas.  So many of the ones that interested me most involved relationships, deciding who is more important, and trying to figure out a good reason why.

I’ve had my moments of anxiety during the course of the coronavirus so far.  But it’s the dilemmas that trouble me most. I get deeply, truly sad when I think about health care workers being forced to make decisions about who has access to life saving medical equipment if supplies are running out.

Here’s an example: Two 50-year old men come in to the ER at roughly the same time, in roughly the same condition, same medical history. About the only meaningful difference is that one of them has three kids, one of them has none. Should that be the deciding factor if only one of them can have a ventilator?

Of course, it only gets more complicated.  What if the one with the kids is overweight and pre-diabetic while the other is in good overall health.  Or one is married, the other is a widower (and what if the one with the kids is the widower, or the one without kids…does that matter?)  One is an affluent business owner with many employees who depend on him, the other is on public assistance.  One is insured, the other is not.  One is African American, the other is White. Add in factors of gender, age, medical history, addiction, other ailments that might be seen as patient life choices (like smoking) and others that are genetic.  You can see how the picture gets very complicated very quickly.  What matters?  What doesn’t?  Who decides?

In our medical ethics classes, we would talk about assisted suicide and the problems with a doctor “playing God,” deciding who lives and who dies…or in the coronavirus case, who even has the chance.

I know a taste of this, from when I was the one who made the decision to take my father off of breathing support to effectively end his life.  Even though he had prepared me to do it and I felt confident it was the right thing, it still stays with me. I will just say that all of this is simpler when it is clear cut.  Still, it is not simple and never easy.

I know there are people who question if this whole pandemic is real.  If all the staying at home and disruption of our daily lives is necessary.  As a member of a family who is supported by a restaurant, I face the same economic uncertainty that has so many people anxious, restless, angry, and scared. I can’t minimize that suffering, but I hope that the help in our communities and from our leaders will sustain us for a little while until we can get the virus more or less medically managed.

What wakes me up at night, though, is thinking of the doctors.  The nurses.  The medical heroes whose hearts and minds will be scarred from watching people die that they truly wanted to help.  That they could have and would have made a valiant effort to save in nearly any other circumstance.  The people they eventually had to walk away from because there wasn’t enough equipment to go around. The trauma to their hearts and minds is immeasurable, not to mention all the people who might not have a chance to survive if we run out of ICU resources.

I believe these moments say much about our values as a culture, as a society. Can we just sit tight for a little bit? Can we help our neighbors and loved ones survive this strange and challenging moment in history?  In my mind, if we can prevent the damage to those who care for us and give everyone a chance to get access to care, as they say flattening the curve can, we should.  If you doubt that this is a real thing, please find a health care worker and listen to them.  Please.

There are a million other issues with this situation.  Reasons to be angry, stressed, depressed.  Some day I may write about my worries over my students now trying to learn at home.  Or the heroism of medical workers who continue to show up and do their jobs when they are inadequately protected.  Or the many other front line workers, often forgotten and in high risk but low-paying jobs.

Surely, some day soon I may be writing about an actual Hans, who lost his hours at his job and needs medicine for his kids. Those stories are out there and more are coming.  The economic, social, mental, and physical impacts will be spinning out for years and years. Once this initial crisis has passed, we will turn our full attention to the suffering of many other groups who need help, who need heart, who need solutions. We will be writing about this for a long time. This is an endurance test. Both our patience muscles and our helping muscles must grow, strengthen, and sustain throughout this marathon.

But for now, in this initial fury, I worry for the doctors and nurses and patients.  It takes me back to those college classrooms, before I had kids of my own, when Hans’s predicament was nothing more than an interesting little thought experiment to ponder. Now I have kids.  And a lot more to lose.  I don’t wish true dilemmas on anyone.  While there is a choice, there is no win.

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