Problems with Pandemic Policy

The very first thing you’re taught about writing in philosophy is to narrow your focus. Before every assignment, every professor will plead, “pick just one idea and develop it!” I tell my students the exact same thing. But today, I am going to do exactly the opposite. Don’t do as I do, do as I say!

I’m gonna take you on a wild philoso-mash up of Camus, Stalin, philosophy of law, ethics, contemporary events, and–for good measure–some existentialism! Buckle up, hold on to your face masks, and let’s hope I pull it off!

Part 1: Rambert’s Situation

In Camus’ novel, The Plague, the city of Oran is hit by a (spoiler alert!) deadly plague. In order to prevent the plague from spreading to the rest of the world, the city officials are ordered to close the city gates and deny exit to anyone. Rambert is a journalist from Paris who just happened to be visiting the wrong town at the wrong time. Like most of us would, he just wants to get back to home. He pleads with various authorities to let him leave. After all, this isn’t his hometown and, more importantly, he wants to get back to the woman he loves.

The various officials tell him that they quite appreciates his position, but “no exceptions could be made [. . .].”

After this refusal, Rambert goes to Dr. Rieux to see if he’ll write him a note proclaiming he’s plague free. Maybe that will allow him to leave. Dr. Rieux says he cannot certify that between the time he certifies and the time Rambert leaves that Rambert will be plague-free. The consequences of allowing the plague to spread outside the walls of Oran are too great. He adds:

“Even if I did give you a certificate it wouldn’t help”

“Why not?”

“Because there are thousands of people placed as you in this town, and there can’t be any question of allowing them all to leave.”

“But I don’t belong here […] Doctor, can’t you see it’s a matter of common human feeling? Or don’t you realize what this sort of separation means to people who are fond of each other” [Rambert is referring to the woman he loves in Paris].

Rieux was silent for a moment, then said he understood it perfectly. He wished nothing better than that Rambert should be allowed to return to his wife and that all who loved one another and were parted should come together again. Only the law was the law, plague had broken out, and he could only do what had to be done.

“No,” Rambert said bitterly, “you can’t understand. You’re using the language of reason, not of the heart; you live in a world of abstractions.” [. . .]

Rambert raised his voice again. “I approached you because I’d been told you played a large part in drawing up the orders that have been issued. So I thought that in one case anyhow you could unmake what you’d helped make. But you don’t care; you never gave a thought to anybody, you didn’t take the case of people who are separated into account.”

Part 2: Lessons from The Plague

This passage raises several interrelated themes relevant to our current situation. First, each of us lives in unique circumstances. We also have individual personalities, needs and wants that–from our own point of view–are just as urgent as those of anyone else. Let’s call this concrete particularity. Rambert, like just about everyone else, is concerned with his particular situation, desires, and feelings. Similarly, what is essential to me might not be essential to you, and vice versa.

The second theme is that of abstraction. In order to make the world intelligible and tractable, we are sometimes required to overlook particularity and think in terms of larger categories. For example, when I say 40 000 people live in Bowling Green, Ohio I don’t name each one. It’s just ‘people,’ in the abstract.

It’s the same with the law. Laws, by definition, are general and apply to abstract groups of people. Therefore, no law can possibly take into account every single person’s unique situation, desires, needs, and feelings. Nor can it anticipate every possible future situation that might merit exemptions. This would require legislators to be aware of the present and future particular situation, needs, and desires or every single person subject to the law and to balance those against the need for the law. This isn’t possible to ask of human beings.

Similarly, if we made special exemptions for every possible reason, the law would fail to serve the purpose for which it was created. As Rieux points out, “[…] there are thousands of people placed as you in this town, and there can’t be any question of allowing them all to leave. And so, inevitably, for any law some people will feel (legitimately or not) that their particular situation, needs, and desires have not been properly taken into account.

This is what we are seeing in response to the laws regulating businesses and citizens during the coronavirus pandemic. Some individuals and groups feel as though their particular situations, needs, and desires have not been properly accounted for and weighed in the formulation of the law. They are like Rambert, yelling at the lawmaker, “you live in a world of abstractions.”

This is where things get tricky. Like Rambert, we each believe that our particular situation merits accommodation. To be sure, there appear to be legitimate grievances, especially where the law appears arbitrary. For example, big box stores like home depot are allowed to stay open (so long as they limit capacity to 50% of fire code). However, small stores must remain closed. Why not let the small stores stay open so long as they only allow 50% of fire code capacity?

There’s also disagreement over what counts as an essential service. What may not be essential for some may be essential for others. But it’s impossible to accommodate everyone’s individual claims for what is essential without completely undermining the purpose of the laws. Lawmakers, with imperfect information, are forced to generalize. They are forced into abstraction.

The third theme is responsibility. In virtue of being a doctor, Dr. Rieux bears a heavy responsibility that he cannot evade. He is responsible for ensuring the plague doesn’t spread outside of Oran. If the plague spreads to the rest of the world as a result of allowing people to leave, Dr. Rieux will be partly responsible for the tragic consequences. And he must live with them. This is a tremendous responsibility to bear and understandably disposes him toward caution.

This reminds me of the first time I observed rounds at an inpatient psych ward. Many of the patients had made attempts on their own lives and had self-committed. They were on suicide watch. My first day observing doctor-patient assessment interviews made me sick to my stomach. Many of patients pleaded with the doctors. “I feel fine now. Please, just let me go. I’m fine. I miss my family. Please, doctor, I’m fine.”

It was nothing short of a nightmare to watch.

The doctors denied discharge to just about every patient. I went home disgusted and livid. How could these doctors be so cruel? Like Rambert, I thought, where is their humanity? Don’t you realize what this sort of separation means to people who are fond of each other?

After a few more days I started to moderate my view. Suppose you were one of these doctors and you released a patient who then killed themselves shortly after release? How would you answer to the family? To their children? To their parents? They were in your care. They were your responsibility. How would you answer to your co-workers? How would you answer to yourself? How could you escape the thought that if you’d just held them for one more day they might have left in a more stable state?

I still don’t have a settled view on the correct moment for releasing self-institutionalized suicidal patients but I do appreciate the tremendous burden of responsibility these doctors bear. Even if we disagree with their decisions, we can at least appreciate that their caution isn’t unreasonable. And it certainly isn’t out of malice.

Something similar is happening with the quarantine laws. Regardless of political ideology, everyone agrees it is a fundamental and legitimate function of government to protect its citizenry from threats to their lives and welfare. The lawmakers are responsible for outcomes–good and bad. It is the burden of responsibility that comes with their position. Nevertheless, they must make decisions with imperfect and incomplete information. They must also make decisions immediately.

If they are too lax and tens of thousands die, they–and they alone–must bear this burden. Under these conditions of imperfect, incomplete information, and an immediate need to act, laws will be imperfect too. Not everyone’s personal situation will be taken into account. Some groups will suffer disproportionately, and what should bring us together will pull us apart. As Camus writes:

Thus the plague by its impartial ministrations should have promoted equality among our townsfolk, it now had the opposite effect and, thanks to the habitual conflict of cupidities, exacerbated the sense of injustice rankling in men’s hearts. They were assured, of course, of the inerrable equality of death, but nobody wanted that kind of equality [. . .]. The feeling was emboldened in a slogan shouted in the streets and chalked up on walls: “Bread or fresh air!” This half-ironical battle-cry was the signal for some demonstrations that, though easily repressed, made everyone aware that an ugly mood was developing among us.”

Part 3: Abstraction Revisited

One last note. Abstraction is often necessary but it carries with it ethical implications when applied to human beings. Stalin is famously quoted as saying “one death is a tragedy, a million deaths is a statistic.” The more we abstract away from individuals to groups, the more we lose track of the individual human features that move us to care. It permits moral indifference.

In many ways Stalin is right. When a single person dies, we learn their story. We are able to empathize and recognize their humanity and suffering. When people are reduced to abstractions–mere numbers or labels like “Liberal, Republican, Conservative, or Democrat–they risk becoming emotionally and ethically distant. Of course, abstraction is sometimes employed as a deliberate tactic to dehumanize. We cannot, however, escape abstraction in thinking about policy-making and so we should be cautious when required to reason abstractly about human suffering.

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