“Father abandoned child, wife husband, one brother another”, recorded a shoemaker and tax-collector, as the plague tore through the great city of Sienna in the autumn of 1348, “for this illness seemed to strike through the breath and sight”. “None”, he continued, “could be found to bury the dead for money or friendship”. “I, Agnolo di Tura, also called the Fat, buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city”.
“All believed it was the end of the world”.
The apocalyptic impact of past pandemics, from the Black Death to the tens of millions who died in the Great Influenza of 1918-1919, hang over the responses of governments to the unfolding coronavirus threat. Irrespective of whether mass death is delivered by guns or disease, history teaches us it can lead civilisation to implode.
Even as lockdowns and social distancing suffuse our lives, though, some have begun to ask if the costs of the pandemic response justify its ends. In one article, author Sandipan Deb noted that the United States managed to live with large numbers of season flu deaths. An extreme form of this argument is that that the current fatality rates in the pandemic—some 3.5 percent of those infected—can easily be sustained in an overpopulated country.
The suggestion, in essence, is that accepting some level of human suffering might serve the greater common good better than the economic dislocation now being caused. As the pandemic unfolds, these questions will become more agonising: who should get care, and how much, at whose cost?
Like everything else, mass death has a moral calculus—and it’s important for Indians to begin reflecting on it now.
Humans’ exquisite limbic systems, evolved over millennia to constantly scan the environment for threats and opportunities, are excellent at seeking to minimise pain, and maximise reward. The limbic system isn’t at its best, though, when confronted with ambiguity, or at discerning complex risks that do not appear to pose an immediate threat. Faced with even small odds that predators might presently eat it, the human brain, wisely, reacts with flight. There is no evolutionary wiring, though, that lets us deal with—say—global warming or pandemics.
Terrorism’s impact on our public imagination illustrates why our choices aren’t always carefully reasoned. In 2019, the most recent year for which estimates are available, all of India’s insurgencies and terrorist groups claimed 621 lives, 330 of those terrorists themselves. That figure dramatically contrasts with the 147,915 people killed in traffic accidents in 2017, the last year for which data is available—a staggering 17 people every single hour.
Indeed, terrorism doesn’t even figure among the ten top causes of premature death in India for 2007-2017: everything from diarrhoea to self-harm claimed orders of magnitude more lives. Yet, the central government spends considerably more on internal security than diarrhoea.
“Even applying a high estimate for the value of human life and a low one for United States counter-terrorism expenditures”. the scholars John Mueller and Mark Stewart concluded in a 2018 paper, “the expenditures would have had to save 11,797 lives per year to be justified”. The actual number killed: an average of six per year, since 2001.
It’s impossible, of course, to judge what might have happened if this money was not spent: it’s conceivable that the United States would then have suffered two 9/11s every year, or India a 26/11 every month. Yet, funding choices were not driven by calm, rational discussion of these prospects. Instead, fear drove our minds.
Lots of similar cases litter our public policy debates. There’s compelling evidence, for example, that the risks to public health from fossil fuels is considerably higher than those from nuclear power plants. The Paul Scherrer Institute and the European Union have estimated that, coal, lignite, and oil claim more than one life per GigaWatt-year of energy; nuclear just 0.2 lives per GWy.
Few people, though, have found these statistics to be persuasive in the face of the images from catastrophic accidents like Fukushima: across the world, public has become ever-more hostile to nuclear energy.
The bottom line is this: our instinctive judgments about risk aren’t particularly rational in the face of a crisis like coronavirus that poses enormous challenges for public-policy decision-making. To make good choices, we have to unpack the moral calculus that underlies our decision-making.
Even though those who could flee the city ran, half of Sienna’s population died during the epidemic of 1348. Faced with certain death, and disintegrating social relations, manufacturing continued; taxes were raised; laws were passed and enforced. Local residents, bar widows, were even forbidden from donning the robes of mourning. Four members of The IX—the oligarchy which ruled Sienna—died in office. The size of the city council and popular council had to be reduced by a third, and the quorum by half, a rough index of the death toll among the élite. The clergy halved in number.
But by 1353, historian William Bowsky has shown, Sienna had succeeded in restoring its finances, and balanced its budget. The church actually benefitted, in the long term, from the acquisition of lands willed by the dead.
This is precisely the moral calculus some are now advocating: societies should sacrifice those most vulnerable to the epidemic—the elderly and the infirm—rather than impact the prosperity and everyday lives of all. The costs of saving some, the argument goes, are simply too high for the many.
Philosophy students encounter this debate as undergraduates, when they study the difference between utilitarianism and deontology. In one popular thought experiment, students are asked whether it is ethical to slaughter a prisoner to donate organs to five people in need of transplants. As the discussion proceeds, students are asked if they would reconsider their answer knowing that the five would go on to make discoveries that would save humanity—or, alternately, spark off world wars.
In essence, utilitarians claim that actions ought serve a greater common good; deontologists respond that there is no certain way to either ascertain what the common good is, or the consequences of sacrificing the rights of an individual for it. For centuries, these issues have been debated; passionate as the arguments have been, there has been no universal, final answer.
Across western Europe’s post-religious societies, various forms of social-democratic liberalism—the idea that each individual human being has inherent rights, and that the state has the duty of defending them—have served to bind together societies. Fighting a pandemic, or poverty, is thus a collective obligation, irrespective of the strains it may impose on the interests of the majority.
In societies like India or the United States, where religion remains important, human suffering is often attributed to divine will. Pain is, simply, the fate of those who are subjected to it, brought about either because of their own moral failings, or a higher cosmic power.
Even in deeply religious societies like these, though, the idea that we have obligations to other human beings—obligations which fell apart in 1348, and so often since—have blossomed. India’s commitments to vaccinating children, ensuring their nutrition and educating them, has steadily grown; these are entitlements, most people would agree, that come with the mere fact of their existence. Families’ claims to have the right to marry off underage daughters, or burn daughter-in-laws, are no longer uncontested.
Put simply, the idea that there is such a thing as a human right—and that society is obligated to defend it—has been nurtured, and grown. This is not an unchallenged idea, though—and as the pressures on the public health system and the economy mount in coming weeks, it will come under even greater strain. How much funding should there be for healthcare? Who should get it, and who should not? How long should schools remain closed? What kinds of economic and social activity restricted, and for how long?
How much are we willing to sacrifice; how many do we choose should live?
Like so often in the past, we can choose to have our decisions guided by our emotions; on judgments made by limbic systems not designed for the challenge they are confronted with. Alternately, as we withdraw a little from the world around us, we can treat this as an opportunity for reflection, on who we are, and what we, as a people, wish to be.
First Published: IST