My initial reaction when reading “The Public Shaming Pandemic” was one that entirely rejected the use of shaming on social media. I was particularly horrified by the story of Wojeciech Rokita and his experience with public shaming. Rokita is not thought to have spread COVID-19 to anyone, but while he was voluntarily confined in a hospital recovering from COVID-19, he and his family were brutally ridiculed and attacked on social media for contributing to the spread of the disease. Rokitia committed suicide and his family struggled to find a funeral home that was willing to take his body while people online continued to ridicule him. What happened to Rokita illuminates the dangers of public shaming and the extreme toll it can have on the mental health and lives of those that are shamed. Public shaming on social media and so called “cancel culture” has an extra layer of brutality that would most likely not be an issue if it weren’t for the anonymity and lack of censorship that social media provides. Anonymity and lack of censorship places those online in a position of power they would not have if a confrontation or shaming was occurring face-to-face. As one of millions of social media users characterized by blurry profile pictures, people can easily join in on a bandwagon of hate without being held accountable for their words. One tweet or comment in a stream of thousands can be easily overlooked unless, of course, you are the person being ridiculed.
However, I struggle to fully condemn the act of shaming. Many do not need the power of anonymity or freedom of speech that social media provides to make their voices heard. For example, Mayor Bill de Blasio as a man already in a position of privilege and power had several options available to him (including simply reaching out to the Garbuz family to ask them to responsibly quarantine) that were not as extreme as tweeting out the name of a local man with COVID-19 along with the name of the law-firm where he worked and the names of the schools his daughters attended. On the other hand, some people or groups are in need of the power that social media can provide. The largest examples of this are the uses of social media by the Black Lives Matter and the #Me Too movements. On social media, Black citizens were able to use social media to release and spread videos of horrific police brutality and demand justice. Women were able to condemn and expose their often rich, famous, and powerful sexual assaulters. We cannot allow shaming on social media to be entirely eradicated as many need it to receive justice against those more powerful who have wronged them. However, we must also not allow social media to turn into a platform for senseless and nameless bullying.
In “How China Controlled the Coronavirus,” Peter Hessler discusses his experience working as a teacher in China during the pandemic. Towards the end of the article he discusses how drastically less successful the United States was at limiting the spread of Covid-19. The vast difference in the number of cases and deaths was tied to China’s more strict policies in response to Covid-19. Hessler notes one of his students saying an additional reason was that “Chinese value life over freedom, whereas Americans take the opposite approach.” Hessler seemed to lean away from this idea, pointing more towards a failure of leadership and institutions. However, I can’t help but somewhat agree with the student on this view of American values. Students at my school laughed when someone suggested that the pandemic might prevent us from having prom or graduation. The idea that we wouldn’t have the graduation ceremony we had been planning to have for four years seemed absurd and, most importantly, unfair.
The idea of an inalienable right to freedom is taught to children in the United States from as early as kindergarten. It is a core tenant of America whether or not the idea of universal freedom is truly upheld or not. So when people were told to stay home, wear a mask, and limit their interactions many began claiming their rights were being violated. We face restrictions of our autonomy daily, but these restrictions were new, unfamiliar, and uncomfortable. People protested the closing of states and argued for their right to get a haircut. Therefore, It does not seem like a stretch to suggest that America has in some ways come to value a sense of freedom and autonomy over life, largely as a byproduct of patriotic and nationalist teachings. The other day, my mother angrily showed me a Facebook post from a family member that almost explicitly reflected valuing freedom over life. He claimed it was unfair to require him to wear a mask because he had a right to put his life at risk if it was his decision (conveniently glossing over the negative health effects his decisions could have on others.) That family member recently contracted Covid-19.
All this being said, it is still important to remember the individual and their rights while making policy decisions such as those surrounding Covid-19. Something that seems like the clear course to saving lives may unintentionally harm some. For example, many were concerned about the closing of the school system in my town because many children rely on school meal plans to provide them with breakfast, lunch, and dinner. The rights of these children had to be considered and a plan quickly put in place to continue providing these students with food while school was occurring online. There must be a balance within society between valuing life and valuing freedom, somewhat similar to Aristotelian ideas. There can be no flourishing without a society taking the proper steps to protect its citizens, but society must also remember to promote flourishing.
Sarah Zhang’s article “A Vaccine Reality Check” discusses the ongoing efforts throughout the world to develop a vaccine for COVID-19. Many hope that a vaccine will allow life to quickly return to as it was before. Zhang warns against this, pointing to the difficulties that will still occur even if a vaccine is successfully developed such as a limited number of available resources needed for mass production and the difficulties that will be faced in distributing a vaccine. However, even if all the difficulties of developing, producing, and distributing a vaccine could be overcome, there is still a glaring concern. Zhang states that “20 percent of Americans already say they will refuse to get a COVID-19 vaccine, and with another 31 percent unsure, reaching herd immunity could be that much more difficult.” The question of how to resolve the issue touches on multiple ethical and moral questions.
The ethical question that seems most relevant to me is whether paternalism is justified in this context. There is a particular brand of liberalism rising within the United States that has been exemplified throughout quarantine. Many have insisted that requirements to wear a mask or adhere to social distancing guidelines are infringements to their autonomy and freedom. The same argument would most likely be raised if any mandates were imposed requiring vaccinations to return to the workplace, school, or university campus. Similar requirements are already in place for many other vaccines, particularly in school environments, and there has been much debate over the topic. However, such a mandate may be needed if the United States is going to reach levels of immunization necessary for herd immunity. A rebuttal I would raise to the argument against mandatory vaccination is a concept that is fairly common in medicine: paternalism is acceptable if restricting a person’s autonomy is necessary to protect others from harm. Refusing to get a vaccination not only puts yourself at continued risk for exposure to coronavirus but could also put others who are unable to receive the vaccine due to economic or health reasons at undue risk.
One question this debate leaves me with is why American society is much more sensitive to paternalism in this case than in the many other daily occurrences where paternalism occurs. The requirement that we all drive on a certain side of the road, laws prohibiting stealing, and many other aspects of daily life can all be seen as the government engaging in paternalism because they believe it is in the best interest of their citizens. People rarely argue that such requirements infringe on their autonomy. What can such resistance to paternalism surrounding vaccines be attributed to? Does it result from a rising culture of medical and scientific skepticism, a genuine concern for health, or something else?
Throughout The Immortal Life of Henrietta Lacks, multiple examples are given of doctors and scientists using their power to coerce consent from patients and research subjects. They have privilege as well-educated doctors or scientists and usually as wealthy, rich, white men. Two large examples caught my attention in part two of the book. Both of these examples came from Chester Southam’s research on whether HeLa cells could cause cancer in those exposed to the cells. His main research subjects consisted of a group of cancer patients and a group of prisoners that willingly volunteered to be a part of the study. Both of these populations clearly held less power and influence than a well-established and respected virologist such as Southam.
In the case of the cancer patients, Southcam lied about the purpose of his injections of HeLa cells and claimed he was “testing their immune system.” These patients, already ill and most likely less educated in the field of cancer research than Southam, were not in a position to question a prominent figure in the medical field when he promised he was trying to help them. The prisoners in the study were clearly in a vulnerable position compared to Southam when they volunteered. As prisoners, their autonomy had already been limited and Southam further relied on the prisoner’s feelings of moral insuperiority to gain consent. Many prisoners cited a need to make amends for their past crimes as their reasons for joining the study.
The examples above show extreme power imbalances between a scientist or doctor and patients or research subjects. However, it does lead me to question at what point we can truly deem a patient or research subject to be in an empowered enough position to truly give consent to physicians or researchers. Most who participate in a study or go to a physician are not as well-educated in the fields of medicine or science as the scientist or doctors they give consent to. There is a focus on educating patients and research subjects enough to guarantee “informed consent.” The complication with this concept is quantifying whether a subject’s or patient’s comprehension of the information they have been given is sufficient. Additionally, in the case of patients, those who seek out treatment from a doctor are typically already ill and must rely on their doctors to receive treatment, making coercion a greater possibility. I question the ability of acquiring valid informed consent in a society where inequalities are so prominent.
In “The Right to a Decent Minimum of Health Care,” Allen E. Buchanan argues that the idea of a right to a “decent minimum of health care” is invalid support for the creation of a mandatory decent minimum policy by a society. The main flaw Buchanan points to in this concept is the lack of a concrete theory of justice to support it. Buchanan argues that a more effective method for justifying the creation of a mandatory coercively backed decent minimum policy would be to make multiple arguments that focus on the topics of special rights, the prevention of harm, and enforced beneficence.
Buchanan reasons that the concept of a right to a decent minimum of healthcare is invalid because there is no clear theory of justice that exists to support the concept. I disagree with this argument. In multiple societies, including the United States, concepts of basic human rights function without being attached to specific theories of justice. For example, American citizens vary and have varied on which theory of justice they adhere to or if they adhere to one at all. Nevertheless, the majority of Americans accept rights such as freedom of speech or religion. These rights are used commonly in decision making and policy creation in the US, and are even an integral part of America’s Constitution despite there being no specific theory of justice that is universally pointed to as justification for these ideas. I would argue this is because these concepts apply more to a sense of common human beneficence than they do to theories of justice. Many support an argument if they believe that it is beneficent before they attempt to apply the lens of a specific theory of justice.
I can understand reasoning for why relying on a right to decent minimum health care alone might not be strong enough to justify a decent minimum health care policy. However, I feel as though the concept of a right to minimum healthcare may still be seen as a valid argument among the other’s that Buchanan offers for the creation of coercively backed minimum healthcare. I believe that this concept of an inherent right can work in tangent to Buchanan’s arguments. Buchan’s arguments can be combined with the idea of an inherent right in order to strengthen the overall justification for a mandatory coercively backed decent minimum policy.
In the text “Paternalism,” Gerald Dworkin argues that there are conditions where a person may not wish to take an action at the time of that act, but at another time, when they are thinking rationally and are able to recognize the benefits of the action, they would agree to let others force them into the same act. Under such circumstances, Dworkin would consider paternalism to be valid. Dworkin applies this argument to the larger context of government and the creation of paternalistic legislation. He argues that certain laws are put in place for what is recognized overall by the people in a community to be in their best interests, even if those people may not wish to obey that law after it is enacted. Dworkin offers the example of taxes. When the time comes for citizens to pay taxes, they might wish not to do so. However, it is in the community’s best interest that they do so in order for the government to provide public goods. Hence, it is the government’s responsibility to continue to enforce tax laws even if citizens may not wish to pay them. Dworkin argues that paternalism in these laws and others are justified because citizens may give their consent to a system of government to limit their autonomy in order to “safeguard” their interests.
Dworkin’s argument does have merit. Paternalistic laws and legislation may be needed in order for a society to function, and realistically, not every citizen can be asked to give direct consent to a law before it is put in place. However, I do take some issue with the lack of clarity on what it means to give consent to a system of governance. For example, are you consenting to be governed paternalistically by simply being a citizen of a country? Furthermore, the argument relies on the assumption that a citizen’s initial consent is valid. A person may give their consent to paternalistic governance due to their inability to join another state or because of pressure to assimilate into a country’s culture. This consent would not be coming from the person’s genuine trust in a government body to act rationally in their best interests when they themself are unwilling to do so.
Further issues can be found with Dworkin’s argument when it is placed in the context of medical care. Based on Dworkin’s argument it could be proposed that if a patient gives consent to a treatment plan early on, their physician is free to continue treatment if they believe the patient to be irrational when they later object to treatment whether the patient is truly irrational or not. Additionally, the problem once again arises of what it means to give valid consent. How can we be certain a patient is not being coerced into receiving treatment by others in their life? The best way to be certain of a patient’s consent is to provide them with multiple opportunities to withdraw it, something Dworkin’s argument does not take into account.