Author Archives: Katherine Gao

The Crippling Effects of Public Shaming during COVID-19

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The article The Public-Shaming Pandemic highlights the effects of harsh online denunciation towards individuals who unintentionally spread COVID-19. While it is understandable why people may be angry at these individuals, the extent to which these individuals are shamed and the devastating effects it has on their lives makes it questionable. Under the framework of virtue ethics, the concept of shaming as a mechanism to realign people with social responsibility may be respectable, but public shaming through modern online platforms during this pandemic seems to have become more of a mechanism for punishment. Internet attacks received at a pace like rapid fire have had detrimental effects on the livelihoods and well beings of COVID-spreaders, many of whom had no intention of spreading the disease to others or didn’t fully understand what was considered proper behavior early on in the pandemic.

In the midst of this pandemic, I think it is important to remember that we are all trying to navigate this together. While it is necessary to remind people of their social responsibility during this pandemic, the motivation behind extreme attacks like death threats seems to be less about regulating personal behavior and more about harassment. When these individuals’ lives are so drastically turned upside down, there is no opportunity for them to learn from their mistakes, ultimately making this kind of public shaming not only damaging, but also counterproductive. 

That is not to say that reckless behavior should not be addressed during this pandemic, but there needs to be ways of condemning harmful societal behaviors without completely crippling an individuals’ character. One of the ways that may help to alleviate the devastation of public shaming is by keeping medical and other personal information private. Low patient profiles would decrease opportunities for impulsive attacks and mass outrage towards already vulnerable individuals like Nhung, who, because of her publicized COVID-19 diagnosis in Vietnam, received harsh criticism and had some people spreading misinformation about her whereabouts even when she was lying in a hospital bed. Another consideration that might help to find this balance is whether social media, because of its potential to spread misinformation and generate mass harassment, could ever effectively play a role in censuring behavior. And if not, what are some practical alternatives?

Life vs. Freedom: a comparison of the Chinese and American COVID responses

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In his article “How China Controlled the Virus”, Peter Hessler recalls his experience as an English professor in Sichuan during the Chinese response to the COVID pandemic, describing strict policies of isolation, community enforcement and shaming, and a strong sense of sociality. Although the pandemic originated in Wuhan, China, China was actually among the first countries to get a hold of the virus’ spread. China’s response was in sharp contrast to that of the United States, where the virus infections and deaths are still at an all time high. Hessler generalizes the difference between these two nations’ pandemic responses as the following: “Chinese value life over freedom, whereas Americans take the opposite approach.” 

This statement is unsurprising. America has always valued individual rights and democracy, which in many cases has proved to be an ideal form of government. However, it’s imperative to recognize when certain situations require a more communitarian approach, particularly when it comes to public health issues. Heeding expert advice on wearing masks, social distancing, etc should be regarded as a social responsibility in order for the country to get back on its feet because failing to do so would first and foremost be putting others’ rights to life at risk. However, it would be unfair to say that the failure of an effective American response proves the weaknesses of democratic values as a whole, since several other democratic nations have done a much better job of controlling the virus than the US has. Rather, it points more to America’s deterioration of leadership, a lack of a national response, the unhindered spread of misinformation, and the politicization of health issues. 

However, the extremities of the Chinese response are also, in many ways, equally as dangerous. Although China was able to effectively control the virus spread, the story of “the Liupold Bloom of northeastern Sichuan” who had been in medical isolation for sixty-five days shows the severe psychological damage that the strict lockdowns and isolation measures had on individuals. Factors like the economy, autonomy, and the mental wellbeing of Chinese citizens were in many ways disregarded.

The dangers of both extreme perspectives on handling public health crises then begs the question: where is the balance? For starters, I believe that misinformation is deleterious to any pandemic response. Additionally, because the benefits of measures like mask-wearing outweigh any sort of trivial inconvenience of wearing them, some extent of paternalism here is justified. Other policies are more nuanced, but it’s hard not to wonder, had America at least kept these two assertions in consideration, where would we be now?

Spread of misinformation and the politicization of the COVID pandemic

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More than seven months into the current COVID pandemic, a number of ethical concerns have been and are still in the process of being disputed. Some of the most substantial debates have been about the politicization of public health issues, the spread of misinformation, and personal autonomy vs duty. These ethical issues have only become more pressing with hope for a vaccine just on the horizon.

First, the politicization of COVID has also led to widespread misinformation, not only about the effectiveness of mask and social distancing guidelines, but also on the speed at which a vaccine will be available to the public. In order to keep people optimistic, the national government has put a huge emphasis on speed of production. However, with worries of speed potentially causing errors in a process that usually takes years, some pharmaceutical companies have pushed back against claims of a vaccine that will be widely available in a month’s time. The ethical debate, then, is whether it is worth withholding factual information from the public for the sake of keeping spirits high. Based on Kant’s Categorical Imperative, the act of lying is always bad in and of itself because it could not become a universal law. In the long run, such misinformation and/or a botched rollout of the vaccine could cause the public to lose trust in the national government and public-health experts, making it even more difficult to distribute vaccines in future epidemics/pandemics. 

Additionally, the debate of personal autonomy vs duty will continue to be relevant with a COVID vaccination. Currently, this debate mostly surrounds mask-wearing and social distancing guidelines. Scientific experts across the world have encouraged such measures, but because concepts of individual freedom are so instilled in the current American system, these measures have not been nationally enforced and therefore, many refuse to follow the suggested guidelines. However, I think it’s important to recognize that one’s rights are only justifiable insofar as they do not infringe upon another’s rights. Because it is scientifically proven that widespread wearing of a mask and social distancing significantly reduces spread, not taking these precautions under the justification of individual autonomy essentially infringes on others’ rights to life, which is why it is so dangerous for public health issues like this to be politicized. Similarly, in the context of a vaccine, many Americans will refuse to even receive the vaccine, so the question becomes: should receiving a vaccine be up to one’s discretion, or is it one’s duty to receive a vaccine, not only for themselves but also for prevention of spread to the rest of society? And more generally, are there situations in which individual autonomy should not be upheld, and if so, where is the line drawn?

HeLa vs. Henrietta Lacks: a Disregard for and Objectification of Medical Subjects

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In Part II of The Immortal Life of Henrietta Lacks, Skloot delves deeper into the sharp contrast between the life of HeLa cells and that of Henrietta and her family. While HeLa cells lived a flourishing life and legacy far beyond Henrietta’s own, Henrietta and her family faced numerous healthcare struggles that only seem more unethical in light of their initial ownership of Henrietta’s scientifically renowned biological material. After Henrietta’s death, Henrietta’s family consented to an autopsy, but both Henrietta and her family were never informed of the removal of her cancer cells for medical research. Even after HeLa cells made huge strides in the medical world and people from all over came to interview Henrietta’s family, Henrietta’s family still had little information about what HeLa cells were actually being used for. On top of this withholding of information, Henrietta’s family constantly struggled to afford much needed healthcare, which was unfortunately ironic considering the impact of HeLa cells. 

I think that this distinct contrast results from what can essentially be boiled down to the perception of colored people at the time as merely a means to an end for selfish, and often economic, motivations. This view of Henrietta’s biological material as a transactional item, especially as it became more and more widespread in the scientific community, diminished Henrietta’s worth as a human, which Gey’s assistant Mary actually points out with her observation of the chipped red polish on Henrietta’s toenails — “I thought, Oh jeez, she’s a real person.” It’s evident that this objectifying of patients, especially colored people, for medical research wasn’t uncommon, as Sonny tells Skloot “John Hopkins was known for experimentin on black folks. They’d snatch em off the street…”

With this in mind, so many other actions of the people involved with HeLa cells become contentious. For instance, Gey’s claim of protection of privacy for Henrietta and her family is greatly undermined by his failure to receive informed consent in the first place and also the lack of compensation to Henrietta’s family. This puts into question: when Gey claimed to protect Henrietta’s privacy, was he honest or was it more about claiming ownership over HeLa cells by not recognizing Henrietta’s contribution? Is it ever ethical for anyone to claim ownership over someone’s biological material other than that someone and perhaps his or her family? And finally, to what extent can utilitarianism justify these members of the scientific community’s actions?

Considerations for Daniels’ Right to Health Care

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Norman Daniels argues a positive right to healthcare, in which others have a duty to help right-bearers obtain that right, on the basis of Rawls’ contractarian theory of justice. He claims that disease and disability limit one’s range of opportunities, and therefore, a right to health care ensures “normal functioning” so that physical or biological disadvantages are not barriers to fair equality of opportunity. However, he acknowledges that there must be constraints to such a right, especially since resources and technology are limited. He seems to suggest that when choosing where to invest medical resources, treatments that meet fundamental health care needs (as opposed to cosmetic surgery, for example) or proven effective treatments (as opposed to experimental treatments) may be prioritized.

From a distance, Daniels’ “fair equality of opportunity” argument is generally convincing; however, when narrowing in towards more specific healthcare scenarios, this theory alone may be insufficient in providing answers. For example, what does “fair equality of opportunity” support when it comes to issues of abortion? Abortion is not necessarily categorized as either a treatment for disease or disability (which are largely what Daniels refers to), and rather than being an issue of justice, it might be more helpful to weigh abortion through a lens of autonomy vs. nonmaleficence. Another scenario to consider may be whether it is worth investing such a large chunk of healthcare resources for the elderly, some of whom may never really achieve “normal functioning” again. In the proposed situation, various parts of Daniels’ argument appear to clash. In a perfect world, the general concept of a right to healthcare seems to warrant taking age out of the equation; in agreement of this, Daniels opposes purely utilitarian justifications and discrimination in the distribution of healthcare. However, in acknowledging resource scarcity, Daniels seems to value the allocation of resources to the most people rather than directing these resources to a few who are furthest away from “normal functioning,” which takes on a utilitarian stance despite his initial criticism of utilitarianism. These contradictions in Daniels’ reasoning make it difficult to speculate where he actually stands in some of the most controversial issues of healthcare.

That being said, I agree with the general notion of a right to healthcare; I simply derive my criticisms of Norman Daniels’ piece not out of disagreement but rather to suggest areas in which Daniels can strengthen his support for such a right.

Dworkin on Paternalism and Patient Autonomy

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In “Paternalism”, Gerald Dworkin negates John Stuart Mill’s position on paternalism by asserting that individuals are not always rational and paternalism does not actually conflict with patient autonomy. Mill supposes that individuals are the most interested persons in themselves, and therefore, will make the most rational decisions regarding what is best for them. However, when discussing intervention in the governmental sphere, Mill makes a few exceptions that seem hypocritical to his stance on paternalism: 1) individuals may lack exactly what it is they need, making them unqualified to make judgements alone and 2) individuals may make irreversible decisions that affect their future, therefore, stripping them of self-determination at that future moment. 

Dworkin suggests that such exceptions are equally as valid for paternalism. In Mill’s first exception, intervention is simply a means to help one achieve a need of which they are incapable of obtaining without guidance. In a medical context, maintaining one’s own health is generally viewed as a priority, and nurses and physicians are generally the most knowledgeable about how to promote good health for a patient who currently lacks such health, so paternalism is justified. With Mill’s second exception, Dworkin essentially argues that in certain situations, supporting paternalism actually gives the patient more autonomy than the alternative. He disagrees with Mill’s assumption that people always act rationally, and in such instances when people have lapses in judgement, paternalism is justified to make decisions that that person would have made in a more rational state of mind, to honor one’s previous requests (e.g. Dworkin’s Odyssey example, DNR), or to protect their future autonomy (e.g. Dworkin’s slavery example).

Ultimately, Dworkin builds a strong affirmative case for paternalism by pursuing a largely consequentialist, or more specifically, utilitarian framework. By contending that, in certain cases, paternalism provides the most autonomy as a whole despite the deprivation of autonomy in the present moment, Dworkin proves that the general positive utility of paternalism outweighs the brief negative utility. Now, Dworkin never disregards opposing arguments; he recognizes that one of the main difficulties in drawing a line for cases in which paternalism is ethical is that people may prioritize different values. In order to address this, he largely adopts a case by case mindset, only really arguing that paternalism should be implemented when the restriction is trivial in nature and does not overwhelmingly interfere with the conception of one’s own life. To strengthen his case, he proposes that to maximize total utility, authorities should always bear a heavy burden of proof and follow the least restrictive alternative. He presents numerous hypothetical situations to exemplify viable cases for paternalism, and being that even just one of these hypothetical situations stands true, Dworkin successfully upholds his argument.