As the lockdown nears the three-week mark, people want to know when the restrictions will be lifted. But it also matters how they are lifted.
Nobody should kid themselves that this can be purely a technical matter left to scientists, doctors and economists. Lives and livelihoods are at stake. Deciding the best course of action will involve grappling with massive ethical issues.
How much of an economic hit should we take to save lives? How much should we sacrifice the livelihoods of the young to protect the old? Should the vulnerable be locked up against their will? And should those who’ve had the virus be free to go out but not those who haven’t had it?
Politicians must, of course, consult the experts about matters of fact: the likely progress of the virus; the prospects for treating it; how long it will take to achieve an effective vaccine; how much the economy will be hurt by different, conflicting policies. But even when they have as good a view of the facts as possible – and many of those facts will be, at best, intelligent guesses – our leaders will still be left with value judgments to make.
How are they to weigh up the competing demands? Philosophy can help, and four particular theories are useful.
One is to look at things through the lens of rights. The most relevant rights are perhaps the rights to life, the pursuit of a good life, fairness and liberty. The snag is that as soon as you make a list of the rights we have, it becomes clear that they can conflict. Protecting some people’s lives may involve restricting others’ wellbeing and freedom.
So while it’s useful to think about rights, trade-offs have to be made. Even if one took the view that saving lives should trump all other considerations, there is a question of which lives to save. If the NHS focuses mainly on stopping people dying from coronavirus, it won’t be able to save so many people from cancer. If the fight against the virus tanks the economy, the bigger the risk of another round of austerity – meaning the health service will be less able to stop people dying (of whatever condition) in years to come.
Though saving lives should be our top priority, should it outweigh everything else? What about people who will suffer from mental illness, domestic abuse and economic hardship the longer the lockdown endures? Shouldn’t their rights be taken into account too? Should we therefore aim to reduce overall suffering, rather than simply save lives?
One philosophical theory for reconciling these conflicting considerations is utilitarianism: the theory that the government’s job is to promote the greatest happiness of the greatest number. In doing so, it should take account of the negative consequences of different policies and subtract them from the positive ones.
But there are many philosophical problems with utilitarianism. For example, can you really calculate happiness and suffering in a consistent way for one person, let alone for a population of 66 million. Of course, governments conduct cost-benefit analyses all the time, in a brave attempt to do so.
Even if the measurement issues could be dealt with, then there’s the issue of fairness. Utilitarianism doesn’t take account of how happiness is distributed around the population – or whether a person is in fact responsible for their suffering or wellbeing. Utilitarian thinking lay behind the decision to bail out bankers in the last financial crisis – even though most were rich and some were to blame for the turmoil. Many people would say that was not fair.
So perhaps any approach that seeks to improve wellbeing and reduce suffering needs to be tempered by considerations of justice. It should consider the way the pandemic is affecting ethnic minorities more than white people, and increasing socioeconomic health inequalities.
But fairness is itself not a simple matter. Philosophers since Plato, and even before, have struggled to pin down the concept. What’s fair to me may seem unjust to you.
Finally, there’s classical liberalism: the theory that people should be free to do whatever they want so long as they don’t harm others. It’s not the government’s job to mollycoddle them. People are the best judges of what’s good for themselves – and even if they are not, they should be free to make their own mistakes.
The main justification for the lockdown is to stop people infecting others who might then die. But a subsidiary justification has been to protect people from themselves. When we come out of the lockdown, the question of how free people should be to risk their own lives may become increasingly pertinent.
Some people will gravitate towards one or other of these four philosophical approaches. But they aren’t quite as diametrically opposed as they sometimes seem. For example, many people would say that liberty and justice are both basic rights.
I therefore prefer an amalgam: people have rights but trade-offs must be made when they conflict; governments should reduce suffering and increase wellbeing, not just save lives; and they must do so in a fair way and only restrict freedom when it’s really necessary. If that sounds messy, well that’s because life can’t be reduced to a neat calculus.
Still, with these theories, we can start to address some big ethical questions as we plan an exit from the lockdown.
How much of an economic hit should we take?
Some people will say there is no trade-off between saving lives and supporting the economy. If the government hadn’t shut down large chunks of business, the epidemic would have spread like wildfire. Not only would hundreds of thousands have died, the economy would have ground to a halt anyway because fear would have naturally kept people indoors.
That’s almost certainly true, looking backwards. But hopefully the number of new infections will drop sharply in the coming weeks. Hopefully, too, the government will eventually ramp up NHS capacity – with more tests, ventilators, protective kit, brand new hospitals and drugs that can treat the disease.
While all this may not snuff the virus out entirely, it could keep it at bay until a vaccine is developed and rolled out. So there is likely to be a choice between keeping tight restrictions which crash the economy and easing them with the result that more people die.
Some will think it is cold and heartless to put any financial value on human life, but we should recognise that politicians can’t make sensible decisions without looking at the numbers. After all, will all die at some point.
The government itself hasn’t produced any estimates itself, but the Centre for Economics and Business Research, an independent forecaster, says the lockdown is costing the UK £2.4bn each day. If we maintain that rate for a year, the cost would be £876bn. Meanwhile, it is worth remembering that in a normal year just over 600,000 people die in the UK, according to the Office for National Statistics.
It would be a mistake to use these numbers in some crude calculus. But when epidemiologists get round to forecasting the lives that can be saved by extending the lockdown, we should look at those estimates alongside the expected economic damage. After all, a healthy economy supports good and healthy lives.
How much should we sacrifice the young to protect the old?
Children are now missing out on their education. Young people are prevented from moving on in their careers, meeting potential partners, buying homes and building families. Yet, unless they have prior health conditions, their chance of dying from the virus is pretty low. The government is shutting them up at home mainly so they don’t catch it and pass it on to older, more vulnerable people.
What’s more, being cooped up may damage the young more than older people. After all, they tend to have smaller homes and are less likely to have gardens. They may also not be living with their partners.
The younger generation isn’t just losing out now. The government’s debt will probably rise by hundreds of billions of pounds by the time the crisis is over, because of the loss of tax revenue as well as the programmes to support people’s incomes. Just one policy – the scheme to “furlough” workers – could cost up to £40bn for the first three months, according to the Resolution Foundation think tank. The young may bear the brunt of paying off that debt via poorer public services or higher taxes in the future.
A particular concern is that governments may lose their already weak appetite to fight the climate crisis because their coffers will be empty after spending so much on the coronavirus crisis. Again, it will be the young who will suffer the consequence of that – by being poorer, living in a nastier world, and dying earlier than would otherwise have been the case.
So there is a serious question of intergenerational justice. Up to now, most young people have been glad to stay indoors to protect their parents and grandparents. But as we look at the next phase of the crisis, will it be fair to demand so much of them?
Justice is often viewed as a balancing act. In this case, one compromise could be to keep some level of social distancing for everybody so that the pandemic doesn’t explode again uncontrollably, but expect older people to do more.
Should the vulnerable be locked up against their will?
We could cut the chance of the NHS being overwhelmed by a second wave of infections by requiring the 1.5 million people identified as most vulnerable to stay put. The remaining 65 million would then be free to circulate with more moderate restrictions. This could be seen as fair, as it would impose the biggest burden of social distancing on those most likely to die from the disease. But putting innocent people, many of whom are lonely, under “house arrest” for a long time would be a massive infringement of their liberty.
Again, perhaps some compromise would be just. The government could sternly warn the vulnerable of the risks of leaving their homes. It could add that, if they get the virus, there may not be enough ventilators to treat them. But it would not actually forbid them from leaving their homes.
Such a policy could be buttressed by taking stronger steps to “cocoon” those vulnerable people who heed the government’s advice and want to minimise the chance of getting infected. For example, extra emergency resources could be given for care of the elderly so the virus doesn’t wreak yet more havoc in care homes.
Should those who’ve had the virus be free to go out?
Matt Hancock, the health secretary, says people who have had the virus may be able to get certificates saying they are immune, as soon as accurate tests can be performed. Those who have the certificates – or possibly wristbands – may have greater freedom to work and play. That way, we could get the economy and society moving again while cutting the risk of a big second wave of infections.
There are a host of practical issues with the idea. How long will it take to get a reliable antibody test from which these certificates could be administered, given that those the government has already ordered have been found not tot work? Covid-19 is such a new disease that we cannot yet know, for sure, that those who have already had it and have recovered are indeed immune.
We must also ask if “get out of lockdown” cards encourage perverse behaviour? For example, could young people decide to get deliberately get infected to enjoy more freedom. There might even be a market in fraudulent certificates, in the same way younger teenagers show fake ID to be served alcohol in the pub. Some young people might just lend their wristbands to their friends.
There is also an ethical issue. Those who play by the rules and don’t catch the virus would lose out; those who break them and recover would have more freedom. That wouldn’t be fair.
Yet again, there could be a compromise. Frontline workers in the health service, care homes and so forth could be tested. Those who had had the virus would then be able to get close to the vulnerable without fear of infecting them. Meanwhile, everybody else would have the same freedom, whether they had had the virus or not.
We should all decide
There are other big ethical issues, even before addressing the question of whether we can build a better society once the crisis is over. Should we use technology to track people’s movements so that, if they get the virus, those who have been in contact with them can be informed?
Ultimately, society as a whole needs to be involved in answering these kind of questions. This is why the government should set out its exit strategy now – as Keir Starmer, the new leader of the opposition, has requested. This should include its best guesses about the human and economic costs of different approaches.
But it won’t be enough just to tell us what is going to happen. Although this is a national emergency, we don’t live in a dictatorship. Some safe way must be found to bring our elective representatives together to debate the exit strategy and consider the trade-offs. It is good that Parliament is thinking about how to do this after Easter.
Involving MPs, the public and the media won’t just improve the exit strategy, it may also make the eventual strategy more acceptable to the public. And that’s necessary, not just because the chosen policies will be more effective if people follow them willingly. Part of our dignity as humans comes from being self-governing. (The Independent)