SECTION III – SOCIAL ARRANEGMENTS and MORAL CONLICTS
9. Well-Being in the Time of Covid-19.
Over the past year and a half, the world has been hit by a dramatic pandemic, which has brought death, suffering and hardships of many sorts to millions of people. For some, however, the pandemic has brought happiness and a better life. In some cases, this apparent contradiction does not present a puzzle. Some individuals have simply been spared by the virus and by the wave of suffering that it has generated. In this chapter, however, I am interested in those individuals whose well-being has increased despite the direct or indirect experience of the virus and its negative consequences. How can we make sense of their situation? I start by rejecting two common explanations. The first is the hedonistic explanation. According to it, these individuals have simply found a way to increase their overall balance of pleasures versus pains, despite the difficult context. The second is the eudemonistic explanation. According to it, the pandemic has led these individuals to develop virtuous traits, which have manifested in activities that have increased their well-being. I propose an alternative explanation, based on the fitting-happiness theory of well-being that I have recently developed with Christine Tappolet. Our theory holds that an individual’s life goes well when the individual is fittingly happy, that is, when the individual affectively experiences items, situations, and activities that are of genuine value and that match the individual’s deepest evaluative attitudes. I argue that, for some individuals, the pandemic has been the occasion to revise their most fundamental evaluative attitudes and has created opportunities for fitting affective experiences that better align with these attitudes. For those individuals, the pandemic has brought personal flourishing despite the suffering.
10. The Role of Public Deliberation in the Allocation of Scarce Medical Resources During a Pandemic.
Alexandru Marcoci & Diana Popescu
During the last 18 months, healthcare systems around the world have been forced to ration scarce life-saving resources such as intensive care unit (ICU) beds, oxygen, mechanical ventilators and vaccines. Professional bodies, governmental agencies and bioethicists have all weighed in on this issue. However, we have yet to hear from those most affected by these decisions: the public. Engaging the public in the design of allocation guidelines for scarce medical resources during a pandemic is a moral imperative. First, decisions about who to save in a disaster situation, such as a pandemic, are not expert but moral decisions. Second, the successful implementation of any allocation guidelines depends on public trust and cooperation. Third, the public will bear the consequences of any allocation decisions made during a pandemic. Not including the public in the design of a decision-making protocol which could recommend denying critical care would be a violation of the democratic desideratum of giving affected persons a say. Furthermore, given that the most severe effects of Covid-19 are concentrated among the elderly and members of certain racial/ethnic groups, ignoring the points of view of those affected risks further entrenching health inequalities. Therefore, in this paper I argue the public should be included in the design of any allocation guidelines for scarce medical resources.
11. Chance, Consent, and COVID-19.
This chapter addresses a puzzle about risk and consent, which lies at the heart of several ethical issues raised by the COVID-19 pandemic. The puzzle comes from Judith Jarvis Thomson (“Imposing Risks” 1985). Thomson observes that in some cases in which one consents to a risk—like, for example, when one voluntarily plays the lottery—one has no grounds for complaint if the risk eventuates. But, in other cases—like, for example, when one chooses to walk through a neighborhood known to be replete with pickpockets—one does have grounds for complaint if the risk eventuates. What accounts for the difference? I survey several possible answers, all with relevance for the complex environment of risk presented by the pandemic. I then move to a closer study of how these answers bear on two model species of decision that might result in a COVID-19 infection. The first is quotidian: a person contracts COVID-19 as a result of deciding to go out and encounter other people during the pandemic. Under what circumstances does this person have grounds for complaint? Here, I consider Gerald Lang’s argument in favor of relaxing lockdown protocols. Lang contends that those who choose to go out and mingle socially are thereby consenting to the risks of contracting COVID-19 (“Costs and Risk Imposition” 2021); I consider the nature of this purported consent, and how it bears on the question of complaint. Then I move to the second model decision: the decision to participate in a human challenge trial, in which participants are deliberately exposed to COVID-19. I ask how volunteers might consent to the health risks of being exposed to COVID-19, and examine how consent offered in the context of a challenge trial might interact with solutions to Thomson’s dilemma (Nir Eyal, “Why Challenge Trials of SARS‐CoV‐2 Vaccines Could Be Ethical Despite Risk of Severe Adverse Events” 2020).
12. COVID-19 and the Social Contract.
This chapter examines different responses to the restrictions that have been put on our civil liberties in the wake of the Covid-19 pandemic. Three types of response are analysed: those of the conspiracy theorist, those of the social dissenter, and those of what David Hume called the sensible knave. It is argued that these three responses are motivated by vastly different reasons, and that while we will always have these three forms of social protest amongst us, during a pandemic, the conspiracy theorist and the dissenter present far less of a threat than the sensible knave. If we accept that political obligation rests on some form of social contract, the conspiracy theorist can be seen as rejecting the civil authority’s evaluation of evidence and its implications; their problem is at root epistemological. The dissenter can be seen as protesting the authority’s management of civil liberties; their protest is about changes to the terms of the social contract. The sensible knave, however, has no objection to the evidence or to the manner in which the civil authority sets the relative weightings of individual liberties and community needs. Indeed, the sensible knave might even regard the reduction of civil liberties as opening up a rich array of new opportunities. Yet of the three “disobedients” it is the sensible knave who poses the greatest risk to society in a pandemic.