Ethics and Public Health

The former executive director of the Association of Theological Schools related school governance to public health. Neither, he said, is sexy work. However, when there is a crisis and you need to invoke governance or public health policy or protocols, you’ll be thankful you have them.

Public health in the United States is a bit of a mess. Yes, that’s understated. The last two years have revealed or underlined so many deficiencies in planning and policy. But this time also certainly revealed the American public approaches the ethics of public health from radically different perspectives.

I am currently teaching an online class about morality and ethics using the NBC comedy series, “The Good Place.” I am among the many fans whose professional work is in public morality, the importance of friendship for a good life, and questions regarding whether or not human beings can grow to be morally better. (I recommend to you a book written by philosophy and ethics professors reflecting on the show, The Good Place and Philosophy.)

In  episode four in the third season, the moral philosophy professor on the show, Chidi, has a serious mental and existential crisis. In his despondent state, he stands in front of his class and explicates in just a few sentences the basic philosophical positions on morality. He tells his class about virtue ethics, utilitarianism, and deontology.

Virtue ethics postulates that we know what is good by looking what at what a good person does. Utilitarianism’s claim is that a moral action should be judged by its consequences rather than by intent. A moral action brings about the greatest good for the greatest number, maximizes that which is beneficial and pleasurable and minimizes suffering and other negative consequences. A deontologist would argue the morality of an action is embedded in the intent of the actor, in the principles that led the actor to take action.

But in his state of existential despair, Chidi testifies the only real philosophy is nihilism. A few scenes earlier, Chidi was walking through a park and approached by a drug dealer. Chidi quotes to him from Nietzsche that there is no God, God is dead and we killed him. To which the drug dealer responded, “I was just trying to sell you drugs and you made it weird.”

Well, if we approached public health from the perspective of virtue ethics and we’re looking for what a good person does, some of us would claim that Dr. Anthony Fauci was a good person to emulate. Follow the science. Trust only legitimate health authorities rather than whatever one reads on social media and hears on partisan news sources. However, Dr. Fauci embodied for others exactly what a good person should not do. For them, the good person to emulate was the business that refused to close or the legislator who advocated to make mask mandates illegal.

Utilitarianism would seem to be an act moral perspective for the work of public health. Connect policies and protocols that result in the greatest good for the greatest number, maximizing benefits and minimizing suffering. However, the suffering of those whose livelihood depended on gathering places that were petri dishes for spreading the virus, whose venues were closed, was significant. It was difficult to negotiate between preventing the spread of the virus and the suffering of lost income due to venues being closed to prevent the spread of the virus.

Considering pandemic responses from the perspective of deontology, one certainly finds competing perspectives on which principle to invoke, which intent to try to fulfill. The principles of protecting the vulnerable and “we are all in this together” were there. Protecting my freedom to do as I please without invoking the wisdom that my freedom ends where your freedom begins was widely on display and often ignored calls to protect the elderly and infirm. We sometimes heard this “keep it open and don’t mask me” position stated as “personal responsibility.” Those of us living in a Red state culture know this mantra.

There were certainly some of our fellow citizens who embraced nihilism and sought to impose their perspective on all the rest of us. A government committed to nihilism under the banner of “freedom” is a frightening image.

There is one other ethical perspective that may have been on display. It’s called ethical egoism. One must always make a decision based on what one believes is good for oneself. This philosophy is sometimes joined with eudaimonism or flourishing. Some eudaimonists claim that if everyone follows their bliss, the universe will coordinate and harmonize.

Given that in the United States most likely over one million people have died of COVID, nine million people lost someone close to them due to COVID, tens of thousands of people are living with long COVID, and civility came closer to hitting rock bottom, the claims of ethical egoism and eudaimonism must be judged as false.

I think we should expect public health to be premised upon some version of utilitarianism, promoting the greatest good for the greatest number and minimizing pain and suffering. I think what we have seen is a principle of “my freedom” exercised without regard to the freedom of anyone else–as long as the freedom we’re talking about is the freedom to remain unmasked.

It was both disheartening and angering to see Christian pastors denigrating public health practices as secular tyrannies and attacks upon freedom. If Christian principles meant more, at least the way that Paul wrote about Christian principles, we would have seen much more concern for the weakest and most vulnerable. Instead, we saw and still see something that looks a lot more like Nietzsche’s world where are the strong scoff at the vulnerable. No person invoking religious principles should resonate.

Dr. Gary Peluso-Verdend is president emeritus at Phillips Theological Seminary and is the executive director of the seminary’s Center for Religion in Public Life. The opinions expressed in this blog are those of the author. Learn more about the Center’s work here and about Gary here.

IMAGE CREDIT: Image used from the New England Public Health Training Center https://www.nephtc.org/enrol/index.php?id=35