The Value Of Human Life
A reader writes:
1. The whole world, perhaps for the first time in human history, is focused on one problem and nobody knows what to do (world wars were really only between a few major powers even if they had consequences for everyone; that nobody knows what to do is evidenced from the range of expert opinions from this to this)
2. The question of the value of each human life vs. money (root of all evil?) is at the center of the developing debate
If I were making a recipe for an apocalyptic cocktail, well, I’d think I’d only be looking for the garnish at this point.
Well, some good news: the lead researcher on that Imperial College paper has dramatically walked back his estimates for expected mortality in this crisis. It was so quick a turnaround, and so dramatic, that I can’t help but be skeptical about it. But let’s hope it’s true. Even if it is true, the horror scenes in Italy and Spain are real, not made up. No city and no country wants to see what we’re seeing there — and right now in New York City. New Orleans is set to be the next epicenter, in part because of all the people who were infected at Mardi Gras. But if we keep up the social distancing, we will force a peak on this virus, and maybe we can get back to work in a couple of months. Even if the death rate is much lower than we feared, that’s still a hell of a lot of people if this thing spreads widely. It’s a mere statistic until it’s your mother, your husband, your best friend.
Whenever this ends, and whatever the death toll when it does, we are learning a lot about who we are, based on what we care most about. This is why this world-historical event is “apocalyptic,” in the sense of an unveiling. It’s an X-ray into the kind of people we are.
To be clear, I don’t think it’s fair to say that either we care about human life or we care about filthy lucre. In the real world, we make decisions all the time about how to balance risk with opportunity. If we had no speed limits on the highways, we would maximize freedom to go as fast as you want, but we would have more deaths. If everybody had to drive at 30 mph, we would have fewer deaths, but the burden that would place on society, and on commerce, would be something few people would be willing to tolerate. When I grew up, nobody used the seat belts in cars. They were thought to be silly nanny-state accoutrements. But things changed, and we came to believe that that inconvenience was worth it to save our own lives.
We will make the same kind of moral calculus in our collective coronavirus response. This is normal. We don’t have enough resources to give everyone the same level of treatment. Italian and Spanish doctors are having to make terrible decisions about who to treat, and who to let die. That these decisions are unavoidable makes them tragic, not evil. But what about the decisions we make under somewhat less dire circumstances? How do we determine when the economic pain from lockdowns is worse than the likelihood of more deaths if we don’t shut down? People like to say, “If only one person was saved because of what we did, it will have been worth it” — Gov. Cuomo said so the other day — but that’s not how anybody actually lives. Again, if we ban cars, lots of lives will be saved … but it will not have been worth it.
How do we know when it’s “worth it”? My general view is that we should have a strong bias towards saving life. I strongly identify with what Southern Baptist pastor Russell Moore writes:
A generation ago, the essayist and novelist Wendell Berry told us that the great challenge of our time would be whether we would see life as a machine or as a miracle. The same is true now. The value of a human life is not determined on a balance sheet. We cannot coldly make decisions as to how many people we are willing to lose since “we are all going to die of something.”
A life in a nursing home is a life worth living. A life in a hospital quarantine ward is a life worth living. The lives of our grandparents, the lives of the disabled, the lives of the terminally ill, these are all lives worth living. We will not be able to save every life. Many will die, not only of the obviously vulnerable but also of those who are seemingly young and strong. But every life lost must grip us with a sense of lament, that death itself is not natural but is, as the Bible tells us, an enemy to be withstood and, ultimately, undone.
That means we must listen to medical experts, and do everything possible to avoid the catastrophe we see right now in Italy and elsewhere. We must get back to work, get the economy back on its feet, but we can only do that when doing so will not kill the vulnerable and overwhelm our hospitals, our doctors, our nurses, and our communities.
And along the way we must guard our consciences. We cannot pass by on the side of the road when the elderly, the disabled, the poor, and the vulnerable are in peril before our eyes. We want to hear the sound of cash registers again, but we cannot afford to hear them over the cries of those made in the image of God.
Read it all. And let me be clear: we are all going to have to pay more taxes, at least for a while, to pay for what the government has had to do for the American people during this mass emergency. I believe that the burden of these taxes should fall on the wealthiest, but I also believe that people like me — not wealthy, but solidly middle class — should accept our part of this sacrifice for those who have less.
How much do the healthiest people in society owe to the most vulnerable?
That question—about Americans’ capacity for shared sacrifice—was at the core of the struggle over repealing the Affordable Care Act during the first months of Donald Trump’s presidency. Now, it’s resurfacing in the escalating partisan debate over responding to the coronavirus crisis.
In designing the ACA, then-President Barack Obama and congressional Democrats put a premium on policies that encouraged more sharing of medical and financial risk among those with greater and fewer health needs, such as requiring insurers to guarantee coverage to consumers with preexisting conditions. During the repeal fight in 2017, Trump and congressional Republicans condemned those same efforts, arguing that the law required the young and healthy to sacrifice too much to reduce the risk to the old and sick.
A similar divergence is emerging as the country grapples with the social and economic strain of containing the rapidly intensifying outbreak. In his public comments this week, Trump—amplifying a chorus of conservative economists, elected officials, and media figures—has effectively argued that shutting down the economy is imposing financial pain on more people than can be justified by the number of lives the restrictions will save. Democratic governors, such as New York’s Andrew Cuomo, counter that the broader society has an obligation to save as many of the most vulnerable as it can, whatever the pain to the many. “Job one has to be to save lives,” Cuomo declared in a video he released Tuesday. “We are going to fight every way we can to save every life that we can.”
These contrasting perspectives place the parties in the same position they were in not only during the recent attempts at repeal but also during the initial debate over passing the ACA in 2009. “It absolutely is a parallel there,” says Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University. “It’s very much about the social compact and how much cost do I have to incur to help my neighbor, who may be in greater need than I am?”
Again, the question is not a stark either/or (i.e., “You love life or you love money”). Nobody is a purist on either side, or can afford to be. The question, though, has to do with where we draw the line. I do not believe that Texas Lt. Gov. Dan Patrick, who said old folks like him ought to be willing to die to preserve the economy for the young, is right. I don’t believe the value of life is measured by the degree to which we are living in middle-class comfort and stability. But to be fair to Patrick, he said he was willing to sacrifice himself for others. He’s not demanding that others die so that he might live as he prefers to. What bothers me about Patrick’s argument is the belief that the lives of the old are not worth imposing serious economic cost on the young. What does that kind of argument say about how we measure the value of human life, versus wealth? I’m sure Patrick didn’t mean this, but it might be implied from his calculus that the lives of the poor aren’t worth living. Read me clearly: I don’t think Dan Patrick is saying the poor don’t deserve to live. Rather, if death of the old and weak is acceptable to preserve the standard of living for the younger generations, why would it not also be true that the poor are expendable so that those with a higher standard of living will be able to continue living as they do?
What are you willing to give up to support those who have lost, or are losing, nearly everything in the virus-caused collapse? I don’t expect any of us to have a clear answer now. But we need to be thinking hard about it, because one way or another, the question of what kind of lives are worth saving will come up. It’s really a question of what kinds of lives are worth living. Sorry to go all Godwin on you, but the German doctors of the early 20th century came up with the concept of “life unworthy of life,” to justify (at first) killing the disabled and those with serious medical problems. We all know where that ended up. Conservatives, especially conservative Christians, have spoken out against abortion and euthanasia — two practices generally supported by liberals — in favor of natural death, because we believe that life is sacred. Liberals, on the other hand, value personal autonomy so much that they support the idea that one has a right to decide whether or not to bear a child when one falls pregnant, and the terms on which one will leave this life.
If you believe that some lives aren’t worth living, though, on what grounds do you tell libertarian-conservatives that they should have to pay a significant financial price, against their will, to support a lifesaving effort that will disproportionately benefit the old and unproductive?
And if you are a conservative who is against abortion and euthanasia on sanctity of life grounds, why are you then quick to accept that we should keep the economy rolling, even though doing so will almost certainly result in many more agonizing deaths than if we had a painful lockdown?
The coronavirus is challenging everybody’s narrative. We are going to arrive at a solution somewhere in the middle. This country will either come out of it with a greater sense of solidarity, or we will fall apart. We’re not going to be the same after it. We will not be able to un-see and un-know what we are now seeing and knowing, about how each and every one of us regarded the value of human life. Rebecca West said that “there is no such thing as an unmixed motive”; it’s best to keep this in mind about ourselves as we think through this crisis. Somehow, I think this passage from West’s Black Lamb and Grey Falcon, her great 1930s travelogue of the Balkans, applies to us now. You can read the full passage in a dispatch in the Atlantic’s archive. This excerpt, from West’s visit to Rab, a poor Dalmatian island, speaks to our situation, somehow:
This was cause enough that Rab should be poor; but there was a further cause which made her poorer still. It is not at all inappropriate that the men and women on these Dalmatian islands should have faces which recall the crucified Christ. The Venetian Republic did not always fight the Turks with arms. For a very long time it contented itself with taking the edge off the invaders’ attack by the payment of immense bribes to the officials and military staff of the occupied territories. The money for these was not supplied by Venice. It was drawn from the people of Dalmatia.
After the fish had rotted, some remained sound; after the corn had paid its 10 per cent, and the wool and the wine and the oil had been haggled down in the Venetian market, some of its price returned to the vender. Of this residue the last ducat was extracted to pay the tribute to the Turks. These people of Dalmatia gave the bread out of their mouths to save us of Western Europe from Islam; and it is ironical that so successfully did they protect us that those among us who would be broadminded, who will in pursuit of that end stretch their minds till they fall apart in idiocy, would blithely tell us that perhaps the Dalmatians need not have gone to that trouble, that an Islamized West could not have been worse than what we are today. Their folly is certified for what it is by the mere sound of the word “Balkan,” with its suggestion of a disorder that defies human virtue and intelligence to accomplish its complete correction.
I could confirm that certificate by my own memories: I had only to shut my eyes to smell the dust, the lethargy, the rage and hopelessness of a Macedonian town, once a glory to Europe, that had too long been Turkish. The West has done much that is ill; it is vulgar and superficial and economically sadist; but it has not known that death in life which was suffered by the Christian provinces under the Ottoman Empire. From this the people of Rab had saved me: I should say, are saving me. They were in want because the gold which should have been handed down to them had bought my safety from the Turks. Impotent and embarrassed, I stood on the high mountain and looked down on the terraced island where my saviors, small and black as ants, ran here and there, attempting to repair their destiny.
Do we spend our treasure to save the lives of others? What if that treasure is our life itself, and like Dan Patrick, we are willing to die so that others may be spared material hardship? What do we owe to our neighbor? Who is our neighbor?