What Next? Thinking Ethically About Mitigating COVID 19 – A Focus on the Margins

“We are all in this together.”

Patrick T. Smith
Patrick T. Smith, Kenan Senior Fellow

This is no doubt true. Politicians, pundits and media outlets repeat this phrase as the reach of the coronavirus spreads. Senators, journalists, athletes, actors, doctors, and academic elites suffer alongside those without that same social standing, health security, and financial stability: small business owners, artists, service industry workers, the unemployed and underemployed, those who are homeless, those who are incarcerated and those who are employed to work in these spaces with them. And there’s a whole range of people in between.

The problem, however, is the suggestion that COVID-19 made this true. It perhaps naively suggests that all of a sudden we will act in ways that reflect human solidarity when deep social fragmentation mar important aspects of our collective life together. Our tribalism, unfortunately, is not so easily set aside.

The challenges resulting from COVID-19 remind us of something that has always been true ethically and sociologically. We are deeply interconnected…and yet our society is structured so that we lose sight of this reality. Those who are marginalized or part of vulnerable communities disproportionately suffer even when – and perhaps especially when – we say that we’re “all in this together.” COVID-19 is a reminder that we cannot easily nor without consequence separate our particular community’s well-being from that of others.

So, yes, “we are all in this together.” In saying this though, we must also be aware that when crises emerge, the long-term health and economic impact for those who survive is often felt hardest by those who already experience disparities in wealth, overall health outcomes and in access to and benefits of health care. All of this suggests that any pathway forward requires and must be attentive to particular and concrete forms of justice.

I am persuaded that what we need is a kind of justice characterized by, as some have suggested, a principle of redress. One that seeks a pathway to minimize the disproportionate negative impact experienced by those on the margins. A principle of redress takes into full consideration that many – even if not all – cases of existing health and economic inequalities result from social injustice. These inequalities constitute genuine health disparities. These states of affairs are not just unfortunate, but actually unjust. And even as we say “we’re all in this together,” a pandemic further exacerbates these situations, which stifle human flourishing and well-being.

So what’s next? In some ways, many of us don’t really know. And I certainly don’t presume to know. However, as we seek to navigate these murky and unprecedented waters, we need to think clearly and carefully about how decisions impact those on the margins of our society – those who may be part of, as Howard Thurman said, the disinherited, the disenfranchised, or those whose backs are already against the wall.

How might we address this pandemic while working hard to minimize the widening of existing disparities in our society? Any responses must take into consideration how policy decisions will impact the most vulnerable among us, including the sometimes overlooked first responders in our healthcare institutions and other frontline services who have an intensified occupational risk in light of the lack of Personal Protective Equipment.

We must frame ways forward with due attention and even preference for the most vulnerable amongst us. Whether thinking about allocating of scarce resources, safeguarding workers or other vulnerable populations, flattening of the curve of the pandemic, allocating money from the Federal government to American citizens, or supporting various industries, I would suggest this attention to the margins must be the case, not only for government, but also for health care institutions and local civic community groups engaged in mitigation efforts. It is problematic for public health professionals to encourage people not to go to work when for some people if they don’t work, they literally don’t eat. What does it practically look like for those who are asked to shelter in place who don’t have adequate housing? How do we discriminate the financial needs of American citizens who need immediate cash from those of us who don’t given current employment options available? Of course, many of these issues are being discussed and some are being addressed. But there needs to be, ethically speaking, concerted attention given to these matters and a fully coordinated federal response that has in its scope “the least of these.”

I am encouraged by the mobilization in localized faith and civic communities to act in medically responsible ways to mitigate the negative impact on vulnerable populations. Many such examples provide those of us who are not professionally trained health care workers opportunities to embody values of solidarity and subsidiarity. For these, we should all be grateful. As Martin Luther King, Jr. said, “We are caught in an inescapable network of mutuality.” As indicated in the title of the last chapter of his book, Where Do We Go From Here: Chaos or Community?, we all live in a shared “world house.”  In some ways, this is our question isn’t it? Where do we go from here? Whatever direction we take, may we develop the “eyes to see” and “ears to hear” those who are on the margins as we seek to reckon with the negative effects of COVID-19.