Dear Carolyn: I cannot understand why some people refuse to wear masks and socially distance and believe they will not get sick. I suggest when they do get the virus and go to a hospital, doctors ask whether they have been wearing a mask and socially distancing. If they have not, they should NOT be treated if that takes a hospital bed from someone who has been doing the right thing. Your thoughts?
— Wondering in VA
Wondering in VA: I understand your opinion comes from a place of justified rage and frustration, but it’s a knee-kick to our social contract.
To illustrate why, let’s start with a different group of angry, brainwashed, ignorant people: neo-Nazis. If we’re denying emergency care to anyone, then they’d get my vote even before the anti-mask buffoons would. Right?
But we don’t do that, mercifully. When neo-Nazis show up in emergency rooms, medical staff treat them as they would any other patient. We don’t parcel out care based on moral worthiness. Impracticality is one reason: Who’s going to decide, while the patient is bleeding or coding or whatever else, whether those fascist tats represent the patient’s current beliefs, or deeply regretted, daily atoned-for past beliefs? It’s not doable to a reasonable moral standard.
Immorality is another reason. Meeting — or refusing to meet — basic human needs based on an arbitrary standard of worthiness is the exact tool oppressors use.
And imagine the psychic weight on a decent person, having to manage this power.
So our system gives urgent medical care based on the urgency of the medical need. Triage may not be perfect, but its clarity of purpose is.
That’s a microcosm of the value of a civilized society: It’s about humanity for its own sake, transcending the muck of winners and losers and individual notions of fairness. Taxpayers fund roads and schools and clean water to serve everyone, simply for existing, not just people who pay for them or use them correctly or are deemed worthiest.
Ironically, this often appears unfair — say, when some anti-mask buffoon occupies a hospital bed that a conscientious person ultimately dies from not having. Yours is a normal emotional reaction to that risk.
But as history has shouted at us at every opportunity we give it, humans tend to abuse power. All you need are — to use America’s ugliest example — people in power who believe brown skin makes someone unworthy, and suddenly the system you envision of saving treatment for the “right” people becomes a crime against humanity.
So, back to your question: Are you ready to empower someone (some inevitably flawed human) to judge who gets care based not on medical need, but instead on perceived value to society? Who chooses, who monitors, this arbiter of worth?
Again, as with the triage example, there’s still room for error. And — again — this can create unfairness, say, when someone finds a way to exploit programs meant for the common good.
But being human means living with imperfection. Always. Here, we get to choose its form: abuse by individuals using a need-based system, or abuse by leaders running a worth-based system, in rewarding some and denying others based on the leaders’ whims, because they can.
The prospect of the latter gives me night terrors. Let’s not succumb to covid-weary temptation to open the lid on that.
