Health
5 Ethical Dilemmas of Today
Key decisions in the time of COVID and of political polarization.
Posted January 26, 2021 Reviewed by Ekua Hagan
Here are five dilemmas related to key issues of our time: COVID and political polarization. For each dilemma, I offer opposing positions.
COVID
1. You own a nail salon in a locale that has a low incidence of COVID and especially of death that's primarily caused by COVID rather than the person’s underlying conditions. But you’re subject to a geographically broad lockdown of salons. Do you honor it?
Or do you do what some of your competitors are doing: sneaking people in through the back door while taking COVID precautions (shields, masks, hand washing, and minimizing time in close contact)? You cry, “They're stealing your would-be customers. My employees and I are struggling to keep from joining the hordes in the homeless encampments, forget the American Dream.” Should you defy the lockdown order?
An argument for following the law: Public health experts have deemed it in the public interest to, in certain locales, keep nail and hair salons closed. Politicians have evaluated those recommendations in light of broader considerations and issued the lockdown order for your geographic area. Following that order is part of the social contract you’ve implicitly signed when choosing to live in a given jurisdiction.
Additionally, we’re learning that new strains of the virus are more contagious and possibly more deadly. Despite your precautions, you may be putting yourself and your customers at risk. After all, each day, a good number of people will be spending extended time in your store, likely one with sub-optimal air circulation, especially in winter when you can’t leave doors and windows open without people freezing and thus refusing to use your salon.
In addition, your violating the law encourages other nail and hair salons to do so, which increases the risk of the pandemic causing your locale's low incidence of COVID to rise. That would impose human costs far beyond the benefits a customer derives from having their nails done rather than doing it themselves. For now, they should buy a bottle of nail polish.
An argument for defying the law: We should think probabilistically. The precautions you describe greatly reduce the chance of contracting serious COVID. That’s especially likely because your county has a low incidence of positivity, let alone death.
Also germane is the utilitarian argument: Does net benefit or liability accrue from defying the law and staying open? The risk seems low and, with certitude, the customers will have derived a measure of happiness from having their nails done professionally, a needed balm in these stressful times dominated by COVID, fears of COVID, the economic decline, the anxiety that having to stay home causes, as well as the tensions caused by the political polarization that has rent this nation.
A final plus: You and your employees and your families will more likely be saved from destitution.
2. You're hospitalized with COVID and beg the doctor to take you off the ventilator and let you go home to die. You plead, "I’m 75 already, have underlying conditions, and have bad arthritis and a bad back. If all your efforts and resources cure me of COVID, sooner than later I'll probably suffer a more prolonged dying. That would torture not only me but my family while using up the health care system's precious resources, which is already so overtaxed that 195,000 people die every year in hospitals alone from medical errors, plus countless more who suffer excess morbidity (more pain, longer recoveries.) Please, please take me off the ventilator so a more deserving person can get the ventilator, my hospital bed, and that expensive medical care that's in short supply!” What should the doctor do?
An argument for the doctor refusing to take you off the ventilator: Doing so is illegal and could result in the physician losing his or her license. Plus, it's a slippery slope. If the physician plays God even in a not-life-and-death situation and, for example, allocates an hour so s/he spends more time caring for a patient who is a young cancer researcher and less time on an equally sick, aged heroin dealer, it starts a dangerous trend.
An argument for the doctor taking the patient off the ventilator: One of a person's most important rights should be the freedom to live or die. Indeed, that's the principle behind the Right to Die laws that have been passed in a number of states.
Apart from legality, humankind has long venerated people who, for example, "regret that I have but one life to give for my country." Far less famously, countless young men with a whole life ahead of them have chosen to be a front-line infantryman, knowing that greatly increases chances of early death. Police and firefighters also put themselves at far greater risk of early death.
That 75-year-old has underlying conditions and pains, and not irrationally asserts that that ventilator, hospital bed, and expensive medical care would merely extend her life so s/he could die a more prolonged, painful, system-taxing death. In this most personal of decisions, ethics dictate that her wishes be honored.
3. You're a healthcare administrator, 45, who doesn’t see patients and you have no underlying conditions. But your county is prioritizing vaccinating healthcare workers, including administrators. There is a shortage of vaccines in your county. Should you take the vaccine or wait until the general public of your age is offered the vaccine?
An argument for taking the vaccine: You indirectly affect the health care of many people. If you contract serious COVID, many people are more likely to suffer. That’s why the county deemed you eligible to take the vaccine. So you should take it as soon as possible to protect yourself and, to the extent the vaccine reduces transmissibility, your colleagues, your work's beneficiaries, and your family and friends.
An argument for waiting: The likelihood of your being debilitated from COVID is small if you follow the standard preventive advice: social distancing, mask-wearing, and hand-washing. Even if you later test positive and, in addition, become symptomatic, at your age and with your lack of underlying conditions, it would probably only briefly keep you from your job. That's not much different from the brief flu-like response that occurs in a significant percentage of vaccinated people in your age bracket. By waiting rather than taking advantage of the law, you'll generate broader benefits: Letting your peers know that you decided to wait will make them more likely to wait, thereby freeing up vaccines for people more likely to contract serious COVID.
Political polarization
4. You’ve tried to convince your adult sibling that liberal policies are wise, yet she insists that conservative policies are better. Do you give up?
An argument for persisting: Most of the intelligentsia believes that core liberal beliefs are best for humankind. Those beliefs include reducing income inequality, racism, and our carbon footprint. It’s worth extra effort to try to convince your sibling of her flawed thinking, not only to change her mind but so that as she speaks with friends and family, she won’t try to convince them to think and vote for conservative lawmakers.
An argument for giving up: Unless you’re unusually persuasive, it’s extremely difficult to change an adult’s perspective on an issue that tends to be so deeply felt. That’s especially so in an era in which most of society’s mind-molders have, for decades now, worked to persuade the public that liberal ideas generally are better than conservative ones.
The most likely outcome of continuing to badger her, even if attempted tactfully, is to build a wall between the two of you that will be tough to dismantle.
Besides, just because liberal views are hegemonic today doesn't mean that there aren't conservative perspectives worth considering. The best society is one that encourages fair-minded consideration of the full marketplace of responsibly held ideas.
5. You're going to hide a portion of your income and plan to give the tax savings to a nonprofit that you believe more efficiently helps people.
An argument for paying the taxes: As mentioned earlier, when you choose to live in a jurisdiction, you have tacitly signed a social contract. That requires you to follow its laws, including paying federal, state, and any local taxes.
An argument for donating the money to a nonprofit: More important than following the law is doing what is best for humankind. The government’s inefficiency with tax dollars is legion, so a person's behavior should be guided by higher principles. As long as you vet the nonprofit, for example, it's highly rated on review sites such as CharityNavigator, it's ethical to donate the money. Of course, hiding the money to buy yourself “stuff” is unethical.
The takeaway
People would get along better, polarization would be reduced, and better societal solutions developed if we recognize that most issues have at least two sides. Perhaps these five examples make that clear.
For more ethical dilemmas, see Ethical Dilemmas: 10 Common Conundrums and Ethical Dilemmas in Counseling.
I read this aloud on YouTube.