Illness and Morality in the COVID-19 Pandemic

The current COVID-19 pandemic has again raised the outdated association between illness and morality. Whether through blaming victims or asserting their own health and moral superiority, many have suggested that those who contract the virus deserve their fate. I draw on previous KineSophy articles on health, fitness and virtue to unpack this connection between illness and morality and argue for a self-directed and other-directed ethical approach to addressing issues associated with the current pandemic.

The Black Death, Illness and Morality

Skeletons dancing during the Black Death

In the fourteenth century, the Black Death swept across Europe. Between 1347 and 1352, the disease killed between twenty and twenty-five million people in Europe, almost one-third of the continent’s total population. In the entire century, close to 200 million people died from this plague.

The Black Death occurred well before the general acceptance of the germ theory of disease, which states that illnesses are caused by microorganisms that infect humans, grow and reproduce, and disrupt normal bodily functions. Faced with the rapid spread of illness and death, fourteenth-century Europeans cast about for explanations for this mysterious disease. Some people believed God was punishing the sick for their wickedness. Others blamed Jews, foreigners and travelers, and suddenly shunned those they had welcomed for years. Sometimes, people burned the homes of those infected by the plague, often with the inhabitants still inside.

Nowadays, most of us accept that a disease like the Black Death is not a form of divine punishment, that it cannot be attributed to specific minorities, that it is not a marker of moral worth. At least, that was true a year ago. But the current COVID-19 pandemic has once again raised the association between illness and morality. Some people have castigated those who contract the disease for being reckless, unsanitary or foolish. Others hold their own health as a mark of morality and implicitly denounce those who are vulnerable to the disease.

Fitness and Morality on KineSophy

I have written extensively on KineSophy about the association between physical wellness and virtue. I have agreed with philosophers like Aristotle who argue that physical qualities such as strength and endurance are virtues just as honesty and kindness are virtues. I have proposed three physical virtues I believe every able-bodied human should possess. And I have argued that physical virtues belong in a well-rounded theory of ethics.

I have also questioned whether or not health is a moral issue. And I have observed that physical virtues are just one part of being an ethical person. A person who is strong but cruel is not a virtuous person. The most virtuous person will excel in every sphere of virtue, which includes physical, intellectual and moral (other-directed) virtues.

Virtues, Actions and Reasons

So where does all this physical philosophy leave us with regard to moralizing the COVID-19 pandemic? I think it’s important to remember that it is not virtues themselves that are important, but the actions that form the basis for those virtues. We don’t commend people for having the title of being strong or honest, but for performing actions that demonstrate strength and honesty. Similarly, it is not just actions that matter to us, but the reasons that motivate those actions. We do not praise someone for being honest if he meant to tell a lie but was mistaken about the facts and unwittingly uttered a true statement.

In many cases, we do not know the reasons why people act the way they do just by observing their actions. When we see people engaging in apparently reckless behavior, we don’t know the reasons behind that behavior. Are they intentionally disregarding the well-being of others? Did they simply forget to observe precautions that have only been in place for a few months? Did they recently test negative and feel secure that they cannot transmit the virus? Are they in a situation where they believe they are unlikely to transmit germs given their knowledge about risky behaviors? Without knowing the reasons behind their actions, it is hard to judge people’s pandemic behavior as moral or immoral.

A woman in a surgical mask, highlighting the illness and morality debate surrounding COVID-19

COVID-19, Illness and Morality

Other people hold their own health up as a mark of morality. “I’m not sick,” such people might say. “Why should I be forced to stay inside or wear a mask in public? I eat well. I exercise. It’s the people who don’t take care of themselves who are going to catch this virus, not me.”

This health-is-morality rhetoric is especially reminiscent of the fourteenth-century belief that victims of the plague were being punished for their sins. And it ignores two critical facts about COVID-19. First, young and healthy people can and do contract the virus and suffer serious consequences. Recently, a healthy woman in her twenties was so devastated by a COVID-19 infection that she became the first U.S. patient to undergo a successful double lung transplant to treat the effects of the virus.

Second, the virus can spread from presymptomatic and asymptomatic carriers. Despite some confusing comments from the World Health Organization in early June, the vast majority of public health experts agree that people without symptoms can and do spread COVID-19. A person with a strong immune system doesn’t have a force field around his body that blocks infectious particles from entering. Instead, the immune system destroys the virus after it enters the body but before the virus can wreak serious damage. Since even those people with the strongest immune systems are susceptible to having some level of the virus in their bodies at some time, it is reasonable to assume that everyone is capable of spreading the virus, even those who never exhibit symptoms of infection.

Furthermore, we do not know for certain how well our immune systems can handle a COVID-19 infection. COVID-19 is a novel coronavirus that was first observed in 2019. Therefore, none of us have had exposure to this particular strain before 2019. Does having a strong immune system put you in a better position to avoid a serious COVID-19 infection? Yes. Is it wise to boost your immunity by eating well, exercising, reducing stress, getting enough sleep, etc.? Yes. But none of those measures provide a guarantee against infection. And they certainly offer no guarantee against transmitting the virus to others.

False Righteousness

Simply put, to assert one’s own health as a moral justification ignores the basic science behind the COVID-19 pandemic and smacks of fourteenth-century superstition and self-righteousness. To claim that one is being punished for being healthy implies that common public health measures are punishments and not precautions taken in the face of an unprecedented pandemic. The same claim might also be taken to imply that unhealthy people deserve punishment in the form of viral infection. In the words of philosopher Damon Young, “It’s important not to be smug about [personal fitness]. Fit people aren’t automatically more ethical. This ought to be obvious, but there is an aura of superiority around the muscular and agile; an atmosphere of glossy righteousness.”

There are enough real issues at play in the COVID-19 pandemic without resorting to moral grand-standing and victim-blaming. A simple and draconian solution to the pandemic would be to close all borders and require everyone to stay in their homes for fourteen days. Obviously, this response, though effective in eliminating the virus, is simply not feasible. But scientific evidence indicates the best strategies to fight the virus are to learn who is infected and prevent the infection from spreading. This approach demands practices like social distancing and contact tracing. But not everyone holds a job that allows them to work from home. People need access to food and other basic needs, which requires maintaining agricultural industries and grocery stores. And there is the question of how much we ought to curtail personal liberties even in a public health crisis.

All of the above issues deserve careful consideration. But it’s also important to remember that ethics asks each of us to consider what we should and should not do, both to ourselves and to each other. It is not enough to declare ourselves healthy (or intelligent or kind). We must act accordingly. We should strive to be strong, intelligent and healthy, but also honest, kind and empathic. Illness is not a divine punishment. It’s time to stop equating illness and morality. Instead, we should bring sound arguments to a constructive debate about the many serious issues at play and figure out how we can live our best lives in all spheres of virtue.

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