April 2020 is over and not a moment too soon. As we enter May, it is reported that over 60,000 people in America have died of COVID-19. There is a measure of relief that some of the most dire predictions of ICU hospitalizations and deaths have not materialized. As many have suggested, a good dose of humility is needed when it comes to predictive models.
Since I last blogged in early March, I have read with great interest some of the many writings about the intersection of COVID-19 and bioethics. Early on, some wondered how big a threat COVID-19 actually was to people who lived outside of Asia. That quickly changed into an important discussion about how we should triage patients in case there was not enough ventilators for all who needed one. (See, for example, the discussion at www.cbhd.org). Others have expressed concerns about how the use of our cell phones as tracking devices to trace COVID-19’s spread might encroach upon our privacy rights. Still others have noted the racial disparities that have arisen during the pandemic, leading Dr Clyde Yancy of Northwestern University to conclude, “A 6-fold increase in the rate of death for African Americans due to a now ubiquitous virus should be deemed unconscionable. This is a moment of ethical reckoning.” These and many issues are worth detailed consideration.
Currently, some are focused on the ethics of reopening the economy. See, for example, the paper recently posted by The Hastings Center on this topic. The issue is not whether businesses should open, but how and when they should. Of course, as you might suspect, there are multiple factors to consider, including the possible return of COVID-19 if social distancing rules are not observed. But others argue that extensive damage has already been done to the economy and that it is worth the risk to reopen things again.
In the midst of all this, it is important to consider the toll that this has taken upon those who are among the vulnerable. Recently, in its series “Voices from the Pandemic,” The Washington Post published the comments of Gloria Jackson, a 75-year old resident of Minnesota. Her statement is heart-wrenching in many ways, because she gives a voice to some of the unspoken fears of many elderly citizens. These words in particular stood out to me:
“I spent my career working for the federal government at Veterans Affairs. I raised my kids by myself . . . I pay taxes and fly a flag outside my house because I’m a patriot, no matter how far America falls. But now in the eyes of some people, all I am to this country is a liability? I’m expendable? I’m holding us back?”
I appreciate Ms. Jackson’s forthrightness. Bioethics needs to speak directly to these fears in order to remind her (and others like her) that she is a valued member of society. Even if her health should fail, she will be treated with compassion. No one is expendable.
COVID-19 has shone a bright light on the needs of the most vulnerable of our society. We overlook them at our peril.