Deadly Bias and COVID-19: Are We On the Right Track?
Updated: Mar 27, 2020
Most wannabe moral philosophers know the “trolley problem” or, to be more accurate, the class of trolley problems, which seek to reveal whether you’d take a deliberate, positive action that you know will harm someone in order to reduce harm to others. The purpose of these thought experiments is to shed light on morality and moral intuition.
The classic exemplar considers whether you’d flip the points on a train track to send a trolley loose from a train that was going to kill three people on its current course down another track where it will kill only one. If you flip the points, then the moral upside is that you saved three-minus-one-equals-two lives net; the moral downside is that you were directly responsible for killing a man.
I think I hear excited moral philosophers’ whispering “It’s happening”: the coronavirus is the trolley problem of the century. Well, almost.
Some government institutions and officers have decided to harm millions of people by closing businesses, making workers unemployed, and separating people from their family and friends … in the sure and justified belief (we assume) that they are mitigating more harm than they are causing.
Perhaps they are. But how sure can we be? And does it matter?
More terrifying than the virus – at least to this writer, who (full disclosure) being healthy, is quite sanguine about his odds of surviving what will almost certainly feel like a nasty flu at worst – is that irresistible government forces have decided to flip the points on the track.
To push the analogy a little over-hard, they seem to think that by doing so, they save lives on one track at the cost of only breaking legs on the other.
But the moral calculus depends entirely on how many lives will be saved or can be saved (they are not the same thing) vs. how many livelihoods will be destroyed and other harms done.
And the answer to that query must account for the fact that those destroyed livelihoods and other harms will in themselves lead to some losses of life – which may be much less visible than deaths from the virus.
We all know why governments are doing what they are doing. By forbidding travel and closing businesses for example, they are attempting to “flatten the curve” – lower the peak number of COVID-19 infections in the hope that a larger fraction of those who suffer from them can be successfully treated. Doing this means that the peak will take longer to reach, and the strategy won’t necessarily reduce the total number of people who become infected or die from the virus in the long-run. (It admittedly may if an effective vaccine can be found but if it isn’t found, then the strategy will buy us very little unless we keep it up indefinitely.)
I am now just one degree of separation from people who have already been made jobless and/or homeless by the enforced shutting of workplaces. If you cannot feed or shelter your family, then on the balance of probabilities, the outcomes for you and your kin are going to be worse than exposure to the virus – especially if you and yours were physically healthy. (Recent figures from Italy suggest that 99% of all deaths from the virus were of people who were already ill.)
The effects of enforced poverty and isolation will accumulate over time – and a few of them may rise as exponentially as the infectious disease they are designed to combat. Some will be related to lack of access to material resources; others to the psychological effects of conditions on which we don’t have the data.
At one level, the world’s reaction is like that of a student who’s just discovered utilitarianism but missed the point of the class. Utilitarianism is the moral philosophy that says that a good or right action is one that does the most good for the most people. One of the fundamental problems with it is illustrated by asking a simple question: if we can save ten lives by killing one person and donating his organs to ten others, shouldn’t we do so? There’s a reason the answer is “no”. Yet, in its response to Covid-19, many jurisdictions are happy to risk huge damage to the physical and material health of many people to save others.
Whether you’re a utilitarian or not, you have to admit the fundamental importance of the question and the principle at stake.
Before you decide whether this is a fair question to ask of government policy, consider that we don’t even forcibly remove a single kidney from a healthy person with two kidneys to save life – even when doing so will likely have no effects on the compelled donor.
So why is it ok to forcibly remove a job and a home and a livelihood from anyone to save the life of unknown another – especially when that other is not the victim of a malign act and is free to take action to avoid potential harm?
The operative word – the moral word – in that last question is, of course, “forcibly”.
We need to revise our trolley problem analogy. To make it a better fit to the situation we find ourselves in under the threat of Covid-19, we need to mention that the people standing on the train tracks within the sound of the oncoming trolley are not without agency. They all know the trolley is coming; they can use whatever choices they have to get off the tracks, and most (although not all, it is must said) have the ability to do so.
Whereas those who are scared of contracting Covid-19 can take precautions, the people who lose their jobs or homes on account of government-imposed measures have no say in what is happening to them. If restaurants in my home city of Seattle were to remain open, no one would be forced to frequent them and expose themselves to the associated risk. All concerned – proprietors, workers, and customers – would have a choice in that. On the other hand, the minimum-wage server who is laid off or the business owner who can’t cover his costs has no means of protecting herself.
And yet, most people are very accepting of the way governments are acting. It is understandable why that is so, and the reason is simple; it is that enough of us believe, “if we allow people to make those choices, the virus is more likely to kill me.”
Perhaps. But the extent to which that is true depends mostly on you.
So how about for the following for fairer and more proportionate?
If I’m more scared about the certainty of losing my livelihood by closing my restaurant or on account of my employer’s doing so, then let me go to work. If I’m more scared about the small probability of losing my life by eating or working at my local restaurant, then, well, let me stay at home.
For sure, people must be given the best information available to weigh and compare those risks from day to day – but why would we remove their ability to do so when the lives and livelihoods at stake - and everyone’s circumstances, are so very different?
That information would of course need to include the (low) probability of anyone’s getting treatment when the hospital beds are full - so if you go to the restaurant as either worker or customer, then you’d better know what you’re risking. Even under near-draconian measures (and that’s not too tough a word for policy that puts thousands of people out of work and potentially makes them homeless), you probably won’t be getting care when you need it because there won’t be enough hospital beds available.
So why not give people information about all of these factors and risks and let them decide for themselves and their loved ones, including their children?
By not doing so, we are on a very slippery slope.
The worst-case projections for deaths from coronavirus are 3% of the infected population. Has anyone done the math on how many lives will be lost on account of the economic effects of a lock-down for as long as it will take for this infection to ride itself out, bearing in mind that the more we slow the infection rate, the longer it takes to reach its peak and the longer the population takes to become immune? Has anyone tried to weigh the last few years of a frail older person’s life against the livelihood of entire families? Do we even want to think in these terms?
If the answer is “no”, then to return to our trolley problem, how can the government even tell on which set of tracks the smaller number of people, or the less vulnerable people, are standing - and down which they think they should send the trolley?
Let us make a final modification to the coronavirus trolley analogy: you won’t be flipping the points; the government is doing that and you’re one of the people on the track. The government action you support is likely a function of which track you think you’re stuck on - and that will depend on your personality, physical health, financial health, and other factors.
If you are scared of getting the virus (perhaps because you’re unhealthy, old, or have a more anxious disposition), you are more likely to support the government’s flipping the points and damaging others’ livelihoods to protect you; if who are not (perhaps because you’re young, healthy or more worried about losing your job), you are more likely to resent the willful damage to your own or others’ livelihoods and be concerned about the long-term consequences of the emergency decisions that are being taken.
In other words, your preference may be about your principles – but it’s also about your biases.
Since we are dealing in lives and deaths, we have a moral duty to examine those biases before we let anyone flip those points … especially because once we let them be flipped, you can bet the flippers will want to flip them again.
There are a good many such biases at play. Here are just three of the big ones.
The first, the pseudocertainty effect, is very evident. This is the tendency to make risk-averse choices (like preventing people engaging in business) if the expected outcome is positive, but to make risk-seeking choices (like shutting down an economy) to avoid negative outcomes.
The second is the optimism bias. That’s the tendency to underestimate greatly the probability of undesirable outcomes (like the consequences of destroying thousands of businesses, millions of jobs and months of education) and overestimating favorable and pleasing outcomes (like reducing the number of people who catch a virus).
The third is the availability bias. That’s the tendency to give too much weight to outcomes about which we have better information or understanding (like dying from an illness) and too little weight to outcomes about which we don’t have information and can’t conceive (like – I hate to be repetitious, but needs must – the consequences of destroying thousands of businesses, millions of jobs and months of education).
In relation to all of those biases, remember that many of the measures being taken under special government authorities to protect lives in the short-run will themselves have unquantifiable consequences on health and lives in both the short and long runs.
Again, has anyone done the math - or are we just reacting; and if we are, have we (to adulterate a fashionable expression in progressive circles) “checked our bias”?
Let’s return to that third bias – the availability bias. It is the one that tyranny is made of, because it causes We the People to allow our civil (and in the USA at least, Constitutional,) rights to be abridged “for our own good”. In a moment of fear or panic, we choose not so much security over individual liberty (“Those who would give up essential liberty, to purchase a little temporary safety, deserve neither liberty nor safety” - Benjamin Franklin) as security over individual responsibility.
You may scoff at everything here with an, “easy for you to say” under your breath. And you would be entirely right: it is very easy for me to say.
But my point is that I – and you – should at least get a say when the stakes are this high - and dying from a virus is, still, a rather unlikely way of losing the gamble.
A say and a choice, that is. Morality and liberty demand both those for the simple reason that leaving me with my choice doesn’t take yours away from you and doesn’t condemn you to death. Not even close.
If, on the other hand, you would take both of those away from me and everyone else, then you’d better be able to look in the eye the minimum-wage single mother and tell her it was worth her losing her job so that you could reduce your chance of dying from an illness by fractions of a percentage point.
And if people like me go out for a meal, and contract something nasty, you can scoff at me again as I am left to suffer at home because there aren’t enough beds at the hospital…
… Not that that would make much difference to me if I’d lost my health insurance – and my roof – with my job and my liberty.