Saving Grandma

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Saving Grandma

By Joel Levin

Should we ever let people die? That is, when reasonable efforts and not unreasonable expenses would save a life should we ever send an individual to their death? Never is a difficult standard, here as everywhere, as we send young people to war, remove dying and incurable patients from life-support, and, in the workplace, construct tunnels and buildings and open mining operations with the near certainty that significant numbers of workers will die in the effort. Less directly, we don’t make machines as safe as we could (for example, installing a breathalyzer necessary to start a car or manufacturing guns that require a code children or thieves would need in order to fire) and allow activities (high school and college football and wrestling) we know will lead to the devastating injuries of a number of people, many of them children.

Although all that is part of the fabric of society, the debate over COVID-19 seems like something different. Take Texas Lt. Gov. Dan Patrick’s comments, that grandparents should be willing to sacrifice their lives to keep America from engaging in great sacrifice itself. Put more starkly than he actually put it, although hardly much of a stretch to imply it, having a small number of old people nudged to die only a little early in order to make life more comfortable for everyone else is a project worth considering. Certainly we do think that in wartime, with the young rather than the old the chosen sacrificial lambs. Why not here?

The reaction to Lt. Gov. Patrick has been moral outrage, outrage expressed as moral protestation and mocking sarcasm rather than on deeper analysis. Is there a better response, one rooted in moral theory, that could begin to locate why Patrick is mistaken or should be condemned, in fact, whether he should be considered to be rational at all? Fortunately, there is. For the last several hundred years, there have been (at least) three well-defined, textured and compelling moral theories developed in the West. While they differ from one another, and each has conceptual and practical difficulties, each, it is fair to say, would condemn sacrificing grandma in order to be able to linger longer at Starbucks.

First, there is not unsurprisingly a theory built around right and wrong. (It has the insane name of “deontology”, better never to be uttered again). This theory or tradition might seem obvious, but it is based on certain radical and fundamental ideas: each human is an autonomous individual deserving of respect with rights that can trump, at times, the public good. It says someone might have a right to do something despite it not being the right thing to do, whether that means smoking or advocating a vile politics or hunting. Part of that theory or, really, tradition, suggests each individual be treated as an end, not as a means. We cannot harvest a kidney from someone who has two healthy ones to save a needy child, much as it would be a great benefit to society, as that would treat the unwilling donor as a thing, a means to an end, an object not a subject. It would not be affording them the respect or autonomy they are due.

This makes grandma’s safety clear. Treating her as a means to social welfare, more jobs, or a stronger economy all fail to see her as an autonomous human being worthy of respect. Her own view is not being respected as relevant, nor are her own needs for autonomy. She is helpful to a worthy end – more of everything that we all, as consumers, seeking pleasure, goods and wealth want to have – but that is at a price this tradition of right and wrong refuses to pay.

But is that it? Don’t we live in a society where we must occasionally sacrifice as individuals to keep the civil society, the government, the state alive and well? We see that in the case of quarantines. Isn’t killing grandma the next logical step?

The tradition here is that of the social contract, the idea we come together, live together and work together for the common good. In fact, it is in part behind the mystique of the U.S. Constitution. Of course, we have not for sometime (if ever) believed in anything like an actual coming together – or if there was something like such a meeting by our predecessors, why they should bind us as individuals who were never at the table – but the kind of agreement we would reasonably be expected to enter. The ideas here are complex and controversial, to say the least. But one factor is (almost) always central: the basic deal is a trade for one safety in exchange for some basket writer bundle of goods. If one’s safety – his or her life itself – is not part of the bargain, there is no bargain. Problems of war and murder tug at the edges of this, but only the edges. In those cases, life itself needs to be weighed against the life of another. There is no trade for comfort, goods and happiness. Social contract tradition worries about the life of every individual, including grandma.

However, a different moral tradition, with an equally ugly name, “consequentialism“, ask us to look at things in a new way. We do not start with what is the right thing to do or what a fair agreement would tell us to be our rights and duties. Instead, we look to maximize what is good or makes us happy or satisfies our goals, while at the same time what minimizes what is bad or makes us unhappy or frustrates our goals. More important or numerous positive things (goods and goals) are weighed against the sum of negative things (unhappiness and frustrations) and then added together for everyone in society to tell us what we should do. If a lot of people would be happy with more stuff (a lot more stuff) and a few people (perhaps barely existing in nursing homes) would be less happy facing death, the trade-off, in this tradition, arguably is worth making. Hence, Lt. Gov. Patrick.

Is that really true? If grandma is in her twilight, not having much happiness to lose anyway, and with only a few years left (if that), is it reasonable to ask for her sacrifice in order to allow us to be able to make rent, pay tuition, buy food, and renew Netflix? If not, grandma (who may have genes that would allow her to live decades more), what about a disabled child, a diseased middle-aged father, an unhappy PTSD veteran? How do we weigh the interests or happiness or desires of any of them? Of course, who gets to assign the values decides everything, and that is a reason, in and of itself, to put brakes on the choices, defaulting to life and autonomy and rights to achieve happiness. That is, the other two traditions count in calculating how to work this new one.

Let us linger a moment on this point. If someone dies suddenly, the loss of their future – dreams and projects, holidays with families, future enjoyment with friends, and accomplishments personal and professional – are all lost. However, if that same person knows that, at any time, the value of their life is up for auction, to be weighed in the calculus of society’s interests, their happiness is under severe attack, their peace of mind is gone, their ability for simple comfort and contentment destroyed. That is the situation here. Who among us and our family are safe? When is the knock on the door coming to our house? Saving grandma means saving ourselves.

The greatest mistakes of the 20th Century often involved a too narrow weighing, looking at the public good while ignoring the value of the individual. Lt. Gov. Patrick is not the only person tempted to make that moral mistake. He is a symbol of it, though. It was reiterated in the midst of the new bailout bill negotiations, prior to a meeting, when House Speaker Nancy Pelosi quoted Pope Francis, saying “Enlighten those responsible for the common good, so they might know how to care for those entrusted to their responsibility”.  Treasury Secretary Mnuchin responded “While you are quoting the pope, I am quoting the markets”.  Presumably most of us would agree with Ms. Pelosi, wanting to keep grandma safe. The rest of us might simply follow another very old tradition, one advocated by Edmund Burke, who said we can only respect ourselves as we honor those who have come before us.