Bioethics Forum Essay
Individual Freedom or Public Health? A False Choice in the Covid Era
When scientists first suggested population-wide social distancing as the only feasible way to suppress Covid-19, they were the first to admit it may not work in a free society. We are now months into placing mass restrictions on human behavior to suppress a virus that lacks an effective vaccine or treatment. Now is the time to ask: is this the authoritarian nightmare many feared, or will freedom and democracy survive Covid-19?
The principles that normally help us answer this question seem helpless in this moment. Human rights law tells us that restrictions on liberty must be proportionate to the policy objective served—yet how do we weigh the harm of suspending an entire economy against the outbreak of a pandemic?
We have essentially chosen the unbearable—the suspension of economic and social life and the enforcement of mass lockdowns—over the unthinkable: the collapse of our health systems and the death of millions.
In the United States, in the death match between the economy and public health, the only winner has been partisan politics: epidemiology cast as liberal virtue, economic freedom as the “American way of life.” Leaders on the right with authoritarian instincts are minimizing the pandemic, both because they (falsely) think that is the way to shore up the economy and to consolidate their political base.
Elsewhere in the world, autocrats from Hungary to India to Zimbabwe have found greater opportunity in censorship, curfews, and emergency decrees than in appeals to economic recovery. Rather than minimizing the pandemic for political gain, they exaggerate it.
The common culprit is the lust for power and the manipulation of a pandemic to shore it up.
But there is a deeper, more insidious culprit—and that is the false choice between public health and individual freedom. It is only once we accept this binary that we invite politicians to politicize it.
For the real sacrifice involved in social distancing and stay-at-home orders is not individual freedom. It is the reality that these measures can cause more hardship for some people than others. For some, that hardship may be lost income; for others it may be the inability to visit their parents in a long-term care facility; for still others, it may be domestic violence.
The solution to these inequities is neither to force people to suffer nor to let them be “free.” Rather, it is to provide people with the social supports that they need to care for themselves and their communities.
In British Columbia, for example, health officials recognized immediately that the key to an effective quarantine was not punishment, but rather social supports—such as food and medical care—that helped people make the choice to stay home. Rather than deploying the police to enforce social distancing in public places, they focused on mitigating the unintended consequences of stay-at-home orders, such as domestic violence and child neglect.
The province’s top health official, Dr. Bonnie Henry, summed it up succinctly: “It really is about the recognition that we are all in the same storm. But we are not in the same boats, so we can’t make assumptions about other people.”
Arguably, the real risk of authoritarianism lies precisely in making assumptions about other people. The philosopher Karen Stenner has argued that what authoritarians truly target are human differences—typically those presented by racial and ethnic groups, political dissidents, and “moral” deviants. Authoritarians thrive on the “othering” of those who are different.
It is once social distancing measures fail to account for human difference that they truly take an authoritarian turn. The authoritarian fear of difference translates into the assumption that people have a home to shelter in, safety in domestic life, the ability to earn an income from that very home. Absent a social safety net, this presents people with an impossible choice: risk your life by going to work or risk your livelihood by staying home.
Inevitably, this double bind intersects with other forms of intolerance. Recently, the Brooklyn district attorney reported that, of 40 people arrested for social distancing violations in the borough from March 17- May 4, 35 were black, four were Hispanic, and one was white. In the Covid-19 era, racial terror colludes with public health advice to normalize discrimination.
Instead of making social distancing the next target for racist policing, we should be providing people with the economic and social supports they need to maintain physical distancing. The problem is that these supports are the very things that many politicians are loathe to provide.
Indeed, for some politicians in wealthier countries, expanding such a social safety net has seemed even riskier than sending people back to work in a pandemic. Not because they fear the redistribution of resources—clearly, they are willing to do that in favor of big business. Rather, because they fear the redistribution of resources to those they would prefer to control—workers, women, and people of color. And what could be more authoritarian than that?
As the writer Keeanga Yahmatta-Taylor put it in May, “For Republicans, the ‘American way of life’ as one with big government social welfare programs would be worse than the pandemic.”
For what, in the end, does a social safety net do? It allows us greater control and agency over our lives. It allows us to stay home and take care of our health, rather than go to work in a crowded factory. It allows us to obtain economic freedom from a violent marriage. In doing all these things, it allows human diversity to flourish.
It is not authoritarian to demand that people maintain physical distance to save lives. It is authoritarian to demand it without giving diverse people the means to do it.
Jonathan Cohen is director of the Public Health Program at the Open Society Foundations. He was a visiting scholar at the Hastings Center in 2018. Twitter: @JonCohenNYC.