31. GET WELL SOON - What Our Ethic of Personal Illness May Tell Us About Our Wider Hopes to be Ethical People

Last weekend I sat in the cinema, watching the movie Just Mercy, and I was coughed on. A lot. The guy next to me, the guy behind, and even the group in front, merrily coughing into the circulating air of the air-conditioned room. The man to my right not only coughed, but occasionally took his Baskin-Robbins napkin and blew his nose into it, dropping the filthy tissue down onto the cinema floor. The people in front were eating popcorn. Like the man who had bought ice-cream at Baskin-Robins, they too had taken money out of their pockets with their coughed-on/sneezed-on hands, and given it to the poor person working the tills to handle. That person, serving food to other customers, had probably passed on whatever was causing all this coughing to whoever they gave those coins to as change. Today, a week later, I have a sore throat I didn’t have before.

But I couldn’t complain. The night before I had come home from work feeling dizzy and weird. I sat on my sofa Friday night, unable to do much more than fall asleep to Graham Norton. Saturday I felt better, but still not 100%. We had tickets for Just Mercy though. The last weekend before we would lose the chance to see it in the cinema. Like my coughing companions I had made the same calculations in my head that I’m sure they had: can I make it? Would I be able to get to the cinema ok and sit through a movie without feeling too bad? I decided I could, and so we went. I bought snacks too - ice cream and coffee - passing my own potentially infected money onto the same cinema staff I seemed to concerned about a paragraph ago.

It occurred to me, as we all sat there, ill and potentially contagious, as all around us the country disproportionately panicked about catching the coronavirus (we have more chance of dying from falling over than we do of dying of the coronavirus), just how selfish our thinking had been. At no point in my own deliberations about whether or not to go out to the public cinema had I even considered the impact my going out would have on other people. I had merely looked at it from my own perspective. Would I feel ok if I left the house? Would it help or hinder my recovery? I had not once weighed my own sense of wellbeing against my potential to infect another person with my illness.

As a teacher, this is an entirely normal way to think. Many times I have dragged myself into the classroom from my sick-bed because I felt I was capable of rasping through my lesson and the idea of setting complicated cover-work seemed more onerous than just taking a few paracetamol and gritting my teeth. My students do this frequently too. Coughing is a constant background sound to our teaching in the winter months. Voiceless students wheezing out answers with an apologetic smile as snot runs down their nose. Others with their heads on the desk:

“I’m not feeling well”.

“Do you want to go to the medical room?”

“No - I’ll be ok”.

They’ll be ok. No concern about the health of their table-mates.

Before Christmas the place where I worked was filthy with viruses - staff and students off every day with a variety of spreading ailments. And by the end of each half term in any busy school you can see the number of absences rise as the latest bug makes its rounds. Seldom, unless there are highly contagious outbreaks of something like norovirus or chicken pox, where a few public health campaigns have made people aware of their contagiousness, are students or staff explicitly told to stay home even if they feel well based on the actual science of when and how they will be most contagious to others. (And even here, many ignore the advice, or, if they follow it for school, ignore it for wider society, with parents taking their ill children into work or to the shops with them despite understanding not to take them into school). In all other cases, the idea that we might make someone else’s day, or week, miserable by getting them sick is not even considered as part of our normal reasoning about being ill or being healthy. It is entirely based on self-interest.

When you think about it, this is a significant moral failing. Sure, giving someone a cold, or even the flu, will likely not kill them (though this is not always the case - some do die of these things, usually in combination with other health problems, but still..), but it is causing them some level of suffering entirely due to your own thoughtlessness or negligence. It would be quite obviously morally wrong for me to take a knife and cut someone’s hand with it (not stab them in any life-threatening way, but give them a fairly painful cut, which would take a few days to heal, hurt a bit, be a nuisance to look after, and be prone to potential further infections), and yet for some reason me going to work whilst still contagious, coughing into my hand and touching a door handle which infects a colleague or pupil and gives them pretty much the same level of pain and discomfort, is considered to be morally ok. Some might even praise me for coming into work sick despite the personal misery of how I am feeling. (I know one colleague who has proudly boasted about never taking days off when they’re ill. If we could show them the number of illnesses they have caused as a result of their “work ethic”, would they be so proud?)

At its most simple, ethics is the study of person-affecting actions and determining right and wrong based on how much our actions affect others’ wellbeing. To be ethical is to be considerate of how our actions impact on other people and minimising the harm that we have the potential to cause. It therefore seems fairly clear-cut that the way we choose to interact with the healthy when we are ill and contagious is an ethical act, and that our consideration when choosing to go out into wider society with our germs should not just be about how well we feel, but about how ill we might ultimately make others despite our own desires to leave our sickrooms.

Possibly our lack of ethical concern about the spreading of diseases, speaks to our larger ethical deficit when it comes to sacrificing any immediate pleasure for the greater good of others: the clothing that we want despite the potential poor treatment of the workers who made them; the holiday that we want despite the environmental impact of our journey; the social media we enjoy despite the potential epistemic breakdown it is causing for many of our civilisation-sustaining institutions… Every time we justify bad behaviour because the thought of benefits to ourselves crowds out even thinking about any potential impact on other people, we are embracing a way of living in which ethics is forgotten. The way we fail to consider others in matters of public health from childhood on suggests that this habit starts early and often, and is perhaps praised and cultivated by a society which rewards us for working sick and punishes us for excessive time off?

And of course, it is this same thoughtless attitude which has led to the anti-vaccine movement. People worried (based on empty fear-mongering rather than scientific fact) about how a vaccine may affect them or their children are prioritising that over the known and proven impact their refusal to vaccinate will have on the wider health of others.

Ethicists since Aristotle have made the link between the moral habits we cultivate and our ultimate ability to actually act ethically when it counts. To my mind, as long as we cultivate the habit of thinking only of ourselves in matters of sickness and health, and not of the countless others whose lives we are impacting with our selfish decisions, then we will continue to be the cause of the suffering of others for our own selfish gain. And if we can’t even get the ethics of having a cold right, how the hell are we to have a chance at solving any of our larger ethical concerns?

Author: D. McKee