COVID-19: A moment for philosophers, physicians to collaborate

By Dr Mutyaba Emmanuel Musoke

When we see what is going on for instance in Uganda in this pandemic period of COVID-19, it makes one to wonder. The experts tell us that coronavirus has no cure, that the only way to reduce its spread is to stay at home and wash hands whenever you enter public places or touch public objects.

Surprisingly, many Ugandans resist such precautions; it is police that tries to force them to take care of their lives by observing quarantine. Many Ugandans do not wash their hands when they enter public places unless when they are compelled despite the fact that the sanitary water is provided in those places free of charge. Quite often we make shallow judgments about this phenomena like: those people who do not respect sanitary precautions are stubborn so they deserve to be punishment, or that they are ignorant they need more sensitization, or that these people are simply primitive they cannot understand even if you teach them simply ignore them. I do not think that these judgments are true to all cases of people who refute medical measures with regards to COVID-19.

According to me the matter lies in the fact that, this pandemic of coronavirus raises both medical and philosophical questions. Medical questions such as, which behaviors help us to avoid getting effected by COVID-19 need an empirical solution which results from observation of a large number of behaviors and tracking their effects on health. The same applies to formal questions like, are sanitary behaviors the ones that prolong our lives? The answer to such questions requires thinking analytically about the concepts of health and life which a physician can do perfectly well.

On the other hand, there are questions that cannot be answered from the formal or empirical inquiry of the physicians. For instance questions like why should I be healthy? Or why should I be preoccupied with my healthy? Why should I fear losing my life? These are philosophical questions whose answers cannot be deduced from the notion of life and health neither can they be got from empirical observation of healthy living beings which is in the domain of health science. Such are the questions that may be filled in the heads of those people who do not see the value in being conditioned by the measures put forwards by medical experts regarding the prevention of the spread of coronavirus. They do not fear putting their lives at risks of being infected by coronavirus which may claim their lives. One reverend sister told me that if it is her time to die she will die even if she stays at home but if it is not, she will not die even if she does not stay at home. So her not staying at home in this pandemic period, is not due to primitiveness, ignorance or lack of sensitization neither is it stubbornness. Her response reveals the facts that though we are physical, our consciousness is not restricted to physical matters alone. This is in line with philosopher C.S. Lewis's claim that, "although we are physically embodied, most of the things that give our lives value are less tangible than material reality, and philosophy is among them." So if we want people to survive this pandemic COVID-19, let us bring philosophy closer to medicine; much as philosophy has no survival value like medicine has, it is one of those things which give value to survival.

The physicians provide medicines and prescriptions that helps to keep people survive while philosophy gives the incentive for people to survive without which they may see no value in surviving hence they will refuse to follow the guidelines of the physicians on how to survive.

People may not take medical measures put down by experts for their own health simply because they do not see why they should be conditioned by their health or their life preservation. In answering the question whether existence should be preferred to non-existence, we rely on philosophy. We need philosophy to explain to people the value of human life, the value of suffering (to console those who are infected or affected by COVID-19). Values are not empirically observed nor are they simply deduced from self-evident truths. Scientific analysis cannot answer questions like to what extent and under what conditions life is valuable. Such questions require more than clinical facts and if the answers to such questions are important, then philosophy which provides them is relevant in this situation of the pandemic COVICD-19 alongside medical knowledge.

Some medical doctors are already in dilemma, the desire to control the spread of COVID-19 seems to contradict the existing medical ethos, like it is widely accepted that individuals have certain rights to refute interventions which they do not consent to. That it is morally wrong to impose medical measures on a competent patient who does not consent to it. Therefore forcing treatment and medical measures like quarantine to COVID-19 patients is bad. To solve this dilemma we rely on philosophical arguments to strike a balance between one's rights to mobility and his or her right to health against the right of the wider population to protection against the pandemic COVID-19. For instance, we can employ utilitarian philosophy and insist that medical measures are permissible if they are to bring greater happiness for the greater number of people. Individuals' rights to mobility and to refuse medical treatment and other measures like quarantine are overlapped by the far-reaching good consequences that medical measures will yield. Respecting the rights of some individuals to refute COVID-19 medical treatment and other measures like quarantine will lead to far-reaching bad consequences beyond themselves. A concrete example of this is the case of the people in northern Italy who went against medical prescriptions of quarantine and they ended up spreading coronavirus across the country, imperiling other communities.

Perhaps stoic philosophy can help us here. The stoics like Seneca, taught that, human beings we are waves of the same sea, leaves of the same tree, flowers of the same garden.

For that matter one's decisions and actions affect others too. So we should be mindful of others when deciding to take certain actions. Much as one may not see value in keeping medical measures for the prevention of the spread of the COVID-19 because he or she does not fear getting infected by it, at least he or she should be mindful of those who his or her refutation of medical measures will unjustly hurt. In other words one's rights to refuse medication, washing hands in public places and quarantine should not violate others' right to health; in cases where they do, like this one of COVID-19, the right thing to do is to restrict those rights.

The stoic philosophy also urges us to remain calm in whatever situation nature presents to us, not to allow our thoughts to be overrun by negativity otherwise we shall suffer more due to our imaginations than by reality. We should try to discover something good out of this quarantine period. It could be an opportunity for us to reflect on our selves, to reflect on the value of life, to learn about our families a little more by staying close to family members days and nights, etc.

The stoics take moments of tribulations as moments were character, resilience and courage are tested; the greater the difficulty, the more glory in surmounting it. Skillful pilots gain their reputation depending on how strong the storms and tempests were which they managed to pass through. This stoic philosophy rose from real-life experience. Stoics such as the Roman emperor Marcus Aurelius lived through the Antonine Plague of 165 to 180 AD, a pandemic that wiped out a third of the population.

The Stoics believed that humans as social animals were created to support each other. If you realize that your friend's food is finished and he or she has no any solution to that in this quarantine time, be generous to him or her. It is not human to take advantage from others' troubles like those vendors who have increased the prices of food and other essential commodities which people need to have in this quarantine period. The stoics insist that no plague can do more damage than those human beings who do perform acts of bad character during the time of the plague. It is by good character that you accept self-isolating not just for your own protection but to protect others. You stay at home even if you do not fear your own death or you do not care for your health but for the sake of others; those are acts of good character. It is a good character if the government suspends its citizens' payments of electricity and water bills till the pandemic is overcome.

After both medical and philosophical efforts to explain to people the importance of taking precautions with regards to COVID-19 that experts have put forward, what should be done to those of bad character who do not accept staying at home, who refuse to wash hands in public places and those COVID-19 victims who refuse medication and run away from hospitals? St. Thomas Aquinas who was a realist philosopher said that those who do not want to do good acts because they are of bad character, they should be compelled!

The writer works with Uganda Martyrs University