The Value of Life: Whose Life Do We Value?
By: Dr. Karen Rezach, Director of the Ethics Institute
Last Sunday, I picked up The New York Times Magazine and was stunned by the VERY LARGE headline on the cover: “WHO LIVES? WHO DIES?” (May 3, 2020). The rather small print in the middle of the page (which required my glasses to see) read, “How Covid-19 has revealed the deadly realities of a racially polarized America. By Linda Villarosa.”
The Trolley Problem
“Who lives? Who dies?” is a question that I have asked thousands of times to students, faculty and parents in our ethics workshops while examining the well-known thought-experiment known as the “Trolley Problem.”
Imagine you are standing beside some tram tracks. In the distance, you spot a runaway trolley hurtling down the tracks towards five workers who cannot hear it coming. Even if they do spot it, they won’t be able to move out of the way in time.As this disaster looms, you glance down and see a lever connected to the tracks. You realize that if you pull the lever, the tram will be diverted down a second set of tracks away from the five unsuspecting workers.However, down this side track is one unsuspecting bystander, just as oblivious as his colleagues. Would you pull the lever, leading to one death but saving five?
- (Philippa Foot, 1967; adapted by Judith Jarvis Thompson, 1985)
There is a huge difference between The Trolley Problem and the cover story of The New York Times Magazine: one is fiction and one is not. One is meant to examine the philosophical differences between utilitarianism and deontology – do we pull the lever in order to save the greatest number of people? Or, is killing ever ok? And is there a difference between pulling the lever (killing) and allowing the trolley to run into the 5 (letting die)? The choice being presented on The New York Times Magazine cover represents the horrifying choice that is being made between one life over another in our pandemic-laden society. When resources can’t meet the need, when there are only so many hospital beds, ventilators, experimental treatments and medical personnel, when in the midst of a crisis and a decision is REQUIRED of us – who lives and who dies? Do you pull the lever?
More times than not, people are reluctant to MAKE A DECISION when confronted with the “trolley problem.”
“This would never happen in real life,” is the statement I often hear.
True – most of us will never be standing next to a lever in a train yard deciding whether or not to divert a trolley to another track! But many of us WILL be in a position to make a decision that doesn’t have a clear, right answer but DOES have real consequences not only for ourselves, but for others, as well. The time to think about the values that would influence that decision is not in the moment of crisis, in the heat of needing to decide. Instead, the time to figure out which values will be utilized to make decisions of grave consequence is before the crisis hits, when we have the time to do some deep self-reflection about the values that are most important and that will guide our decisions in life.
The answers to these life-altering dilemmas are not simple. But the time is NOW to make those decisions: What societal values will be utilized to determine how we ration needed medical care? How do you apply the value of equality and the principle of justice when deciding which life to value more when not all lives can be saved? Who lives? Who dies?
What the Data Illuminates . . .
As Ms. Villarosa indicates in her New York Times Magazine article, the data collected on the mortality rates from the Covid-19 virus reveal “deadly realities of a racially polarized America.” Current data suggest a disproportionate burden of illness and death among racial and ethnic minority groups (CDC, April 22, 2020).
Perhaps this is the more troubling statistic: Coronavirus fatalities in long-term care facilities have surpassed a grim threshold in much of the country, accounting for at least a third of the deaths in 26 states and more than half in 14 of those. The data, which was published by the Kaiser Family Foundation, reports tallies from a variety of care facilities, including nursing homes, adult care residences, and other skilled nursing care settings (NPR.org, May 9, 2020). In New Jersey alone, of the 7,223 deaths reported on the same date, 5,709 were among people 65 and older (https://covid19.nj.gov).
News outlets flood the airwaves with images of senior citizens sitting alone in their nursing facilities, isolated, lonely, having meals delivered to their room doors, and waving to their loved ones through a window. The 65+ demographic includes all races, ethnicities, socio-economic statuses, sexual orientations and genders. Age does not discriminate. Certainly there are reasons why the elderly population is more vulnerable to this virus; however, when one looks at the data and the devastating rate of death among the “Silent” and “Greatest” generations, is it a statement about who we value most, or least, in our society?
Making Difficult Decisions
Back to the Trolley Problem: during the workshop discussions about whether or not “you would pull the lever,” many say that they would “do nothing.” Let fate have its way. That would be easier and would not implicate any individual in the outcome. But, doing nothing is, in fact, doing something. Watching the trolley go by and plow into the 5 workers is a decision, though it is a decision involving indirect action.
There is no debating the fact “the trolley problem” as an ethical dilemma because it has no right answer; instead, there is only a way to consider the intentions and consequences of action or inaction. Deciding who lives and who dies is never an easy choice, and a decision that most people would rather avoid, or let others make.
But our times demand that we answer the question of who lives and who dies. And in doing so, we directly or indirectly decide who we value most in our society. Are there vulnerable members of our society who valued less – the elderly, the disabled, racial minorities? Have we made the most vulnerable of our society even more vulnerable? The least valued and most vulnerable are usually the ones without a voice.
When this is all said and done, and history looks back at the data from Covid-19, the numbers will speak loudly about who we did and did not value as a society. The data will provide insights into who the most vulnerable in society was, and who we let live and let die.
Could we have acted? Was there a “lever” that we pulled, or didn’t pull?