The Ethical Imperative of the Hour is Physical Distancing

…Also, the “hour” will probably last more than 60 minutes…

As the number of reported infections and deaths from the pandemic grow also in Turkey, people are facing a situation that disrupts their usual lifestyle and coping mechanisms much more deeply and thoroughly than any other crisis they have experienced before.

As the Turkish Health Minister and the President have repeatedly said on TV: Covid-19 is a global crisis but we have to solve it on a national level.

I would add to that: Covid-19 is a global and national crisis, but they key to the solution is the behavior of each individual person.

So how should people behave in face of the Covid-19 threat – apart from washing their hands properly and frequently?

Looking to a framework for ethical decision making, first we recognize that this is in fact an Ethical Issue.

Could this decision or situation be damaging to someone or to some group? Does this decision involve a choice between a good and bad alternative, or perhaps between two “goods” or between two “bads”?

The answer is clearly yes. The behavior of a single person can affect the health of many other people and cause stress, even harm to the healthcare system and the economy, hence also the economic well-being and prosperity of others. And there are certainly “better” and “worse” behavior options.

Is this issue about more than what is legal or what is most efficient? If so, how?

Another clear yes. Laws and regulations have trouble keeping up with the spread of the virus and there us a certain degree of freedom in behavior that even the most oppressive regimes on Earth cannot control.

What are the relevant facts of the case? What facts are not known? Can we learn more about the situation? Do we know enough to make a decision?

We meanwhile have quite large statistics how quickly the Coronavirus spreads, what percentage of infected people required hospitalization and may die.

What individuals and groups have an important stake in the outcome? Are some concerns more important? Why?

Everyone can be infected although not everyone will get severely ill and of those who do, not everyone requires hospitalization. We also know who’s more at risk: the elderly, people with immune deficiencies and chronic illnesses. There’s no known immunity in the human population.

What are the options for acting? Have all the relevant persons and groups been consulted? Have we identified creative options?

We currently don’t have medicines that are proven to be effective in treating Covid-19. But studies are being conducted in many places. There is no vaccination but research has started. However, we might still be more than 12 months away from having an effective vaccine. There’s a clear need for acting quickly because of the exponential growth of the infections.

Frequent and thorough handwashing with soap is effective to destroy the virus on your hands.

Keeping physical distance of 1,5 to 2 meters from other people will reduce the risk of getting infected from droplets in the air from people sneezing, coughing, speaking.

Staying at home and keeping away from any places where people intermingle reduces the risk of getting near infected people.

Now we can evaluate the options by asking the following questions:

1. Which option will produce the most good and do the least harm? (Utilitarian Approach)

2. Which option best respects the rights of all who have a stake? (Rights Approach)

3. Which option treats people equally or proportionately? (Justice Approach)

4. Which option best serves the community as a whole, not just some members? (Common Good Approach)

5. Which option leads me to act as the sort of person I want to be? (Virtue Approach)

Answering these questions, it is pretty obvious to me that there is only one Ethical Imperative of the hour: to protect oneself form getting infected and thereby protect others from being infected, potentially failing ill, needing hospitalization, intensive care, artificial ventilation and finally dying. Protect society, even humanity, by protecting yourself. And there is currently only one sure way of doing this: putting physical distance between people.

This is being mostly referred to with the technical term “social distancing”, an English language technical term from public health and epidemiology which has been widely used by governments, institutions and media and that has been verbatim translated into other languages, also into Turkish.

It is also a very unfortunate term as even the WHO has meanwhile realized , because it can be misunderstood and cause anxiety about social isolation and cutting social contacts with other people where it just means to put enough physical distance between people so they can’t infect one another.

The Turkish government has used even more unfortunate expressions. First, people were simply instructed to stay at home (“evde kal”) without giving more explanations of what this meant and what it did not mean. In addition, officials keep telling people on the media to isolate themselves (“kendinizi izole edin”), which should even cause more feelings of anxiety than mere “social distancing”. Even Turkish mobile phone operators have started nudging people by changing their operator name displayed on phones to “#EvdeKal TR” (Vodafone) or “EvdeHayatVar” (Turkcell).

So it comes as no big surprise that, even with a new government regulation as of March 22 that forbids most people over the age of 65 to leave their homes, many Turkish people did not comply and had to be warned and sent home individually by the police in the first days. Last weekend one could still observe people ambling in groups and picnicking at the seaside in Istanbul, men fishing in the Bosphorus, elders sitting together drinking tea and playing Okey – of course without keeping the recommended distance from one another.

And as the days go on and every new day brings new and more restrictive directives from various ministries, some people in Turkey are either ignoring them or knowingly violating them until they are forced to comply by police sanctions.

Why is it, that changing the behavior of people in this country – in their own best interest for their wellbeing and protection – is so difficult even in light of such a tremendous threat to human health, the stability of the healthcare system, the national and global economy – and with the daily news from the ever increasing number of people infected and dying through Covid-19?

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