My masters in public health curriculum was heavily based on case studies and ethical dilemmas that we had to resolve, one way or another, through group work. It was an excellent model of how most jobs in the field play out–collaborating across disciplines with peers following shared principles towards the highest collective good at the lowest cost. We wormed our way through the nooks and crannies of each stakeholders’ perspectives, potential solutions, compromises and middle grounds, testing if our approach could hold water. My teammates must have gotten sick of me early on; as a budding anthropologist, I couldn’t help poking holes in everything.
They called recipients of our hypothetical interventions clients or consumers, but I insisted they were citizens, or at least residents. They asked us how we would respond to a highly infectious, highly lethal viral outbreak (oh hey those case studies were relevant) and I refused to agree to a mandatory quarantine. (Funny enough, my professor laughed at what I suggested but it’s essentially what’s happening: I said it would be requested but not mandatory, but if people were “noncompliant” we would tighten restrictions.) At the worst moment for me, they asked us to prioritize organ donors, and I cringed as my classmates and I discussed how to rank ten people for survival based on their risk factors and contributions to society. I hated that exercise, how it reduced the idea of a person to a list of attributes: formerly incarcerated, congenital heart disease, medical doctor, alcoholic, philanthropist, eight years old, eighty-seven years old. I know people like that, I think–disabled, depressed, elderly, sick, addicted–and I think they deserve to live just as much as any of us. But there we were, making a list, because we were told to make a list.
This scarcity-driven approach to health care is taken for granted in the U.S., but it’s not the only way to serve a population. I’m also not the only one who has found it morally repugnant. In recent years we’ve seen trends like #IAmAPreExistingCondition and #NoBodyIsDisposable erupt on social media against health policies that affect who lives and who dies. #NoBodyIsDisposable is a recent movement declaring that fat, disabled, queer, and BIPOC bodies are unjustly disadvantaged in the official COVID-19 triage protocols, and such disadvantage amounts to eugenics.
Such a claim may sound extreme to you–eugenics was a wild experiment of the past, you might think, it was debunked and it clearly has no place in our society today. We all know that was just Charles Darwin’s kooky cousin takinig the idea of evolution a little too far. You’ve noticed my sarcasm by now, I hope, so here’s the counterpunch: in my studies I have actually argued that eugenic concepts of racial purity are present today not only in terms of who is imprisoned, sterilized, or killed by the state, but also whose lives are valued and sustained by the state versus whose are not. In fact, my old pal Foucault would say that where once the king or queen or emperor had the right to chop off the heads of rebels and renegades, now the democratic republic was empowered to “foster life” or “disallow it to the point of death” ().
If this still sounds implausible, let’s look at our current coronavirus case study. This will definitely be one for the casebooks, let me tell ya. First, we have the conditions that have been simulated in public health spheres for decades now: a highly contagious virus that infects healthy people of median age almost as much as older people and young children and can result in death for all ages. You can tell that the true infrastructure of our public health system, held up by seasoned veterans like Anthony Fauci, is ready for this moment–as is now common knowledge, they have been preparing. Second, the polemic Trump presidency and the upcoming election make the connections between health and politics clearer than ever. Third, policies defending human rights to shelter, a living wage, groceries, and protection from disease are more widely implemented and popularly supported than they have been in years. I get excited about the possibilities of carrying our claim to these rights beyond the pandemic.
Yet at the same time, some bodies are clearly being protected more than others. Construction, yard work, shipping and transporting, groceries and pharmacies, and health care providers and staff are still going to work, interacting with their colleagues and their clients day to day.
skeptiki 