Human Rights and Christian Ethics: Finding Convergence in Response to Communicable Infections
Israel Chukwuka Okunwaye
In a 2016 article in the American Journal of Law and Medicine, George Annas developed four guiding principles, which he argued could helpfully chart a broad health and human rights response to the spread of infections that threaten public safety. First, he suggested that prevention should be the primary goal when formulating public policy responses to such pandemics. This focus stands in contrast to more responsive policies that take action only in the aftermath of an outbreak. Along with this suggestion, the pursuit of research or non-treatment interventions that make prevention ineffective would have to be justified to be conducted. In brief, according to Annas, the primary concern when combating an epidemic must be preventing the disease from taking hold and spreading in the first place, and when such a disease does begin to spread, ensuring against the further spread. Preventative strategies should always be given higher priority than treatment and other responsive strategies. Second, Annas argues that the government’s primary responsibility is to care for the health of the people and to make sure their right to health is protected, especially for women and children. Third, Annas asserts that “interventions should be sustainable and contribute to building a healthcare system and healthcare infrastructure, not increasing silos.” Fourth, ensuring “informed consent” is always inviolable, even during disaster situations.
At the core of Annas’ argument is the desire to hold the government accountable for its policy responses to a public health crisis so that bad decisions are not executed under the guise of health and safety measures. These principles are consistent with human rights values that uphold the dignity of human beings and secure people’s right to health, which includes the right to be treated professionally and with due care, to live safely in public, and to have access to available treatment and information. In essence, the government must recognize its position of responsibility in protecting and defending each individual’s right to life. These principles are also intertwined, as there is a rational basis to presume that once preventative measures collapse, then treatment becomes a viable option which the government has to take full responsibility to enable, but also ensure it continues to function. That means financial investment must go into improving the wellbeing of individuals in a State. When Annas speaks of “increasing silos,” the caution appears to be a warning against opportunism that goes against the grain of sensitivity and prudence in a time of health crisis, where inappropriate. The focus should be utilising resources for the utilitarian health benefit of society. The running thread is ensuring public safety but as well as the wellbeing of all affected, this goes to the root of respect for the dignity of the human person, and that also means those treated must have given their consent to any bodily invasive treatment.
In the current public health battle against the Coronavirus, it is worth revisiting Annas’ four principles and their grounding in fundamental concerns for human dignity and the right to health. Annas’ framework is broadly consistent with core bioethical norms, which uphold the need to treat each person with dignity. It is based on the notion that people ought to be done no harm, protected, have their decision and person respected, and that to not take that into cognisance is a failure in policy construction. Similarly, Christian ethics call for the same principle of dignity to be demonstrated when infectious disease threatens to wipe out a population. Civil authorities have the obligation to take measures to protect the vulnerable and the ill, to meet their health needs, and where applicable, to not impede spiritual care.
The COVID-19 pandemic [Coronavirus] has caused many deaths and has contributed to massive global disruptions to economic and social life. Many countries have restricted international and local travel and movement as a precautionary measure in an attempt to slow the spread of the virus and flatten the curve.” Such measures restricting movement are justifiable grounds in law without infringing on the right to dignity,1Article 1, 3, 5, 13, 20 and 27, vis-a-vis 29 and 30 UDHR 1948, the combined effect indicates a permissible exception, for the purposes of health preservation of the public. The rationale in law is justifiable, it is feasible to see judicial pronouncement towards public safety, and a balancing act of granting access to treatment as well as the ability of people to access care. According to Barbara Misztal, respect for human beings means also granting access to treatment and due professionalism in care:
In the public sphere, the idea of dignity is not only limited to health care. The principle of human dignity, understood as the universal value that belongs to every person by virtue of being human, is also frequently associated with the call for social justice. This association between dignity and justice is illustrated by a common justification for the welfare policy to treat all citizens as part of a more inclusive national order that distributes rights and recognition.
Anna Hogg similarly notes that Christian ethics and doctrine maintain “the essential dignity of humanity and the infinite worth of each individual person,” which have important implications in terms of public health policy. But Hogg stresses that questions of personal behavioral change and redemption still remain. Misztal had stated even more strongly that the notion of dignity is to be understood not only as a key legal notion but more as a “fundamental aspect of democratic society.” Dignity also extends to taking into account the individual’s spiritual care, their belief in God, and prayer in difficult situations.2James 5:14; Isaiah 58:6-8; Job 42:10-12; 1 Timothy 4:4-5. The Scripture allows for prayer in reverence of Christ for grace, and the proper utilization of the blessedness of creation (herbs, food, water etc) to nourish the human body. A deep sense that taking practical responsibility to allow professional treatment and personal hygiene, do not operate in contravention to matters of faith and godly interactions, and a need to respect the preferences of patients.3 Joseph Tham, “Bioethics and Anointing of the Sick” (2007) 74(3) The Linacre Quarterly 253-257.
Ethical consideration should be given to preparedness as a strategy to tackle the health crisis. As Annas suggests, aiming for prevention is the primary goal. We should be considering how to improve the quality of life, and asking questions such as whether immunization could have been done prior to the onset of the health disaster;4Chaya Greenberger, “Religion, Judaism, and the Challenge of Maintaining an Adequately Immunized Population” (2017) 24(6) Nursing Ethics 653–662. Subject to ‘reasonable risk’, “In the face of a major lethal epidemic it might be reasonable not only to expect people to present themselves for vaccination but even to require them to do so. Indeed most legal systems allow for the possibility of compulsory immunization. We can assume that immunization involves injection and therefore the invasion of bodily integrity, some pain and a small risk of lethal side effects”, John Harris, Soren Holm, “Risk-taking and professional responsibility” (1997) 90 Journal of the Royal Society of Medicine 625-629, 628 and we consider whether actions are in place to sensitize the public and fund research as quickly as possible. The ideal would be to envisage a healthy public space, but when the mechanisms for prevention have collapsed and the virus is spreading, then the option would be to galvanize a response to effectively curtail ― and where scientifically possible, eradicate ― such diseases that threaten the population at large.
Israel Chukwuka Okunwaye holds postgraduate degrees in law from Nigeria Law School, Lagos and Birmingham Law School, as well as a masters degree in Evangelical and Charismatic Studies from the School of Philosophy, Theology and Religion at the University of Birmingham.