Are we in a war against novel coronavirus?
If so, then who are the soldiers? Medical personnel on the “front lines”? Essential workers maintaining supply chains? Consumers venturing out to keep the economy from collapsing, as Donald Trump recently suggested?
And who are the noncombatants? Vulnerable populations such as the aged and the immuno-compromised? White-collar professionals who can work from home? People living in rural areas, far from the epicenters of disease?
Despite these challenges to drawing a direct comparison, portraits of overwhelmed hospitals, morgues, and entire cities make clear the usefulness of the battle analogy. War’s extremities are often the best approximation we have for the impact of a global pandemic without precedent in over a century.
If made into a moral argument, however, the analogy can be confusing, almost laughably misleading (as commentator David French pointed out), or even dangerously misused (as scholars Christoph Laucht and Susan T. Jackson argued). Argument by analogy is appealing because it is a component of casuistry—the method of moral reasoning central to both medical ethics and military ethics. Casuistry, or case-based moral reasoning, can be an extremely effective form of ethical analysis, capable of generating reliable moral judgments in situations of ethical and epistemic uncertainty. But to argue a case well, the analogy must also be analyzed; both the similarities and differences between cases have moral significance. Similarities can be illuminating, pointing the way toward novel solutions for unprecedented ethical quandaries. Ignoring differences, on the other hand, can lead to ethical disaster.
The conclusion of any argument by analogy is only as sound as the analogies are tight. By mixing two fields of casuistry, talking about a pandemic like it is an armed conflict obscures the clear distinctions of purpose and means between them, leading to faulty ethical judgments and potentially creating additional moral and material harm.
Differences and Similarities between Medical and Military Ethics
The ethical purpose of medicine is to promote healing or reduce physical suffering caused by disease, injury, or infirmity. Medical interventions are judged ethically by their ability to achieve those goals without sacrificing other basic moral values. As with chemotherapy or surgery, medical treatments often harm in order to heal, but even the goal of saving a life does not justify overriding the core values of patient autonomy or beneficence.
The ethical purpose of war, on the other hand, is collective defense of the innocent and the interdiction of grave political injustice when other means fall short. In the pursuit of justice, wars harm: lives and livelihoods are lost, societies disrupted. That is why both the cause of the war (jus ad bellum) and how the war is fought (jus in bello) must meet stringent criteria for the war to be morally justified: to incur the actual costs of acting, the moral price of not acting must be higher.
Fighting a pandemic is like fighting a war in this respect: loss and harm are unavoidable. When one is attacked, whether by a virus or an army, the only possibility is to limit the harms incurred. Avoiding suffering altogether is not an option. Fighting a pandemic is not about defending a higher value than human life (as some have suggested); the goal of the fight is to limit the losses.
Fighting actual wars also involves the loss of autonomy—such as through conscriptions, blackouts, rationing of essential goods, and nationalizing of certain industries—along with loss of life. In the normal practice of medicine, on the other hand, no one is required to risk death, and no autonomous adult is forced to provide or undergo care.
Pandemics are also different from the normal practice of medicine because the most effective way to uphold the medical norms of reducing suffering and promoting health in a pandemic is by infringing on the autonomy of the general population, a policy that carries its own risks and fears. Unlike with normal clinical medical ethics, in a pandemic there are more parties to the moral calculation than just medical providers and patients.
Arguing by Analogy: Legitimate Authority in War and Pandemic
In addition to confronting unavoidable harms, pandemics therefore resemble wars in another way: they require a level of collective action that is more typical of a wartime mobilization than normal clinical medical practice. To justify the restrictions on individual liberty that such collective action requires, we can draw on the just war principle of legitimate authority: only a legitimate political authority may make a just (and therefore morally binding) declaration of war.
Similarly, society-wide decisions about how to fight a pandemic rely on legitimate authorities. In classical casuistry, legitimate authorities are not only moral authorities (the medieval priest-confessors for whom high casuistry was developed), but also subject-matter authorities: Who can accurately describe the phenomena (is a business investment a form of usury)? Finally, who understands what might resolve the problem (how can a lending relationship be just rather than exploitative)?
In a pandemic, legitimate authority for making collective decisions resides in political authorities—those charged with protecting the public good—and in medical professionals, infectious disease experts, public health officers, and immunologists who know the most about how to stop a deadly disease in its tracks. Doing justice in a pandemic—which in the political realm includes a society rightly ordered to the common good—means both aspects of legitimate authority for communal decision-making must be present. Because pandemics affect every sector of society, leaders of all kinds of organizations (not just in health care or government) are also responsible for making decisions about the well-being of the people they lead. Their authority, however, is subsidiary to political and medical authorities.
Legitimate authority must be moral: a tyrant, or one who violates the duties of office, is not a legitimate authority. Legitimate corporate decision-making authority is political, not personal: just as no single citizen has the authority to declare war, neither can an individual legitimately dictate his or her own pandemic response policy. These claims further illustrate that in a free society, successfully fighting both a war and a pandemic relies not only on good policy decisions but also the voluntary compliance of citizens. So the overriding principle in a pandemic is not liberty, but charity.
Should We Wage Total War against a Pandemic?
The analogy between a just war and a pandemic response could probably be taken further: just war criteria prohibit total war, or destroying an enemy’s ability to sustain its non-combatant population. This prohibition could be interpreted to suggest that the fight against the pandemic should not leave an economy ruined for a generation—except that in the case of a global pandemic, the economic and health risks of particular battle tactics are to one’s own people, not one’s enemies, and an uncontained pandemic can be just as economically ruinous as the alternative.
A pandemic is different from a just war in another respect: we rightly seek complete elimination of the viral enemy, an impermissible goal when fighting a human foe. Eliminating the virus is also practically possible: historical (smallpox) and contemporaneous (New Zealand) examples demonstrate that fact. A bold, decisive, coordinated strike that contained and then eliminated the coronavirus with minimal loss of life and livelihood would probably have been the best course of action, meeting the jus in bello criteria of proportionality.
Conclusion: The State of Play
Lacking any offensive weapons in the battle against coronavirus and limited in our application of defensive strategies, we have failed to achieve New Zealand-levels of harm minimization globally. This highlights another departure from the traditional context of just war thinking: a pandemic is an enemy that threatens all alike, meaning that international cooperation, not conflict, is how societies achieve defense of self and others.
Most Americans have not faced this kind of collective action problem in their lifetimes. This pandemic is a severe test—not only medically and economically, but also politically. Our ability to see the problem for what it really is—to classify it correctly, and then to apply the appropriate principles for ethical decision-making—is one key part of the challenge. If we are going to use the reasoning of war to help fight a pandemic, we must use that reasoning well.