On our responsibilities when faced with moral atrocities
Choosing what to do, how far to go, in a suffering world. Part three of three.
In my last two essays, I engaged with the question of how our morals might constructively guide the arguments we advance and the science we generate in pursuit of health. I did so as part of a broader, ongoing, conversation about our values and how they inform all we think and do in our efforts to build a healthier world. The challenge is that in engaging with the world we are regularly faced with events and ideas that are truly terrible, that lead to much suffering, destruction, and death. These events pose a challenge to a values-driven field like public health. When we see moral atrocities, there is an implicit challenge to us to act on what we are seeing, to put our values into practice by saying or doing something, anything, to address the suffering of the world. I have lately found myself thinking about these moments and their implications for how we should or should not act.
Should we always act when we see terrible events occurring? Or should there be limits on what we do in these moments? It is necessary for us to ask these questions because, sadly, there are always truly terrible events happening in the world. People born in certain places die 20 years before people born in other places through no fault of their own, simply because their region faces disadvantages arising from a range of factors like economic unfairness and colonial influence. That is terrible. There are wars happening where innocent people are caught up in them and die, including conflict in the Middle East with tens of thousands dying in Gaza, and Israeli civilians being killed by Hamas. That is terrible. There are generations of women who are deprived of opportunity and self-actualization in countries upon countries. That is terrible.
All this terribleness surely must, at some point, make one say, we should act, and act now. And, in some respects, we have always seen—and are seeing now—eruptions of activities by some who have felt they needed to act and now. The university encampment protests are, in part, a reflection of this. They express the feelings that an atrocity is being committed, motivating a need to act, to feel like something is being done. I am deeply sympathetic with this need to act when feeling like an atrocity is unfolding unchecked. And I am sympathetic to the feeling that if we do not act in the face of genuine moral atrocities there is a case to be made that we are complicit in them. Ideally, then, we should all have the courage to act in the face of moral atrocities, and it is easy to admire those who do.
History tends to celebrate those with such courage, as do many religions. Growing up as I did, in a Catholic context, I was from an early age exposed to the example of the saints, many of whom were notable for taking stands against moral evil which placed them against the grain of prevailing opinion or social norms in the times and regions where they lived. In learning of their example, and the example of others who took similar stands on behalf of the good, one is left with the question: what is stopping us from behaving as they did? Why do we not act to address moral atrocities when we see them, taking our opposition to them as far as it can possibly go, even to the door of great personal risk or death? Is it simply cowardice, fear of pain or of losing material comforts? Or is our hesitance to act sensible, justified? Should there be limits on doing what we believe to be right? What would happen if we all acted on what we felt passionately about, by any means necessary? On one hand, there would be far less delay in addressing injustice, and perhaps a quicker end to the terribleness of the world. On the other hand, if we all dropped everything all at once to address moral atrocities, who would do the mundane, necessary business of keeping the world running smoothly? What, then, is it best we should do in a world of moral atrocities? In such a world, is there even a best to aspire to?
Such questions have long been of interest to philosophers and poets who have wrestled with the challenge of how to take moral actions in an often-brutal world. The first action to take, it seems to me, is to call out evil when it occurs, to refuse to participate in silence or obfuscation over what we are seeing. Aleksandr Solzhenitsyn said, “The simple step of a courageous individual is not to take part in the lie. ‘One word of truth outweighs the world.’” This is something we should all aspire to do. Then there is the question of what to do next, what additional actions to take, and here is where the matter can get more complicated. Leonard Cohen, one of my favorite artists, a philosopher, and a poet who was keenly attuned to the moral dilemmas of the violent and tragic 20th century, once sang, “There is no decent place to stand in a massacre.” This line captures the challenge of working out what actions are best to take in a context of catastrophe, recognizing that, sometimes, what we can do is limited, our options a matter of choosing not what is best but what is least worst. This suggests the necessity of an honest reckoning with our limits, as we work to find a “decent place to stand” in a world, and a historical moment, which may not afford one. Should we then, in keeping with this, adopt principles to guide our actions when we are wrestling with what to do in the face of moral atrocities? I offer two thoughts in this regard, built on and learned from the work of many. These are not meant to neatly resolve this difficult problem, but to suggest two core points we might consider in grappling with the challenge of living in a world with much that is wrong and only so much we can do to set it right.
First, in considering any action, we should ask ourselves: are we sure we are right? Moral clarity often dims in the sunlight of careful examination. This aligns with the importance, always, of trying to grapple with nuance, looking to understand events in front of us from different points of view. This takes engaging with compassion and, whenever possible, without preconceived notions, to try to arrive at the truth of a given situation. Once we have done so, we may well come, if rarely, to regard what we are seeing in black and white terms—some issues are that stark—but we should never arrive at this position without having first done the difficult, necessary work of considering the complexity of a situation. Having carefully weighed the issues at hand sobers the mind and gives greater weight to a second consideration.
Second, in considering an action, we should ask: what are we trying to achieve? I have long argued for a consequentialist approach to health, which is to say an approach which focuses our energy and resources on what helps get us pragmatically to a healthier world. We can sometimes be tempted towards taking the most extreme path to tackle injustice because of the understandable feeling that a world that contains so much injustice deserves to be burned down. But this is nihilism, and makes bad situations worse. What ancillary cost is incurred by action? If we choose to throw aside half measures and go all-in on a course of action, we should be clear-eyed about what we are doing. It was this clarity that informed, for example, Nelson Mandela’s extraordinary efforts to navigate a country out of one of history’s great injustices. He was willing to forgo eminently justifiable calls for vengeance in order to minimize the ancillary costs that such an approach would have brought. We should be trying, always, to make the world better, and, in doing so, recognizing that making the world better requires that there is a world left standing to be so improved.
As I contemplate these principles, I find myself asking uncomfortable questions: are these principles there to provide a fig leaf for inaction in the face of injustice? Do they come from a place of cowardice? One hopes not, even as it is important to acknowledge these unflattering possibilities. I would close simply by suggesting that there are indeed times to act, and by any means necessary. But history and life teach that, while the world presents some such times, life is complex, humans are fallible and limited, and such cases are rare indeed.
The question, then, becomes how do we act to build a better, healthier world within the context of moral atrocity and within our own limits as people? This requires the wisdom to know when and how to act. Where does wisdom come from? Aeschylus said
“Even in our sleep, pain which cannot forget
falls drop by drop upon the heart
until, in our own despair, against our will,
comes wisdom through the awful grace of God.”
Perhaps it is in our awareness of the tragedy and pain of the world that we can find the wisdom that helps us chart a course towards consequential action. Such action should, indeed, aspire to be consequential, which often means being pragmatic, accepting a radical incrementalism in our pursuit of a better world. Fundamentally, our morals should serve as motivation for us to take the steps that get us to such a world. This almost always means making the moral case on behalf of health, generating quality population health science as a prerequisite for these arguments, and acting pragmatically in pursuit of a better world. That does not mean we are falling short of what the moment demands, but rather that we are finding the wisdom to find light in the heat of charged moments.
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Also this week.
New in BMJ Global Health, with Mohammed Abba-Aji: on the need to address the mental health care gap in Nigeria through stigma reduction, community-based initiatives, and trauma-care services.
Thoughts with Michael Stein on patent rights and wrongs in the latest Observing Science.