Science, Darwin, and Advocacy Ethics

“Back in the day” there was a piece of advice that admonished us to remember that if you went on a first date, or when you invited the boss to dinner, or while you were at work, or during similar scenarios where you needed to be aware of the sensitivities of the company you kept, you should make sure you avoided conversations about religion and politics.

The reason to avoid those conversations with folks was clear: you always wanted to be sure you didn’t offend someone else at the beginning of a friendship or relationship or ongoing with people you would spend so much time with, day in and day out.

As was true then, and is true today, you never get a second chance to make a first impression.

Those of you who have known me over the years know I’ve made a huge deal out of suggesting that advocates in private practice keep their political views out of the public eye. I stand by that admonition (find links below to various posts on that topic. It’s important!)

There will be some of you who believe this post is a diversion from that stand; but no – it’s not.

Included in my admonition is to measure how our work with patient-clients is affected by politics, and therefore to be ready and able to discuss healthcare-related issues with others in a balanced and measured way. As advocates, we have a duty to be able to speak to those issues without making them political (at least to the extent that’s possible.)

So, as an educated women who is incredibly distressed over the death-count in the COVID – Coronavirus crisis, and as an ethical patient advocate who has put her blood, sweat, and tears into building the profession of advocacy, I must comment on one aspect of today’s political landscape as I see it affected by those who who may work within advocacy, while ignoring science.

Ignoring science means people die. As an advocate, if one takes steps based on the “freedom” to ignore science, that person can no longer be considered an ethical advocate.

Unfortunately, one UNethical advocate can taint the rest of us, making such science-ignoring choices even more unethical.

What you won’t find here is support of any particular politician. Nor will you find mention of any political party. This isn’t about the party that will take away Social Security, Medicare, or coverage for pre-existing conditions. This isn’t about the politician who locks children into cages.This isn’t about someone who doesn’t know the difference between truth and lies. This isn’t about someone who simply pretends science doesn’t exist because it works better for his or her own preferences.

Instead, what you will find is a position on the need to recognize what science tells us about the current health landscape and the probable outcomes if science is ignored.

Science tells us that the virus will march on and continue to kill people, or make them sick, or have a negative effect on their health for the rest of their lives (which, by the way, all of us will pay for, if not in our own health, then at least through higher insurance premiums, or higher Medicare or Medicaid costs, or through taxes.) No matter what our opinions or wishes or pretending are, ignoring science will become costly in healthcare, death, and money, too.

The only way to stop the virus is also about science: vaccines. But we don’t have access to an effective one yet, and (regardless of what politicians tell you) we won’t have access to one for at least many more months, possibly longer.

So, pretending or wishing that the virus is waning, or pretending that it’s now “safe” to go without wearing a mask, or being so self-centered as to believe that “freedom” gives one a right to ignore science at the expense of others, is just foolish.

The coronavirus will kill hundreds of thousands more Americans before it is stopped – IF it is stopped – because too many Americans believe charlatan politicians who tell them they have the “freedom” to not wear a mask, socially distance, or stay away from crowds.

Believing that one’s personal rights trump science is really no different than ignoring traffic laws, causing an accident that kills someone. Or drinking and driving, and running over a small child. Or any number of scenarios that are based on “freedoms” that kill or debilitate others.

None of us have that right.

As a patient advocate, it is unethical to intentionally do harm to (at least) your client-patients. In particular we work with immuno-compromised, and elderly people – the two largest groups of people who can be harmed by ignoring science. In my (not so) humble opinion, it is unethical to harm any human being.

Therefore, patient advocates must make choices to protect their clientele and others, and cannot ignore science. As an advocate, you must wear a mask. You must socially/physically distance. You must avoid crowds. You must keep your hands clean or sanitized. You have no freedom to do anything else if you want to be considered ethical.

You must do so for yourself, for your friends and loved ones, for your clients, for mankind, and for your profession.

Darwin tells us that viruses, when left unchecked, when allowed to run amok, will continue to mutate and kill people. Viruses are too often the fittest! If you don’t do all you can by wearing a mask, distancing, and keeping your hands constantly washed or sanitized, you will continue to prove – unethically – that Darwin is right.

Don’t even get me started on climate change. Yes, it’s science, and yes, it affects health. You can take everything I have written above and apply it to taking steps to protect the climate.