Should Doctors Be in Charge of Pandemic Policy?

statue of Plato
More than two millennia ago Plato argued that since life is more than mere health. (Photo: lentina_X/Flickr)

Would the world be a better place if it were governed by physicians instead of politicians? The Greek scholar, Plato, asked that question 2,500 years ago. After all, physicians focus on healing the sick and promoting the health of the well. Why would you not want to put them in charge? That focus, Plato says, is precisely why you should not let them have that power. There is more to a good life and a good society than health alone.

The art and science of the politician lie in balancing the claims of health with the claims of liberty, prosperity and creativity. Today, the idea of a physician must be broadened to include everyone who does research or practices in the biomedical sciences – medicine has become too complex to be the exclusive property of a single profession. This empire has its own arguments and divisions. It remains united, however, around the goal of preserving lives and of managing nature and society to achieve that. It resists questions about the importance and the social and economic costs. It is the duty of politicians to ask the questions and decide what answers to accept.

This resistance has become more obvious as the COVID-19 pandemic has rolled on. At the beginning, the virus was new and frightening. Extreme measures were justified when we saw the scenes from hospitals in China and Italy.

Politicians were right to “follow the science” as the biomedical empire tried to work out what kind of threat this presented. Was it a threat to the future of humanity? Was our species to be wiped out by an invisible chunk of RNA in a protective coat?

As time has passed, it has become clear that those chaotic hospital scenes made good TV but were not typical. Even in February, the World Health Organisation was suggesting that 80 percent of those infected would not need to be hospitalized.

Today, there is strong evidence that at least 30 percent of those who have an active virus do not know it. Another 30-40 percent seem to have it in such mild form they confuse it with other minor respiratory infections. For the remainder, almost everyone will survive even if a few may have a bad time.

The risk of serious illness or death is closely related to age and general health. Even for 90-year-olds, though, these risks are not much different from influenza in a bad season. Given this, it might seem logical to expect politicians to ask why we are inflicting such massive damage on society, our economy and our children by persisting with the sort of control measures adopted back in March.

Instead of asking how limited, specific measures could contain the threat to higher-risk groups, the UK Government is doubling down on controls. COVID marshals will patrol the streets and curtain-twitchers be encouraged to turn in neighbors. People from social, ethnic and faith groups that favor large families will be forced into conflict with the law if they try to maintain traditional and important connections.

These decrees lack legitimacy. For 30 years, social scientists have been trying to educate scientific elites in the value of taking ordinary people with them rather than dismissing skepticism about science-based actions. This work has just gone out the window. The biomedical elite has looked to politicians to compel ordinary people to accept rules that inflict suffering and do not match their well-founded perception of the absence of risk. Politicians have failed to ask why their constituents should accept these rules.

There have been few ways to hold representatives to account. There have been no debates in Parliament, no elections, and congested courts. Much media coverage has been uncritical.

There is a common plea – do this or people will die. The politicians’ duty, though, is to ask “which people at what cost?” Is the price of Covid-19 a wave of more easily preventable deaths from cancer, heart conditions or stroke? How many people will die from the diseases of despair due to the unemployment that has been created by the elites “following the science”?

Plato’s politicians were learned and able, capable of critically evaluating claims of groups within society, listening to arguments and debates and distilling them into action. They were not captives of special interests or followers of the last person who talked to them. It makes no difference whether those special interests are biomedical scientists or arms dealers.

Their claims should be subject to equally critical scrutiny. We need political leaders who can do that job.

This article first appeared in the Sunday Express on September 13, 2020.

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Robert Dingwall

Robert Dingwall is a professor of sociology at Nottingham Trent University. He also serves as a consulting sociologist, providing research and advisory services particularly in relation to organizational strategy, public engagement and knowledge transfer. He is co-editor of the SAGE Handbook of Research Management.

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