Less than a year after Penn President Amy Gutmann and Penn Integrates Knowledge Professor Jonathan Moreno launched their book, “Everybody Wants to Go to Heaven but Nobody Wants to Die: Bioethics and the Transformation of Health Care in America,” the world was taken by storm by COVID-19, the greatest global health crisis since the flu pandemic of 1918. This past week, the scholars joined virtually together on BlueJeans—with a Penn Alumni audience including renowned journalist Andrea Mitchell—to discuss an afterword they penned during the summer of 2020 for their book, which is now available in paperback.
Gutmann and Moreno’s new addition, titled “Pandemic Ethics,” takes readers through the unique and staggering bioethical concerns that have bubbled since the very first sign of the novel coronavirus. Mitchell, a Penn alumna and emerita trustee, served as moderator for the hourlong Power of Penn event, which was livestreamed to nearly 2,000 households.
The discussion began with a focus on a major theme that is highlighted throughout their afterword: the importance of society overcoming the inequities exacerbated by the disease. Gutmann, a political scientist, and Moreno, an expert on medical ethics, health policy, and the history and philosophy of science, considered what they call the “pillars of pandemic ethics,” which are solidarity and science. But how do we unite in a country as divided right now as the U.S.? Mitchell asked.
Good leadership is vital, Gutmann said, noting Germany Chancellor Angela Merkel as a prime example in her eyes. The Biden administration, less than one month in, is taking important steps, Gutmann and Moreno agreed. They added how imperative grassroots leaders have been along the way.
Consider all the work being done by “mayors and governors and local officials,” said Gutmann. “It comes from the Oval Office, to my office in College Hall, and to the altars in churches and in synagogues.”
Commenting on the nation’s reliance so far on individual states for vaccine distribution, Moreno noted a dualism in American policy of how natural disasters are defined—one that surely needs updating, he implied.
“I don’t understand why national disasters are only defined as physical,” Moreno said. “[COVID-19] is a natural disaster. Earthquakes, hurricanes, floods, tsunamis—we wouldn’t say to the states, ‘you’re on your own,’ we would say, ‘we’re on the way,’ if we were the federal government.”
The COVID-19 pandemic is, as are all health crises, also a national security issue, Gutmann added, making an argument they aptly describe in their book.
Although improved leadership is essential to ensure a better vaccine rollout than what has been seen so far, the U.S. also faces a history of vaccine skepticism.
“It’s a history we really need to work hard to overcome,” Gutmann said. The good news in an otherwise bleak environment, she noted, is that the vast majority of Americans across political lines believe that medical research and science are essential to their lives. “They are right, and we’ve got to build on that,” Gutmann said.
The conversation shifted to public health, as well as mental health, both areas Gutmann and Moreno have been longtime advocates for improving. (Not only have the duo written a book together, but they’ve also served for years on President Barack Obama’s Bioethics Commission—Gutmann was chair and Moreno was senior adviser).
“Domestically the rise and fall of support for public health infrastructure has varied unfortunately in a bipartisan fashion,” said Moreno. “That can’t continue. We obviously need to do far, far better.” He said later, “We have a horrible failure to address mental health in this country.”
Concerning mental health, Gutmann, Moreno, and Mitchell reflected on the short- and long-term implications COVID-19 has and will continue to have on a span of people—from the oldest in society to the very youngest. With the goal of “Everybody Wants to Go to Heaven” and “Pandemic Ethics” to promote constructive responses to historically devastating problems, the authors encouraged a much stronger investment in and attention to mental and emotional health care in society.
They also discussed how fear is propagated, and how it is absolutely dire to pay close attention to science, while sharing facts and striking down misinformation. Comparing COVID-19 to the response to Ebola as well as the HIV/AIDS epidemic in the mid-1980s, Moreno said, “The honesty and openness about disease is still difficult, as advanced as we like to think we are. … There’s a level of cultural maturity we have to get about disease that we still don’t have.”
When it comes to “rugged individualism,” and how the pandemic has challenged it, Gutmann discussed the pull between making a living, and actually living, which has played out in U.S. politics.
“We have to come together to resolve this,” Gutmann said. “To make a living, we first need to be alive, but the only good way of resolving this terrible tension is to use what we call the least restrictive means possible to get it under control. I live this day to day as Penn’s president.”
Gutmann explained how she is constantly seeking to give Penn students the maximum ability to be able to see each other, and to have some semblance of a normal life while staying healthy. But meeting this type of goal, even on the broadest level, takes thought and consideration. It takes intentional acts like universal mask wearing, and aid to small businesses and low- and middle-income families, particularly those unemployed. It takes ramping up the production of vaccines, and administering them in an equitable manner, Gutmann said.
“You also take steps to address systemic racism associated with higher rates of hospitalization and death among people of color,” she said. “We’re living this right now with the debate over the sequel to the CARES Act, right? We’ve got to mitigate this tension between what we all want to do, which is live a more normal life as soon as possible, and also save as many lives as possible.”
Gutmann, Moreno, and Mitchell also discussed why it is not only morally important but also pragmatic in a global economy for the U.S. to not be “America-first” regarding vaccines and their distribution. They also talked about the apparent uptick of students interested in medical school as of late, as well as what the upcoming fall and spring semesters might look like for students (they’re cautiously optimistic).
In concluding, Moreno shared a personal experience of how he’s come to appreciate interactions with others, but in a different way than before. Behind masks, how we now use our eyes or a head nod to communicate with our neighbors, for example. “That is really an interesting human impulse, and we can build on that,” he said.
It is people, said Gutmann, that everything comes down to. “It’s really interesting that while this is a worldwide crisis, each one of us can make a difference.”
Gutmann added a major takeaway from everything that’s happened in the past year: the importance of public health. She explained how a significant increase of investment in public health would be “the smartest, as well as the most ethical, investment that this country can make.”
“And we at Penn want to continue to contribute to that, both in the science, the social science, the humanistic understandings, and with our resources,” Gutmann said. “I think that would make this crisis truly one that we did not waste, if we can look 10 years from now and say this country is now investing much more in the public health of all of its people and this country is working internationally to make sure that people around the globe can live healthier, more productive lives.”
Amy Gutmann is Penn’s president; the Christopher H. Browne Distinguished Professor of Political Science in the School of Arts & Sciences; and a professor of communication in the Annenberg School for Communication. She holds secondary faculty appointments at the Graduate School of Education and in philosophy at the School of Arts & Sciences.
Jonathan Moreno is the David and Lyn Silfen University Professor at Penn where he is a Penn Integrates Knowledge Professor. He is also a professor of medical ethics and health policy at the Perelman School of Medicine; and of history and sociology of science and of philosophy in the School of Arts & Sciences.
Andrea Mitchell, a Penn alumna, is Chief Washington Correspondent and Chief Foreign Affairs Correspondent at NBC News; Correspondent/Anchor at Andrea Mitchell Reports; and a University Trustee Emerita.