Trustworthiness and ‘doing ethics’

It’s amazing how much (and how many people) we trust in and how reliant we are on trust. Imagine a world in which you never trusted your doctor to try to do her best for you.

In an emergency such as the present one when things are so uncertain trust matters even more. But you cannot just command trust (‘Trust me I am an expert/Minister/whatever’) and when trust has been built up over time it is very easy for it to be destroyed in an instant. Moreover, as philosophers writing on the subject have noted there is a difference between ‘trust’ which can be described in pretty straightforward factual terms and ‘trustworthiness’ which is a very different matter and has a value component. It is about what or who should be trusted. Unfortunately, we can both trust those who are not trustworthy and not trust those who are.

So, governments cannot just ask for people to trust them; they have to earn trust and do so in the right ways. They should not just be trusted but also be trustworthy. As Hugh Whittall’s previous blog rightly says trust and transparency go together: we can only trust in what we are clear is being asked of us. The Government may well have a strategy both for now and for the next few months – and even beyond. But it is not clear – and certainly not always clearly and publicly stated – what it is.

Moreover, whilst the Government might ask us to ‘trust us because we are being led by science and only doing what the evidence supports’, there are two important replies. First, we need to know what that science and evidence is. This is not least because there is not a single scientific truth on each and every matter which lies ready to hand for use by politicians. Indeed, as has become apparent in very many commentaries and academic analyses there are different predictive models of what might happen, different accounts of how COVID-19 might be having the effects it is. (Are there, for instance, important cultural and social variables in its transmission and outcomes of infection?), different assumptions in play (can we really achieve ‘herd immunity’ through a certain level of infection in the population?), and so on. It is a characteristic of science that it needs to be properly analysed, contested and evaluated. We need to scrutinise whether it is accurate, adequate and well founded. We also need to know what we don’t know.

Second, any official strategy to deal with a pandemic rests not just on science but on moral values. Indeed, science and ethics are often inextricably connected. A recent comment in The Lancet noted of the predictive modelling of different possible measures of quarantine and social distancing that, however robust the scientific justification of the relevant predictions, each measure came with different social costs and varying consequences for different social groups. Ethics determines whether a strategy should be chosen because it seeks in simple utilitarian terms to secure the best overall aggregate balance of harms and costs. Or whether it rests on a belief that there are fundamental human rights that should never be sacrificed. Values inform a judgment of what is a proper or proportionate balancing of the loss of individual liberty and privacy for the gain of certain public goods; or whether it is fair to expect some social and age groups to suffer disproportionately in any public health initiative.

Perhaps this Government does not ‘do ethics’ – in the way perhaps that Alastair Campbell famously said on behalf of Tony Blair that ‘We don’t do God’. Which would be astonishing and at odds with the thoughtful, deliberated and explained policies of very many other countries. Or else it does but is not properly explaining how. Which would be an abandonment of its democratic obligations to justify its actions to us; and would in itself provide reason not to trust a Government.

Of course, values and ethical justifications are not – just as scientific claims are not – ready to hand and readily agreed. They can be various and contested. Yet, if we do not know what is in play we cannot challenge or debate them and perhaps find agreement. Of course, we might not agree. Democracies do not reach consensus on everything. Yet we need some degree of moral agreement. It is the responsibility of Government to take the lead in this. Those clinicians I have spoken to at the frontline are bewildered and frustrated by the plethora of ethical guidelines on offer. These were supposed to relieve them of the awful and anguished making of choices in isolation and uncertain of what might be right. Yet what we have are several sets of guidance that do not guide in respect of everything, and which doctors and nurses still have to be choose between.

It is not partisan politics to question or criticise Government policy. It would be reasonable to challenge any Government that asked for trust and failed to show exactly why it was trustworthy. There are instances where Government is right not to reveal everything – the intelligence that underlies its military strategy is a favoured example. Yet this pandemic is not, despite the liking of some for bellicose metaphors, a war. It is a dreadful virus whose containment and eventual cure demands a huge collective effort. The Government can trust us to make the effort, but it needs to more clearly demonstrate its trustworthiness in telling us why we should make it.