We will learn to live this way!!

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We will learn to live this way!!:

With the inception of this pandemic, the perception of living has changed and with it, the world. While the entire world has faced lockdown in one way or the other, the intensity with which life has been affected is not the same to all. Considering the affluent people of developed countries, this might not be as troublesome as to those who belonged to Low Middle Income Countries like ours as we don’t have enough back-ups for extreme conditions like this, especially to those who run their lives on daily wages. And what about the people in this country who were not even ready for this disastrous state of three months long physical, emotional, socio-economic and mental instabilities. We might have seen curfews and national level strikes in the past which limited our activity and affected our living in some ways but the duration for which we faced those, didn’t produce the same level of frustration as the present pandemic has done to us. 

We-will-learn-to-live-this-way!!

Most importantly the skills of handling the bioethical issues, which are learnt over the years with experiences, have been the major problem in the recent times. The disease and its management is not something to worry about, that will be under control with proper medical trials and better guidelines to the health care system. But what about the bioethical issues which not only affect a person alone but others around too, both emotionally and spiritually. We cannot run away from the ethical and practical dilemmas that the people are facing; social stigmas and discriminations that have affected our daily living for a very long time. More concerning issue is that these challenging topics are the least advocated.

Though medical profession has been a backbone in fighting this battle with the COVID-19 bug, this pandemic has raised a lot of thorny medico-legal ethical dilemmas. Bioethics has become much more relevant than ever in the present times, since handling these issues is urgent and heart-wrenching. The scarcities of resources like ventilators, personal protective equipment, etc. and lack of proper guidelines on how to manage other diseases along with COVID-19 has mostly affected the practice and judgment of most of the medicos. Where one patient is dying in need of a ventilator but you are ordered from the higher authorities not to admit new patients as a reserve facility for the suspected COVID cases. Who should get a ventilator if we do not have enough of those? How can we protect the most vulnerable (especially the young children and disabled or elderly people) from discrimination in the face of difficult triage decisions? How should we balance our need for surveillance with considerations of privacy? How do we weigh individual liberty against the public interest of keeping people confined? There are many such issues which need answers, but the interesting thing is we are going to get different answers from different places. And here comes the need of a proper governing ethical body.

Besides patient’s care, the medical professionals have been mentally traumatized with the fear of health and safety of their families and the loved ones. Personal difficulties dealt by these medical professionals will remain the same as they will be haunted in a similar manner till this pandemic sees an end. But the additional difficulties their landlords have put on them, have made working much more difficult as they have already compromised so much on personal protection. A mother nurse is deprived of meeting her 3 months old child and a pregnant doctor is still in charge of the services where she herself is reaching her date of delivery. Who is accountable for managing their present status? Should they leave the patient care and be accountable to their families or to the general people? Who will decide that?

Likewise the general people too have their personal dilemmas to deal with. For landlords whose only source of earning life is the income they generate through the rents, should they listen to the government’s directions on not charging rents during this period of crisis or accept the acquisitions of being inhumane or callous from the people around? Similarly the scenario is as haunting to the tenants as they don’t have a job right now but cannot delay the rents to their landlords as they demand it anyway. So is the case with locked out restaurants, hotels, shopping complexes, etc. Had it not been a problem then a couple from Butwal would not have ended their life together due to the economic crisis that they were going through when their entire business in the city crashed and drowned them in debts. 

Similarly for a culturally diverse nation like Nepal, where rituals and traditions are almost a part of their daily life, inviting some relatives while leaving out the other just as to maintain social distancing is itself a dilemma. What about the elder sister in Chitwan who missed her younger sister’s wedding in Rasuwa just because of lockdown? What about the lady who died of corona following the delivering of her baby in Kavre? Her family could not arrange a proper funeral for her just because she was a COVID-19 positive case. Similar is the case with those who attended the Tablighi Jamaat in Delhi? Had they return to their nation or pull them back just because they might be a risk to the people in their country? Every single person is traumatized in one way or the other as their lives are not normal anymore. And the problem is who is going to decide what is wrong and what is right.     

So will life after the lockdown become normal? To be more precise, lockdown and post lockdown living is the new normal the people will have to live anyway. The bioethical issues will become more challenging and the people will face more problems following the immediate lockdown release. The fear of pandemic will still haunt them. The economic crisis will most probably take some time to settle. So in such a situation, coping with these issues won’t be individual anymore, but will need a collective effort that connects people globally, not just within the country. The post lockdown health care system needs to be more coherent, equitable and transparent. Likewise isolated autonomous decision making and policies should be stepped back while the entire focus should be upon understanding each person collectively on a cultural and social basis. The idea seems colossal and conceptually daunting but post pandemic ethics should embrace the challenges raised by justice in a global context emphasizing transparency, trust, solidarity and compassion as leading norms. 

“Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks, and dead ideas, our dead rivers, and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.”                      – Arundhati Roy

Sagar Panthi

BPKIHS, Dharan, Nepal.

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