Hard Head, Soft Heart

Walking through Paris yesterday, I saw the following slogan daubed on a wall:

Coronavirus: Inequality Equals Comorbidity

I doubt that this was done by someone completely without education. Indeed, I would be prepared to place a small bet that, to the contrary, whoever did it had a university degree.

Nevertheless, what he wrote was not only inaccurate but inaccurate in a very significant way, insofar as it implied, and was intended to imply, that inequality was a factor that causes the illness occasioned by coronavirus.

Admirable Evasions: Ho... Theodore Dalrymple Best Price: $12.26 Buy New $13.35 (as of 11:00 EST - Details) It is true, of course, that the relatively poor in France, as elsewhere in the world, were more affected, and more severely affected, by it than the rich. There is nothing unusual in this: There are very few diseases, especially infectious, that strike the rich more and worse than the poor, and this is so even in countries that are rich overall.

But is the cause inequality in itself? It is, rather, the conditions in which the relatively poor live: overcrowding, poorer diet, dirtier work, and so forth. A society in which everyone was equal but lived in the conditions in which the poorest now live would not be healthier or better able to resist coronavirus than the society we actually have, rather the reverse. In other words, it would be as true to say that inequality is a precondition for health as it is to say that it is a comorbidity of coronavirus, both propositions being absurd and misleading.

The confusion is a common one. An analogous confusion is that between equity and equality, where by equality is meant equality of outcome. Medical journals are particularly prone to this confusion, or perhaps I should say (to be accurate) that I am particularly prone to notice it in them. A recent opinion piece in the Journal of the American Medical Association, written by an eminent black cardiologist in the wake of the Black Lives Matter movement, was only the latest to elide the two concepts. The Terror of Existenc... Kenneth Francis Best Price: $13.47 Buy New $14.96 (as of 03:14 EDT - Details)

Equity is the quality of fairness or justice (again, related concepts, but far from identical, it being unfair that I am not more handsome than I am, but not unjust). Equality is the identity of persons in some respect or other, and even where it is a reasonable aspiration, as in equality before the law, it is rarely fully accomplished in practice.

Furthermore, it is rarely acknowledged (though it is also perfectly obvious) that while equity and justice are desirable, they are not the only qualities that are desirable, and in some instances may actually be undesirable. We should always bear in mind Hamlet’s response to Polonius when the latter says that he will treat the actors who have come to Elsinore as well as they deserve: Use every man after his desert, and who should ’scape whipping? And if justice entails using every man after his desert, as surely it must, justice would require a universal whipping for Mankind, but few except evangelical sadomasochists would propose such an eventuality because it was in accordance with the dictates of justice.

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