Is it ok to visit someone in need during COVID-19?

You’ve been hitting us up with your COVID-19 ethical questions. We’ve been sending our ethicists into the philosophy lab to cook up some answers.

This week, we’re talking about trade-offs. How do we the balance risks and potential harms from our behaviours against the value they might have?

I have family members who are at high-risk from COVID-19 but who are also at risk of mental stress from isolation, what should I prioritise – their physical safety or their psychological wellbeing?

When I was teaching medical students (about ethics, nobody wants me teaching them science), I was often relieved to find an openness to considering the holistic needs of the patient. They weren’t interested in healing the body at the expense of the mind. This was thanks in part to something called the ‘biopsychosocial model of health’, which basically suggests that we need to think of health at the intersection of the physical body, the mind and the environment we find ourselves in.

What this model reminds us of is that we don’t make trades between mental and physical health – those terms are somewhat of a misnomer. There aren’t different kinds of health; there’s just health. Someone who is suffering from a virus isn’t enjoying a healthy life; nor is someone whose depression is worsening as a result of isolation.

Think about it this way: if your family members were diabetic and needed to go to the pharmacy to fill their insulin prescription, you wouldn’t advise them not to go because they were high risk of COVID-19; because that’s not the only thing that’s going to set back their health. I’m not convinced you should think about their health any differently because the problem is mental rather than physical.

That said, it’s important to bear in mind that you should still do what you can to minimise the risk to your family members – not least because they may not be the only ones who are at increased risk of infection if you choose to visit. Again, think of the diabetes analogy. It would be unreasonable to tell them not to go to the pharmacy for fear of COVID-19, but it would be safer if someone who wasn’t high risk collected their prescription on their behalf.

By the same logic, if there are ways you can alleviate their sense of loneliness and isolation without increasing their risk, then you should do those things. You might not have to choose between minimising the risk of infection and helping a lonely family member at a time when loneliness is rife. But if you can’t, it’s helpful to remember that you’re dealing with risky options either way.

I’m struggling to decide whether I should visit my two loved ones in their aged care facilities right now. Do I leave them and trust they will get the correct care if the outbreak spreads or ‘check in’ and visit them?

Ever heard the story of the two wolves? It’s an old proverb. A Native American elder explains to a young man that there are two wolves inside us all. One represents the lesser demons of our nature, and the other the better angels. The wolves are in constant battle with one another to determine the kind of person we’ll be. ‘Which wolf wins?’, asks the young man. The elder responds, ‘the one you feed.’

In times of enormous stress and uncertainty, the two wolves duking it out inside us tend to be our attitudes toward control. One wolf screams ‘Jesus take the wheel!’ and surrenders all sense of agency – throwing in the towel and hoping for the best, taking no responsibility for the future. The other wolf cries, ‘let me drive!’ and tries to manage every possible variable to secure a half-decent outcome. And, just like the story goes, the wolf we feed – the one we reinforce through behaviour and habit – is the one that will win out.

The reason I share the story of the wolves with you is because your concern for loved ones doesn’t seem to be primarily about giving them social connection or making sure they’re not lonely. Rather, your question suggests what’s bothering you most is whether the carers will do a good job without you to check in. That kind of distrust is likely the product of one of two things: reason or anxiety.

Do you have reasons why you suspect the care for your loved ones will languish in your absence? If so, I can only imagine how heart-wrenching it must be to stay away at a time like this. However, if you’ve generally had good experiences and haven’t had any reason to distrust the staff until now, it’s worth reflecting on whether your inner micro-managerial wolf needs some time off to meditate.

I mean that sincerely – most of us need to meditate during this pandemic – to get clarity on how we manage uncertainty. Do we have trouble accepting our lack of control? Are we too lackadaisical or passive when shit hits the fan?

The truth is, I can’t answer the question of whether you should check in on your family – and in doing so expose them and everyone else at those aged care facilities – because I don’t know if you’ve got good reasons for concern. But let me plead with you on behalf of every person who has loved ones in aged care: if you’re doing this because you’re anxious and scared, please stay at home. We’re all scared for our loved ones, but hopefully you can see that resolving that fear by exposing the people you love to risk is as pointless as howling at the moon.

You can contact The Ethics Centre about any of the issues discussed in this article. We offer free counselling for individuals via Ethi-call; professional fee-for-service consulting, leadership and development services; and as a non-profit charity we rely heavily on donations to continue our work, which can be made via our website. Thank you.