Updated: Jul 23, 2021
By: Shamantha Lora, MSc (Candidate), HBSc
Shamantha Jahan Lora, a 2020 candidate for MSc in Medical Sciences at the University of Toronto, received an HBSc from the University of Toronto.
As an advocate of medical ethics, racial equality and justice; the COVID-19 crisis in Toronto called for moral scrutiny in the policies which shape the pandemic future. The conception of this article was inspired by grassroots movements that demand transformational change. The city of Toronto raised and educated me into what it means to be a part of a diverse community. Yet, examples of racial injustice and pervasive prejudice continue to haunt North American societies. What makes matters worse, is that pandemic risks heighten and contribute to disproportionate disease burden to marginalized communities.
Pandemic policy and implementation of public health strategies can be found crossing both domains of public health and social justice. SARS-CoV-2 revealed many instances of structural racism that affects our communities. The intention is to spark a dialogue within the scientific community regarding the role of enforcement in carrying out public health policies.
As we persist in a dystopian world, we continue to experience rising fear and uncertainty. The COVID-19 pandemic has posed novel ethical quandaries for the government and health officials. The Institute of Medicine iterates that the crisis standard of care should be based on the ethical principles of fairness, duty to care, transparency, consistency, proportionality and accountability. While researchers around the world are striving to create a vaccine, public health experts look towards non-pharmaceutical interventions as a response for disease containment, urging countries to practice social distancing.
Although public health officials have identified social separation as a method to combat the pandemic, many legislative bodies view it as an ineffective policy without the assistance of institutions such as the police to enforce strict guidelines. However, enforcing monetary punishments has been unfair and ineffective. People are more resistant to complying with these laws when it’s apparent that institutions employ undemocratic and unjust methods of enforcement. Instead, legislative bodies that have adopted evidence-based pro-public health conduct combined with educational and social support have been successful in reducing transmission. Additionally, the intergenerational egoism that exists within the police force coupled with institutional discriminatory enforcement has exacerbated the public health crisis for marginalized communities and has limited that community’s access to educational support programs.
In countries such as Italy, China and Canada, individuals have been charged for COVID-19 related violations. An interactive mapping project that shared and documented information across Canada regarding police intervention related to COVID-19 counted a total of 4575 people fined within the month of April. These tickets were as high as $2000 in Saskatchewan, $1546 in Quebec, and $880 in Ontario. This online platform drew attention to provinces such as British Columbia that have not initiated police enforcement and fining yet were the first to flatten the curve using proper educational messaging.
Within weeks, the evident shift from education to enforcement had taken place in Ottawa, Montreal and Toronto. However, compliance with public health strategies and gaining public trust can be derived from educational approaches rather than coercive fines. By using government resources to advise the public on potential risks, evidence based practices and research that justifies public health officials’ guidelines such as social distancing, marginalized communities are then empowered to make informed decisions regarding their health.
To identify the balance between optimizing public health outcomes and protecting human rights and freedom, it's crucial to consider the principles of reciprocity, and justice when assessing how law enforcement fit into this process. First, disciplinary actions can be morally justified by the principle of non-maleficence or 'do no harm'. In other words, public health authorities and policy makers claim to implement restrictive means and sanctions to prevent harm in the name of public health, yet trends of highly racialized, gendered and classed enforcement continue to emerge in the context of COVID-19 disease control.
Consider the unequal infection rates within the community when combining demographic characteristics and variation in socioeconomic conditions of recent immigrants, LGBTQ2S, older populations in long term care facilities, those in precarious housing who are forced to share temporary space, migrant farm workers, students living in crowded apartments. These marginalized communities are disproportionately composed of Black, Indigenous, and other racialized minorities who are in considerable need for public health support as opposed to law enforcement and fines.
Vulnerable populations that are disproportionately impacted by punitive enforcement measures also include individuals who are suffering from mental health challenges during COVID-19. The police-involved death of Ejaz Choudry, a 62-year-old schizophrenic individual shot by Ontario’s police during a plea for assistance with a mental health crisis, exemplifies the ineffective approach of police intervention. Prejudiced enforcement, especially against marginalized communities, can be misused as a tool to instill fear in certain communities rather than as a means to protect the overall public health.
In another case, 8 homeless youth in Montreal were each fined $1546 when found grouped together as the resources which served to accommodate them were closed at the declaration of the state of health emergency. In Toronto, homeless individuals were fined with $880 tickets for sitting on public benches. A point that is often neglected is that ineffective methods of disease control, like unjust policing, can cause more harm than the virus itself. What seems illogical is to have consequences that can lead to more people imprisoned in overcrowded jails leaving them at a higher risk of exposure to a communicable disease. Pandemic police power can encourage discrimination towards marginalized and Indigenous communities, creating an atmosphere of mistrust, which only serves to drive people away from healthcare. This ultimately leads to a detrimental trend of underreporting, higher mortality rates for minority groups and racial disproportionality.
At a time where many questions remain unanswered, social distancing can become a powerful precautionary tool in restricting spread of disease. This being said, policing can be a violent institution with systemic power that is not designed to handle public health crises.
The distinction between a public health recommendation and a legal requirement needs to be made. A public health crisis is not a criminal justice problem, and we shouldn’t approach it as such. Instead, legislative bodies should take a robust approach to tackle this public health crisis, by demonstrating a long-term commitment to education and pro-public support where the police can be perceived as an accessible institution for help rather than a threat.
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Dystopian:Relating to or denoting an imagined state or society where there is great suffering or injustice.
Quandaries: States of perplexity or uncertainty over what to do in a difficult situations.
Incubation period: The period between exposure to an infection and the appearance of the first symptoms.
Egoism: An ethical theory that treats self-interest as the foundation of morality.