In the middle of the largest public health crisis in living memory, it is a curious situation to find a Minister for Health closing a vaccination centre. But there was little if any protest when Stephen Donnelly suspended operations at the Beacon Hospital in south Dublin last week.
This situation arose, of course, because the hospital had administered twenty vaccinations to teachers and staff at the fee-paying school, St Gerard’s. These doses were described as “leftover”. St Gerard’s is located across the county line, in Bray, Co. Wicklow, 12 kilometres from the Beacon. There is a primary school – Queen of Angels – 450 metres from the hospital complex, raising the obvious question of why the offer of leftover vaccines was not extended to this school?
Many have concluded that the reason these vaccines were administered to teachers in the distant secondary school is that this is where the children of the Beacon hospital’s chief executive, Michael Cullen, attend. He explained that the decision “was made under time pressure and with a view to ensuring that the vaccine did not go to waste”. The Minister for Health responded by declaring this “such a slap in the face to so many people”. The idea of “leftover” vaccines has even been disputed, since each vial has to be prepared in such a conscious fashion that a rolling schedule is typically implemented in relation to the daily expectation of patients. It is hard not to see this as a profound failure.
Distraction from vaccine roll-out
Of course, before we rush to moral condemnation, we should recognise that it is very convenient for the Department of Health to have Joe Duffy’s listeners inchoate with rage about this incident instead of calmly assessing the strengths and weaknesses of our how we have organised the vaccine roll-out in general. And while people who willingly skip the queue for vaccines display an egregious disregard for very basic concepts of solidarity, it seems that happens about one in every thousand cases. If the goal is to get as many vaccines into as many arms as possible in as short a time as possible, this sort of incident might seem trivial in the long-run. (Although I suspect the Principal of the school in question will have quite the morale problem long into the future as those who did not get the vaccine will wonder why…)
To grant these qualifications does not mean letting the Beacon or Michael Cullen off the hook. Calibrating our perspective should sharpen our ethical position, not diminish it.
Should the strong support the weak?
When people are asked to zone in on what exactly enrages them about this incident, the terms get vague and fuzzy. “Fairness” seems to be the phrase people land on, which seems like too weak a term to warrant shutting down a vaccination centre that was able to inoculate a thousand people a day. But our verbal imprecision doesn’t suggest that ethics don’t matter and we should just ignore this violation. Rather, it testifies to how hard it is to think seriously about ethics when we are trained to think in purely utilitarian terms. There is more to life than cost/benefit analyses and the fury that people feel about cases like this is sourced in that foundational moral insight. Some things are too valuable to have a price. Ensuring that those who need the vaccine most get it first is one of those concepts.
People are angered by this case because people still believe that it is the responsibility of the strong to support the weak.
And in this instance, when a very rich man who runs a private hospital exploited access to precious vaccines to ensure a slightly easier time for his children at a private school, the strong are found to be supporting the strong.
It is worth noting – if only in passing – that the only justifications that can be marshalled to support this action are utilitarian. Maximising the greatest good for the greatest number – which is the utility function that gives utilitarians their name – almost by definition involves exclusion. There will always be individuals who are not included in the statistical calculation of maximal effect. I will leave it to the reader to reflect on whether this poses a fundamental tension, barely acknowledged in contemporary discourse, between our desire for inclusive justice and our reliance on such thinking.
History of Irish ‘friendly’ corruption
But one way to think about this case which offers more precision and potency than talking about “fairness” is to classify this as corruption and to understand that in Ireland, corruption is always an expression of disordered community. Think of all the recent financial controversies and how the same names keep appearing, as if the population of Ireland was reduced to the size of a small village. Think of Bertie’s dig-out and the Maple 10 that sought to rescue Anglo Irish Bank from Sean Quinn’s collapse. Think of how Michael Fingleton and Seán FitzPatrick colluded on loan warehousing. Think of how Alan Dukes, who oversaw a bailout of AIB in 1985 became a director of Anglo Irish after nationalisation. Think about how Denis O’Brien profited from Michael Lowry’s corruption and was then decisive in the media market that was responsible for uncovering the truth in the aftermath of the global financial crisis. Corruption in Ireland almost always rests on a foundation of real friendship. The people who helped Bertie were his friends. Fingleton and FitzPatrick are friends. Seán Quinn is certainly no longer pals with the people he used to do business with, but the public rallies in his support in Ballyconnell were attended by prominent people who were similarly at his side.
It is not just that Michael Cullen served himself when he was charged with serving others. It is that corruption in this culture habitually takes the form of a convivial elite supporting and reinforcing the privilege and benefits that come from already being wealthy. It may be the case that the teaching is better at a fee-paying school. I wouldn’t know. But the reason we are tempted to send our kids there is nothing to do with pure pedagogy and everything to do with enmeshing them in the social circles that equate with advancement.
This is the unfairness that inspires such anger and that means that people are not upset to see a vaccination centre shuttered. This is not a productive decision when assessed in terms of cost and benefit. But it is significant as a declaration that there are things more important than productivity.
Solidarity of Irish society
In his timely encyclical Fratelli Tutti, published last Autumn, Francis calls us to serve what he calls social friendship. This is the stance that we as individuals can take towards the wider society that serves the common good, by recognising that the gifts that we have received – status, wealth, position, authority, energy, etcetera – are meant to be shared on, gifted to others. Francis argues, “only by cultivating this way of relating to one another will we make possible a social friendship that excludes no one” (Fratelli Tutti §94).
The corruption at the Beacon vaccination centre reminds Irish people that even for all our talk about justice and inclusion, there are realms and rights that are afforded to people of means and kept from everyone else. This isn’t fair. It is corrupt. It is a form of friendship that has been perverted so that goods we can only really enjoy when we share them in common are stolen for individual gain. The rage is not pointless. It is a reminder that Irish society has a moral sense and a commitment to solidarity, however imperfectly we implement it.