- © 2007 Canadian Medical Association or its licensors
You probably don't think of trust as a matter of public health. But for political philosopher Francis Fukuyama, “a nation's well-being, as well as its ability to compete, is conditioned by a single, pervasive characteristic: the level of trust inherent in the society.”
In his 1995 book, Trust: The Social Virtues and the Creation of Prosperity, Fukuyama defines this societal trust as the expectation among members of a community that others can generally be relied upon to act in a generally honest and cooperative manner to maintain an orderly society. “That is, we trust a doctor not to do us deliberate injury because we expect him or her to live by the Hippocratic Oath and the standards of the medical profession.”
Our capacity for trust is rooted in the values we share. It is an ominous sign of declining trust when a significant number of individuals appear to have lost their sense of social responsibility.
Consider the case of the American lawyer, Andrew Speaker, who touched off an international health scandal this summer. Speaker, 31, a property rights lawyer from Atlanta, Georgia, was diagnosed in May with multidrug-resistant tuberculosis. Doctors told him he shouldn't travel because he posed a risk to others. However, even before he formally received the results of his tests, Speaker flew to Greece to get married.
The Center for Disease Control in Atlanta tracked him to Rome. He was told to check into a hospital and informed he'd been placed on a no-fly list. Speaker, however, flew with his wife to Montréal, rented a car and drove to the United States. Three days later, he contacted health authorities.
Canadian officials later said they were never informed of Speaker's no-fly status. Greek and Italian officials said they hadn't been informed in time to act.
The naïveté of health officials in trusting someone in Speaker's condition in an era when a person with an infectious disease can fly around the world in hours is certainly disconcerting.
But more troubling than institutional incompetence is that an educated professional would act so irresponsibly. To be sure, Speaker apologized, sort of. “I'm very sorry for any grief or pain that I have caused anyone,” he said in a television interview. “I really believed that I wasn't putting people at risk.”
The regret rings hollow. As a lawyer, Speaker wouldn't hesitate to sue anyone who justified harmful behaviour on the basis of personal belief. Furthermore, the apology's phrasing implies that he's sorry for any grief or pain his actions caused, not for the act itself.
Speaker's actions betray a narcissism that is all too common nowadays. Indeed, in part because of the politically corrected weakness of our judicial and political institutions, symptoms of social irresponsibility are spreading — everything from violence-prone panhandlers in Vancouver to street-side drug dealing in Winnipeg and graffiti vandals in Ottawa. But you might also recall that during the SARS outbreak in 2003, people under quarantine blithely left their homes to do errands or grab a quick meal without, as it seems, thinking of the danger they presented to others.
People who behave in this way appear to have no grasp of transcendent moral principles against which they judge their behaviour. Indeed, concepts of right or wrong seem foreign to them. What concerns these people, morally speaking, is whether they can get away with what they will. If they aren't caught, they assume they haven't done anything wrong. Such an attitude reduces morality to an egocentric calculus. Social responsibility doesn't enter into the equation.
Every society, as sociologist Philip Rieff wrote in his 1973 book, Fellow Teachers, involves a dialectic between what is permitted and what is prohibited. A healthy society balances freedom and duty, permissiveness and restriction. Extreme freedom becomes self-indulgence. This leads to disorder. Or, as Rieff succinctly states: “Behind the hippies are the thugs.”
Avoiding disorder, of course, requires a system of formal rules and regulations. The law substitutes for trust. Cooperation requires coercion.
Thus, the breakdown in trust can produce a kind of soft authoritarianism. And that is where we are heading as a society if we continue to indulge those who assume their “rights” take precedence over social obligations.
Footnotes
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Robert Sibley is a senior writer for the Ottawa Citizen.
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