BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n314 (Published 04 February 2021)
Cite this as: BMJ 2021;372:n314
Covid-19: Social murder, they wrote—elected, unaccountable, and unrepentant
Kamran Abbasi, executive editor
Murder is an emotive word. In law, it requires premeditation. Death must be deemed to be unlawful. How could “murder” apply to failures of a pandemic response? Perhaps it can’t, and never will, but it is worth considering. When politicians and experts say that they are willing to allow tens of thousands of premature deaths for the sake of population immunity or in the hope of propping up the economy, is that not premeditated and reckless indifference to human life? If policy failures lead to recurrent and mistimed lockdowns, who is responsible for the resulting non-covid excess deaths? When politicians wilfully neglect scientific advice, international and historical experience, and their own alarming statistics and modelling because to act goes against their political strategy or ideology, is that lawful? Is inaction, action?1 How big an omission is not acting immediately after the World Health Organization declared a public health emergency of international concern on 30 January 2020?
At the very least, covid-19 might be classified as “social murder,” as recently explained by two professors of criminology.2 The philosopher Friedrich Engels coined the phrase when describing the political and social power held by the ruling elite over the working classes in 19th century England. His argument was that the conditions created by privileged classes inevitably led to premature and “unnatural” death among the poorest classes.3 In The Road to Wigan Pier, George Orwell echoed these themes in describing the life and living conditions of working class people in England’s industrial north.4 Today, “social murder” may describe the lack of political attention to social determinants and inequities that exacerbate the pandemic. Michael Marmot argues that as we emerge from covid-19 we must build back fairer.5
A pandemic has implications both for the residents of a country and for the international community, so sovereign governments should arguably be held accountable to the international community for their actions and omissions on covid-19. Crimes against humanity, as adjudicated by the International Criminal Court, do not include public health.6 But David Scheffer, a former US ambassador for war crimes, suggests that we could broaden the application of public health malpractice “to account for the administration of public health during pandemics.”7 In that case, public health malpractice might become a crime against humanity, for leaders who intentionally unleash an infectious disease on their citizens or foreigners. Others have argued similarly for environmental crimes.8
If not murder or a crime against humanity, are we seeing involuntary manslaughter, misconduct in public office, or criminal negligence? Laws on political misconduct or negligence are complex and not designed to react to unprecedented events, but as more than two million people have died, we must not look on impotently as elected representatives around the world remain unaccountable and unrepentant. What standard should leaders be judged by? Is it the small number of deaths in countries such as New Zealand and Taiwan, or the harsher standard of zero excess deaths? Deaths do not come as single spies but as a battalion of bereaved families, shattered lives, long term illness, and economic ruin.
From the United States to India, from the United Kingdom to Brazil, people feel vulnerable and betrayed by the failure of their leaders. The over 400 000 deaths from covid-19 in the US, 250 000 in Brazil, 150 000 each in India and Mexico, and 100 000 in the UK comprise half of the world’s covid death toll—on the hands of only five nations.9 Donald Trump was a political determinant of health who damaged scientific institutions.10 He suffered electoral defeat, but does Trump remain accountable now that he is out of office? Bolsonaro, Modi, and Johnson have had their competence questioned in differing ways, and McKee and colleagues argue that populist leaders have undermined pandemic responses.11 The prospect of accountability in autocracies such as China and Russia is more distant still and relies on strong international institutions and the bravery of citizens.
The “social murder” of populations is more than a relic of a bygone age. It is very real today, exposed and magnified by covid-19. It cannot be ignored or spun away. Politicians must be held to account by legal and electoral means, indeed by any national and international constitutional means necessary. State failures that led us to two million deaths are “actions” and “inactions” that should shame us all.
DELUSIONAL NEW ENGLAND JOURNAL OF MEDICINE GOES FULL POLITICAL & FASCIST – CALLS FOR TRUMP TO BE VOTED OUT & PRAISES CHINA'S LOCKDOWN'S AS 'EFFECTIVE" https://t.co/Rc4ampWdmQ
— Marc Morano (@ClimateDepot) October 8, 2020
NEJM: "China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay. These measures were severe but effective"
Morano Response: Locking people in their homes in dramatic fashion while being filmed for drama is not "effective."
— Marc Morano (@ClimateDepot) October 8, 2020