Approaches to COVID-19: bioethics, empathy and the Spinozian perspective

Abstract

COVID-19 is a sanitary and humanitarian crisis featured among the greatest pandemics humanity has ever known. This article highlights its syndemic character, taken on by encountering populations with greater economic, social, and environmental vulnerability. Before such contexts, the essay proposes an ontological reflection about the human being and how moral enhancement can facilitate empathetic dialogues that generate national and international solidary solutions during pandemic crises. For this purpose, it draws upon the concepts of syndemic, bioethics, ontology, moral enhancement, facilitator, dialogue, dialectics, empathy, conatus , affections, appetite, desire, and continuum and their potential for reducing harm during COVID-19. Finally, this paper will conclude with a brief discussion based on Spinoza’s rationalist perspective.

COVID-19; Syndemic; Bioethics; Empathy

Resumo

A covid-19 é uma crise sanitária e humanitária inscrita entre as maiores pandemias que a humanidade já conheceu. Este artigo destaca o caráter de sindemia que essa pandemia assumiu ao encontrar populações com maior vulnerabilidade econômica, social e ambiental. Diante desses contextos, intenta-se refletir, ontologicamente, sobre o ser humano e como o aprimoramento moral pode tornar-se um processo facilitador de diálogos empáticos, que gerem soluções solidárias nacionais e transnacionais durante crises pandêmicas. Serão considerados os conceitos de sindemia, bioética, ontologia, aprimoramento moral, processo facilitador, diálogo, dialética, empatia, conatus , afetos, apetite, desejo e continuum e suas potencialidades para reduzir danos durante a pandemia de covid-19. Por fim, este trabalho será concluído com um breve olhar a partir da perspectiva racionalista de Spinoza.

Covid-19; Sindemia; Bioética; Empatia

Resumen

La COVID-19 es una crisis sanitaria y humanitaria que está entre las más grandes pandemias que afectó la humanidad. Este artículo destaca la sindemia que asumió esta pandemia al encontrar poblaciones más vulnerables económica, social y ambientalmente. En este contexto, se pretende reflexionar, ontológicamente, sobre el ser humano y cómo la superación moral puede convertirse en un proceso facilitador de diálogos empáticos, que genera soluciones solidarias nacionales y transnacionales durante las crisis pandémicas. Se consideran los conceptos de sindemia, bioética, ontología, superación moral, proceso facilitador, diálogo, dialéctica, empatía, conatus , afectos, apetito, deseo y continuum y su potencial para reducir los daños durante la pandemia de la COVID-19. Por último, se harán breves consideraciones finales desde la perspectiva racionalista de Spinoza.

COVID-19; Sindémico; Bioética; Empatía

In 2019, humankind was stricken by a new pandemic, COVID-19. Previous experiences of the kind had included, among others, smallpox, plague, cholera, tuberculosis, Spanish flu, typhus, HIV/AIDS and swine flu (H1N1).

The spread of infectious diseases can occur in different ways: outbreak (unusual and sudden increase in cases of a disease in an area or in a specific group of people and at a certain time); endemic disease (continuous presence of a disease or infectious agent in a geographic area); epidemic (situation in which a disease affects a large number of people in a large geographic area)¹ ; and pandemic (a large epidemic, which spreads across several countries, in more than one continent)² .

In the 1990s, the American medical anthropologist Merrill Singer³ coined the word “syndemic” to explain how the interaction of two or more diseases causes greater damage than their simple sum in contexts of greater economic, social and environmental vulnerability or susceptibility, thus requiring a healthcare model focused on a biopsychosocial approach. This article will draw on the concept of syndemic to address COVID-19.

Understanding the impacts of a syndemic on different populations and individuals requires identifying the agents that may cause, enable, mitigate and/or prevent suffering; patients, who are susceptible or vulnerable; the moral framework of the ethos of moral agents and patients, from an ontological perspective, interpreting the health crisis and the empathetic and dialogic competence of the former towards the latter; the affects that can be harnessed for the moral enhancement of individuals and groups; and the facilitating processes of the continuum⁴ that exists in these biopsychosocial relationships.

In this sense, conceptualizing and reflecting on the structuring terms/words used in the argumentation of this article is key to understanding what underlies the morality of the practices adopted in the context of syndemics, with the aim of employing bioethics tools to support choices and decision making.

Bioethics

A “toolbox” to address syndemics

Etymologically, bioethics can be understood as “ethics of life” or “ethics about life”⁵ . Therefore, it can be viewed as an ethic that stems from life, enhancing the possibilities and powers of the human way of life. On the other hand, there is also an ethic that imposes itself on life, which reveals to what extent life can be undermined and/or constrained when subjected to biopolitics and biopower devices.

Indeed, it is not uncommon for nation-states, through their political representatives and corporations of business, financial and technological capitalism, to put their specific interests above common needs, whether of humankind or of populations and their specific macro- and micro-groups.

The World Health Organization (WHO) has insisted on the idea that vaccines against COVID-19 are a global public good. Thus, their distribution and administration must be free from any practice of destination or privileged access that admits, implicitly or explicitly, the discrimination of their recipients by criteria such as nation, ethnicity, national development status, economic, financial, political or technological power or any parameter other than the actual condition of humanity, intrinsic to each individual and population group.

This stance adopted by the WHO is aligned with the meaning of bioethics as “ethics of life,” in an attitude of resistance to the biopower devices governed by the biopolitics of states, regional geopolitical blocs and economic and financial interests of the research and pharmaceutical industry—producer of vaccines and active pharmaceutical ingredients (API)—or of state political and ideological positions.

In addition to its two-fold concept—ethics of/about life—bioethics can and should be acknowledged, in its epistemic sense, as a powerful “toolbox” of analysis, resistance, normalization, regulation, intervention, protection and harmonization⁶ .

As a tool of analysis, bioethics can be used to understand the context of morality (concerning positive and negative moral aspects) and the discourses and their enunciations (or units of communication/interaction between individuals) during a syndemic. Thus, it decomposes, that is, it deconstructs—which is not synonymous with destroy—the dialectic present in openly stated discourses and those that are unvocalized but implicit in actions, according to Derrida’s practice, which, operating through the deconstruction of discourse, identifies the restrictions to dialogue, concealed and disguised within it.

As with literature, philosophy can also both expose or unveil and disguise or delude, under the opalescent effect of a veil, that which constitutes the essence of thought. As expressed by Derrida in Plato’s Pharmacy:

A text is not a text unless it hides, from the first glance, at the first encounter, the law of its composition and the rules of its game. A text remains, moreover, forever imperceptible. The law and the rules do not hide in the inaccessibility of a secret; they simply never surrender, in the present, to anything that can rigorously be named a perception.

With the risk of, always and in essence, thus being lost definitively. Who will ever know about such a disappearance?

The dissimulation of the woven texture can, in any case, take ages to undo its web. A web that envelops a web, undoing the web for centuries. Reconstructing it also as an organism. Indefinitely regenerating its own tissue behind the cutting trace, the decision of each reading⁷ .

This is one of the tasks of bioethics as a tool of analysis: to deconstruct and then reconstruct the discourse in order to analytically decipher it, bringing to the surface the different senses and meanings contained at the heart of the interrelationships and disputes in any context—including during syndemics such as COVID-19—and guiding the distribution of health resources during global crises.

Bioethics, by taking on the role of a tool of resistance, is able to identify, in the relationship between individuals, groups of individuals, nation-states, regional blocs, multilateral international organizations (such as the WHO) and intranational social groups and transnational economic and financial institutions, the forms of biopower that drive and make them biopolitical. Thus, it is able oppose them with resistive and antagonistic power when simple resistance is not enough, according to the configuration proposed by Negri and Hard⁸ , who interpret biopower as the resistive power of the multitude, and, therefore, a form of opposition to biopolitics.

As can be seen, the ethical management of resources in contexts of global crises, such as those of syndemics, clashes with the need to resort to bioethics as a tool of normalization and regulation.

In adopting the Kantian principle of doing one’s duty—often criticized but sometimes pragmatically necessary or inescapable—the difficulty of human nature to spontaneously do what is good and fair for everyone justifies the use of deontological ethics to design health and humanitarian contingency strategies. The aim is thus to introduce the concept of equity in the management of resources and policies that are indispensable to morally oriented distributive justice, seeking to produce a normalizing, normative and regulatory framework in which desirable behaviors (universally fair) are converted into actual practices (pragmatic actions)⁹ .

In this case, the concept of normalization, eschewing the commonsense perspective of comparison between what is supposedly normal (ranging between maximum and minimum acceptable limits) and pathological (outside those acceptable limits, above or below), introduces into the debate the meaning assigned to the term “normal” as a benchmark for what can be admitted as universally applicable.

This term can be understood as everything that most of those involved wish to be provided with according to a moral and/or well-being rule. It is about the triple validity or moral applicability of a thought or action, regardless of whether the individual is in the position of moral agent or patient, or even in a neutral situation. The pragmatism resulting from this culture of normality is consistent with the ethical sense, typical of moral perfectionism.

From the recognition of what has been defined as normal, one moves on to the establishment of normative, tangible and clear frameworks and principles in the form of enunciations that will guide the policies and governance responsible for determining the distribution of available resources, since a human disposition for injustice requires rules to protect those who are more susceptible and vulnerable.

Even with a sense of ethical normality and normative enunciations, regulatory supervision is still essential: practical measures need to be monitored, quantified and qualified, that is, regulated.

These processes of normalization and regulation lead to a combination of moral perfectionism and skepticism in which, rather than antagonistic, these two “isms” become symbiotic.

The Universal Declaration on Bioethics and Human Rights , in Article 2, f, addresses the imperative of promoting equitable access to medical, scientific and technological developments [including vaccines] as well as the greatest possible flow and the rapid sharing of knowledge concerning those developments and the sharing of benefits, with particular attention to the needs of developing countries ¹⁰ .

This goal suggests the potential use of bioethics as a tool of intervention guided by justice. This bioethics proposed by Garrafa¹¹ makes it possible to intervene in vulnerable contexts marked by social, political and economic imbalances—such as North-South international relations, characterized by income concentration, lack of equity in access to health, education, clean water and sanitation, healthy housing conditions, etc., with a pro-North skew.

By reconciling utilitarianism (providing the greatest possible well-being to the greatest possible number of individuals), consequentialism (implementing measures that result in the best possible collective consequences) and solidarity—albeit to the detriment of certain individual situations—intervention bioethics contributes to the adoption of fairer distributive measures¹¹ .

Bioethics sometimes functions as an ethics of life, as an instrument of protection of susceptible and/or vulnerable individuals or populations. Bioethics of protection, conceived in a South American context, is inspired by the etymological origin of the Greek word ethos , which implies shelter or protection for the wounded and stricken, individuals who were victims of processes of affectation, injury and exclusion stemming from globalization¹² .

Bioethics can also become an instrument of social harmonization based on empathetic relationships. The word “harmonization” derives from “harmony” (well-ordered arrangement between the parts of a whole; concord). Hence, it is inferred that harmonization constitutes a number of actions that comprise a process, intended to culminate in peace or a satisfactory resolution of tensions and conflicts, as long as they are perceived as such by the individuals involved. It therefore implies compatibility, conciliation, combination, agreement and renegotiation (if necessary), as a result of the active participation of the actors involved, immersed in a continuum of sequential and uninterrupted events⁶ , ¹³ .

Harmony becomes possible by bringing closer those who are different and their prima facie interests—justifiable but non-convergent and potentially antithetical, especially when subjected to a “universal normalization,” according to the aforementioned concept of normal (which is reciprocally admitted by agents, patients or neutral individuals).

The origin of the term “empathy” justifies its status as guarantor of the harmonization process, as Schramm clearly explains:

(…) The term “empathy” (from Greek εμπαθεια) generally denotes the emotional union or merging with other beings or objects (considered animate) or, more specifically, the ability to understand the feelings of others, regardless of sharing their experiences and beliefs (…)

Indeed, we can only experience empathy with someone who is different from us, who is not assimilable to us; with someone who is transcendent to us, but with whom we wish to establish some form of dialogue, a seemingly impossible thing outside a dialectical logic capable of integrating the contradiction in order to overcome it. Empathy, therefore, is based on the impossibility of putting oneself in the other’s place and results merely from the ability to live our own experiences with other subjectivities, with other communities and with society as a whole¹⁴ .

Without empathy there is no productive or successful dialogue between singularities. The result is stark divide rather than the closeness that is indispensable to a fair solution for the ethical sharing of resources.

Ontology

Understanding the human essence

Philosophy, whose strict meaning is love of wisdom ¹⁵ , and bioethics, defined by Potter¹⁶ as a bridge between biological sciences and human and social sciences, are also dedicated to the knowledge and study of the nature of “being”—that is, to ontology, understood as the branch of metaphysics that concerns what exists ¹⁷ .

Ontology is a compound word ( óntos + logos ) that means “science of being” and expresses the idea of knowledge of being, of study or reflection that is exercised in the mind/body, being traversed by “ logos” —a word that explains, defines and clarifies about life, the cosmos and, in this reflection, what concerns “being.” Therefore, it suggests the idea of something intended and/or understood as finished, complete, self-sufficient, fully realized.

This idea contains an attempt to mime the rational theological meaning present in the definition of the “being” God (“I am”), expressed or categorized, according to Spinoza’s philosophy, as an absolutely infinite being, that is, substance consisting of infinite attributes, each of which expresses eternal and infinite essence. (…) Absolutely infinite but not infinite in its own kind, as we can deny infinite attributes to what is infinite only in its own kind, but to the essence of what is absolutely infinite pertains everything that expresses essence and involves no negation ¹⁸ .

On the other hand, when it comes to humans, the best categorization is that which describes them as someone who “is being”: a being who is inserted in a dynamic-metamorphic existential process, which makes him at once an agent that can influence and a patient that can be influenced; someone in construction-deconstruction-[re]construction; an unfinished individual, immersed in reciprocal relationships of exchange.

Thus, the ontology of “being” is set apart from another ontology, which would be better categorized as that of “being human,” as it differs from the former in acknowledging the countless existential processes that transform an individual during the course of his life as well as the multiple impacts that this same “being human,” dynamic and “metamorphic,” tends to cause on his fellow creatures, other species and the environment which he and other living things inhabit.

Moral enhancement

The sum of freedom, moral motivation and moral discernment

According to DeGrazia¹⁹ , the moral behavior of humans presupposes an anatomy of moral conduct, which is constituted by moral motivation associated with moral discernment or vision to generate morally desirable behavior. Through this process, individuals, or “being humans”—a neologism created by the authors of this article—that are morally well motivated²⁰ (or, in other words, well affected, according to the Spinozist perspective¹⁸ , and applying moral discernment to their actions) supposedly engage in appropriate moral behavior¹⁹ .

However, another element must be considered as key to the analysis of the quality of moral behavior: the freedom of the moral agent in his decision-making. Indeed, contingencies foreign to the moral actor may condition or affect his moral conduct¹⁹ ; in this case, its visible action may stem from motives resulting from pressure from the environment rather than internalized ethical values that have become inherent to the ontological subject (becoming, therefore, an integral part of the “being human”).

DeGrazia¹⁹ thus deduces that freedom, moral motivation and moral discernment produce truly valuable moral behavior, which can also be defined, from an Aristotelian point of view, as virtuous, that is, ethically just.

At the beginning of the syndemic, due to the low global production of COVID-19 vaccines, the European Commission, which represents and defends the interests of the European Union in a globalized world, initially pronounced itself against the delivery of those vaccines to countries on other continents before its member states had received the number of doses purchased from pharmaceutical companies headquartered in them²¹ .

This is an example of how circumstances and contexts can affect the morality of individuals, groups and institutions in decisions that expose their moral behavior in the face of an external factor that poses risk. The freedom factor—in the moral meaning of courage or ability to enjoy an independence that transcends one’s particular needs for self-protection—feeds moral motivation and instructs moral discernment, generating truly powerful and valuable moral behavior¹⁹ , which reflects singular/personal or plural/collective moral enhancement.

Facilitating process

During pandemic emergencies, relationships between people are subject to deterioration in their ability for cooperative coexistence, which paves the way for the loss of altruistic skills. The other, who was already a moral stranger, may come to be viewed as an opponent or existential rival, someone with whom one competes for means and resources that are essential to life or to its maintenance in more favorable conditions. This mental and emotional disposition becomes a relational obstacle and tends to be aggravated in contexts of economic and social asymmetry.

This circumstance requires the identification of moral instruments that facilitate the process of building “bridges” between the different moral agents and patients, setting up a shared, solidary and co-responsible governance of means and resources. Such governance is endowed with essential ethical elements that are sufficient to enable the global overcoming of the syndemic, which is a type of event that requires solutions capable of reaching everyone to ensure effective control of the effects. Solutions that do not include all individuals end up prolonging the syndemic.

Empathic dialogue can be mobilized by conatus , affects, appetite and desire, as conceived by Spinoza’s rational ethics¹⁸ , as they are conducive to behaviors and attitudes that can contribute to the comprehension and bioethical management of collective well-being in times of globalized health crisis.

Dialogue and dialectic

The concepts of dialogue²² and dialectic¹⁵ , ²² are synergistic, as the pragmatic meaning of one word nurtures the other. These two complementary dialogic modes maximize their powers by bringing individuals and unique groups together, reducing their mutual repulsive impulses—which led them to interrelate and act like the moral strangers described by Engelhardt Jr, recalled in the Madrid article²³ . This opens opportunities in reason and affects for convergences and identifications, of both existing and potential synergies, sheltered under the overarching condition of “being humanity,” which likens and may associate them.

Dialogue

Since pre-Aristotelian antiquity, dialogue (which means “sharing the logos ”) has been established as the discursive format of greater excellence²² . This method comprises a non-asymmetrical model of discussion between two or more people who, through the exchange of questions and answers—that is, intellectual exchange—seek together a condition of harmonious coexistence or a place of friendly living, where they share the common interest²² .

Still considering Abbagnano’s²² definition of dialogue, the Greeks understood it as the natural expression of this joint search for the objective or solution to achieve common, collective and higher desires of the polis , which could be extrapolated to the Cosmopolis (global city or village) .

Dialogue implies reflecting on and responding to alien theses, requiring an empathetic attitude from those who are willing to engage in dialogue, otherwise the dialogic fruit shall prove to be sterile and incapable of reproducing or re-editing itself once more, due to the very frustration caused to those who devoted to the act of dialogue their expectations, efforts, intelligence, altruistic and solidary predisposition, good faith and hopes.

A bioethically consequentialist dialogue results in better collective results, even to the detriment of situations that conceal privileges¹¹ . It necessarily implies reciprocal and unreserved availability to allow oneself to be fertilized by each other’s theses and to fertilize each other, forming a kind of egg-cell or zygote in which both, separately, simultaneously are and play the roles of sperm and egg, but, together, generate a third “being” that unites, enables and harmonizes the genetic heritage—in this case, the existential heritage—of the members of this relationship.

Dialectic

Dialectic, in turn, is a term derived from dialogue and which has non-univocal meanings in the history of philosophy²² . Despite its various senses and interrelationships, it can be limited to four fundamental meanings, originating from four doctrines that translate it, namely: 1) method of division (Platonic doctrine); 2) logic of the probable (Aristotelian doctrine); 3) logic (Stoic doctrine); and 4) synthesis of opposites (Hegelian doctrine, revised in Kierkegaard)²⁴ .

For the purposes of this article, the focus is on the meaning of system [which intends] to overcome the contradiction between thesis and antithesis through synthesis ²⁵ [of opposites]²⁴ , the synthesis, in turn, is contradicted and the process is repeated until final perfection is reached ²⁵ . In a world of moral strangers, of endless identitarianism, of a Zeitgeist characterized by increasing distinction and fragmentation, a dialectic that facilitates the synthesis of opposites²² seems to be something more instrumental and useful in considering the other(s).

In syndemic times, Hegelian dialectic broadens the horizons of critical thinking by proposing a means to resolve the contradictions in which finite reality is enmeshed ²⁶ . For Hegel, according to Abbagnano, all reality moves dialectically and, therefore, Hegelian philosophy everywhere sees triads of thesis, antithesis and syntheses, in which the antithesis represents “the denial,” “the opposite” or “the other” of the thesis, and the synthesis constitutes the unity and, at the same time, the empowerment of both ²⁶ .

The Hegelian concept of dialectic stood out for three characteristics: 1st) D. is the passage from one opposite to the other; 2nd) this passage as the conciliation of the two opposites; and 3rd) this passage (therefore conciliation) is necessary ²⁷ .

Kierkegaard, as Abbagnano states²² , revised Hegel to view dialectic as the possibility of recognizing the positive in the negative, without, however, requiring conciliation or synthesis. From this perspective, by not eliminating or annulling the opposition through the necessary passage through conciliation or synthesis, the connection between opposites maintains the opposition static and (consequently) the tension permanent²² . However, if the tension is permanent, wherein lies the advantage? It lies in rendering unnecessary the capitulation or subsumption of the other by the self—or vice versa—in a pre-empathic realistic stage-step.

Singer and collaborators³ also observed how social and environmental conditions facilitated the interaction between two or more diseases and COVID-19, increasing their impacts and making less economically autonomous populations and groups even more susceptible and vulnerable.

Empathy

The moral enhancement of the relational capacity of the individual or social self with the individual or social other requires empathy as a basis for development. The way in which nations and regional blocs act regarding resources for prevention (vaccines) and means of care and rehabilitation for those who become more seriously ill during the COVID-19 syndemic exposes a global deficit in empathy, as shown by WHO’s excellent COVID-19 dashboard²⁸ , where one can monitor, with a maximum delay of 24 hours, confirmed and recently reported cases of COVID-19, besides the total number of deaths and vaccine doses administered worldwide and in each country.

The faulty distribution of vaccines reveals the global health inequity in access to the vaccine, due to lack of empathy, resulting in the continuation of the syndemic worldwide.

Empathy is a basic moral capacity or attribute for mediating dialogue between moral strangers; it is the willingness to dialogue with someone who is different from us, who is not assimilable to us, who is transcendent to us, based on a dialectical logic that integrates and overcomes the contradiction with the other, in the impossibility of taking their place or living their experiences, beliefs and feelings. However, one can live one’s own experience alongside other individuals, communities and society(ies) as a whole¹³ .

Understanding this is inextricably linked to the very etymological meaning of the word, as it makes it possible to emotionally unite different beings through mutual understanding.

It is a true that signs of poor empathy can be observed not only in relations between nation-states but also internally, when access to vaccination is greater among social segments with lower risk of spreading the disease, thanks to better housing conditions, lower household occupancy rates, access to personal hygiene supplies (hand sanitizer, hygiene and cleaning products, personal protective equipment, etc.).

Empathy can be a subject of reflection; it can be taught, learned, developed and practiced, especially when it is understood that humankind comprises a single “pan-social” body. There are no effective solutions that preserve or favor some over others.

While it constitutes a projection (never in absolute terms) of the individual or social self onto the individual or social other, empathy can produce the perception that the self is the other of the other, of the one who is considered a moral stranger in relation to the self, but who, from a perspective of projection, could be the actual self. Empathy, in this sense, is found within the scope of an ethos that, by proposing and prescribing the inclusion of the other in a preservation or conservation project similar to what is desired for the self, protects, shelters and gives refuge¹² to a collective, social and fully inclusive self.

Conatus, affects, appetite and desire

Benedictus de Spinoza (1632-1677), a rationalist philosopher of Iberian origin, developed, in his work titled Ethics , four philosophical concepts that are worth considering to understand the motivations that give rise to human actions and passions: conatus , affects, appetite and desire¹⁸ .

In global health emergencies, such as the COVID-19 syndemic, the rationality of decisions and actions can be undermined by a kind of “every man for himself” riddled with egocentrism and ignorance and the false notion of core-periphery—a concept stemming from a globalized, transnational world, whose borders are permeable to the flow of capital, goods, culture, people and pathogens—which expands and prolongs global risks, as there is no exit that can free some and confine so many others.

Conatus

Each thing, as far as it can, tries to persevere in its being²⁹ . In developing his idea of conatus , Spinoza starts out from monism¹⁸ , a concept that considers universal singleness (God as absolutely infinite and all the rest as finite modes of God). Conatus consists of a continuous drive or effort of fundamental universal self-preservation of human existence to persevere in its existence—its being—as a collective existence¹⁸ . This goal implies increasing one’s own power to act inclusively, providing, even during syndemics, solutions that conserve/preserve everyone.

Thus, the action and effort that, according to Spinoza¹⁸ , aim at self-conservation, are executing the natural law of self-preservation. The efforts observed in WHO’s statements and actions concerning the COVID-19 syndemic express this effort of or for such conatus , which lies at the origin and rationale of the founding of multilateral organizations that agree to protect the whole/wholeness called humanity.

Affects

They are the affects of the body, whereby its active power is increased or diminished, encouraged or constrained, and, at the same time, the ideas of such affects. (…) by affect, then, I understand an action ³⁰ , [that is,] an affect cannot be restrained or annulled except by an opposite and stronger affect than the affect to be constrained ³¹ .

Unlike Cartesian dualism, which separates mind from body, Spinoza perceives them from a monistic and/or unitarian viewpoint, and understands that the being can affect and be affected, being active and passive. In both cases, the affects are determined by the affections, which are the result of the interaction between bodies. A body can affect the other(s) or be affected by it(them). This interaction may increase or decrease the power of the being, increasing or decreasing its capacity for self-preservation¹⁸ .

Rationality, according to Spinoza¹⁸ , lies in the mind’s effort to actively affect itself, that is, increasing the active power that is an adequate cause, resulting in collective self-preservation, since passive affects are an inadequate cause, generators of decreased power or capacity for self-preservation.

The circumstances of this syndemic—production and supply of resources (vaccines, intubation kits, hospital beds, healthcare teams, etc.) below the rate required to assist everyone equitably—pose the challenge of exercising rationality according to Spinoza’s logic of self-preservation of the whole rather than only the part¹⁸ . This is the conatus that active affects, stemming from an adequate cause (the well affected being), should produce. And only a stronger (active) affect can restrain or annul a (passive) affect that reduces the power for self-preservation¹⁸ .

Appetite

Endeavor (…) referred solely to the mind, is called will; but referred to both mind and body together it is called appetite, (…) therefore it is nothing else than man’s essence, from the nature of which necessarily follow those things conducive its preservation, and which man has thus been determined to perform³² .

If, on the one hand, the capitalist model of production stimulates competition for markets, expanding the production capacity of goods and services, on the other, in its modus operandi , it degrades and consumes natural resources; impacts the environment, fauna and flora; and also puts pressure on traditional populations (indigenous peoples, quilombola communities and others), competing with them for land/housing and livelihoods, intensifying imbalances and new syndemics.

Appetite, as an effort of the body-mind to preserve its being, is in the human essence and in the resulting acts that are useful for its preservation. The global society must continuously commit to seeking and adopting governance mechanisms of a solidary kind.

Desire

Desire is appetite with consciousness thereof³² . Spinoza, as a rationalist philosopher, is not guided by feelings. Concepts such as conatus , affects, appetite and desire, despite sounding sentimental, are guided by the rationality of geometers, for whom lines, planes and volumes translate universal natural laws that conserve and sustain expressions/modes of the natural God, absolutely infinite and eternal substance. Human beings are manifested as finite forms/modes of Spinoza’s God and subjects of the natural order of the self-preserving universe, and must live and act consciously.

Continuum

The term continuum⁴ relates to an accumulation of events, experiences and actions that follow each other without reprieve, like a continuity in progress, with apparent similarity between the previous, current and subsequent stages—which indeed is not true, as there are distinctive nuances that ultimately make it possible to ascertain that the beginning differs from the end. This is the result of adaptations and adjustments directed towards more sophisticated and functional results that persevere in preserving the actual ensemble.

Humankind is self-preserving precisely through the conatus that grants it renewed processes of improvement and correction of its existential path, in which each new affection of the body (interaction between bodies) communicates with the mind, in a monistic relationship.

In the syndemic, as partial and incomplete solutions are devised and even adopted, the emerging criticism of the mind corrects and indicates a better, more comprehensive, fair and inclusive solution.

Final considerations

The “being human” must heed the need to operate according to relational modalities, prioritizing collective interests and reducing risks, dangers and damages to humanity, other species and the environment. Globalization—a difficult trend to revise—socializes the deleterious effects of a way of life based on the intensive consumption of natural resources, goods and services, and also on the widespread movement of people and precarious work relationships.

The human being or “being human” must increasingly view itself as “being humanity,” as a pan-social and planetary body. National solutions or those arising from regional blocs end up generating islands of relative prosperity, which are pressured by the disorderly migration of waves of refugees in search of survival.

The risks and impacts on humans and non-humans are evident. We may be forced to live with the occurrence of new global health emergencies, and some form of global governance will likely be imposed to manage resources and solutions.

Neither walls nor seas nor oceans will make the excluded accept their exclusion: exclusion is not natural, exclusion is not normal, exclusion is not moral, exclusion is not the result of justice; instead, it ends up damaging justice and creating damaged people that may require a “toolbox” such as bioethics to be evaluated and applied.

Moral enhancement can be taught, learned, apprehended and practiced, facilitating empathetic dialogic processes. Spinoza’s philosophy, through conatus , affects, appetite and desire, proposes guiding concepts of collective self-preservation through a rational pathway that results in a cumulative continuum of solidarity-generating experiences.

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Publication Dates

• Publication in this collection
  08 May 2023
• Date of issue
  2023

History

• Received
  25 Apr 2022
• Reviewed
  06 Dec 2022
• Accepted
  23 Jan 2023