On Our Moral Duty to Wear Masks

During recent weeks, world events have driven people to ask important questions about religious liberty, the role of the state, the nature of the common good, and the balance between individual freedoms and duties. As we’ve all sat in our homes with minimal chance to venture out, there have been gigabytes of data invested in the writing and reading of thoughts about the present, the future, epidemiology, and our longing for the delivery of our most recent online purchases.

One of the more recent questions that has arisen as many states and localities look forward to lifting their restrictions is: Should we wear masks in enclosed public spaces?

Unfortunately, for some, this has been turned into a political question related to a sense of submission and control, but at its heart, it is a question of neighbor love and concern for life. It is that angle—the concern for the preservation of life—that I will examine, ignoring the tangled web of frustration, argumentation, and misrepresentation.

Simply put, at the present time we have a moral duty to properly wear masks in enclosed public spaces.

Efficacy of Masks

Masks are worn because they help to slow the spread of viruses due to coughing, sneezing, speaking, and breathing from the nose and mouth. Essentially, even homemade masks help filter out the virus particulates that may be carried by our breath.

According to the CDC’s website,

It is critical to emphasize that maintaining 6-feet social distancing remains important to slowing the spread of the virus.  CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

There was confusion early on in the pandemic, particularly as people tried to acquire necessary medical supplies and sought to use masks to protect themselves, which led to contrary guidance.

Confusion has been increased because the World Health Organization, which has to attempt to cross cultural barriers and a wide range of socio-economic conditions, is ambivalent on wearing masks to limit the spread of COVID-19. Most of their cautions have to do with the misuse of masks (e.g., repeatedly touching them to adjust them), wearing soiled masks that cannot be cleaned, or that wearing a mask would give a false sense of security leading to people not observing other significant precautions. Given that the WHO recommendations have to somehow support possible solutions in majority world countries as well as highly industrialized countries, it is not surprising there are a range of competing concerns that may be largely contextually driven.

It also does not help that there are intentional efforts to spread misinformation, to divide the nation, and to make simple, empirical decisions seem to be politically motivated. There are so many people writing about this issue that it is entirely possible to continue to search until we find an opinion we like and then point to that as decisive. Our best bet, though it will certainly be imperfect, is to go with the officials appointed by our government to do this research on our behalf and make recommendations. We should, unless it causes us to sin, obey authorities placed over us and use the best wisdom we can about less clear decisions.

Through all of this, we should remember that cloth masks, or simple surgical masks, are not particularly effective at preventing getting the infection. In fact, if you wear mask incorrectly (e.g., are constantly adjusting it, or think it functions as a shield for germs and don’t take normal precautions), wearing a mask may increase your likelihood of picking up germs.

Masks in public, as proposed and sometimes mandated during the current pandemic, are not primarily about protecting yourself. They are intended to prevent being a source of the infection. COVID-19 is unlike other common respiratory diseases in that it has, in some cases, a relatively lengthy asymptomatic period in which a person can also be contagious. There is a long period of time where we may be infected and contagious and have no idea, which makes COVID-19 different than many other respiratory diseases.

The moral duty in the case, is not simply to wear a mask, but to do so responsibly while maintaining other appropriate hygienic precautions, like frequent handwashing and maintaining personal space. We do this for the good of others, not (primarily) to prevent getting it ourselves.

Obedience to Authority

If a legitimate authority mandates that we wear masks, we should wear them properly if we are able. Rom 13:1-7 is fairly clear that we ought to submit to government authorities (or store owners, when on their property, or church leaders, when in their sphere of influence). If you are in a locality that requires masks, then you really don’t need to read the rest of this long article, because it is your moral duty to wear a mask properly, as long as you are able, in those situations mandated by the legitimate authority.

There are reams of explanation by Christians from many ages of Church History explaining that we need not obey authorities if it requires us to violate our conscience. However, apart from really odd reasoning (wearing protective gear obscures the image of God? If so, what do clothes do and what should we do with that?), belief that personal comfort is an absolute good, or some sort of belief that somehow not wearing a mask is subverting a conspiracy for social control, I have not seen much that argues that protecting the lives of others violates conscience.

An obvious caveat to this is that some people do feel an inordinate sense of anxiety due to some significant trauma if they wear a mask. That isn’t most people. But our duty is to ensure we obey authority and not to enforce the rules on others.

Risks of Infection

The likelihood of getting any virus is dependent on the concentration and duration of our exposure to those particles and the fighting ability of our immune system. Assuming equally healthy people, the person who is exposed to the greater number of virus particles for the longest time is more likely to get sick than someone with a lower exposure.

This is why many of the recommendations center on eliminating virus particles (e.g., by washing hands and sanitizing surfaces) and diluting the concentration (e.g., 6 feet distance, occupancy limits, etc.). There is also a time factor in the equation, so that reducing the time we spend in enclosed spaces reduces our risk of getting or spreading the disease, barring excess exertion that makes us breathe especially hard.

These are all probabilistic factors that we do not yet fully understand the exact values of, but reducing exposure is a critical means of lowering the chance the disease is transmitted.

No sane person wants to get the disease and we should take reasonable precautions to avoid it.

However, we also have a duty as Christians to minimize the potential that we spread the disease. Wearing a mask is primarily about preventing the spread of COVID-19.

This is particularly important since current estimates indicate that about half of the people who have the disease remain asymptomatic, there is a lag between becoming contagious and feeling symptoms even in bad cases, and asymptomatic people are capable of spreading the disease. In other words, we can feel perfectly fine and be spreading COVID-19.

Risk of the Disease

It is not clear at this point exactly how deadly COVID-19 is. Everyone admits that the death rates have been skewed upward because of the limited availability of the tests (especially early on when only those very ill could get the tests) and the number of asymptomatic people who are never tested.

However, COVID-19 tends to affect vulnerable populations more significantly. The elderly and those with underlying medical conditions often fare poorly. These are the sorts of people that our society tends to value less, but who Christians should be particularly ready to protect.

Even relatively healthy and youthful individuals who get the disease have described it as being severe. Experiences vary, often depending on the degree of exposure and the immune system’s response. In the most severe cases, people can require ventilators to supplement the body’s natural respiratory function.

It was concern over the availability of ventilators that initially led to the lockdowns in many states and cities.

Some areas, especially those that are populated most densely, have seen significant spread of COVID-19. Other areas, especially more rural parts of the country, have seen few cases.

This has fueled frustration in some less affected areas, which have faced strict restrictions with little visible impact. Those frustrations are increasing as low-density areas are being treated like high-density areas in a way that seems unfair and is damaging to the economy. There is some validity in the frustration; many of the lockdown measures were imposed broadly when narrower targeting would have been sufficient. (I am very thankful not to be one of the people trying to make these decisions right now.)

Presently, the restrictions on travel and commerce are helping to stop the transmission of the disease. However, the increasing frustration and significant economic harm being caused by the restrictions are pushing decision makers to lift those restrictions.

This is exactly the point of time when the tendency will be to relax the protective measures like wearing masks and maintaining personal distance. This is also exactly the point in time when those measures will be most important.

In the current condition, having stayed in contact with our families or very small clusters of friends, we have essentially proved that we have clusters of people who are no longer infected with COVID-19. All to the good.

However, when we begin to more freely associate and travel increases, we will be back to square one, unless we continue some of the basic precautions like maintaining physical distance from one another, washing hands frequently, and wearing masks to protect others.

There is no guarantee that we can prevent from getting the disease. We should protect our health reasonably, but as Christians we should be particularly concerned about protecting the health and lives of others. Our continued adherence to the recommendations of the CDC and other recommendations and regulations of our state and local authorities is part of our moral duty to protect others.

Especially those of us who come in contact with a broader public should be much more careful in preventing our spreading the disease unknowingly and inadvertently. This is exactly the reason properly wearing a mask in enclosed, public spaces is a moral duty right now.

Duty to be Cautious with Life

Most Christians are familiar with the 6th commandment, which prohibits murder. (Ex 20:13)

Contrary to much of the recent online discourse, accidentally spreading COVID-19 to someone who later dies is not murder. Neither is desiring to responsibly engage in economic activity and expression of disdain for healthcare workers or for the vulnerable populations around us.

But Christians have a duty to protect life beyond avoiding maliciously killing others. Christians also have a duty to be careful of life. Humans, even the ones we don’t like, are all made in God’s image and are precious to him.

As John Frame writes in his Medical Ethics,

The general principle of respect for human life also forbids any kind of physical harm (Exod. 22:12–36). God even forbids his people to put others in danger of such harm. (I believe that this is part of what God had in mind by legislating “cities of refuge” in the Old Testament [Num. 35:22-28; Deut. 19:4ff.].) Accidental killing is a crime, because we ought to be supremely careful with human life. . . . The moral obligation to be supremely careful with human life and not to take it accidentally is the fundamental principle of medical ethics: primum non nocere––“first, do no harm.”

He later refers to this as the “doctrine of carefulness,” which I think is an apt description of an obligation to avoid even the careless harm to others.

The doctrine of carefulness is the reason why we follow OSHA regulations at the worksite. It is the reason why we drive at a reasonable speed when there are kids playing soccer on the side of the road, even if we have to go slower than the posted speed limit.

The doctrine of carefulness is the primary driver behind wearing masks properly under the current conditions in enclosed, public spaces.

When we wear a mask, we are protecting the lives and health of others. The worker in the store has to stay inside the enclosed, recirculating building. The other members of our church are breathing in the air we have exhaled. Based on the CDC explanation, mask wearing minimizes their risk, even if it does not significantly protect the mask-wearer.

My Risk or Their Risk

The person who is receiving the risk is a critical element of this argument. In other words, am I putting myself at risk or another person?

If I choose to go skydiving or rock climbing I am taking risk upon myself that is unnecessary. Within certain parameters (i.e., we have an obligation not to be foolhardy to the point of suicidal risk) that is permissible. I can take risk upon myself.

Thus, for me to care for an infected individual is morally permissible, even if I don’t have all of the preferred protective gear. I should be careful, but I assume that risk.

I do not have the right to force that risk on other people, however, according to the doctrine of carefulness.

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If I choose not to wear a mask, at this point in the pandemic, I may have been infected and I may therefore be pushing risk on other people that is unnecessary. That is unjust and immoral.

Obviously, it may be that I have been isolated for several weeks and finally returning to the grocery store. It may be that in that situation I have next to no potential to have the infection to spread to others. In that case, if there is no authoritative requirement (the store does not require it and governmental orders have been dropped) to wear a mask, then I am not bound to.

Most of us, however, will be out and about on a regular basis in the coming weeks as the restrictions are lifted. COVID-19 will inevitably spread more rapidly for a period of time after normal social and economic activities are restored. As we go back to stores and back to work, even on an intermittent basis, we will no longer be sure that we are “clean and free” of COVID-19. At that point, even if we believe we do not have the disease because we feel fine, we should choose to wear a mask properly in enclosed, public spaces out of love for our neighbor, to protect his or her life. We have no right to put our neighbor at risk any more than necessary.

There is, I think, in many circles a false sense of security and minimization of the real risk of COVID-19 because the drastic actions taken to reduce the spread have worked. Many people, therefore, do not know someone directly who has suffered from it and have not seen how dreadful it is. By the account of those who are seeing the work of the disease, it is significant and potentially deadly.

Particular Duties of Christians

Christians should likely be among the most cautious of people regarding this infection. Apart from sports, churches are often among of the largest gatherings of people in our communities. We come together a few times a week after we have been separated and gone out into the world, to various businesses and places of work.

Churches, therefore, are likely to be among the main ways that the disease will be spread. Not only do we gather and scatter, but we also often sing, which seems to be a particularly effective way of spreading the disease. Shouting and singing both encourage deeper breathing and, because of the extra force to make the sounds, tend to aerosolize the particulates more, which increases the likelihood that they spread.

Therefore, once we return to gathered worship (may the day come soon), especially inside, we are among the most likely to spread the disease and become infected. As a result, we have a greater chance of imparting risk to those we come in contact with. We should choose, therefore, to bear the mild inconvenience of wearing a mask to protect the lives of our neighbors.

Let us be known as the people who value life even over comfort and personal freedom.

Reasonable steps may include, and I think should include, choosing to wear a mask properly in enclosed, public spaces (beyond church) even after the CDC recommendation has been lifted or the local ordinances are dropped.

Masks and Christian Liberty

Some may argue that the stronger brother (mask wearer) should bear with the weaker brother (non-mask wearer) in this regard, when it comes to social interactions. In other words, I should be able to have the liberty to choose not to wear a mask if I don’t want to. That argument has the actual pattern reversed.

First, we have a duty to obey the authorities of those placed over us unless it causes us to sin. If there is a mandate to wear a mask, then we should wear one if able. Wearing a mask is not sin, even if we chafe at the restriction. If the leadership of a local congregation chooses to require a mask, then we should voluntarily do so.

However, if others in the congregation ask us to wear a mask, we ought to agree to it, even if we don’t like it. We should yield to them as the weaker brother, in this case.

As Paul describes eating meat sacrificed to idols in 1 Cor 8, it is our obligation to yield our rights to others. In this case, we ought to yield our perceived right not to wear a mask to those who feel that a mask is necessary for safety. Aside from the risk we are imparting on the other individual, our refusal to wear a mask is likely to force others to violate their conscience by not attending church. As Paul writes, “But take care that this right of yours does not somehow become a stumbling block to the weak.” (v. 9)

The meat eater must bear with the abstainer, not the other way around. In this case, the bolder action is to avoid the mask, therefore it is the mask abstainer that should yield.

On the other hand, if the congregation agrees not to wear a mask, then they should not look down on those that choose to avoid gathered worship until they feel comfortable. We should not attempt to force people to violate their conscience, even through social pressure, which is Paul’s point.

We have no right to expect others to choose the same level of risk that we accept for ourselves or others. We have no right to expect someone to violate their conscience by risking the spread of the disease. Those that choose to accept the risk should do so voluntarily and be prepared to bear whatever consequence results, but it should be mutually accepted.

Masks and Absolute Morals

One obvious question that arises from this discussion is whether the duty to wear a mask is absolute. How is it that we now have a duty to wear masks, but in January people would have thought us strange for wearing one? Has God’s truth changed? (After all, Scripture says nothing about COVID-19, etc.)

The answer is that absolute truth applied to a changing circumstance leads to a different action.

Sex is not sinful in and of itself. However, consenting sex outside of marriage is sinful. The circumstances are part of the moral calculus.

We have a duty to protect life. When our child is bleeding out in our back seat, that may lead us to violate the speed limit. When there are children playing soccer near the road, that may lead us to go well under the posted speed limit. The duty is the same, but how we live it out changes.

At the present time, the risk—especially the unknown risk—of COVID-19 is such that properly wearing a mask in enclosed, public spaces is morally warranted.

There will be a day at some point in the future that that will no longer be the case. As Christians, demonstrating love for neighbor, we should be among the more cautious when it comes to life. It does us little credit when people who claim the name of Christ demand autonomous personal freedoms without consideration for the vulnerable. We should be willing to sacrifice our comfort and convenience for the sake of the health and lives of others.

The moral absolute here is the duty to be careful with life. That does not mean absolute prevention of risk, but it does mean that we should work to minimize it, especially during a time of relative crisis like this.

We won’t know when the exact moment that it was no longer necessary to wear a mask until some time after it comes. To err on the side of caution is the morally prudent course of action.

Masks as a Historical Practice

Somehow, obscured in the politicization of this issue, people seem to be missing the fact that donning a mask has been a consistent practice recommended for visiting immunocompromised people for years. Perhaps I’m just unaware, but I’ve never heard or read anyone who objected to protecting the life of their child during cancer treatments by wearing a mask.

The duty to wear a mask was always conditioned upon the circumstance. The efficacy of masks has been assumed when dealing with visiting cancer patients, but suddenly it is being questioned now that the request is being made outside the sick ward.

The most reasonable arguments for this are that people aren’t going to wear the masks right, and will assume that the mask keeps everyone totally safe. Therefore, we shouldn’t wear masks.

People can be stubborn and ignorant, but repeated communication should help convince people that physical distance, hygiene, and proper mask wearing are three distinct (but related) measures to reduce spread of COVID-19.

Inability to Wear a Mask

If for some reason someone cannot wear a mask, then they should not wear a mask.

Churches should, within reason, work to accommodate those who cannot have a mask on. However, it may be that, since our buildings were not constructed for a respiratory pandemic, that accommodation may include being treated differently than those who can wear a mask. Different conditions may warrant different treatment.

People that cannot wear a mask can fulfill their duty to protect others through hygiene, maximal isolation, and maintaining distance as rigorously as possible.

We should do our best to bear with those who, for whatever reason, cannot take the same precautions for our health. This may include ensuring those individuals do not have to come in contact with infected individuals by running their errands, etc.

The simple fact that some cannot wear a mask should not prevent us as individuals from wearing masks or congregations from requiring them of everyone who is able. The goal is to minimize risk as much as reasonable, not to pretend we can entirely eliminate it.

At the same time, people who can wear a mask, but don’t want to ought to wear a mask. “It makes me feel hot and fogs my glasses” are not moral arguments against wearing a mask. (Trust me, I’ve worn a mask for an extended period of time during this and it’s no fun.)

Conclusion

Obviously, this is an ever-changing situation. If, for whatever reason, it becomes clear that properly wearing a mask in an enclosed, public space actually infects more people we should not do it. Our duty is to be cautious with life, not to wear a particular article of clothing.

When the CDC recommendations are relaxed, we should consider our own risk of being infected and be cautious about reducing our efforts to put our neighbor at risk. Leaders of churches should be especially cautious, as they will be setting the rules that will protect or endanger their congregations and the local communities. As I noted, churches are among some of the most high-risk activities that exist in our communities when it comes to communicable, respiratory diseases. It’s one thing to threaten someone with the common cold, it’s another thing to put them at risk of COVID-19. And, by putting those that attend at risk, we also put our communities at risk because of the particularly insidious nature of the disease.

We have no obligation to police our neighbor’s Facebook feed to see if they are wearing a mask. Our obligation is to ensure we are not spreading the disease, not to ensure others are not doing so. We should take appropriate care of our own health and lives, which may include avoiding corporate worship if the congregation refuses to take reasonable precautions. However, our goal should not be to shame or divide the congregation, but to reflect a consistent concern for life in a responsible, spiritually mature way.

At the end of the day, we will all give an account to God for our moral choices. Those that are in Christ will be covered by his blood, but our goal should be, as much as reasonable, to fulfill our duties as outlined in Scripture as much as possible for God’s glory. In this case, that requires us to take caution with the lives of our neighbors, which presently includes properly wearing masks in enclosed, public places.

The Great Risk Shift - A Review

There has been a shift in recent decades in the United States on several fronts. The rise of the internet has both fragmented local communities and allowed cliques to form over great distances around a common (and sometimes really weird) interest. Politically, the two dominant parties in the United States have become more polarized than in the middle of the 20th century. And, according to Jacob Hacker, there has been an invidious shift in risk from broad risk pools to individuals.

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Hacker’s book, The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream, is meant to show that injustice perpetrated by Republicans and other economic and social conservatives that tend to lean that direction (particularly given the options) is keeping the little guy down. The nation has seen continued attacks on the policies of redistribution imposed by FDR’s New Deal and LBJ’s Great Society movements. Defined benefit corporate pensions have been replaced by 401k plans, which force individuals to take responsibility for their own saving.

In The Great Risk Shift, Hacker presents a declinist narrative with a call to make America great again by expanding government programs, moving back toward pensions in corporate jobs, and generally trying to spread out risk to the entire nation. He begins by painting an apocalyptic picture of economic insecurity, focusing particularly on the financial crisis of the last decade. That shows, according to Hacker, how precarious life must be. In the second chapter he puts a line in the sand between those who feel that there should be a measure of accountability in risky decisions to those who believe risk should be shared equally. In the remaining four content chapters Hacker presents some data that illustrates his point about the risk to jobs, families, retirement, and due to the rising costs of health care based on a refusal to nationalize all risk. He concludes the book by a call to create new government programs, expand the ones we have nearly indefinitely, increases taxes dramatically, and hopefully get a robust economy that makes everyone reasonably wealthy simultaneously.

Hacker teaches at Yale, so he likely has done careful, well-reasoned scholarship to ascend to that level. This book is not that, but is a call to action intended to mobilize the already outraged. The argument, such as it is, in The Great Risk Shift is likely to galvanize the convinced, but has little power to convince those (like me, for example) who might agree with a number of his premises, but want an approach that takes reality into account. After the first couple of chapters, the book is a tedious tirade that is likely to ensure Hacker gets to speak on cable news, but does little to expand the range of human knowledge.

At the same time, Hacker has some worthwhile observations. There has been a significant shift in the last few decades toward a more individualized burden of risk. The shift away from the life-long, supposedly guaranteed, defined benefit corporate pension has changed the landscape of employment. To Hacker’s mind, that has been entirely to the negative. This example is perhaps the best way to show the major flaws in Hacker’s argument.

Based on Hacker’s argument, corporate pensions have been replaced by the 401k. That is entirely bad because fewer people have access to permanent security that gets funded on their behalf. All people had to do back in the good old days of pensions (when America was great?) is work at the same job for a few decades and, if they made it to 20, 30, 35 years, or whatever, they would walk away with a gold watch and a steady stream of replacement income for life.

Missing from Hacker’s account, however, is that when you get a jerk boss and you are five years from retirement, you are now forced to sit and take it or lose your permanent financial security. Also missing from the rosy story is that if both spouses work (something he laments and celebrates at the same time) and one gets the opportunity for a relocation, you now have a much bigger decision to make. Finally, Hacker ignores the accounts of the pension plans that have gone bankrupt or been significantly reduced because they were underfunded (in part due to changing assumptions for longevity, but also due to bad actuarial assumptions). In Hacker’s paradise, the risk seems reduced, but it merely makes the fall so much more stunning when the collapse cuts your supposedly guaranteed pension in half.

We can have a meaningful debate about the duties of a company (which may not exist by the time you retire) to permanently fund your future life, but the data to have that debate is missing from this book. Additionally, Hacker ignores the real benefits of individual retirement accounts, because of the mobility they provide. As someone who has changed careers several times, I appreciate having a retirement account that follows me rather than having wasted those years of accrued service.

For Hacker, people like me are waging a war against the rights of the poor to be protected because we see the benefits of portable retirement accounts, the ability to purchase insurance plans that cover the most likely risks for me and my family, and who see the benefit in allowing workers at all levels to keep more of their earnings. There are certainly those among fiscal conservatives who embody a more Randian individualism and think all risk should be individual. However, there are others (like myself) who think there is a place for pooling of risk, but that it need not be at the level envisioned by communism, democratic socialism, or lighter variations like those proposed in the so-called Great Society, New Deal, or the (not very green) Green New Deal.

What Hacker and others that urge greater government intrusion in life through more expansive redistribution programs is that a reduction in risk is typically coupled with a significant loss of potential. So, for example, a minimum of 15% of my lifetime earnings have already been assigned to the government’s preferred vision of a retirement plan through social security and FICA taxes (both my share and that deducted before my salary is offered by the company). If 15% of my productivity isn’t enough to satisfy Hacker, then how much of the reward of my labor should be dedicated to satisfying his need to avoid economic difficulty? Is 50% enough, or 75%? Or, should we shift to simply pooling our goods and then distributing the results according to government’s needs? Never mind that the progressive tax system already discourages me from being more productive because having the top end of my wages reduced by 50% through various state and federal taxes makes it not worth earning more. (Never mind the realization that for the first $388k a person earns, they make out like a bandit from Social security, but it becomes a rip off after that point.)

All of this is to say that a safety net a real need, especially in an industrial economy that draws people away from their families and has, as a discernable downside, the disruption of lifelong communities. However, some thought might go into being more efficient with the large portion of people’s wealth that is already taken for redistribution and reducing risk before we plan on taking a bigger chunk of the available resources to use according to the planners’ desires. Additionally, if books on important topics like The Great Risk Shift are to be taken seriously, then they ought to consider the existence of real arguments against their positions and the fact that there is no proposed solution that does not have obvious and likely downsides.

NOTE: I received a gratis copy of this volume from the publisher with no expectation of a positive review.