I had to go into a hospital today (nothing major for me, in case anyone wonders!) and I was genuinely surprised by something. Only around one person in every five was wearing a face mask, despite these being given out for free at every entrance. This really made me think about personal responsibility and how that would be applied to face masks. Personal responsibility is central to a number of political stances, not least libertarianism, which seems to have been wholly embraced by Liz Truss and Kwasi Kwarteng (disastrously so). So how might or should this principle apply to wearing a face mask?

What is Personal Responsibility?

(NB, this gets a bit deeper into the philosophy of ethics than I originally thought, so feel free to skip to the next section for the meat of the argument).

It might be an obvious question with an even more obvious answer to some, but it is an interesting philosophical point. In my view, it is about taking ownership of decisions or actions you make and agreeing to help if your actions cause negative consequences. In other words, if you harm someone whether directly or through inaction (thank you Isaac Asimov) then you indemnify the victim for that harm and adjust your behaviour to minimise future harm.

This becomes a little more difficult when you have a cost to mitigating your current behaviour and you need to compare that cost to the harm that you do. At that point you would need to assign relative costs to both the actions you take and the harm that would be done as a result. This ends up being hugely subjective and has been the subject of endless debates between ethicists for millennia.

Personal responsibility is a balancing act

In my view, though, the moral position can be reduced to:

• If you have the option to reduce harm with no cost to yourself, then the only moral option is to reduce harm.
• If you are faced with a choice to cause yourself a cost but it would not reduce harm, then it is not a moral imperative to pay the cost.
• In the majority of cases, there is a mixture of harm and cost, and it is necessary to quantify these according to an individual moral framework.

Within most moral systems there is the idea that causing harm to others is generally worse than minimising a loss for oneself. In other words, one could be better off by stealing from someone else, but unless that theft is necessary to preserve life or reduce harm to others, it is genuinely hard to see how this could be considered moral.

What are Face Masks?

Face Masks – what do they do?

This might fall into the category of blindingly obvious, but it might be worth revisiting what these are for. Masks aren’t just for virtue signalling or decoration, after all. They provide a tangible benefit in the control of infections. Importantly the main benefit isn’t to the mask wearer. Instead the mask helps to stop the wearer from passing on their germs to others. It’s a little like sneezing into a tissue – that action isn’t for the sneezer, but for all the people around them that might otherwise be sneezed on.

When it comes to certain pathogens (viruses, bacteria and fungi), airborne transmission is the primary means of infection. Sometimes you can be a carrier of an infectious pathogen without displaying any symptoms, so simply “feeling fine” is not a guarantee that you aren’t carrying an infection that could be lethal to someone else.

I mentioned cost above as a reason not to do something, so it’s worth revisiting the costs of wearing a face mask:

• Cost of acquisition – usually free at the point of use. There’s an argument that NHS trusts or private hospitals have to foot the bill so we pay indirectly, but I would argue that these decisions are made on a cost-benefit analysis by individual trusts.
• Cost of wearing – usually nothing. The masks can feel uncomfortable, but this is usually a minor inconvenience. There is some talk about face masks reducing oxygen saturation in the blood, but this largely seems discredited.

This is obviously different for people that cannot wear a mask for medical reasons – clearly the cost for them is insurmountable. For most of us, though, wearing a mask is nothing more than a minor inconvenience.

Personal Responsibility and Face Masks

Here we come to the discussion of how personal responsibility and face masks intersect. When it comes to personal responsibility, I summarised that it would be immoral to do something that caused harm to others if the cost was negligible to not do that. Under the topic of face masks, I concluded that, for most of us, the cost of wearing a face mask is negligible.

I therefore think that the conclusion is inescapable. Wearing a mask has minimal or no cost and potentially saves lives. As such, it certainly seems to me to be entirely moral to wear them where there is likely to be a positive effect. Hospitals are likely the place most likely to result in deaths if infections are allowed to spread uncontrolled, and they are the place where masks are still provided free of charge for everyone.

Possibly more importantly, in most hospitals there is a good chance that there will be some patients there who did not make a choice to go there – instead they are there because of an illness or injury that they certainly would not have chosen to acquire. As such, there can be no use of the “they chose to go there and accept the risks” type of argument that could be used to oppose mask mandates.

My conclusion is not to suggest that a mask mandate should be reintroduced nationally. However, I genuinely feel that those who turn down free masks in hospitals run the risk of killing someone else by accident, and personal responsibility should make them pick up face masks and wear them with pride.