In April 2020, an ER physician in Toronto, Ari Greenwald, started an online petition to bring tablets and phones to his patients in hospital, because hospitals had imposed strict No Visitor rules to limit the spread of COVID-19. Greenwald said that, “As challenging as this COVID-era of healthcare is for us all, the hardest part of patient care these days is watching patients suffer alone without family and friends at their bedside.”
No visitor rules do more than deny patients access to family members’ hugs and companionship. They also deny those families a chance to care for their loved one while they’re in the hospital. Family members can’t hold their hand while they are dying or say good-bye in person and ease their own grief by knowing that they supported their loved one at the end. In lucky cases where the patient has a device in hospital, families get to say good-bye in some fashion online. But, many other families learn through a phone call from a healthcare worker that their loved one has died, without them.
No visitor rules, social distancing, self-isolation, and quarantine are agonizing for us because we are deeply social creatures. Our social needs may even be more important than our needs for food, water, and shelter. Social needs are a human right.
We are so deeply social that meeting our social needs – for decent human contact, acceptance within a community, companionship, loving relations, and interdependent care – is more important than meeting almost every other need we have. The exceptions are our basic need to survive – which the social-distancing orders prioritize – and our need for clean, breathable air. (Hold your nose and close your mouth for two minutes to see if you disagree with how fundamental that need is.)
The thought that our social needs are more important than our needs for food, water, shelter, health, education, free movement, free expression, due process, and the rest, is a revisionary one gaining traction amongst social psychologists, neuroscientists, and some philosophers, which implies that Abraham Maslow’s famous pyramid of the hierarchy of needs is incorrectly ordered.
Maslow put on the bottom, most basic level of his pyramid our physiological needs for food, water, and sleep, and then, on the second level, our safety needs for physical shelter, bodily security, and health. He called these our basic needs. Above them come our so-called psychological needs which include, on the third level, our needs for belonging, intimate relations, friendships, and love, and, on the fourth level, our needs for esteem and a sense of accomplishment. Finally, at the top of this five-level pyramid, sit our needs for self-actualization to realise our full potential in creative endeavour.
There are several reasons why Maslow’s ranking of needs is mis-ordered and our social needs really sit on the bottom, most basic level.
Humans necessarily depend on each other to access the goods that Maslow took to be most basic. We cannot securely access food, water, a safe place to rest, health care, or bodily security without other people’s continued support. This is true most obviously when we’re babies and children.
But it is not only in childhood that we depend on each other to meet our needs. Throughout our lives, we face innumerable challenges that we cannot weather well without help, including giving birth, surviving illness, recovering from injury, facing death, grieving, withstanding loss of employment, returning from prison or exile, acquiring education, expressing ourselves, and cultivating spirituality and faith.
But our social needs are also important in their own right. Even when we’re healthy, able adults, we are defined by our sociality. Our brains are hardwired to think about social connections when we don’t task them to think of other things: this is our default neural network. And, we typically choose to spend much of the time that we’re awake with other people.
A sceptic might note that (some) people can thrive perfectly well without human contact. There are some real-life Robinson Crusoes after all, such as Richard Proenneke, a former military carpenter, mechanic and self-taught naturalist, who lived alone at Twin Lakes, Alaska, for close to 30 years.
But, Robinson Crusoes are the exceptional ones, and their ability to survive or thrive in isolation does not change the fact that most of us need persistent, supportive social contact and care.
If our social needs are so fundamental, basic, and universal, they lead us necessarily into the territory of human rights. Human rights protect the brute moral minimum, i.e. the least that we owe each other as human beings. We must have, at the very least, a human right against social deprivation, or rather a right to have access to decent human contact, to try to form and keep good social connections, to be protected in our connections once they exist, to be put into supportive connections when we’re unable to make social overtures, and to have the social resources we need to sustain the people we care about.
Social deprivation doesn’t occur just in institutions of forced segregation like solitary confinement, isolated immigration detention, or quarantine. We can also be socially deprived when we’re surrounded by people who treat us brutally. This is the reality in many prisons where violence, sexual assaults, harassment, and intimidation define inmates’ lives.
Heartbreakingly, home can also be sites of social deprivation when it’s defined by abuse. The spike in domestic abuse reports in many countries during the COVID-19 pandemic is evidence of a tragedy that governments anticipated when they closed the schools. Many people – including many children – are leading socially deprived lives.
Despite the social horrors that many people are suffering, the time of the pandemic is also witness to a remarkable outpouring of social overtures and social contributions. News stories highlight the famous hotel that made its secret cookie recipe public, and the children’s artists who are offering free lessons online. There are the shoe companies and spectacles companies providing free goods to healthcare workers, and the restaurants that are running soup kitchens (delivered to people’s houses). There are the families sharing supplies and shopping for each other, the theatres posting concerts, plays, and musicals free online, and the audiobooks seller making the children’s section freely available while schools are closed. There are the people in lockdown lowering baskets of bread from their apartment balconies for the homeless people below, as well as the actors and sports stars who are using their fame to get more personal protective equipment to healthcare workers. Wealthy people are making substantial donations; hotels are offering rooms free of charge to commute-exhausted healthcare workers and newly arrived immigrants; and thousands of willing volunteers want to help. There are the evening cheers for healthcare workers heard around the world and the countries donating PPE to other countries that are in greater need.
The full effects of this season of social chaos are yet to be seen. We have made a necessary choice to prioritize human life and health over sociality. But, we are paying a high price for it – an often invisibly high price – which we must not ignore. We are fundamentally social beings. Tablets in hospitals, face-to-face conversations, and hugs are as vital as food and water for our survival and wellbeing.
Featured Image Credit: by Tim Mossholder on Unsplash