key: cord-315217-sg6vnur0 authors: Biana, Hazel T.; Joaquin, Jeremiah Joven B. title: The Ethics of Scare: COVID-19 and the Philippines’ Fear Appeals date: 2020-04-20 journal: Public Health DOI: 10.1016/j.puhe.2020.04.017 sha: doc_id: 315217 cord_uid: sg6vnur0 nan The Ethics of Scare: COVID-19 and the Philippines' Fear Appeals COVID-19 took the world by surprise; and, as of early April 2020, the virus has already claimed more than 80000 lives and infected more than a million people around the globe. 1 To combat the pandemic, most governments strongly enforced social-distancing, area-wide lockdowns and curfews, and contact-tracing of persons under investigation (PUIs). To motivate people to take preventive measures, some heads of states used what may be characterized as the "friendlier" strategies in the form of infographics, infomercials, and hashtags. 2 On top of this, other governments have resorted to rather extreme tactics, which play on people's fears to regulate behaviour. Witness some cases in the Philippines as examples. In the country's National Capital Region (NCR), which has the most COVID-19 positive cases, most areas have an assigned town crier who, while on a recurida or a mobile audio truck, threatens residents with fines of up to Php5,000 (US$100) and possible jail time for noncompliance with set curfew hours. 3 In Cainta, Rizal, a province north of Manila, local officials signal the start of the curfew by sounding the alarm from the horror movie The Purge (2013). 4 (The Purge's story revolves around the "purging" or violent killing of people in a single night while emergency services are suspended.) Even the Philippine president, Rodrigo Duterte, dissuades the public from disobeying the enhanced community quarantine (ECQ) with remarks like, "...If there is trouble or the situation arises that people fight and your lives are on the line, shoot them dead". 5 The psychology literature refers to these scare tactics as "fear appeals". Fear appeals are nothing new. As a pioneer on the subject, Howard Leventhal explains, feararousing communication is a tool often used to persuade others to act and behave in a certain way. 6 Parents use it to discipline children; bosses to drive staff productivity. Even medical practitioners employ "fear-based medicine" in clinical encounters when they try to coax patients to follow a course of action by issuing "if you don't, then..." threats. 7 Fear appeals have also permeated public health campaigns. Visual health warnings on cigarette packaging, for example, are a case in point. 8 While some, like R.F. Soames Job, have argued that such campaigns are ineffective 9 , others, like Kim Witte and Mike Allen found that "strong fear appeals and highefficacy messages produce the greatest behavior change" 10 . The verdict is still out whether such campaigns are effective or not. 9 As Irish Olympian John Treacy once said, "fear is a great motivator". It pushes our survival instincts into high gear. While fear appeals and scare tactics have been used in clear and present public health emergencies like COVID-19, the ethics of such public health communication interventions needs to be scrutinized. 11 In particular, whether these appeals and tactics are morally acceptable and appropriate. 12 It might be argued that scare tactics are acceptable in times of crisis so long as they urge "large population segments, who are at moderate risk, to adopt risk-reducing practices... to influence those who are at high risk". 11 Such a reason may perhaps be grounded on the utilitarian principle of doing what best promotes the greatest benefit for the greatest number. On the other hand, an argument premised on a Kantian, rights-based moral philosophy might say that if these tactics violate certain moral and legal rights that people hold inviolable, then such appeals are morally inappropriate. To preserve the Kantian ideal for appropriateness, it might be suggested that fear appeals "should exclusively be used when pilot studies indicate that an intervention successfully enhances efficacy". 13 In a time of the uncertainties of a global health crisis like COVID-19, however, a utilitarian may question this suggestion's moral acceptability. On the whole, then, the rightness of fear-mongering might therefore be the balance of its moral acceptability and appropriateness. The editors of this journal have stated that the global health threat of COVID-19 requires collaborative health actions from different sectors from around the world. And they called for a strong public health response to combat this pandemic. 14 Whether this call extends to the use of scare tactics is something that the public should morally examine. One line that epitomizes a scary tactic is President Duterte's fierce pronouncement on a live telecast that COVID-19 is a "crisis with no solution in sight". 15 Whether the statement is true, or whether it contributes to the well-being of the general public are beside the point. We just hope that that was a mere fear appeal as the very thought of it makes us shiver from sheer fright. World Health Organization. Coronavirus disease Department of Health -Philippines. Infographics | Department of Health website Six Metro Manila cities enact COVID-19 curfew City in the Philippines plays "The Purge" announcement to enforce coronavirus curfew Philippines President Rodrigo Duterte warns against violating coronavirus lockdown -ABC News (Australian Broadcasting Corporation Fear appeals and persuasion: the differentiation of a motivational construct Fear-based Medicine: Using Scare Tactics in the Clinical Encounter -The Health Care Blog Fear Appeal Arguments Effective and ineffective use of fear in health promotion campaigns A meta-analysis of fear appeals: Implications for effective public health campaigns. Heal Educ Behav Guilt, Fear, Stigma and Knowledge Gaps: Ethical Issues in Public Health Communication Interventions A Method for Evaluating the Ethics of Fear Appeals Threatening communication: A critical re-analysis and a revised meta-analytic test of fear appeal theory COVID19 -The need for Public Health in a time of emergency Duterte says there is 'no solution in sight' for COVID-19