Nelson Mandela

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In a post at Practical Ethics, Dominic Wilkinson asks a thorny question that seems like a simple one at first blush: Should some people, who are considered exceptional, receive health care that others don’t? Of course not, we all would say. Human lives are equal in importance, and our loved ones are just as valuable as the most famous or successful among us. But Wilkinson quickly points out that Nelson Mandela, probably the most beloved among us during his life, received expensive and specialized care that would have been denied almost anyone else in South Africa. But how could we deny Mandela anything, after he sacrificed everything and ultimately led a nation 180 degrees from a civil war that could have cost countless lives? You can’t, really, though I would wager that Peter Singer disagrees with me. The opening of Wilkinson’s post:

There are approximately 150,000 human deaths each day around the world. Most of those deaths pass without much notice, yet in the last ten days one death has received enormous, perhaps unprecedented, attention. The death and funeral of Nelson Mandela have been accompanied by countless pages of newsprint and hours of radio and television coverage. Much has been made of what was, by any account, an extraordinary life. There has been less attention, though, on Mandela’s last months and days. One uncomfortable question has not been asked. Was it ethical for this exceptional individual to receive treatment that would be denied to almost everyone else?

At the age of almost 95, and physically frail, Mandela was admitted to a South African hospital intensive care unit with pneumonia. He remained there for three months before being transferred for ongoing intensive care in a converted room in his own home. Although there are limited details available from media coverage it appears that Mandela received in his last six months a very large amount of highly expensive and invasive medical treatment. It was reported that he was receiving ventilation (breathing machine support) and renal dialysis (kidney machine). This level of treatment would be unthinkable for the vast majority of South Africans, and, indeed, the overwhelming majority of the people with similar illnesses even in developed countries. Frail elderly patients with pneumonia are not usually admitted to intensive care units. They do not have the option of prolonged support with breathing machines and dialysis at home.”

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From Ryan Irwin’s Foreign Affairs appraisal of South Africa after Nelson Mandela, which argues that the late President was ideal for a transitioning nation but that the country needs a different kind of leader for its next phase:

“Turning Mandela’s pluralism into a coherent governing doctrine was difficult. Mandela is remembered today mostly for his symbolic acts, gestures that ‘made South Africans feel good about ourselves,’ in the activist Desmond Tutu’s words, such as embracing the country’s national rugby team, the Springboks, during the 1995 Rugby World Cup. Mandela developed actual government policy slowly as he negotiated his country’s constitution between 1994 and 1997, taking a hard line on multiculturalism while relinquishing his commitment to wealth redistribution. In Mandela’s words, it was at a World Economic Forum in Davos, Switzerland in 1992, when he ‘realized, as never before, that if we wanted investments . . . we had to remove the fear of business.’ Storytelling could only go so far.

South Africa today is a reflection of Mandela’s presidency and the grand strategy that preceded it. By cultivating such a pluralist stance toward anti-apartheid activism, Mandela’s ANC successfully ended the legitimacy of South Africa’s minority white government. These efforts, however, cultivated unusually high expectations among the supporters who embraced the ANC for reasons as diverse as South Africa itself. The resulting dissonance has made South Africa a paradox: imbued with a rich vocabulary of civil, political, economic, social, and human rights, the country remains plagued by pervasive income inequality, structural unemployment, and widespread poverty.

Another Nelson Mandela would not cure South Africa of these ills. To thrive in the twenty-first century, the country needs not hope and activism but technocrats and engineers who can develop workable solutions to the messy realities of urban blight and rural poverty. This perhaps would be Mandela’s message to the generation born after 1990. ‘There are good men and women in all communities,’ he reflected shortly after his retirement in 1999. ‘The duty of the real leader,’ he asserted, is not only to bring these people into the fold but also to ‘give them tasks of serving their community.’ Modern South Africa needs a leader who can do the latter.”

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It obviously takes not only an extraordinary person but also an extraordinary challenge to end up with someone like Nelson Mandela. The question: Now that he’s gone, who among us comes close to measuring up to him or will come close to that standard in the near future? Do we know that person’s name yet?

“Nelson Mandela,” by the Specials.

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