CABA, Buenos Aires / Argentina; June 28, 2020: Argentine flag with the message Stay at home, in the context of the pandemic and the quarantine to prevent the spread of coronavirus disease, Covid-19

Bioethics Forum Essay

Covid-19 in Argentina and the Abuse of Bioethics

More than a year after the beginning of the Covid-19 pandemic, many Latin American countries are being devastated by excessive loss of life, many sectors of society falling below the poverty line, and health systems being overwhelmed.  As collateral damage, some countries in the region are witnessing an eruption of populism and autocratic trends and an increasing erosion of already weak and unstable democracies. 

Can bioethics be a useful tool for managing this crisis?  Argentina provides a case study.

In June 2020, the Argentine Ministry of Health convened a group of experts in bioethics and ordered the formation of the Ethics and Human Rights Committee in Covid-19 Pandemic. According to its foundational principles, the role of the committee is to advise the government on “the bioethical dilemmas posed by the Covid-19 pandemic in Argentine society,” essentially in public health, supporting the protection of human rights and dignity of the individuals,with particular emphasis in achieving justice by promoting equality in burdens and benefits in a framework of fairness and transparency.

The committee has issued seven reports. Five of them are conventional bioethics documents:  reflections on resource allocation during emergencies, the enumeration of the committee’s purview, recommendations for accompanying hospitalized persons during the pandemic, a report to the Ministry of Health, and the criteria for prioritizing access to the health care system during the pandemic.

The last two reports, produced last month, depart from bioethical considerations, and take on a markedly partisan tone in defense of the Argentine government’s position on the role of the independent press and the attempt, thwarted by the Supreme Court, to close public schools in the Autonomous city of Buenos Aires. One of them is entitled “Iatrogenic Information: Ethical and Human Rights Considerations.” The other is called “Interruption of Educational Attendance: Ethical and Human Rights Aspects.” In both cases an explicit appeal is made to human rights, which is more common in bioethics in Latin American than in the United States.

According to one of the standard textbooks of internal medicine, “an iatrogenic disorder occurs when the deleterious effects of the therapeutic or diagnostic regimen causes pathology independent of the condition for which the regimen is advised.” The Iatrogenic information report blames independent media for  exacerbating “mistrust and skepticism” within Argentinean society  by manipulating the information related to the governmental handling of the pandemic, especially in the acquisition and distribution of the vaccines  This critical media coverage, according to the report, undermines societal trust in the government which, due to the emergency, implies a direct attack to the imposition of public health measures. 

In fact, the extensive lockdown imposed in Argentina was not based on epidemiological considerations but was the result of inadequate testing and poor decisions made by health authorities based on ideological biases rather than on public health principles.  As a result, Argentina has been left with the worst possible scenario: the economy is in tatters with an unprecedent 42% of the urban Argentinean population living in poverty; almost 70,000 deaths; more than 3.3 million cases of Covid-19; and more than 10 million children and adolescents stopped attending school during the pandemic, a major factor being the lack of Internet.

The committee’s bizarre application of the clinical concept of iatrogenicity to public health implies that criticism of the health authorities’ handling of the pandemic has induced an illness in the body politic, a transparent attempt to blame the messenger.  A journalistic investigation carried out in one of Argentina’s main newspapers, La Nación, revealed that Pfizer had offered the Argentine government 13.3 million doses in December 2020 that the COVAX fund, which is co-managed by the World Health Organization, offered 25 million vaccine doses, but that the former health minister accepted only 2.5 million doses of vaccines.

Or perhaps the committee is using the term iatrogenic in response to another scandal, unearthed by the media in February, when only one-tenth of the vaccines promised by the Russian government arrived in Argentina and less than 8% of the elderly and other vulnerable people were vaccinated. Again, the press denounced preferential administration of vaccines to members of the ruling party and young partisan groups. The ensuing scandal engulfed the minister of health and he was forced to resign.

Or maybe the committee’s use of the term iatrogenic refers to the critics of the opaque arrangements that the Argentine government had with Russia to receive Sputnik V, the vaccine produced by the Gamaleya Research Institute of Epidemiology and Microbiology, and the consequences of the Russian government’s failure to deliver vaccines as promised. In part because of that agreement, only 11% of Argentina’s population has been vaccinated so far.

The second report, “Interruption of educational attendance: Ethical and Human Rights Aspects,” supports the federal government’s decision to shut down the schools  in Buenos Aires. Buenos Aires is divided into the nation’s capital–the Autonomous City of Buenos Aires–and the province of Buenos Aires.  The latter is ruled by the Peronist party, which also holds the national government. The former is governed by a coalition formed by the opposition.

The federal government ordered the suspension of classes in both districts. That decision was not based on epidemiological grounds, as many public health experts testified, but on  political scuffles within the government. Fearing a federal intervention, the Buenos Aires governor brought the case to the Supreme Court, which reaffirmed the constitutional status of the capital city and left the decisions about in-person schooling to the local government.  This second committee report explicitly supported the Argentinean president, who, frustrated by the Supreme Court ruling, stated, “I will take care of the health of Argentines no matter how many pages of sentences they write.”

What is worrisome is the use of a government-appointed bioethics committee as a partisan tool, especially when discussions should be conducted based on the ethical and moral considerations of the difficult issues being discussed and not on political interests.  Even more worrisome is the idea of a bioethics committee urging that the free press be silenced or that the separation of powers should be overridden, a cornerstone of democratic norms.

The dramatic circumstances brought about by the Covid-19 pandemic call for dispassionate reflection on all the elements at stake that will affect the lives of millions in the years to come. Both bioethics and human rights are words that carry moral significance. The banal and partisan use of these words by bioethics committees only succeeds in stripping them of their meaning and gravity.

Sergio G. Litewka, MD, MPH, is an associate professor of surgery at the University of Miami Miller School of Medicine and director of international initiatives of the Institute for Bioethics and Health Policy. Jonathan D. Moreno, PhD, is the David and Lyn Silfen University Professor at the University of Pennsylvania, where he is also professor of medical ethics and health policy, of history and sociology of science, and of philosophy. He is a Hastings Center fellow, @pennprof

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  1. As an Argentine born, Italian-American, I can say that these sorts of appropriations might not be unusual in the work of Argentina’s federal government, but then they are not unusual, anywhere. In understanding a bit more charitably how different governments are struggling to meet the complex health care and educational needs of their citizens within the context of an unprecedented pandemic via, perhaps, well-intended measures allows us to recognize that the general effort is likely not politically devious, thus the term “abuse” might be a bit unjustified, as we can’t have an instance of the morally culpable (and thus objectionable) kind of abuse without abusive intent. And whether the intent was to abuse the influence of the committee or the committee itself, hasn’t been made very clear in that we don’t have evidence of what the precise reasoning was behind the decision to support federal measures. Recommendations in accordance with an “ideology” are not necessarily recommendations caused by that set of beliefs. Although in principle, I agree, we’re simply missing some important information for the moral position being indicated.

  2. Thank you very much Dear Prof. Litewka and Moreno for this article. As an argentine lawyer and bioethicist I feel relief to know that I’m not alone struggling with the partisan ideologization of pandemic in my country. This is happenning right from the very beginning of the pandemic when we were confronted with some professionals surrendering science integrity to politics. Truely, Bioethics and social sciences in general have been completely absent in decision making during this pandemic at my country. We were reduced to a virus, with a dangerous biologial determinism approach. Our federal government is making public health decisions not based on science but on merely politics convinience. Schools can be closed no matter the huge evidence of risks and harms to our children deprive of school and social interaction with their peers…….but we can celebrate football matches, organize a Footbal International Championship or mourn a football player with large crowds with no preventive measures, while ordinary people was deny the basic human right to say goodbye to their loved ones. They don’t even have a vaccination plan and some of the few vaccines that arrived to my country went to politicans, friends of the ruling party or even their mistresses.

  3. Bioethics from the north. Playing with the truth?
    Response to Litewka and Moreno by the Bioethics and Human Rights Committee for COVID 19 (CEDH COVID19) Argentine.
    As members of the Bioethics and Human Rights Committee for COVID 19 of the Ministry of Health of Argentina, we are greatly surprised by the tone in which the authors refer to the reports produced by the committee, including unfounded accusations about our political ties to and support of the government. This is not the place we used to express our position, however, but since the readers are left with a text ripe with false and unfounded assertions, we find it necessary to state the following:

    • we constitute an independent national ethics committee that receives requests for advice from the Ministry of Health and to whom we send our reports. We promote a non-partisan bioethics rooted in human rights, committed to collective health and the protection of the most vulnerable sectors of society;
    • the committee has forcefully proven its independence and autonomy, e.g. by publicly condemning the scandal related to the improper handling of the vaccination process (vaccination in secret of a group of privileged people). This led to the removal of the Minister of Health of the Nation, something which is not mentioned by Litewka and Moreno (https://www.pagina12.com.ar/325233-el-comite-de-etica-covid-contra-los-privilegios-de-unos-ciud).
    • the sources consulted by the authors, and from which they have drawn their dubious assertions, are from a newspaper in the country with well-known political ties and whose journalistic independence has been seriously questioned. Nothing prevents an opinion from being partisan as long as it is recognized as such, and as long as its assertions are sufficiently substantiated and does not simply repeat other interested “opinions”.
    • the authors do not seem to have read any of the reports made by this committee (all have been published in Spanish, (see: https://www.argentina.gob.ar/salud/coronavirus/comite-bioetica), and apparently they have only read the titles of the last two reports, which, in their understanding, somehow, capture all their content.
    • the two reports mentioned are absolutely objective, contain a rich bibliography documenting the sources consulted, and refer to two issues that cross not only Argentina but all the countries of the region. These are issues that do not seem to be known by the authors:

    1) The negative impact of false information on social behaviors. Fake news hav been described and denounced by WHO itself (infodemic). False information directly influences the collective conscience and contribute to the increase of anxiety and anguish of people, also in the field of health. This can have not only unwanted but harmful consequences to the point of putting at risk life and quality of life. It can also generate doubts with regard to the motivation of people to get vaccinated and adhere to personal and social protection measures such as distancing and the use of face masks. In no case has any reference been made to restricting freedom of expression, rather an appeal has been made to responsibility with regard to the proper use of information (https://www.conicet.gov.ar/tag/fake-news/; https://www.conicet.gov.ar/conicet-research-team-has-refuted-more-than-a-hundred-fake-news-on-coronavirus/; y http://www.uncode.cafe/mentiras-y-verdades/las-fake-news-quien-las-crea-para-que-y-como-se-propagan).

    2) The debate about the reopening of schools involves all Argentinian provinces, and concerns a fundamental human right; the right to education. Taking into account that two of the major determinants of the spread of the disease are school attendance and social gatherings with numerous participants, it was of fundamental importance to express this opinion (See: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00622-X/fulltext; also see: https://www.feduba.org.ar/2021/05/12/informe-sobre-el-impacto-de-la-presencialidad-escolar-en-los-casos-confirmados-de-covid-19/). In fact, as of yesterday, the whole country has adhered to the decision to suspend classes, including the city of Buenos Aires. The report of the committee was published one month before the events mentioned in the opinion piece of Litewka and Moreno, and not as a response to them, which is also missing from the truth.

    • the authors’ sweeping statements about the epidemiological situation of the country and the handling of the pandemic, are made without any bibliographic reference.
    • in relation to the purchase of vaccines, the authors fail to mention that 10 countries have hoarded more than 75% of the world stock of vaccines, (See: https://news.un.org/es/story/2021/02/1488202 ; and https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-148th-session-of-the-executive-board), and that pharmaceutical companies have imposed ethically unacceptable conditions on low and middle income countries (https://www.thebureauinvestigates.com/stories/2021-02-23/held-to-ransom-pfizer-demands-governments-gamble-with-state-assets-to-secure-vaccine-deal; https://www.thebureauinvestigates.com/stories/2021-03-10/vaccine-contract-forces-dominican-republic-government-to-pay-if-pfizer-makes-mistakes; https://www.batimes.com.ar/news/world/held-to-ransom-pfizer-demands-governments-gamble-with-state-assets-to-secure-vaccine-deal.phtml; and https://www.pharmaceutical-technology.com/news/company-news/pfizer-latin-american-vaccine/).

    • Argentina is a middle-income country faced with a complex economic situation that has impacted not only its negotiating capacity, but also the way in which the measures to prevent the pandemic has affected the economic and social level.
    • The authors’ critique of the human rights approach of Latin American bioethics is not new, and it reflects not only ethical positions, but political positions as well. This is not the right place and time to address that critique.
    • Finally, speaking of impartial and unbiased debates; we believe that what current bioethics needs most, is precisely that its exponents, not the least when they are from the first world, do not try, and notably from a supposed position of academic independence, to disqualify the efforts we make in a disinterested and “ad honorem way”. In these complicated times, what we try to achieve, is the promotion of ethical principles in the design of public policies aimed at the protection and promotion of human rights.

    As members of the Bioethics and Human Rights Committee for COVID 19, we strongly reject the opinion piece of Litewka and Moreno; it offends the dignity and honor of each and every one of its members and it increases the level of uncertainty and confusion in the population.
    We expect our answer has the same visibility in this webpage.

    1. However, the new “Minister” has vaccinated his parents well before their time. The President of the Chamber of Deputies has done the same with his fathers and his parents-in-law. As far as I know no action was taken on these case. Not to mention the numebr of politicias lovers that have been vaccinated despite being in prime health and in general less than 30 years old….

    2. It is worrisome that in the original report and in your comment here you state that school attendance is a significant contributor to community transmission of COVID-19. Both in the report and in this comment you cite one reference to support that assertion: a letter to the editor authored by Gurdasani et al that focuses on the importance of mitigation measures for school openings (measures that are conspicuously absent from your discussion). Are you aware that the CDC and WHO have stated unequivocally in their official communications that current evidence suggests that schools do NOT in fact contribute to community transmission? Are you aware of the multitude of studies that have been reviewed by the CDC and WHO that support that conclusion? Your report does not elaborate on any methods for review of the relevant evidence. Was such a review conducted prior to the discussion of the ethical aspects of school openings?

    3. It’s quite interesting that while disqualifying La Nacion newspaper you cite Página 12 that is practically the house organ of the government. Furthermore “Cherry picking” the letter to The Lancet regarding school attendance and COVID epidemiological risk while there are several articles stating otherwise including recommendations from the WHO and citing the committee conclusions that have been seriously challenged by experts for a lack of statistical evidence doesn’t help to have confidence in your supposedly unbiased opinion.

  4. I believe that reading the Committee’s reports from a partisan political standpoint is to ideologize texts that provide international and extra-partisan support to their ideas. As a matter of fact, it puts into practice what is being disputed: using the pandemic as a political party instrument. And it´s unfortunate that it´s being done in prestigious places such as this magazine.
    But beyond the allegations claimed in the text by one of the authors linked to the NIH (and that is very timingly associated with an escalation of mis-information in Argentina, accusing the authorities and complaining about the need to resume negotiations with Pfizer), I want point out that if the recommendations of epidemiologists were followed in Argentina, it is because both there, as the rest of the world, they are suffering an epidemic whose main cause is a virus. Therefore the advice of experts on this matter is absolutely necessary, and what demonstrates this is the fact that the same measures were recommended in all countries by epidemiologists.
    It is not worth debating arguments about the world wide recommended and implemented closing of schools; the same goes towards the argument of avoiding contact with the deceased.
    It is totally false that there is not a vaccination plan that is being fulfilled in Argentina; on the contrary, it´s being carried on in spite of the problem of vaccines being held by the countries of the first world. I´d like to also state that the unsubstantiated complaint that the vaccines were only for officials is completely false.
    In all countries there have been abuses with the vaccines, but in very few of them the minister of health had to resign because of it.

  5. Among the comments to the Litewka text, I find one that definitively associates what it says with partisan political responses, since it is an outright criticism of the Argentine government.

    It is clear to anyone who takes the trouble to read the texts of the Committee, criticized by Litewka, that these texts
    focus on putting white on black issues that concern the defense of human rights, mainly the right to life; this defense,
    which is not the privilege of any government, but must be the obligation of all, especially in times of pandemic.
    Litewka’s text is very valuable because it forces us to search for and know the original documents of the Committee
    and allows us to coincide with its arguments in defense of the rights to health, education and information accuracy.

    Among the comments to the Litewka text, I find one that definitively associates what it says with partisan political responses, since it is an outright criticism of the Argentine government.

    It is clear to anyone who takes the trouble to read the texts of the Committee, criticized by Litewka, that these texts
    focus on putting white on black issues that concern the defense of human rights, mainly the right to life; this defense,
    which is not the privilege of any government, but must be the obligation of all, especially in times of pandemic.
    Litewka’s text is very valuable because it forces us to search for and know the original documents of the Committee
    and allows us to coincide with its arguments in defense of the rights to health, education and information accuracy.

  6. Regarding the comments made by Ms Vidal, I would like to point out the following. In the Ministerial Resolution designating the Bioethics Committee there is no reference to the alleged expertise and background of the designated members, just the typical “designated members have the required expertise and competence to be in this committee”
    The most controversial reports are signed ONLY by 8 members, the rest of the designated members are not mentioned
    I would suggest to those interested in the “depth” of the Committee’s analysis to read the report on “The ethical and human rights (sic) reasons for interrupting school presence”. The number of unsubstantiated declarations about the quality of the digital education in Argentina during 2020 is really amazing. Given that most children in Buenos Aires province are poor and lack internet access and the necesssary hardware to access the classes, and the absolute lack of training of the vast majority of teachers at the kindergarten and elementary level in digital teaching, it is basically an act of political faith by these people to say that digital education is an alternative to the presence in shools. And to complete the picture, official statistics show that the vast majority of children have not attended the virual classes during 2020. Even at the elite bilingual schools, attendance and results have been lacking so you can imagine the results in the poor areas of Buenos Aires. There are many ways to diminish the circulation of people in pandemic times, the interruption of schools should be the last resort, not, like in Argentina the first tool, before soccer matches, the burial of Maradona, the presentation of incomplete housing projects or the wake of a Minister who died in a car accident while violating the quarantine imposed by his own government. Best regards

  7. Thank you very much for this timely article. I live in Argentina and I´ve read the Committee´s reports. It is truly disturbing that a Committee dedicated to “Bioethics and Human Rights” has not been outspoken about the numerous human rights´ violations that have taken place in Argentina during the 2020-2021 lockdown (https://www.hrw.org/news/2021/03/26/argentina-abusive-covid-19-measures-northern-province; https://www.amnesty.org/es/countries/americas/argentina/report-argentina/) . The last two reports were perhaps the worst, since the partisanship was so obvious that it was almost shameful. The Committee also remained suspiciously quiet when the Sputnik V vaccine was authorized practically without information and in the absence of regulatory due diligence, placing the citizenship´s lives at risk. It seems to me that the Committee was set up to defend the government´s decisions and, thus, it is far from independent.

  8. I am an Argentinean physician-bioethicist who has practiced clinical and research bioethics for over thirty years in the US, Argentina and other Latin American countries. I am a university professor in bioethics and human rights and has never held any political appointment. However, I am not so naïve as to not recognize the political motivations of many bioethical schools of thought and writings. I contend that this essay’s essential motivation is political and specifically interested in underminining the actions of the current Argentinean government to control the pandemic.

    My country is not a model of political and social stability, and social conflicts abound and are very difficult to solve. As for the economy, it was ravaged by the latest rightist government, which generated an unpayable foreign debt and increased poverty to extraordinarily high figures. The advent of the pandemic exposed terrible preexisting and longstanding inequities, social injustices and public health deficiencies. However, the assertion by the authors that the pandemic crises have brought autocratic trends worldwide might be applied to a number of countries (such as the USA, under former president Trump) but not to Argentina, which has enjoyed uninterrupted democracy and the rule of law for almost 40 years, after the last military dictatorship (which, by the way, and as is well known, had been supported by the USA government).

    The authors make a number of unsubstantiated and biased assertions in attempting to “prove” that the current government, (which obviously is not of their liking, presumably for ideological reasons), coopted bioethics by appointing a group of experts to an Ethics and Human Rights Committee in Covid-19 Pandemic to advise the government on a number issues and measures to preserve health and life during the pandemic. According to the essay, the last two of seven reports “departed from bioethical considerations”, as one discussed the health effects of fake news and disinformation by the mass media regarding the pandemic (is this not a bioethical issue?), while the other addressed the ethical and human rights considerations in the management of school class attendance, either in-class or online (is this not a bioethical issue?) . The authors do not provide any documentation that indeed the Committee members (all unpaid and reputable bioethicists without political affiliation) “rubber stamped” a dictated report from the government. Thus it is all about suspicions, probably based on ideological bias, without proofs nor substantiation. Furthermore, the authors conveniently neglect to say that the latter report had been issued a month before the topic became a contentious between the national government and the city of Buenos Aires government (and not the other way around).

    Citing unsubstantiated allegations by the newspaper La Nación does not help the case of the authors, as this newspaper is notoriously antigovernmental, having disseminated disinformation about the pandemic and supported protests against public health measures by the government to contain the pandemic. The authors of the essay, understandably, preferred to delve into an unsubstantiated allegation of impropriety in Argentina than to address the issue of the hoarding of over 80% of vaccines by a few wealthy countries with less tan 20% of the world’s population, which in my view, is the foremost ethical violation on vaccines, of which Pfizer and other global big pharma are the culprits.

    In conclusion, it seems that in the authors’ views, it suffices that an advisory committee coincides with a government on a particular issue to deem it coopted. This view is indeed bizarre, and reflects either ignorance of the Argentine situation or, worse, covert political partisanship by the authors against the country’s governmental policies. In my view, the authors of the essay are the ones who abuse bioethics to favor their ideological views and in total disregard from the truth. Accusing a group of reputed experts in bioethics without proofs to be stooges of a government is a serious offense that would require apologies in any civilized country.

  9. It is curious that the comments choose education among the topics discussed by the Committee. This issue has been and continues to be used as a workhorse in the media universe in Argentina, forgetting issues such as health care, which is a subject of much more urgency than education, because no one can get an education if they are not alive, and the issue of fake news that are the ones that permanently feed the rejection of publics politics in Argentina.
    Regarding education, it is interesting to note that the publication in The Lancet of the results of the SputnikV vaccine was considered the guarantee that it was safe and effective, however when talking about school presence, the research carried out by The Lancet or other scientific publications is not cited, because they reject school presence when the infections grow.
    We can also point out that when WHO is cited, the adjective “cared” used by this institution to qualify presence is forgotten. Care requires conditions in schools that only a small percentage in Argentina fully meet. This is due to years of declining budgets for education in Argentina. “We all want children to return to class, but for that it is necessary that students and teachers do so in a safe framework,” said the entity’s director of Health Emergencies, Mike Ryan. In this sense, the WHO official advised that this be done “only if the contagion levels are low” and if the establishments “have prepared reaction measures” in case of the appearance of positives in the classrooms.
    One comment affirms that many children do not have access to technological means to have virtual classes. It is true, and it is precisely the lack of budget that prevented them from having them until the beginning of the pandemic. For this reason, the most affected in terms of health and education are children from poor families. It is mentioned that closing schools will prevent equality in the future because it will generate educated children (those who went to school) and uneducated children (those who did not attend), as if in the world prior to the pandemic that difference had not existed.
    Closing schools for a year or two will not be the factor that
    increase inequality among children in a country where 60% of children are poor.
    Those who care so much about presence today will have to remember that concern in the future to achieve an equal education. Do not forget to remember at the same time that in order to achieve this, an equal life is necessary for all children.

  10. It is not the task of an ethics committee to make party politics, however it is to give ethical foundations to government policies. I am grateful to,
    Sergio Litewka, as an Argentine citizen, for having led me to know the Committe`s document that I did not know before and to realize that the
    Commitee fullfit his role. All this argements are ethical and are supported with documents, it es likely that his considerations based on respect
    for human rights, especially respect for life over respect for commerce or even education, have encouraged some government
    practices, which it shoud make us happy.
    There are policies that defend rights an others that do not. Let us remember the policies of the NIH (Agency of the US Department of Health &
    Human Service) that supported the research of Pfizer with AIDS drugs in Africa, denouced internationally.
    Interested comments such as the one published by the Hasting Center do not benefit anyone, least of all those who suffer this pandemic in
    their own flesh.

  11. Covid-19 en el mundo y la corrupción de la bioética
    Juan Carlos Tealdi, Director, Comité de Ética y Programa de Bioética,
    Hospital de Clínicas, Universidad de Buenos Aires

    Aristóteles diferenciaba entre generación, como aquello que llega a ser, y corrupción, como aquello que deja de ser. El artículo “Covid-19 en Argentina y el abuso de la bioética” de Sergio Litewka es un ejemplo de aquello que ha dejado de ser bioética aunque se postule como tal. Y adjudico el trabajo a uno de los autores porque guarda estricta correspondencia con su provocadora actividad en las redes sociales, del estilo de Donald Trump y Rush Limbaugh, y porque no creo que Moreno, de quien guardo buena amistad y mayor estima por su seriedad académica en bioética, pueda haber escrito una sola palabra del vergonzoso panfleto mencionado.
    El artículo dirige su crítica al Comité de Ética y Derechos Humanos en la Pandemia Covid-19 de Argentina porque sus dos últimos informes mostrarían “un tono marcadamente partidista en defensa de la posición del gobierno argentino” y sería preocupante “el uso de un comité de bioética designado por el gobierno como una herramienta partidista”. El autor no adjunta el enlace a los documentos mencionados para que los lectores juzguen por sí mismos, pero se pueden acceder en https://www.argentina.gob.ar/salud/coronavirus/comite-bioetica.
    No voy a opinar sobre esos documentos, los lectores sacarán sus conclusiones, pero creo que lo más importante del artículo de Litewka es su posición personal dado que mientras que los productos del comité argentino sólo pueden tener algún alcance dentro del país, una nota en el Hastings Center Report, la revista de bioética más influyente del mundo, tiene otro alcance y otras consecuencias. Y a esto se suma que el artículo no ofrece una sola idea bioética y en cambio ofrece, de principio a final, una posición política sin fundamentos empíricos ni argumentativos en contra del gobierno argentino. Se trata de mera retórica discursiva, reaccionaria y parcial, que abusa de tópicos comunes a la jerga fundamentalista de la extrema derecha en Estados Unidos y el mundo. Por eso es que un análisis del artículo en cuestión sólo puede hacerse en perspectiva política ya que de bioética no tiene nada.
    En los dos informes del Comité bajo crítica, el autor dice que “en ambos casos se hace un llamado explícito a los derechos humanos, que es más común en bioética en América Latina que en Estados Unidos”. Como Litewka se graduó en la Universidad de Buenos Aires en 1979 debería saber que no es raro que así sea dado que Argentina tuvo una dictadura cívico-militar entre 1976 y 1983 con crímenes de lesa humanidad juzgados y condenados y Estados Unidos no ha tenido para su país este tipo de atrocidades aunque sí las promovió y apoyó como queda reflejado en los documentos desclasificados por su propio gobierno, tales como el derrocamiento del presidente Allende en Chile y la organización del Plan Cóndor de las dictaduras del Cono Sur.
    A esto se suma que los Estados Unidos han sido el país con el mayor número de invasiones militares a nuestros países, que por esa trayectoria se niega a someterse a la Corte Penal Internacional, que no reconoce el derecho a la salud porque no ha firmado el Pacto Internacional de Derechos Económicos, Sociales y Culturales, que ha sido el único país del mundo en lanzar bombas atómicas sobre la población de otros países, o que su embajada ha estado detrás de golpes recientes contra las democracias latinoamericanas (Brasil, Bolivia, Paraguay) acusadas de populistas como hace el autor con Argentina. Por eso es explicable que el llamado a los derechos humanos sea más frecuente en nuestros países y el autor lo sabe aunque lo niegue con esa frase de “es más común”, como si se tratara de preferencias culturales.
    La bioética en general ya suma varias etapas y en su historia muestra corrientes que han ido postulando un progresivo regreso en su arquitectura constitutiva. Nació como una concepción universalista con el Código de Nuremberg contrario al supuesto de “las vidas indignas de ser vividas” propio del programa de eutanasia y los experimentos de los médicos nazis, y se consolidó con la Declaración de Helsinki como su continuidad. Se reformuló como bioética liberal con los enfoques casuístico y de principios que se difundieron entre 1970 y 1990 en su momento de mayor relevancia con autores de distintas visiones aunque sólidamente fundados y respetuosos de la diversidad tales como Dan Callahan, Edmund Pellegrino, Mark Siegler, Alex Capron, Warren Reich, H.T.Engelhardt, Bob Beauchamp, Al Jonsen, David Thomasma, Raanan Gillon, Peter Singer, y tantos otros.
    Pero inició un grave retroceso con la postulación del doble estándar entre 1990 y 2003 bajo el aliento de la introducción del pragmatismo de Rchard Rorty en 1994 y su convocatoria a dejar de lado los derechos humanos y la Declaración de Helsinki, y culminó en un giro regresivo radical en 2003 con el editorial de Ruth Macklin sentenciando por su carácter “inútil” al concepto fundamental de una bioética que había nacido como respuesta moral y jurídica a “las vidas indignas de ser vividas” del nazismo. Por eso en 2004 la FDA abandonó la Declaración de Helsinki para quitar obstáculos al interés estratégico de Estados Unidos en el desarrollo corporativo en ciencia y tecnología. Y si para ese entonces se había propuesto cruzar la línea más atrás de 1947, el artículo panfletario aunque de mala calidad de Litewka nos indica que esa corriente de opinión política iniciada en 2003 ha dejado de ser bioética, esto es, se ha corrompido.
    Para quienes llevamos ya muchos años trabajando en bioética nos resulta lamentable ver esto porque hay que pensar que aunque sea parcial, habrá seguidores de esta desmesura. Que este texto impresentable pueda haber sido publicado en una revista con el prestigio de la trayectoria del Hastings Center es penoso. Y que se use la palabra bioética para encubrir opiniones infundadas, parciales, y laudatorias de las mayores injusticias y desigualdades, sólo merece repudio.

    1. Since Dr. Tealdi’s response avoided discussing the Bioethics and Human Rights Committee documents that inspired this piece and instead chose an ad hominem response, I feel compelled to offer a few clarifications:

      The universal rules on authorship states that when two or more authors sign an article, it is precisely because they share such authorship: These lines are not an exception to the rule. Furthermore, I attest that I have not usurped Dr. Moreno’s mind.

      Dr. Tealdi equates me to Ross Limbaugh or Donald Trump when he affirms that my “aggressive attitude in social media “is similar to their style. I regret to confess that, so far, I have only about 270 followers on Twitter while I follow almost 500 and that my attitude there is pathetically passive. Yes, I usually like or a retweet a comment here and there, but I don’t think that it merits much attention. The low number of followers is a testament on how boring I am..

      Dr. Tealdi has dug in my history and went even to my graduation year (that’s right, it was in 1979), then I have a confession to make: In the 2020 US presidential election I voted for Joe Biden. And I did so for the same reason that I would not vote for the administration that appointed Dr. Tealdi’s bioethics commission: I do not sympathize with elected representatives who fraternize with authoritarian regimes around the world, accuse the independent press of disseminating “fake news” or try to destroy the independence of the judicial system, foundational basis of the democratic system. In that sense, I would believe that the past administration of President Trump and the current administration in Argentina have too many points in common, beyond the different ideological extremes they represent.

      In brief: All these ad hominem, inaccurate and irrelevant charges expressed by Dr Tealdi should not be a distraction from the underlying point made in our blog post: No governmental ethics committee should attempt to quash dissenting voices.

  12. Litewka practica desenfadadamente lo que pareciera querer criticar severamente. Y lo hace con citas parciales y sin adjuntar enlaces a las fuentes que presenta como motivo de su observacion. Digo presenta porque los verdaderos motivos son indubitativamente de índole ideológica y para nada escondidos detrás de la crítica a un comité de bioetica independiente. La endeblez de las argumentaciones sentenciatorias debido al escaso respaldo empirico y fáctico de las mismas sustraen calidad científica a una publicación que obliga a trasladar la discusión desde el ámbito científico hacia el de la política e incluso al de las pasioenes personales, como he constatado en otros comentarios. Lo lamentable no es la discusión en sí, sino que se pretenda dar la misma en el terreno académico y con pretensión de objetividad y de “no contaminación política “.

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