Caught in a Covid affair

The first thing we expect from a doctor is the sense of duty to his/her next. A doctor’s education and  professional training are focused on this duty of care. It doesn’t matter the gender, the race, the nationality, the cultural background or the medical school, what makes us peers and related is our common and prevailing desire to preserve life – not only ours, but the lives of all those around.

The Hippocratic Oath is the earliest expression of medical ethics in the Western world, establishing several principles which remain of paramount significance today, including principles of medical confidentiality and non-maleficence.

However, beyond the ancient oath, that might be somehow distant from our modern reality, the profession evolved to be guided by four principles of bioethics: Beneficence; Non-maleficence; Respect for autonomy and Justice.

These are self-explanatory concepts – Do good unto others regardless who they are and how they can pay back; refrain from doing harm or evil; ensure the right of choice and self-determination; bring some sense of equity to human existence.

Innumerable ethically questionable clinical cases and situations requiring medical intervention or counselling have now been examined using this conceptual framework.

Similarly, health and care services, any public health guidance, the development of drugs and vaccines, immunization programs and all political decisions related to this pandemic we are living must also be under this bioethical approach.

We have certainly had many examples of individuals who have broken this code of ethics along the years, but we can firmly say that during this pandemic doctors, nurses, healthcare professionals and frontline workers acted as no less than heroes facing the fury of titans.

All sort of challenges and obstacles were overcome in our relentless struggle to fulfill our sense of responsibility towards the next and our duty of care.

The same cannot be said about the underlying public administration and management of this catastrophic crisis. Since the beginning, the absolute lack of any sort of contingency planning and the insulting disregard to the conditions in which health care was provided became evident in the threatening scarcity of hospital beds, ventilators, oxygen supply, personal protective equipment; in the limping infrastructure and the chronic staff shortage.

Neglectful and malicious leaders, who denied the seriousness of the pandemic, disinformed the population, ignored scientific opinion, suggested ineffective and potentially harmful therapeutics and delayed lockdown measures that could have contained or reduced the contagion.

The world economy collapsed and many lost their lives, their loved ones, their jobs, their savings, their dreams of a happier life.

Some profited – certain businesses and people make a profit even out of the worst human miseries.

Our hopes were laid on vaccines, and we all waited long months for one that could contain the transmission. Do you remember the time when everyone thought that if we succeeded in developing a vaccine problems would be solved?

They arrived, after billions were invested – basically, your money. There is no such thing as public money, only taxpayers’ money; and the capital injection made by the pharmaceutical industry also came from you, who has not stopped buying and being a loyal customer – so many sick people who got even sicker. The sector was one of those that profited the most with the tragedy.

I saw a lot of people romanticizing and clapping for the founding couple of a pharmaceutical company…

Your money, which has been badly and barely reverted to you. Except for few countries, the COVID vaccine roll-out has proven to be a battle between crooks and buffoons. The drama of disputed contracts and oblique negotiations, followed by the drama of morose delivery and uncertain distribution, followed by the drama of who can vaccinate more and who cannot vaccinate anyone, followed by the drama of millions of doses waiting for approval due on risks of side effects that have not been properly assessed, refined, circumscribed nor investigated, plus the political drama of extolling made-for-profit vaccines while discrediting the not-for-profit ones, plus the lobby of the pharmaceutical industry and its elusive agents (some of them doctors and influential politicians) to avoid the suspension of patent protections aiming especially to prevent profits from being diverted to the collective benefit of the community.

Can we just stop clapping and nodding?

The principles of beneficence and justice are certainly the hardest hit, they were practically pulverized.

There is no doubt that these real life dramas can fairly fit into the blatant corruption of those principles we described above. It is so easy to see – Beneficence; Non-maleficence; Respect for autonomy and Justice. Which of them have you considered as not being corrupted?

The second thing we expect from a doctor is integrity, what evidently implies incorruptibility. How can someone who violates bioethical principles and betrays the best interests of the community in favor of one’s own be trusted to take care of your life? 

We all know that this virus cannot be defeated except by a joint effort that embraces all humanity. The disease is widespread to all corners of the world and we know that this virus has the ability to mutate and become more virulent (more contagious and deadly).

It means that if we do not vaccinate everyone and stop transmission, in less than one year, we will be in contact with new variants that will burst our bubbles of immunity with a soft blow.

Are you not anxious?

Because the pharmaceutical companies, their lobbying actors and stakeholders already know that without breaking patents, a massive, egalitarian vaccination that could bring us back to normality will never happen, and that new and more expensive doses will be needed, feeding the endless virtuous (or vicious) cycle of their gain. 

Doctors should never lobby for the pharmaceutical industry. It is not ethical.

If it has not been clear that pharmaceutical companies and patients may have a fundamental, unsolvable conflict of interests, through this pandemic it will be. 

Don’t you feel outraged to see them craving so ardently for the gain they will have out of this protracted misery and disgrace of ours? The old story of the poor becoming even poorer and the rich becoming even richer does not affect you anymore, even if it might involve the ones you love directly? Do you call it work in progress? Do you feel safe and patronized?

I particularly consider it a backward step. We should be much more evolved in terms of solving problems that demand understanding of interdependence and global cooperation.

We could also feel more responsible, less alienated and patronized; after all, if it is happening, it is right under our noses, provided we have not seen, not paid attention, not scrutinized or given it importance; provided we are still fighting and disputing over solutions we do not own and problems that have been only ours.