This document aims at responding to the time of Health Emergency declared in Mexico last March the 30th giving an overview of the situation, the ethical guidelines, and the main terminology in the context of Covid-19.
The mysterious American writer Emily Elisabeth Dickinson (1830-1886) is mostly known for her unusual life, spent mainly reclused in her house in Amherst, where she was born. Her work, in addition to her well-known poetry on the brain “The Brain is wider than the Sky”, has one poem dedicated to the storm.
Translated by Eugenio Montale in 1945, this poem, number 1593, reads:
There came a wind like a bugle;
It quivered through the grass,
And a green chill upon the heat
So ominous did pass
We barred the windows and the doors
As from an emerald ghost;
The doom’s electric moccason
That very instant passed.
On a strange mob of panting trees,
And fences fled away,
And rivers where the houses ran
The living looked that day.
The bell within the steeple wild
The flying tidings whirled.
How much can come
And much can go,
And yet abide the world!
The world learned about the Coronavirus on January 12th, 2020 when the World Health Organization (WHO) recognised it as “2019-nCoV” (i.e. new Coronavirus 2019) and its related pathology “COVID-19”. The Coronavirus has spread globally as a “storm” striking a globalized and technologized world that moved frantically and almost unstoppably towards the achievement of its growth, production and efficiency objectives, rewarding with fame the typical “hard” and “soft skills” of our industries 4.0.
For months, silence, isolation, the desert of our cities, the solitude of our monuments have become our existential “storm”.
In an evocative, though eerily empty Piazza San Pietro, on March 27th, Pope Francis described this tragic moment with these words:
“Dense darkness has thickened on our squares, streets and cities; it has taken over our lives filling everything with a deafening silence and a desolate void, which paralyzes everything in its passing: you can feel it in the air, you can feel it in people’s gestures and looks. We found ourselves afraid and lost”.
As the Israeli historian Yuval Noah Harari recently pointed out, on the one hand, we are living in the best time to be able to clinically and technologically face this pandemic thanks to the development of molecular medicine, biotechnology and artificial intelligence. On the other hand, the coronavirus storm is exposing our vulnerabilities, leaving uncovered those superfluous certainties with which we have built our agendas, our projects, our habits and priorities.
SARS-Cov-2 (the new Coronavirus) has no boundaries, is not subject to barriers, nor walls, affects everyone, does not look at anyone, does not consider passports, social class and does not read the titles on our business cards. But the same reason why it spreads — our common human nature — makes us rediscover the common antidote: we are not monads closed in on ourselves, but we are all united and intrinsically connected to each other as no one can survive on their own. The Coronavirus should awake us from the deafening frenzy to which we were accustomed, and which now frightens us for its unrecognizable silence. The pandemic that struck us underlines how we are all deeply in communion with each other through the multiple interactions that connect us, so today more than ever we feel the thrill of the common bond to which we cannot escape: to belong as brothers. None of us lives alone, others’ lives are always present in mine in what I think, say, do, work. And vice versa, my life enters that of others.
“We have realized that we are on the same boat, all of us fragile and disoriented, but at the same time important and needed, all of us called to row together, each of us in need of comforting the other. On this boat… are all of us. Just like those disciples, who spoke anxiously with one voice, saying “We are perishing” (v. 38), so we too have realized that we cannot go on thinking of ourselves, but only together can we do this.”
(Pope Francis, 27th March 2020).
On the horizon, we may face a significant, longer-term problem concerning the issue of surveillance and individual control through biometric recognition that states could maintain and implement even after the epidemic crisis. Harari warns us: “one of the dangers of the current epidemic is that it will justify extreme control measures … But even after it, this idea will remain”.
We are called to reinvent our relationships and to discover our deep skills, those relating to our empathic ability, to know how to be with others, to listen, to be in solidarity, but also to be morally sound and responsible.
To reflect on this existential situation we are experiencing, the Neurobioethics Group and Brain Circle Italia organized a day dedicated to the topic “The epidemic at the time of artificial intelligence. A new anthropology for a safer world?” which took place on 23rd April 2020 live from the Neuroscience and Neuroethics Facebook page.
A panel of the highest scientific and cultural depth divided into 5 sessions debated today’s epidemic contingency in an interdisciplinary discussion. Over 5,000 people followed the event.
The digital revolution has the potential to become a new form of coexistence among people who, in their fight against the new enemy presented by epidemics, prompt us to reconsider the concepts of privacy and freedom. The need then emerges for a pact between citizens and institutions to rethink the methods of application of what Hobbes would call a new “law of nature”. But how much of our identity spaces are we willing to give up to fight these invisible threats?
Prof. Claudio Bonito presented and moderated the event. After the greetings from the academic authorities, Viviana Kasam, President of BrainCircleItalia and Father Alberto Carrara, Director of the Neurobioethics Group introduced the topic at hand.
The morning (10:30-12:30) was divided in a first scientific portion with the presentations of:
Gian Carlo Blangiardo, President of ISTAT
Luca Maria Gambardella, University of Lugano, Dalle Molle Institute of Studies on Artificial Intelligence USI-SUPSI.
In the second medical-clinical portion of the conference spoke:
Matilde Leonardi, neurologist, pediatrician, Director of UOC – IRCCS Foundation Neurological Institute Carlo Besta, Milan;
Stefano Mazzoleni, professor of Computer Science and Big Data Analytics – Bari Polytechnic.
The afternoon (15:30-18:30) opened with the legal session, with the following speakers:
Amedeo Santosuosso, scientific director, European Center for Law, Science and New Technologies (ECLT), University of Pavia;
Avv. Tania Cerasella, lawyer, member of the GdN
Avv. Emanuela Cerasella, lawyer, Coordinator of the Neurolaw subgroup of the GdN.
The technical-analytical-philosophical session followed with the presentation of:
Damiano Sabatino, CEO Travelport and Guido Traversa, philosopher, European University of Rome – Master Coordinator in Philosophical Consultancy and Existential Anthropology.
The conference Concluded with the psychiatric session in which the following speakers are present: Donatella Marazziti, psychiatrist, University of Pisa, Professor at the Unicamillus University of Rome, Head of research BRF Brain Research Onlus Foundation
Armando Piccinni, neurologist and psychiatrist, Professor at Unicamillus University of Rome, President of BRF Brain Research Onlus Foundation.
Nuestras investigadoras Mariel Kalkach Aparicio y Ma. Elizabeth de los Ríos Uriarte junto a un grupo de trabajo interdisciplinario, en diálogo constante y con base en la experiencia de médicos en España, Italia, México y EU, han trabajado sobre una guía práctica con 7 pasos que son recomendaciones para el personal de salud que se enfrenta a la toma de decisiones éticamente difíciles durante COVID19.
Coherentes con los esfuerzos de organismos internacionales que exhortan a los países e individuos a proteger y acompañar a los profesionales de la salud en esta pandemia de diversas formas (5, 6), el propósito de esta guía es dar un acompañamiento de ética a la toma de decisiones de los profesionales de la salud. Se propone un listado de siete pasos concretos a tomar en cuenta durante la valoración de lo que se cree que pudiera ser un dilema moral en la atención médica durante la pandemia. De tal modo que el médico que la considere tome decisiones informadas para el beneficio suyo y de la sociedad. Al integrar consideraciones éticas en beneficio de su paciente y su sociedad, el médico comparte su responsabilidad con la sociedad y dicha sana distribución de cargas, permite su alivio psicológico y moral porque ha hecho lo correcto. Aunado a esto, la transparencia en la justificación detrás de cada postura otorga a la sociedad una sensación de certidumbre muy importante en este momento, de acuerdo con las recomendaciones de la Organización Mundial de la Salud (OMS). (4, 7)