Bioethics in Latin America: 1991–1993

Abstract

A number of bioethical issues have been the subjects of recent discussion and concern in Latin America. The topic of new reproductive techniques and practices has provoked greater interest among legislators, as evidenced by seven draft laws submitted in Argentina for their regulation. Equally important is an interest in promoting family planning and preventing early pregnancies. Abortion continues to be penalized in most Latin American countries, although it has been the focus of wider public discussion. Increasing legislative protection of the fetus is perhaps a precursor to a focus on maternal-fetal conflicts. Something similar may be likely to occur in cases involving severely disabled newborns, since protectionist legislation for the disabled is quite prevalent. However, the first clear evidence of respect for patient autonomy as a fundamental value is beginning to appear in serious discussion of informed consent requirements, with a Jehovah’s Witness case that reached the Argentine Supreme Court paradigmatic of this new emphasis. Also important is the decree on patient’s rights signed in Uruguay. AIDS-related issues have heightened sensitivity to the need for confidentiality in the physician-patient relationship. In countries with such differing health systems as Argentina, Brazil, and Cuba, the right to equitable access to health care has been emphasized, although in diverse ways. With regard to organ transplantation, Argentina has offered two responses. At the national level, the legislative attempt to universalize coverage was vetoed by the Minister of Economy;, while at the provincial level, Buenos Aires has created a special fund to finance all medically prescribed transplants for those who lack the necessary financial resources. Moreover, in Argentine legislative discussion, there has been an important emphasis on the notion of “presumed consent”. Euthanasia remains a subject of public discussion, and the first bill on euthanasia has been proposed in Brazil. Although the definition of brain death is an issue of general interest in a number of countries, it has been especially discussed in Cuba. Finally, the creation of National Bioethics Commissions in Argentina and Mexico are a good illustration of the increasing political interest in bioethics.