Distance Articles

Distance for the protection of rights

We need a fair distance to get a disenchanted view of the emergency and to become aware of how far we are from a context where the right to a life with dignity is guaranteed

Gianni Tognoni

Physician Department of Anaesthesia, Resuscitation and Emergencies, Ca’ Granda Ospedale Maggiore IRCCS Foundation, Milan, Former Director of the Negri Sud Consortium.

Alice Cauduro

Researcher, Department of Law, University of Turin

By June 2020July 3rd, 2020No Comments
Photo by Lorenzo De Simone

It is necessary to get distance from Covid-19 to shift from the inside perspective of the emergency and to be able to better see the few certainties and the numerous and very broad questions that are left [1]. The following are reflections about a long-term “aftermath” that risk being characterised only by considerations on mortality data that are surely important but without future.

1. The first distance is essential. It’s the distance from the figures, the estimations and the bulletins that seem to give the same importance to deaths, swab tests, facemasks, decrees and closures etc. Someone, one that knows what happened, will tell this story. Maybe many will and there will be many stories. Hopefully they will all give a glimpse of the only sure thing: the distance between the enormity of the human tragedy and the substantial inadequacy of the policies (with a few exceptions) that managed it.

2. Covid-19 is no longer predominantly a healthcare chapter. The incredible and concrete community of frontline health staff revealed absolute stars. Hopefully their most shouted request will remain: “Saying no” to the existing healthcare system, changing it and not continuing to highlight its flaws, which are well known, as they’ve been in the spotlight for a long time.

3. Covid-19 has been- and every day becomes more and more- a diagnosis of culture-civilisation. It uncovers the numerous faces of a deeply fragile model that in order to be global used to pretend (and still does) to be inviolable. It now also evidences the need for a decision, that cannot be radical and for the long-term, between two strategies:

– To impose, no matter the cost and from any point of view, a continuity, only seemingly (perhaps just to defuse the rage of those suffering and to guarantee further income for the usual few) distancing ourselves from the model, that the emergency showed the unsustainability and violence of.

– To use the abovementioned healthcare related “shouted request” as an indicator of the more foundational distance we have yet to overcome, the distance to the right to life (in all its forms of human dignity) of all those populations exposed to permanent pandemics, with or without virus. The old and much celebrated “plagues” of our times, the inequality resulting in misery, hunger, war and the inaccessibility to essential necessities…

4. Just like in the clinic, this is an incurable disease, with no immediate news in sight around a solution. Should we communicate this or not, and how to tell the patient and those around them? Or should we continue with a relentless treatment that transforms suffering into investments and income? With or without the formality/justification of a signed consent, that mimics participation and democracy? There are no easy, linear or guaranteed answers for the “aftermath” that we are now living, which is definitively not just an Italian experience. However, a clear distance has to be guaranteed. It is an obvious one but very hard to achieve: the distance from people “selling solutions” (scientists, industrials, politicians…), those that ask us to trust them because they are the minorities who own the knowledge and the capitals and that know the winning decision-making algorithms. This distance has a name (perhaps it lost value because it has been used for so long to make promises instead of getting things done): common research, testing ideas and plans for the future that will bring a real discontinuity from the pre-existing context, and building bridges to overcome the distances of the structural pandemics mentioned above.

5. The post-Covid-19 context we are witnessing, while we are more or less involved in the drugs, vaccines and diagnostic sector, is definitively a very instructive global observatory for a word so rich in imagery like distance. All the actors, producers, guarantors, overseers, institutional or private bodies (and at the bottom, but there still, also the citizens, subjects, receivers) are present, with all their interests and powers over capitals, public image and politics. The junctions and conflicts (whether good or not) stay the same. The real distance that we need to overcome coincides with the fundamental question of the global legal and economic system: is there space in the concreteness of the current and future world for emergency or normal living, for health (model of common welfare indispensible for life, that plays a role in the market), for an economy that does not consider the lives of people as a discretionary or optional value?

Aside from the hostility of the term lockdown, that became a global mantra (even though we know how offensive its falsity is for those living in favelas or that are homeless), distancing is an ancient measure of common sense. It can be reasonably efficient and even instructive, if shared as a safety measure but also as a mean to expand and protect the rights to health (though often unnecessarily violating many other ones) that were threatened by an unforeseen and little known “enemy”. There is a condition. In order for the good principles of (international or national) law to become reality- a reality that will be enjoyed more after the emergency by the most marginalised- they have to recognise the need to search: their systems, their relationship (now intolerably subaltern) with the economy, the definition of the basic level of care, the compulsoriness of environmental rights and the future of new generations.

Distance- when chosen, not imposed, with a healthcare system that reflects social living- defines the space and direction that we should head toward in order to share the rights to a life with dignity.

In conclusion, distance has been defined as “social”; there is no better adjective to mask its ambivalent meaning. The imposed distance is separation, absence, privation and asociality. It talks about poverty and ignorance, and not knowing what to do. It highlights how- despite all our scientific prosopopoeia and the desire to show we have answers and that we are benefactors- the reality is that we can only offer archaic recommendations. We wish for this adjective to take on the hardest task, one that is also urgent for the present and the future: reminding us of the duration and length of the path needed to overcome the distance between the affirmations of the law and the concrete and social subjects of Article 3 of the Italian Constitution (and its associated, equivalent, or complementary European or international legislations).
Distance- when chosen, not imposed, with a healthcare system that reflects social living- defines the space and direction that we should head toward in order to share the rights to a life with dignity, avoiding the pandemic of inequality. Distance shows us how much we see ourselves in pope Francis, a living icon, alone and fatigued in a dark San Peter square: we realise that we, not as depressed individuals but as citizens of the future, are all in the same precarious boat, with no exceptions.

References
[1] Tognoni G, Cauduro A. Healthcare, drugs and vaccines. Volere la Luna, 27 May 2020.

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