2023-08-20 12:29:00
Norway? Or Argentina? She has lived for 15 years abroad; between Montevideo and Myra, a small Nordic town. She has traveled to more than 23 countries as a UNESCO official. In Norway she has the comfort and tranquility that many would envy. But Susana Vidal is becoming more and more sure. She wants to return to her native Córdoba.
There everything is very orderly, planned. Dramatically anticipated (laughs). But social distance is very important to them, a lot of etiquette. Not for bad They do it out of respect. Also, renovating my residence is very expensive. On the other hand, here, Ian has just been given the Argentine residency.
Ian is Jan Solbakk, her husband, a Norwegian who loves (sic) Latin American culture. The spontaneity, the debates; the meetings that always look like an opera, details Susana Vidal and remembers amused: Everyone speaks at the same time.
After participating during the 90s in the creation of many of the ethics committees of public and private hospitals in Córdoba, Susana María Vidal spent 12 years in Montevideo where she directed UNESCO’s Regional Bioethics Program for Latin America.
This experience allows him to state that together with Brazil and Colombia, Argentina is the country in the region with the most development in this area. Greater respect for patients’ rights. Today it would be unthinkable, for example, for a doctor to refuse to explain a treatment, he says. But he argues that even so, it is necessary to change the educational model of health professionals.
And he explains why, it’s not just about content:
The hidden curriculum has more impact. What doctors do in their daily practice, and students learn. Hierarchies, paternalism towards the patient. But also within the health teams. The largest resident mistreats the newcomer. There is an asymmetric power relationship, which, by the way, continues to be worse with women.
Susana Vidal received her medical degree from the National University of Córdoba 40 years ago (she is 64), and although she did her residency in internal medicine and won an ad hoc competition at San Roque, she was assigned to intensive care. She learned a lot, she admits in train to see half full, but she also lived in situ the culture of intensive care of the time: macho, vertical and despotic, she lists. The prototype of the hegemonic medical model. And patriarchal. I don’t know now, but I did at that time. The bosses bitched at you. Conchuda, one insulted the girls.
Susana Vidal saw the opportunity to leave there when the psychologist Manuela Cabezas from Oviedo, Lita, gave a course on service training: essentially, one more medicine in contact with the community. A project of the Pan American Health Organization (PAHO), steeped in the community pedagogy of Brazilian Paulo Freire.
Simultaneously, the Hospital librarian (who knew her well) gave her a PAHO bulletin (nobody is going to read it, she told her) where a note on bioethics dazzled her.
Dignified death, assisted reproduction, biomedical research, consent… Topics that were not discussed here. Wow… I knew right away that I wanted to dedicate myself to that.
Susana Vidal managed to get her transferred to the Ministry of Health.
It was very painful to leave the hospital. I was a doctor. But with a nice, extraordinary team, we started the bioethics committees. Lita, we have to do this, and this, I told Lita Cabezas, the psychologist, and she, well, do it. I also went to the Medical Council with the idea, and there we organized a Bioethics Commission. I started to train. In 1994 we already did the first course from the Ministry. Then we went hospital by hospital. We held large interdisciplinary meetings where even the goalkeeper participated. We included the private ones, except for the Private Hospital, the only one that already had an ethics committee.
From that boil that put medical practices and patients’ rights on the agendaSusana Vidal also points out that at the end of the 90s she promoted the projects of informed consent (that the patient knows what they will do to him) and that of ethics of pharmacological research (that he be informed when he will be included in drug trials).
Although initially in the Ministry of Health the latter was accepted without buts, soon after someone got upset, Susana Vidal speculates:
The lobby started. He did not suit the laboratories, nor some private clinics that did their research without control. With a phone call they informed me that the Commission (Provincial Ethics and Investigation) was dissolving. And they left me behind.
His expectations frustrated, with a master’s degree at the University of Chile, (my parents paid the registration and helped me take care of my son so he could travel. The master’s degree organizes you. He made me a puff… on the head −shake hands), in 2006 Susana Vidal began her international journey at Unesco, which had then created the Bioethics Network.
The most important thing in those years, he synthesizes, was working from the perspective of human rights, far from the Anglo-American model reduced to the biomedical field that initially dominated the discipline in the region.
Instead, it broadens human rights to think about life’s problems, considering social and environmental determinants. For example: global warming, poverty, unfair distribution of resources, vaccines, the pharmaceutical industry. A situated discussion, he stresses. And interdisciplinary (including philosophy and gender. Speaking of gender, she told me that during her management the Unesco Network of Latin American Women Philosophers was also created).
After the pandemic Susana Vidal leaves Montevideo and goes to live in Norway with her husband, a colleague whom she met at the offices of the international organization. But at the time she doubt arises. Norway or Argentina? She can choose: she is a visiting researcher at the University of Oslo (virtual work and spaced trips), and she chairs the UNESCO Bioethics Network wherever she is.
For a few weeks now, Susana Vidal and her husband have lived in a gated community in Villa Allende. No doubt. She would only change her decision in the face of a dictatorship like that of 1976. She receives me with imported tea (for visitors, she laughs) and sourdough pudding; a bright house where everything has quickly been put in its place. Only about fifty boxes of books neatly stacked in the guest room are waiting their turn. And Bolt, a saint (sic) westy from Córdoba with shiny hair who accompanied her all these years outside the country, frolics.
Susana Vidal is rediscovering Córdoba. With the penalty of absences. She is missing her son, the musician Agustín Druetta who lives in Europe. And his parents are dead. Carlos Vidal −Doctor Vidal−, cardiologist, candidate for governor for the Intransigent Party. President of Sade. A hero to me, he says he in a whisper. And his mother, daughter of a commander of the Republican Army shot by the Franco regime; survivor of the Spanish Civil War: Concepción Susana Suárez, whose death does not stop hurting him.
He should be left to die with dignity. Withdraw life support as recommended by the consulted ethics committeesmaintains Susana Vidal when I ask her about the family that these days is fighting for a dignified death for a patient admitted to the Emergency Hospital.
That’s why a living will or advance directive is so important, he adds. It is true that the patient can change his will. But you have to talk about it first. That way it would be easier to make decisions.
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