Florencia Luna

Reproductive Health and Research Ethics: Hot Issues in Argentina

In this article I focus on two issues concerning bioethics in Argentina: reproductive health and ethics in research. Although these topics are quite dissimilar, they share a particular feature: their special relationship with context.

Identifying and evaluating layers of vulnerability - a way forward

Abstract “Vulnerability” is a key concept for research ethics and public health ethics. This term can be discussed from either a conceptual or a practical perspective. I previously proposed the metaphor of layers to understand how this concept functions from the conceptual perspective in human research. In this paper I will clarify how my analysis includes other definitions of vulnerability. Then, I will take the practical‐ethical perspective, rejecting the usefulness of taxonomies to analyze vulnerabilities. My proposal specifies two steps and provides a procedural guide to help rank layers. I introduce the notion of cascade vulnerability and outline the dispositional nature of layers of vulnerability to underscore the importance of identifying their stimulus condition. In addition, I identify three kinds of obligations and some strategies to implement them. This strategy outlines the normative force of harmful layers of vulnerability. It offers concrete guidance. It contributes substantial content to the practical sphere but it does not simplify or idealize research subjects, research context or public health challenges.

Infertility in Latin America: looking for a new model

En este trabajo argumento que deberia tomarse a la infertilidad como un problema de salud publica y analizo la situacion de infertilidad en Latinoamerica. Sin embargo, no apoyo una extension y copia del modelo privado de tratamiento al ambito publico. Argumento, en cambio, a favor de la necesidad de repensar el modelo de implementacion de las tecnicas de asistencia en la reproduccion con una mirada diferente, que deberia ser amplia e inclusiva. La infertilidad esta directamente ligada a la salud de la mujer, por lo tanto un enfoque legitimo desde la salud publica, para Latinoamerica, debiera formar parte de una aproximacion integral a la salud sexual y reproductiva de las personas. Uno de mis objetivos es tener particularmente en cuenta el flagelo de la infertilidad secundaria en la region. Asi, la nueva mirada desde la salud publica que defiendo implica hacerse cargo de la salud sexual y reproductiva de la mujer desde sus inicios, abarcando las diferentes etapas y problemas que esta involucra, ya sea desde la adolescencia para evitar un embarazo no deseado (cuidarla para evitar enfermedades de transmision sexual asi como abortos inseguros); como en la juventud para lograr la maternidad y el hijo ansiado. Tambien abordo el problema de la infertilidad desde una mirada etico- politica. Pregunto por la falta de un planteo coherente y estrategico en Latinoamerica, sobre todo, desde el feminismo y desde posiciones progresistas.In this article I consider the situation of infertility in Latin America and argue infertility should be considered a public health issue. However, I contest the copy of the private model of assisted reproductive technologies (ART) to the public health arena. I argue instead that we should rethink the implementation procedure and stand for a holistic and inclusive proposal. My aim is to consider secondary infertility due to a lack of access to sexual health as well as the consequence of unsafe and illegal abortions whose prevalence is much higher than in Europe or the USA. This implies looking to infertility as part of our sexual and reproductive life. Thus beginning with prevention and care at adolescence where pregnancies might not be desired and continuing through all the reproductive life of the woman until the time when pregnancy and building a family might be the aim. I also bring in a political analysis of the situation and ask why there is such a reluctance to endorse ART by feminists and progressive positions in Latin America.