Cordoví and medical confidentiality. An ethical debate in the Cuban Health system

Cordoví and medical confidentiality. An ethical debate in the Cuban Health system
Cordoví and medical confidentiality. An ethical debate in the Cuban Health system

Ernesto Cordoví and his wife Nayla Airado Rivero are two Cuban doctors better known for their media work in defense of the “Revolution” than for their contributions to medicine. Both fulfilled an “internationalist mission” in Guyana and from there they promoted a YouTube channel that today has approximately 12,000 subscribers and is called “Guardians of Health.”

Ernesto Cordoví was a professional member of the Young Communist League and after returning from his mission in Guyana, he was appointed deputy director of the “Enrique Cabrera” General Teaching Hospital and director of Maternity.

Currently, he still serves as «youtuber “revolutionary” and social media fighter and director of the Hijas de Galicia Hospital in the Cuban capital. This is the healthcare center where eight premature babies died in January 2023 as a result of a hospital-acquired infection that they acquired in the intensive care room.

Sometimes, Ernesto Cordoví functions more as a “cadre” who “understands” social networks than as a doctor. This was demonstrated on May 23, 2024, when in his personal capacity he responded to a complaint from Janet Zulueta Curbelo made the previous day on Facebook.

Janet Zulueta is the mother of Laura Castillo Zulueta, a young woman who died at 25 weeks of gestation. According to Janet’s complaint, her daughter was mistreated at the hospital run by Cordoví and her neglect was the cause of her and the baby’s death.

Upon Janet’s complaint, the youtuber The doctor published in a Facebook post details of the procedures and care that, according to him, Laura Castillo Zulueta received at the hospital he directs. To his detailed explanation, he attached an explicit image of the surgery that the deceased patient underwent in a hospital different from his own, “El Nacional.” The photo shows Laura Castillo’s abdomen open, her intestines exposed and enlarged.

Cordoví justified the use of the image because it constituted evidence of the cause of death and the diagnosis made by the doctors at the Hijas de Galicia Hospital who first treated the deceased and who, according to their statements, guided her transfer to the National Hospital. A transfer that, according to Cordoví, the patient’s mother opposed.

Beyond Cordoví’s arguments to justify the use of explicit images and confidential details about the medical procedure to which the patient was subjected, the comments he made to other users in his publication demonstrate that his main objective was not to defend his doctors or his institution (which they have many methods to do so), but rather to expose the mother of the patient and complainant, who he believes should be imprisoned for “defaming a Cuban medical institution.”

In the Oath of Hippocrates that doctors still repeat today when they graduate, it reads: “Everything that I have seen or heard during the cure or outside of it in ordinary life, I will keep silent and will always keep as a secret, if it is not permitted to me.” say it.”

The commitment to confidentiality not only covers clinical aspects, but also matters related to dignity and respect for the patient. Few facts are more contrary to the dignity and image of a person than showing them as a “fair animal” by exposing their sick body. Especially when it is done without the consent of the affected person or his or her family and without pursuing an educational purpose, but rather a vindictive one.

Inspired by the Hippocratic Oath, many countries have established laws, codes and decrees to ensure medical confidentiality. Among them, the Geneva Declaration adopted by the World Medical Association stands out. The declaration expressly recognizes that it is an obligation to keep and respect the secrets entrusted to doctors, even after the death of their patients.

But in the case of Cordoví – otherwise the director of a Health institution – medical ethics succumbs to the need to defend a political model and the Health system that it maintains. Cordoví seems to be a doctor who understands that before loyalty to the patient there will always be loyalty to the system that he idolizes and that he believes must be defended at any cost in the face of complaints such as those made by Janet Zulueta. Complaints that, furthermore—without being able to assert their certainty in this specific case—are credible given the overwhelming evidence of the deep crisis that the Cuban Health system is experiencing.

People like Cordoví believe that the crisis that he himself has recognized is solved by sending to jail those who show their dissatisfaction with the system through pain. Although Cordoví requests prison for the mother of a deceased patient, it is he who could and should be suspended from his professional practice and sent to prison in accordance with the rules of the game defined by his “Revolution.”

The Penal Code—in force since December 2022 and used to repress those who dissent from the regime that Cordoví supports—establishes in article 393.1 that it is a crime to disclose or transmit photos or videos of a personal or family nature without the consent of the affected person if the purpose is to affect your personal and family privacy. The Penal Code also stipulates that the sanctions for this crime are aggravated and may involve sentences of one to three years in prison, fines of 300 to 1,000 quotas or both if “the reproduction, dissemination or transmission is carried out on social networks or media. social communication, both in its physical and digital spaces.

However, beyond what the Penal Code establishes, those of us who know Castroism know that in Cuba a grieving mother can be repressed much faster than a doctor and “youtuber revolutionary” that breaks the most basic medical ethics under the argument of defending the Revolution and the Cuban Health system.

A doctor who acts like this because he knows that in Cuba this attitude, more than reprimands, implies encouragement.

If you are interested in legal topics, you can visit our project elTOQUE Jurídico, in which you will find analysis and debates about the laws, rights and legal processes in Cuba.

Also follow us on Twitter: @eltoquejuridico

 
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