Pases sanitarios para COVID-19

Problemas prácticos y éticos

Autores/as

  • Gustavo Ortiz Millán Universidad Nacional Autónoma de México (Ciudad de México, México)

DOI:

https://doi.org/10.35305/cf2.vi18.143

Palabras clave:

COVID-19, pases sanitarios, certificados de salud, vacunación, libertad

Resumen

Diversos países han implementado pases sanitarios o certificados de salud para COVID-19 para promover un regreso más seguro a actividades sociales presenciales. Estos certificados se han propuesto como un modo de que la gente pueda probar que ha sido vacunada, que se han recuperado de la enfermedad o que tienen resultados negativos en una prueba diagnóstica. Sin embargo, mucha gente ha cuestionado su justificación ética. En este artículo se presentan algunos problemas prácticos y éticos a tomar en cuenta si se quieren implementar estos pases. Entre los primeros, se discute qué tan precisas son las pruebas diagnósticas para garantizar que una persona no es contagiosa; si la vacunación garantiza inmunidad; cuáles son los niveles de inmunidad tras la infección, la vacunación y la protección ante las variantes; el hecho de que los pases se puedan falsificar; si estos incentivan la vacunación y el problema de que no haya un certificado universalmente reconocido. Entre los problemas éticos se discute si los pases sanitarios promueven la discriminación y la desigualdad, y si vulneran el derecho a la privacidad y a la libertad. Se concluye que los pases sanitarios pueden justificarse éticamente como para ser implementados.

Citas

Referencias

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Publicado

2021-12-30

Cómo citar

Ortiz Millán, G. (2021). Pases sanitarios para COVID-19: Problemas prácticos y éticos. Cuadernos Filosóficos / Segunda Época, (18). https://doi.org/10.35305/cf2.vi18.143

Número

Sección

Dossier: Bioética después de la COVID-19