pp. v-vi in Bioethics for the People by the People, Darryl R. J. Macer, Ph.D., Eubios Ethics Institute 1994.

Copyright 1994, Darryl R. J. Macer. All commercial rights reserved. This publication may be reproduced for limited educational or academic use, however please enquire with Eubios Ethics Institute.

Preface


The title of this book has more than a symbolic meaning. Bioethics is both a word and a concept. The word comes to us only from 1970, yet the concept comes from human heritage thousands of years old. It is the concept of love, balancing benefits and risks of choices and decisions. This heritage can be seen in all cultures, religions, and in ancient writings from around the world. We in fact cannot trace the origin of bioethics back to their beginning, as the relationships between human beings within their society, within the biological community, and with nature and God, are formed at an earlier stage then our history would tell us. The history of bioethical reasoning is influenced by our genes, and the forces that shaped these genes into the people, society and cultures that we have. We now have the power to change not only our own genes, but the genes of every organism, and the power to remodel whole ecosystems of the planet.

Some academics have tried to define what bioethics is, what are the basic principles, and how we should apply these to our lives. To make good choices, and choices that we can live with, improving our life and society, is certainly a good thing. The choices that need to be made in the modern biotechnological and genetic age are many, extending from before conception to after death - all of life. The timing of reproduction, contraception, marriage choice, are not new. Euthanasia, a good death, is also an old choice, forced upon us by our mortality. A key question is who should define bioethics - and this book says that the people should. This is not a complete description of Bioethics "by the People", but it is intended to refocus our attention on where we should be looking to "develop" bioethics. People have been using ideas of bioethics over history, especially in religions, bioethics is the part of this behaviour, ethics, that relates to biological questions, and to all human relationships.

One way to examine the reasoning people have is to ask them in surveys of opinion. Scholars may go through literature, and historical studies, but often these studies are selected by their choices, rather than the peoples. We need to look at more than history, and more than policies that governments have developed, we need to reach into the hearts of people. In 1993 a survey was performed across ten countries of the world, including Australia, Hong Kong, India, Israel, Japan, New Zealand, The Philippines, Russia, Singapore and Thailand. The results can be compared to surveys in North America and Europe. The purpose was to look at how people think about diseases, life, nature, and selected issues of science and technology, biotechnology, genetic engineering, genetic screening, and gene therapy.

In total nearly 6000 questionnaires were returned from 10 countries during 1993, and the results are included in this book. The questionnaires
included about 150 questions in total, with 35 open-ended questions. The open questions were designed not to be leading, to look at how people make decisions - and the ideas in each comment were assigned to different categories depending on the question, and these categories were compared among all the samples. Out of ethical commitment to those who participated in the survey, I believe it is important to release all these data as soon as possible for other people to use. It is only a small thank you to those who participated in the survey.

People around the world are interested in these issues, afterall they affect all our lives. People made very interesting comments. The diversity of comments was found to be the same in different countries, suggesting that reasoning about these issues goes deeper than cultures, or religions. About 30% of the respondents in different countries also requested summaries of the results, and another purpose of the survey was to generate debate in different countries, among the public. The survey focused on agricultural biotechnology, and medical genetics, with some other questions looking at environmental attitudes and attitudes to disease.

Half of the book is looking at images of nature and life, two central issues of bioethics, through comments and pictures that people made. I believe these images to be important in looking at the future of society, and for looking at how our life affects nature through the use of technology. These images may change with time, and we can see what they are in the decades from now, and in more countries than we were able to survey.
As seen in the contents list and the brief index, there is more in this book than statistical data. In fact, some statisticians may be disappointed that not all the statistical comparisons are presented. In this book, a "significant" difference or similarity has at least a 95% probability of being correct, using statistical tests. The results to the survey questions are found in the data tables (p. 186-215), with discussion of the results together with international collaborators in section III of the book. A summary and overview is on p. 125-138.

Section I of the book looks at universal bioethics, which is not just a proposition, but I believe an observation - it is not something we only hope for, it already exists. Although societies are different, people and families are not. Section II has a series of papers on International Bioethics from different countries of the world, representing academic approaches and descriptions of these issues. At the end of section II is an extensive paper by Jayapaul Azariah looking at global bioethics and common hope, which comes back to the theme of universal bioethics see throughout this book.

I would like to thank many people for their assistance throughout the survey project, in addition to those collaborators and helpers thanked in the International Bioethics Survey section (p. 187). I also thank Shiro Akiyama, Yukiko Asada, Yuko Kato, and Miho Tsuzuki for general assistance. The Japanese comments from the International Bioethics Survey were translated by Yuko Kato, and the comments on bioethics from the high school survey in Japan were translated by Yukiko Asada and Nobuko Macer. The Russian comments were translated by Vijay Kaushik, and the Thai comments by Peerasak Srinives, Prasert Chatwachirawong and Oranart Suntornwat. For advice on the questionnaire I also thank Dr Alex Mauron, Dr Masahiro Morioka, Dr Yuzuru Oguma and Dr Yasuko Shirai. I also thank Isamu Yasuhara for efficient and speedy typesetting and printing arrangements.

For assistance in all ways, from discussion, typing, translation and arranging pictures, I thank especially my wife Nobuko. My thanks again to all the people, and I end with the hope that the common heritage that people share will be a common future in which biotechnology is a blessing, not a curse.

Darryl Macer
Institute of Biological Sciences
University of Tsukuba
Tsukuba Science City
Ibaraki 305, Japan.
March, 1994


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