pp. 46-49 in Human Genome Research and Society
Proceedings of the Second International Bioethics Seminar in Fukui, 20-21 March, 1992.

Editors: Norio Fujiki, M.D. & Darryl R.J. Macer, Ph.D.

Copyright 1992, Eubios Ethics Institute All commercial rights reserved. The copyrights for the employees of the US Government, are subject to other copyright arrangements. This publication may be reproduced for limited educational or academic use, however please enquire with Eubios Ethics Institute.

Historical Background of Bioethics in Medical Genetics in Japan

Kiyoshi Aoki,
Director, Life Sciences Institute, Sophia University, JAPAN

This is a very difficult title. As Prof. Hoshino has introduced, I would like to talk about the historical background of bioethics in Japan. The title of my presentation relates to medical genetics, and I would like to refer to medical genetics with the term DNA. Previously there have been presentations dealing with DNA. This era is moving on to the era of the manipulation of DNA and of life manipulation.

First I would like to talk about the era of life manipulation. Recently, the terms recombinant DNA and cell fusion are well accepted by the general public. The mass media uses these terms very often. Until a decade ago these technologies were associated with danger, but now these technologies have been smoothly accepted and are developing. Life manipulation is making rapid progress. Life science is deepening and expanding its sphere day after day, which has been exemplified in the presentations before. The progress of life science is very much related to the progress of molecular biology which rapidly developed after World War II. The study of life science before 1970 focused on bacteria and viruses, but in recent years we are directly studying the DNA and genes of complex organisms. By doing this we will look into the immunological processes of human beings, and genetic disease and cancer. We can look into the DNA of each individual patient. In the later half of the 1980's, many including myself, we started studying the brain functions from the point of view of DNA. DNA science is indispensable for discussion of life science and biology. My understanding of life science is DNA science, so I'd like to talk about DNA science and bioethics.

With the development of life science, and the progress of biotechnology there was a meeting held in 1984 where representatives of seven countries of the economic summit attended. It was titled the first Wiseman's conference on Life Science and Mankind. This was the first international meeting in Japan where ethical issues relating to life science were discussed. This meeting was supported by the Ministry of Foreign Affairs. Prof. Okamoto served as the chairman of this meeting. I believe this is the first meeting in Japan relevant to life science and bioethics. This was the first international meeting in Japan relevant to DNA and life science. Before that in Tokyo in 1975 the 29th annual meeting of the World Medical Association was held. Informed consent, and detailed guidelines to ensure informed consent in human experiments, was added to the Helsinki Declaration. But at that time, the life science progress and life manipulation, and issues relating to bioethics were not dealt with.

In 1979 I joined Sophia University. There was an international meeting which was solely dedicated to discussion of bioethics. We had members of the Kennedy Institute of Bioethics, Georgetown University, Washington, USA, and there were 7 overseas representatives from the USA and West Germany and we had 30 Japanese researchers. The meeting was held for three days. The Encyclopedia of Bioethics had just been compiled, and the chief editor, Dr. W.T. Reich, came to this meeting with this encyclopedia, of four volumes. The audience was greatly impressed by the huge scale of the contents of the encyclopedia. At the same time they realised they were very much behind the study of bioethics in Japan. As well as this, at the meeting there was discussion of bioethics and life science as one of the issues. Unfortunately the Japanese side was not very well prepared to enter detailed discussion, which was very unfortunate.

In 1984 the first summit meeting, the Conference on Life Science and Mankind, was held in Hakone, Japan. It was promoted by Prime Minister Nakasone of Japan, and he opened it. This meeting was held from 1984 to 1988, in Japan, France, Canada, West Germany, and Italy. The seven economic industrialised nations held these meetings with specific themes. At the second meeting in France we dealt mainly with the ethical issues relating to inheritance in Japan, in human beings, they discussed about genetic manipulation and genetic engineering, prenatal diagnosis, postnatal diagnosis and in vitro fertilisation, and support for the third world. Even in Japan Prof. Okamoto headed the special meeting. Prof. Watanabe and Prof. Kato also led the way to open the Japanese Wisemans committee to discuss these matters. For each meeting was held overseas we despatched three representatives from Japan. In the fifth meeting held in Rome in 1988 we discussed whether the genetic information can predict the future, who will have the property right of the information and genetic manipulation. Also they discussed gene therapy. Following these meetings, there were many studies on bioethics and life sciences started in Japan. However, we did not see much progress in those days, and therefore the bioethical issues were only dealt with from an abstract perspective. Not many practical discussions were made in those days.

In relation to this the Japanese Government promoted the study of life science. There were some efforts by the government to promote bioethics. The Ministry of Education issued a report promoting life science study in 1976. In this report life science is regarded as an academic biological science that recognises basic life phenomenon. The report promotes the study of life science. But, at that time not much consideration was given to bioethics. It was only when the bioethics research study group was established in 1986 that a proposal was given to the government. This study group opened up a way for bioethics and life science study promotion which was very relevant to this bioethics study, because the bioethical impact of life science on society needed to be considered. One chapter of the proposal was dedicated to the understanding of society and the attitudes of researchers to bioscience study. We especially dealt with the bioethical issues. In 1983 Prof. Hyakudai Sakamoto of Aoyama Gakuin University headed a research project on bioethics supported by the Ministry of Education. On the overhand, in 1984 there was a Life Science Promotion Report by the Science and Technology Agency. In the report it states that science and technology should not just move ahead, but we should go back and look at the benefits for society and people, and understanding the human being is necessary and understanding and harmonising the relationship between science and technology and society is important for development. Those were the bioethical issues dealt with in this report.

I believe that the fact that the government started to talk about bioethical issues was first triggered by the International Conference of the Wisemen in 1984, proposed by Mr Nakasone, when he was Prime Minister. At this point I should talk about the Ministry of Education guidelines on the study of DNA. In the past these guidelines were only covering non-humans, but in recent years we have rapid progress and their is a high possibility for human application, therefore we need to set new guidelines.

Now let me talk about the Bioethics Society in Japan. Earlier I mentioned that Prof. Sakamoto headed a project supported by the Ministry of Education to study bioethics. And in November 1988, Prof. Sakamoto became the first president of the Japanese Society of Bioethics. This Japan Society of Bioethics is the collection of researchers that are studying bioethics, and was the first Japanese society to deal especially with bioethics. Researchers study their own speciality, and gather together.

When you look at its characteristics, bioethics is very unique, each individual speciality should be a very rigid framework, but at the same time the interdisciplinary concept is questioned. Is this interdisciplinary approach feasible in discussing bioethics? I do not think that this interdisciplinary concept is sufficient. What we need is not just collaborative study, but interdisciplinary study in a wider perspective. That is the reason why we have been actively working on the bioethical issues. Prof. Hoshino is the current president of this society, at the same time the research group of bioethics was organised where the general public is participating. Their major topic is whether organ transplantation is feasible in Japan, and not much discussion is taking place with respect to recombinant DNA techniques and its progress. Professors Fujiki, Hoshino, Sakamoto and Kimura who are all members, are all working actively on an international forum to form international meetings. I think these activities were all very much influenced by the formation of the Japan Society of Bioethics a few years ago.

As a result we have a lot of activities going on in Japan. But, when it comes to medicine or medical treatment, this is under the jurisdiction of the Ministry of Health and Welfare. In 1983 they established a discussion group for life and ethics. When this was first organised, there was a report on the first successful in vitro fertilisation in Japan. In 1984, the summit meeting was organised, as discussed. In the future, with DNA technologies we will concentrate much more on the treatment of intractable diseases and the study of such issues becomes very important. At the same time, bioethics should function properly in this framework, hand in hand progressing with these technologies. This is the only way we can have successful development of these technologies and the human genome project and life science. This conflict of science and human beings is one of the issues we have to deal with. I will limit myself to a few last comments.

The advancement of science and especially of DNA technology and the human values become very important issues and there is a conflict. And then there is the discussion relating to religion, and occidental religion. I believe it is all right to discuss about religion, but that this is not a solution for the development of science and technology. Because the science that we have been promoting has been based on what has been taking place since the Renaissance period. The conflict between the human being and science should be discussed from the point of view of bioethics. Genetic treatment will be the focus of study relating to the human genome project in the future. There will be issues relating to the dignity of human life. How important a role bioethics can play is a question, a very important role in prompting the future development of these technologies I believe.

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