pp. 1-9 in Bioethics in Asia

Editors: Norio Fujiki and Darryl R. J. Macer, Ph.D.
Eubios Ethics Institute

Copyright 2000, Eubios Ethics Institute All commercial rights reserved. This publication may be reproduced for limited educational or academic use, however please enquire with the author.

O1. Opening Address

Mizuo Kuroda.

The Japan Forum, Tokyo, Japan; Former Ambassador to UNESCO

Ladies and Gentlemen, it is a great honour and pleasure for me to be given this opportunity of saying a few words as chairman at the opening of the UNESCO Asian Bioethics Conference (ABC'97). First of all, I would like to extend warmest welcome to all the participants who have gathered here, in particular to those who have come all the way to Kobe from overseas countries.

I think it is significant and even symbolic that this conference is held in Kobe which suffered a gigantic damage from a terrible earthquake two years ago and which is now rising up gain like a Phoenix out of the ashes by the assiduous efforts of its citizens. At this conference, reports and discussions will be made under several major topics, including, "Law and Ethics in the world", "Foundations of Asian Bioethics", "Health and Asian Bioethics", "International Education and Ethics", "Population and Environment issues", and Genetics. In this way, this conference will deal with major issues of bioethics from various angles, and I am confident that the conference will be of enormous significance for the Japanese people, and for international bioethics community as well. In the opening session we have already enjoyed a number of excellent presentations to our benefit.

In the past 4-5 decades, bioethics and genetics have made revolutionary achievements. This is one of the conspicuous testimonies to the fact that humanity is standing on a spring-board for another great leap forward towards the 21st century. When I hear that chromosomes are connections between the world of information and the world of matter, I feel as if it had a special meaning for us, who are living in a full-fledged information era.

Biologists are now clarifying the physical and chemical process of life. And, we are now capable of reading the book of life. The dazzling achievements of biology have caused us to be more philosophical and to seriously reconsider the relations between human being and the world, the relations between human being and animals, plants and others, and the relations between humans and nature as a whole.

I have twice participated in the seminars at Fukui, and attended the joint seminar of MURS-Japan and IBC UNESCO, held in Tokyo 2 years ago. Attending these meetings, I was given the wonderful opportunities of listening to a number of superb reports. I had the feeling that a new horizon opened before me, when eminent biologists, medical doctors, lawyers and philosophers from Japan and other countries, made sharp analysis of the problems involved, and presented their well-considered views and proposals on the issues of biology and genetics at these meetings.

Some of the remarks and propositions were as follows:

1. We should realize how close the relations that human beings have with other creatures are, and how dependent we ares on their support, and, accordingly, we should bear responsibility and we should play a proper role.

2. It has now become difficult to find the difference between human beings and other creatures. Together with the realization of the importance of ecology, biology has lowered the privileged position of humanity in the world.

3. When people talk about the respect for the dignity of human beings, what do they mean by "human beings?" Madame N. Lenoir, president of UNESCO's International Bioethics Committee, made a number of penetrating remarks at the Tokyo Seminar. She pointed out that "Bioethics is a means to consider our future and our values." "Bioethics has a profound meaning which is the search of moral values in a society which is more and more dominated by science and technology and thus by money." By the same token, Prof. Okamoto, in his speech this morning mentioned that in Japan now there is a wide search for the basis of morals and ethics.

The Japanese people have a keen interest in advanced science and high technology, especially in the field of biology. However, the relationship between the individuals and society in Japan is not necessarily identical with that of western countries. Japanese individuals tend to be generally less assertive than their Western counterparts. Ethical values in Japan are not necessarily the same as in the Western countries. (Ethical values are firmly rooted in the respective societies and cultures.)

In this connection, I am looking forward to the presentations and discussions which will be made at the 3rd session of this conference, "Foundations of Asian Bioethics" and at the 4th session "Health and Asian Bioethics". I am sure that Asian experts and scholars will inform us of the impacts which the progress of bioethics has given to their societies, and of the way how their societies are meeting with the impacts. It would be greatly appreciated, if they enlighten us on such questions as: What is the difference between Asian approach and Western approach in bioethics? And what are the common points between the two approaches and how do they want to harmonize the two approaches?

I earnestly hope that this symposium will contribute to the development of bioethics in this country. (We have just heard from Prof. Mori of the birth of Japan's Bioethics Commission.) Again, I sincerely hope that this conference will give a good stimulation to the bioethics communities of Asian countries, and throughout the world. I would like to express together with other participants in this conference, heart-felt thanks to the mayor of Kobe, for Kobe city's cooperation for and support of this symposium.

Before concluding, I would like to express deep and warm appreciation to Dr. Norio Fujiki, who has been working so hard for the materialization of this conference. Dr. Fujiki is the vice-chairman of UNESCO's International Bioethics Committee and is the dedicated promoter of MURS in Japan. Without his assiduous efforts, this conference would not have been born. Thank you.
O2. Opening Remarks

Michio Okamoto

Conference President; President MURS Japan.

The 19th and first half of the 20th centuries were the age of Physics. Its crowning achievement was the splitting of the atom, which in the end gave birth to the atomic bomb, one of the hottest issues the world faces at present. It is said that the second half of the 20th and the 21st centuries will be the age of the biological sciences. The highlights of biological research may well be the brain and the mind. When we understand the mechanism by which the brain gives birth to the mind, and can rule the mind through control of the brain, we can anticipate that even more serious problems will arise. When we look at the progress of the age of science and technology from the 17th century onwards, we realize that we cannot just dwell happily on its positive results, but must always keep our attention on negative aspects as well. It is important for us always to bear in mind whether that progress is really proceeding in the direction of the happiness of, and a future for mankind.

On this occasion, bearing in mind the character of this conference, I should like our discussion to proceed with two main objects in mind. The first is, in this age of science and technology where should we seek our source of ethics and morals? Originally it would have been hard for the most part to imagine considering ethics and morals without a religious basis. However in this age of science and technology interest in religion is gradually waning worldwide. Here we must not just rely on religion only but look afresh to find a source of ethics and morals from within the science and technology age itself. Essentially this must be an issue of science. For those of us alive today this is an important and essential theme, and this is the reason for holding a meeting on ethics in these times.

The other is that while on one hand science is claimed to be objective and universal, unchanging with time and place, on the other hand it is recognized as being influenced by the cultural background of time and place. We know of science that, while it did not conquer the world in the same way as modern science and technology born in the west, in a different time and place was outstanding; the science of India and of China among others, we can imagine that although known in the same way as "science", depending on differences in cultural basis, these will influence people in different ways. Present day science and technology was born against the cultural background of 17th century Western Europe, and has come to dominate the world, but now when today we confront problems of the global environment, resources, population etc., in order to solve these might it not be profitable to turn our eyes to science established on differing cultural foundations? In particular now that Western science and technology are facing many problems, and even more so as we great an age of further scientific and technological advance, especially in the biological sciences, is it not important for us to consider science and technology, and at the same time related ethical and moral problems, from an Eastern cultural background, often seen as dramatically opposed on various points?

From this viewpoint, and seeing the reason for holding this meeting, as well as hoping that this conference will end in success because of its important significance, I would like to thank among others Professors Fujiki and Sakamoto, for their efforts in bringing it about, and all of those of you from home and abroad, particularly from far off countries, who being aware of the significance of this conference, have actively come here to participate. I now declare the meeting open.
O3. Welcome Address

Yukitoshi Sasayama

Mayor, Kobe City, Japan.

We wish to welcome you to the city of Kobe, and give our greetings from the city. It is a great pleasure to represent the city of Kobe in this UNESCO ABC. Bioethics is a subject of great importance today, and to have people from around the world to discuss this issue is very important and we look forward to important results for the future of bioethics. We thank you for choosing the city of Kobe as the site for this conference and we express our gratitude.

Kobe is a city blessed with many resources and a good environment. It is a city that has developed as an international city with a great deal of interchange and trade, but as you all know, we had a terrible earthquake here three years ago, which devastated the city. During the last three years we appreciate the help from around the world to help reestablish the city, and even though there are a few problems still remaining we have been able to get back on our feet.

We look forward to making this city one for the 21st century, being representative of the international atmosphere, and that will participate actively in the internationalization process. This is probably the most pleasant season of the year. The leaves on Mt. Ryoko are changing colour, and it is cool. We hope that you will enjoy this time of year and will be able to see some of the sights. We want to express our gratitude to all the people involved in putting this conference together, and we look forward to a very beneficial result of this conference.
O4. Welcome Address

Andrezej M. Wojtczak

Director, WHO Center for Health Development, Kobe, Japan.

I would like to convey to all participants of UNESCO Asian Bioethics Conference the best greetings from the Director General of the World Health Organization, Hiroshi Nakajima. I like to associate myself with these greetings and expectations, as the meeting is taking place in an important time for the world health.

Bioethics in the recent years is becoming one of the most important areas of general concern, as it is dealing with many problems of birth and death, as well as quality of life. The recent advances in natural sciences and their application in medicine open an unprecedented opportunity for the control of human diseases and even our biological future. But each advance also present difficult choices and questions: What medicine can offer? What is it able to do? What should be permitted to be done?

A good example can be the successful cloning of an adult sheep by a team of scientists from Scotland that raised a great interest and also a great concern in all sectors of societies of all cultures. This spectacular development of biotechnology, and DNA technology in particular, is creating a growing number of the ethical issues. We need also clear guiding principles of medical practice in such areas as: DNA diagnosis, mass screening, prenatal diagnosis, carrier detection of genetic disease, as well as prediction for genetic susceptibility for common diseases.

The World Health Organization is preparing, for the consideration of all 191 Member States, a renewed strategy Health For All. This document will guide the countries in the development of their health policies for the 21st Century, in an effort to improve the health of their citizens. However, the growing dominance of the market economy, unstable political systems, worsening poverty, environmental degradation, and violation of human rights are factors that constitute serious impediments to improvements in health. All of these give rise to a number of ethical issues.

We are guided in this venture by the generally accepted principles of:

* Adequate level of health care, recognized as a universal and fundamental human right;

* Equity as a fundamental principle for health policy,

* Effective, accessible, affordable and socially acceptable health services,

* Meaningful participation of communities in the development of health policies and services.

However, the challenge before all of us, is to clarify the meaning of the rising ethical issues, and to help to assess current needs and practices. We need to review, and to build up consensus on the technical and ethical safeguards to be applied, and to consider how to move from moral reasoning to global action in the interest of advancing human well-being. This multi-professional forum of experts, are able not only to discuss in depth many of the rising ethical issues related to the fast progress in biomedical and health-related research but also to formulate the recommendations.

Therefore, I would like to wish you very lively discussion where the ethical aspects of the health-related research and technology should be at core of the debate. WHO expect from this high level scientific and multi-professional forum, the sound recommendations in this very difficult areas, where we have to try to find consensus in this multi-cultural world.
O5. Message from the Director-General of UNESCO

Federico Mayor

Director-General, UNESCO.

Bioethics has developed in a context in which the repercussions of scientific and technological progress are giving rise to increasing public concern. Preoccupations are centred in particular on advances in the fields of genetics, neurobiology and embryology, which have given human beings the power to transform the development processes of all living species, including the human species itself.

Society is now measuring the implications of these advances, which are a source of hope and fear at the same time. Public and private decision-makers are appreciating more and more the potential impact of this new knowledge. Scientists involved in research in these fields are recognizing bioethical thinking as an integral part of the development of such research. Throughout the world, there is a growing awareness that bioethics - involving issues of social change and ecological equilibrium as well as vital moral questions - must accompany scientific research and anticipate its possible applications.

Since the early 1970's, UNESCO has been one of the principal promoters, at the international level, of the reflection on the ethics of living forms. The International Bioethics Committee of UNESCO (IBC), established in 1993 at my instigation, has proved an invaluable forum for reflection and debate and for the elaboration by UNESCO of standard-setting instruments, in particular the declaration on the human genome.

The reason I am unable to be with you today - as you may be aware - is that the twenty-ninth session of the General Conference of UNESCO is currently being held at our Headquarters in Paris. And one of the most important events during was the adoption of the Draft of a Universal Declaration on the Human Genome and Human Rights. This Draft was finalized by a committee of governmental experts in Paris July, 1997 after four years of deliberation and preparatory work by the IBC's Legal Commission.

I believe that the adoption of this Declaration by the General Conference - on the eve of the fiftieth anniversary of the Universal Declaration of Human Rights - will go down in history as one of the UNESCO's most significant contributions to the standard-setting activities of the United Nations system. However, the Declaration on the human genome will not be an end in itself but rather a point of departure. It will hopefully and above all create a momentum that will heighten world awareness of the need for reflection on the ethical implications of the application of scientific and technological knowledge.

I congratulate all involved in the UNESCO Asian Bioethics Conference on their work in this important field, and I extend my best wishes for a most successful conference. I am confident that your discussions will be as fruitful as they are wide-ranging, and that they will promote a broad public debate on the future choices necessitated by an exponential scientific development.
O6. Science, Technology and Bioethics

Wataru Mori

Cabinet Council on Science and Technology, Japan.

I am very honoured to be given the chance to speak on this auspicious occasion. Originally I am a doctor, a pathologist. After retiring from Tokyo University, I followed Prof. Okamoto footsteps as a member of the Science and Technology Council. On this Council we discuss science in general. I would like to introduce some work I have been involved in recently, on science and technology policy in Japan. Some of this may not seem to have a deep relationship to the purpose of this conference, but I think it has relevance to ethical problems in their wider sense. Some of these points will be of interest to you.

As you already know, Japan has a lot of people living in a small space, without many natural resources. It has to rely on imports from abroad for food and agriculture, and nearly all our energy resources are from abroad. This is the kind of situation in which we live. Under these circumstances how are we to build a wealthy nation, one that can be admired abroad? This is a new and old problem in Japan. Many different suggestions have been made on how this policy can be made, but amongst many people, particularly academics and politicians, bureaucrats, etc., a consensus has been reached that we should be establishing a science and technology country. In other words Japan should develop as a country based on science and technology.

Recently we have developed a policy to make Japan a Science and Technology based Creative Nation and enacted the Science and Technology Basic Law in 1995, then sent on to institute a Science and Technology Basic Plan. As part of this, while calling for favoured budget status for science and technology, we have instigated the necessity for vigorous assessment and evaluation, as well as raising the total budget for Science and Technology. Along these lines, "Evaluation guidelines for commonly use for Research and Development" have been decided.

The law outlined how Japan would become a science and technology based country in the 21st century. That is to advance science and technology, and we are drawing up a framework on fundamental science and technology policy, which includes many things. But to carry out and achieve the ideas in this law, in the climbing stage of this we have asked the government to give concrete details on what is actually planned, and we have given concrete details on how they should go about this. In order to put these policies into affect, the institutions must provide funds. We have asked them how they will secure funds. After six months of intensive discussion we finally completed our fundamental plan for science and technology.

People of Japan have many expectations of science, as something to solve the problems that the country faces and also to face basic fundamental value as human intellectual heritage. We thought it was necessary for us to take the lead in challenging and untrodden areas of science and technology. On the other hand, funding for science and technology decreased in 1993 and 1994, and the % of GDP spent on R&D funding is low compared to Western countries. Also the various agents involved in science and technology lack flexibility, and they have many restrictions placed on them. We also emphasized in our report, that the research base in the universities and government research institutes with respect to equipment is at a very low level compared to other advanced countries.

As an example of the concrete policies we have suggested, over 12 million square metres of universities and government research institutes are run down, with very confined and cramped facilities and that need to be improved. In the same way 800,000 square metres of space in the government research institutes needs renovation. While continuing to see what needs to be done, we suggest that we need to paint a detailed picture of the planning that is needed to renovate these research institutes and facilities. Furthermore, we need to increase greatly the amount of investment that we the government make in R&D, and we have suggested that by the beginning of the 21st century we need to bring this level to the same level as other advanced countries.

After the completion of this basic fundamental plan on science and technology, we draw up various individual plans in different areas of R&D. At present the only one that has been completed is on life sciences, and the others will follow. It was last year that we published this fundamental plan on R&D. We defined life science as science and technology related to life for the benefit of humanity. Based on this definition, we suggest that we need to develop from the present state of research which focuses on the micro or molecular level of the phenomenon of life, to understand life at the individual and ecological level of life, the macro-integrated approach to research. On the other hand we consider the various benefits that life sciences have given to society to be very important. Considering this, and the fierce international competition, and the fact that life science research is becoming very large scale, we need to consider further from now on how we are going to develop our life science research. As well as allowing and respecting individuals to research based on their own conceptualization, and opening up their own original research fields, we suggested we need an integrated system for research and development in the biosciences.

In particular we also view very importantly the harmony between human and life sciences and its environment, so in our report we have touched on the importance of the dignity of people and ethics as they relate to where the life sciences touches on humanity, people and nature, and we need to take these ethical problems into consideration. The life sciences have become more and more popular and the focus of public attention, but individual scientists need to explain their own research and obtain the understanding and agreement of the population itself. We need to think of the problem of human dignity as a problem of ethics, not just from the standpoint of the natural sciences, but also from a social and cultural point of view. Scientists need to continuously autonomously deal with these products, like cloning. Recently cloning has become a topic of great interest. We suggest the we should allow cloning of individual animals for agricultural purposes, and also we should allow cloning of human cells as long as it does not lead to human individuals. However, cloning of individuals still has not obtained social consensus, and it contains many problems from the scientific safety point of view, and also has problems relating to the essence of what a human is. So we have judged that it should not be carried out at the moment. Also in the whole of life sciences there are any problems that need to be worked out with regard to safety, methods for evaluation of safety, etc.

We also indicated policies on fundamental original research leading to new scientific knowledge, and of applied science, i.e. science answering social needs. We think that applied science should help the public lead a richer and safer life, and be used to build a better society. It should also be used to assist in the sustainable development of human society, in harmony with nature and the earth. We also see applied science leading to the opening up of new kinds of business opportunity in industry.

So I have discussed this basic policy for S&T and I hope that you have understood that we have tried to give sufficient consideration to the various ethical problems in the wide sense that the development of S&T entails. Along with these problems there was another piece of homework that we were left by our predecessors that was very important, this was the problem of evaluation of research. This was included in a section on the provisions for the development for basic research. After evaluating the present system of assessment we suggested it was time for the implementation of a strict new system of assessment, in the framework available to this. We started work on the governmentfs overall policy for the implementation of assessment methods common to various government research and development organizations, and this was made public in 1997. The first part covered the positioning of the policy and its purpose, the second what the subjects and objects of this assessment would be, and the third was the assessment itself and the responsibility of researchers and assessors, the fourth how we were going to carry out the assessment, the fifth the problem of assessment of research itself, the sixth the assessment of research organizations, the seventh was policy for review.

Rather than discuss all this detail, I would like to discuss various events that occurred during our development of an overall strategy. The background to this is that public funding is used in R&D effort, and by appropriate assessment of this more effective use may be attainable. But this leads to thinking that if we can get a bit more from one area than the others, we ought to try somewhat harder, or we ought to offer some basis for an increase in the budget from the Ministry of Finance each year. But this tends to lead to concentration on just the economic and fiscal side. However, if we are using tax payers money in this way in R&D, we should not just concentrate on the economic side of things in being stringent in the use of money, rather we must include extra problems like exports, whether the researchers are fulfilling their responsibility to explain to the public the results of their research. However it is very difficult to include these kinds of ideas in the actual main parts of the body. So this type of thinking was included in the approach of the committee chairman, and after this the contents of the report itself changed greatly. The report on assessment was published together with the overall policy report in 1997.

Of course, the public money is used there should be some assessment that it is being used properly, and this is true in any situation, research development is not an exception. Most people around me seem to think it is enough for the few selected individuals to perform the evaluation, and that its main purpose is to justify the usage of a tax. Nevertheless I recognize that the true purpose of evaluation is not the above but rather to explain to the general public the present state of Research and Development promoted with governmental funds in plain language as exactly as possible, so that people can make a sound overall judgment for themselves, inclusive of the ethical aspects. Needless to say, we must assess results not only in the field of Research and Development in Science and Technology but also in other fields. I believe such "accountability" of itself will lead naturally to the appropriate usage of tax.

It is very difficult to leave this assessment to the people themselves, we need some kind of intermediate judge to stand between the public and the scientists. Many people around think this should be left to a few who have been chosen to do this job, but their job is to ensure the effective use of public money. I think that the assessor should be a kind of judge as well as someone who explains it to the public, but finally the public has to make judgment on the way their money is being used. Probably different members of the public have different judgment criteria. Some will be concerned about if the money is being well used while others will be concerned about the actual content of the research, some may be interested in the ethical aspects of that research. Whatever point of view, the evaluation made by the assessors has very important weight. Their job will be to explain as simply and accuracy the content and aim of the public science and technology development, so the public can make a final judgment.

The policy document covers a wide area, some have very clear aims, such as development, while some are on the level of very basic research which may be impossible to evaluate. There are many levels in between but we need to fund measures suitable to the various kinds of science. Also one of the most important elements of this will be consideration of privacy and human rights, but also we must respect the freedom of researchers in carrying out their research. After evaluation if there are some points to improve they should be indicated, and even from the point of view of effective use of public money they should be implemented dutifully by appropriate measures. Evaluation should not be a dark image, rather it should be viewed as improvement of what is already good. We should aim for even better development, forward looking and bright, based on suggesting and supporting those involved in the work. I do not mean we should use a whip on researchers when I use the word strict.

I have discussed the various policies that I have been involved in developing over the past few years. Concerning these problems just a few days ago a committee on bioethics was established directly under the Prime Minister, so we could say from the point of view of science and technology that the investigation of bioethics has only just begun. We will be asking for opinions from abroad on ethics with regard to this, and we hope we can deepen consideration of these problems, and I ask for the assessment of the people from UNESCO ABC in doing this.
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