pp. 299-300 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.

C5. Closing Address

Darryl R.J. Macer,

Director, Eubios Ethics Institute, New Zealand and Japan

In the past week, at the UNESCO ABC and at the Third International Tsukuba Bioethics Roundtable, we have considered what Asia can offer to international bioethics. We have to learn from each another, and this is important in any culture.

The spirit of learning says that what I think is true may not be so. It also says that at the end of the meeting I should have changed my world view. It says that it is OK to learn from each other and make mistakes. During our life we can synthesize a world view, that may mean turning around in circles several times to seek the truth.

To begin to study we need to think of what we mean as "bioethics". I think there are three ways.

1. Descriptive bioethics. The way people view life, their moral interactions and responsibilities with living organisms in their life.

2. Prescriptive bioethics. To tell others what is good or bad, what principles are most important; or to say something/someone has rights, and others have duties to them.

3. Interactive bioethics. Discussion and debate between people, groups within society, and communities about 1 and 2 above.

What bioethical world views have we heard? Anthropocentric can be individualistic, family centred, nationalistic, racial or communitarian. Biocentric focuses on biological organisms and may also make a hierarchy. Ecocentric considers the ecosystem or biosphere as a unit. Most talks followed an anthropocentric view, which is perhaps disappointing, but not surprising.

This interchange of interactive bioethics should never be one way. At this meeting we had talks from International visitors informing us about the situation in different countries, and with lessons for all of us about Japan and Asia.

I wish to share a few thoughts about Japan. I am not a historian but it is obvious that bioethics did not start when the word was made, but the ideals of doing good and avoiding harm, and of choices from autonomy versus social justice, have been with us since the beginning of civilisation. Yet it seems we have to reinvent the wheel very often. Let me give a few examples from Japan.

I think the concept of "informed choice", should replace the concept of "informed consent". Both concepts are found early in Japan. Last century Hanaoka Seishu records informed consent for breast cancer operations in Japan. Why do we use Informed Consent in katakana, not kanji? Japanese like to introduce new words which can be a positive trait, but why are new ideas better than the same idea in an old name? Of course, if it really is the same idea is a question for us to examine.

It is said that death is a taboo in Japan, but actually more elderly people live at home with the family in the sometimes depressing years of fragility that old age brings, than in the West. The daily experience of death and futility may be more common in Japan, yet discussion of death is said to be less common than overseas. Maybe in America they talk about futility but put the elderly in separate care. In independent care they can pretend that they are young, and on the positive side keep a cheerful active life. However, this is also avoiding to see death by the family.

If we look for bioethics in literature we can find stories of the beauty of dying in nature, as in many countries. We can also see stories like "Ubasuteyama", which could be translated as "Grand-mother throwing mountain". This practice was relatively well known before the Meiji era, and involves the son carrying the mother up to the mountain to leave her there to die. It was made famous in a film "Narayama bushiko" which won a Cannes film prize. The reason was usually the shortage of food. This unpleasant practice is reported to still occur in Korea, and is also shared with Siberian tribes such as the Yakuits and Mongolians, who are close to the Koreans and Japanese in origins.

Mabiki is another practice that involved pulling out extra rice seedlings, used for killing of unwanted babies. This we can see more broadly across cultures, and it also relates to the dilemmas of prenatal testing. We also see a very interesting practice of Mizuko statutes, water-children, which is a griefing process for remembrance of aborted fetuses, miscarried children, and babies who died very young. It is a Japanese response to a universal dilemma.

Japan is a country where you may get a warning time before a parking ticket is given. There is less involvement of law in medicine, and more consensus then confrontation. This I believe to be a plus of Japan, as long as individuals can be protected if this harmonic system fails.

There are good and bad points of all cultures, the neighbourfs grass can be refreshing but it is not always greener. All societies are a mixture of opinions, and survey data show there is not one view of any culture on one issue. We should build societies that respect diversity and tolerate choices that people make.

In conclusion, the discussions here help us in UNESCO IBC and also for HUGO Ethics. They were possible only with the help of all here and especially Prof. Fujiki. We also want to thank all the people from coming from afar, many at their personal expense. We could only offer limited help for travel, so we thank you all for finding discount tickets to bring you here.

In conclusion we can ask if we made good music? I think so, but the symphony is not finished.

Please send comments to Email < asianbioethics@yahoo.co.nz >.

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