Cross-Cultural Bioethics

- Darryl Macer, Ph.D.

Institute of Biological Sciences, University of Tsukuba, Tsukuba Science City, 305, JAPAN

Eubios Ethics Institute Newsletter 2 (1992), 57, 59.

Bioethics includes medical and environmental ethics, and a broad range of issues concerned with the economic, environmental, ethical, social and legal impacts of "biotechnology" (Biotechnology in its broad meaning, i.e. medicine, agriculture and environmental use).

The contents of this newsletter cover many of these issues, and the function is to report on literature, conferences and events of importance to bioethics, as rapidly as possible. Various letters and small papers are published, in an attempt to stimulate discussion consistent with the goals of the Eubios Ethics Institute. The views expressed in this newsletter may not always reflect the views of the Institute or editor.

In order to develop cross-cultural bioethics it is important to include information and thoughts of people in countries that may miss the mainstream of bioethics development - often because they lack resources to allow them the time to develop their thinking on bioethics. Yet at the same time these financial restraints may allow fresh light to enter the spectrum of bioethics, and therefore it is for that reason that contributions from people living in these countries are especially invited.

The newsletter has its focus on international developments, and it is open to be a forum for dialogue. In this issue there is a paper from Dr. Frank Leavitt in Israel, asking what integrated cross-cultural ethics should be. He also looks at the controversial topic of euthanasia. We look forward to comments and criticism in following months.

Another point for your thoughts, I would like to ask why people need to be identified with particular countries, and why ethicists so often view justice as a principle which only extends to their national boundaries. This philosophical flaw continues to support the tragic misdistribution of resources on this planet and I remain amazed at how naive many bioethicists of industrialised countries apparently are, and at how many others fail to raise these issues more loudly in rich countries.

The Inaugural Congress of the IAB will be held in Amsterdam 5-7 October, 1992. The IAB has the potential to be a truly international professional group aiding the coordination of bioethics research in a cross cultural manner - something that is only just beginning to occur. There are numerous other societies of bioethics. Many follow national or regional boundaries, and therefore are at risk of developing incomplete views of bioethical issues and lack the ability or human resources to formulate global bioethical approaches. Let us hope that the IAB can fill in some of this missing ground in the currently inadequate development of cross-cultural bioethics.

In addition to the stated objectives of the IAB, let us hope that the IAB can in particular encourage the development of research and teaching in bioethics in the poorer countries (though the rich countries, by definition, still have much to learn!). It may be able to coordinate research projects at international level that may allow funding of research by rich countries as collaborative projects, in developing countries - which would provide much useful information for all of us, and may be a better utilisation of research resources (not only a more just one). It would also stimulate research and teaching in those countries. We can hope that the largest funders of bioethics research, such as the NIH in the USA, and the EC bodies, and various funding agencies direct more support to such international research projects, to aid the UN agencies and other foundations which support international research. We also hope that the US funding of social impact research of biotechnology, of US$9 million in 1992 (the 1993 proposed budget includes US$9.2 million), will be matched by some other rich countries. Japan spends less than 1/100th of this amount on such issues!

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Conference Reports: Toronto '92 : The Third International Conference on Health Law and Ethics, July 19-23;

Budapest: VIth European Conference on Philosophy of Medicine and Health Care, August 12-14

I was fortunate to be able to attend the above two conferences, which were well organised. Both were attended by many people, the Toronto meeting having more lawyers and the Budapest meeting more philosophers. They both included many concurrent sessions which is always frustrating at such meetings. Attendance tends to fail, and it is interesting to see the numbers in concurrent sessions fall throughout the meetings.

Such a range of issues were covered that it is difficult to summarise them. The merits of single issue conferences are highlighted in such meetings, as the researchers in bioethics become more specialised as the level of actual research is more intense than even three years ago.

The Toronto meeting covered issues of AIDS, National Health services, women's health, epidemiology, reproductive health, and transplantation. In amoung this, there were also some interesting papers on genetics and reproductive technology. Woman's health was focused on more than in the past ASL&M conferences. There were also clear differences in perceptions of health care delivery in Canada and the USA.

The theme of the Budapest meeting was social policy and health. Being mostly Europeans, or from countries with government-run social welfare systems, there was more emphasis on ways to modify health systems along these principles. The issue of how "post-communist" countries arrange their health care was discussed. Although there is a problem of bribing doctors to move up waiting lists in the socialist model, not only in such countries, there is much to fear from the sudden privatisation of medicine. This may lead to a two class system, replacing the socialised systems.

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