Re: How (bio)ethical are bioethicists? Responses to the editorial in the July issue, pp.43-4

- Darryl Macer, Ph.D.

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

Eubios Ethics Institute Newsletter 3 (1993), 57-60.


Quite a good response was made to the editorial in last months issue, in which I said I think bioethicists could do with some criticism and thoughtful changes in attitudes and lifestyle. May be it was a good topic to raise. I included the subjects:
1. Replying to letters or gifts
2. False words & anti-social behaviour
3. Too many conferences and no coordination
4. Conferences, money and productivity
5. Too many journals
6. Journal Review Times

In the following pages there are a variety of letters on these topics, plus two letters on general issues in bioethics. A call for conferences is being made here and in the International Journal of Bioethics. We want people to send a list of planned bioethics conferences and a list of officially announced bioethics conferences. The first one will be circulated among organizers, and the second will be published in at least these two journals.

Further comments on the morality of conferences are seen in BME (June), 6, with comments by Richard Nicholson (see his letter above), that I agree with. I just received the letters about the International Conference on Medical Ethics in Beijing, which has a registration fee of US$2850 - which must set a record (at least for a deal without airfare - there are higher priced trips available for some tour packages that are arranged from Japan, but with air travel). Much cheaper trips can be arranged through travel agencies.

International bioethics survey project report

See previous issues, or contact me. Surveys of public (P), medical school students (M) are nearly completed in New Zealand (P=335, MS=96), Australia (P=200, MS=110), and Japan (P=350, MS=435); and are continuing in India, Russia, Thailand, and other countries. Questionnaires are available if you are interested in conducting such research in other countries.

High School Bioethics Education Project

I have also just begun a project to look at the introduction of bioethics into the high school curriculum in Japan, funded by the Ministry of Education. As part of this project, yet more surveys are underway, of biology and social studies teachers in Japan, New Zealand and Australia. Questionnaires are available.

Three books planned for January-February 1994

Three books are planned to be published by the Eubios Ethics Institute early next year, more details will be given in the next issue. Two will be the English and Japanese proceedings of the Third International Bioethics Seminar in Fukui, on Intractable Neurological Disorders, Human Genome Research and Society , to be edited by N. Fujiki and D. Macer. Another one will be written mainly by me, also with a variety of papers written by collaborators of the International Bioethics Survey, and other people on International Bioethics, called Bioethics For the People By the People.


General letters:

I very much agree with your editorial on 'How (bio)ethical are bioethicists?' I hope I am among those who did not forget to say many thanks for the Eubios Ethics Institute Newsletter. I also hope that my work in the field of bioethics is not an ivory tower sophistication but something which contributes to some very much needed changes in medicine and health care. It is certainly true that only those should engage in teaching and writing about ethics who, themselves, have at least somewhat higher moral standards than those from whom they expect the often stated virtues.

Besides the above written few remarks I am enclosing a preliminary questionnaire on corruption and honesty in health care systems. This is another Network of the International Association of Bioethics that I have the honor to coordinate. In case you have space for it, I ask you with the utmost respect to publish it in your Newsletter. I have already sent out about a dozen copies to various bioethicists in different countries, and I am looking forward to receiving replies. You may, of course, condense it as you wish or just have a short summary of it for the periodical.

Finally I must congratulate to you for your very comprehensive Newsletter that has really a very wide area of short reviews. It is certainly very useful and well edited. I like it.

- Dr Bela Blasszauer
Medical University of Pecs, Pecs, Szigeti u. 12, 7624 Hungary

Ed- Please contact Dr Blasszauer for the survey.


As one who has been in the bioethics business for the past 15 years, I can understand your frustration, hurt, and anger at the way you've been treated by colleagues. I, too, have experienced many of these frustrations, and I have also questioned whether bioethicists are as sensitive of ethical standards as those in "glass houses" should be. Yet, as I read through your list of particulars, I sense that your criticisms, however well-founded, extend far beyond bioethicists to academics in general, even to people in general: rudeness and lack of consideration, waste of money, waste of time and trees, etc..

Since bioethicists are people who come out of their respective cultures and societies, I rarely expect more of them than I would from a non-professional from that same society. Indeed, I have found that the non-professionals are occasionally more sensitive and respectful than the professionals, but I'm sure that doesn't come as a surprise to you. In summary, I wouldn't paint bioethicists with too broad a brush, but I would suggest considering the lowering of your expectations. I remember having a similar discussion with Dr. Richard Nicholson, editor of the Bulletin of Medical Ethics (London), who editorialized in 1985 (I believe) about US ethicists being guilty of "ethical imperialism." He had a point, of course, but the danger is that that point gets lost amidst too broad an attack.

Again, my continuing thanks for your excellent work, and my best wishes for a more satisfying New Year, academic as well as calendar.

- Dr Leslie S. Rothenberg
Division of Medical Genetics, UCLA Dept. of Medicine, Los Angeles, CA 90024-1736, USA


I have just read your article on "How (bio)ethical are bioethicists?" and agree with it entirely. One of the issues that I have been contemplating lately, is that all those who have power must be concerned about using that power ethically. We need to recognize that often persons who are proclaiming or seeking to implement "ethics" (which is a very worthy cause providing it is genuinely undertaken) are also engaged in an exercise of power and we must make sure that this exercise of power is ethical. There is also the problem in even the most altruistic endeavours, that some persons see these endeavours principally or even simply as an opportunity for promotion of their own interests. There are some sad examples in this regard, for instance, in the area of medical research. It also occurred to me to wonder about the relevance, to the issues which you raise, of values of gratitude, loyalty, trustworthiness, commitment, honesty, integrity, etc.. While none of us always live up to his or her best ideals, perhaps, bioethicists have more than the usual obligations to do so.

- Prof. Margaret Somerville,
Director, McGill Centre for Medicine, Ethics and Law, 3690 Peel Street, Montreal, Quebec, Canada H3A 1W9.


I resonated to several of the rather dour observations about courtesy and speed in bioethics, but I hasten to add that it is not distinctive to bioethics. I also bristled a bit about lack of thank-you's and acknowledgements for free books and publications and such. I am sure I am not alone in getting more than one such unsolicited freebie every day. It is simply a logistical impossibility to keep up with it all, and I already can't thank all the people who make direct and substantive contributions to my work enough. I don't feel very defensive about it. I have had the same feelings you do, but have come to realize that it simply isn't practical. You have to count on personal meetings from time to time, I think, to do the social work of collegiality. I'm sure its much harder from Japan and New Zealand than it is here.

- Dr Robert Cook-Deegan,
Institute of Medicine, National Academy of Sciences, 2101 Constitution Ave, N.W., Washington D.C. 20418, USA


In your July editorial of the Eubios Ethics Institute Newsletter, you put some vigorous and, in some way, justified criticisms regarding how ethical are bioethicists.

One of the criticisms concerns conferences and risks of duplication. Although some good reasons could explain the overlapping of meetings on the same topic (some will take place on the national level, others in the international arena) or the remake of the same meeting (to update information and knowledge of the participants), a large number of these meetings could certainly be reduced, nationally speaking.

But we should not forget that bioethics has also become a political phenomena. Therefore, it is a means for international or national institutions, lobbies, citizen's associations, to affirm their role in the bioethical debate.

With time going, a selection will certainly occur among bioethics organizations which generate conferences. I am not so sure that this selection will only leave the most experienced and competent. I hope we could work to help them to survive and find their way in the bioethics jungle.

Coordination, as you suggest, then appears as a limited but possible way to promote such a view, but my limited experience as special advisor for bioethics in an international governmental organization reveals that you should not ask the question "who can coordinate?"

The best thing is to behave yourself as a coordinator, while you give the feeling to all the others that they are the coordinator. So I will do by proposing that respected and notorious international bioethics journals (your newsletter, Bioethics, The Hastings Center Report, The Kennedy Institute of Ethics Journal, the Journal of Medicine and Philosophy ... and of course my own journal, the International Journal of Bioethics) will make a call for 1994 (and future) conference announcements with the engagement to publish a common list in all the journals. I am of course ready to do it even if the others do not assume it.

- Judge Christian Byk
62 Bd Port-Royal, F - 75005 Paris, France.
Secretary General of the International Association of Law, Ethics and Science and Editor of the International Journal of Bioethics.


Letters to Journal editors and Response:

As part of the response to the letter from C. Byk, editor of the International Journal of Bioethics, we sent the letter below to the editors of the following journals, and those that responded are indicated.

Dear Dr ...(Editor), 23 July, 1993

We are writing as editors of two bioethics journals. We are seeking ways to gain more international coordination regarding the timing of bioethics conferences and meetings. This is the result of our general feeling that something should be tried. Some comments were made in the editorial by one of us, "How bioethical are bioethicists", Eubios Ethics Institute Newsletter 3: 43-4, a copy of which is enclosed.

We suggest that a list of bioethics conferences is shared between all the main bioethics journals, to be called for in the coming issues of the journals. This would allow the construction of a common list for conferences in 1994 and beyond, so that conference planners may be better able to avoid conflicting dates for international bioethics meetings.

Your comments will be published in the September 1st issue (if they arrive before then) of the Eubios Ethics Institute Newsletter , together with a list of journals to whom we sent this letter; as well as comments received on other matters in the editorial.

We look forward to your comments and suggestions, sent via E-mail, fax or letter to Darryl Macer as indicated above.

Yours sincerely,

- Darryl Macer, Editor of the Eubios Ethics Institute Newsletter, and co-coordinator of the IAB Genetics Network.

- Christian Byk, Editor of the International Journal of Bioethics,

and Secretary General of the International Association of Law, Ethics and Science.


Response (Yes; No)

Y Bioethics
Y Bulletin of Medical Ethics
N Cambridge Quarterly of Healthcare Ethics
Y Canadian Bioethics Report
Y Forum Bioethica
N Hastings Center Report
N Health Care Analysis
N Kennedy Institute of Ethics Journal
Y International Digest of Health Legislation
Y J. Clinical Ethics
N J. Medical Ethics
Y J. of Medicine and Philosophy
Y KOS
N L'arco di Giano
Y Social Science and Medicine


From the editor, Bioethics

Regarding the proposal for listing conferences, we will be prepared to do it, as long as:

1. Conference listings are just that, i.e. title, organising body, venue and date, not a descriptive paragraph on each one.

2. We run to a long lead time, so we would want at least lots of notice. I am sure for that reason, Eubios Ethics Institute newsletter is a better forum for this, if you are widely enough read.

- Prof. Peter Singer,
Centre for Human Bioethics, Monash University, Clayton, Victoria, Australia 3168.


From the editor, Bioethica Forum

Thank you for consulting me about the coordination of bioethics conferences. I think it is a brilliant idea and a useful initiative. Here are some comments and propositions:

A list would be useful, some lists would be more useful. I think we should distinguish between:

(i) a list with planned conferences (before the first announcement) which could be accessible mainly to other organizers who are also planning a conference and searching for a convenient (non overlapping) date.

(ii) a list with official announcements of conferences. This list could be divided in chapters (or separate lists) according to the conference location and /or importance of the manifestation (local, national, continental, worldwide ) (e.g. I know that I cannot make a plane trip for a one-day conference).

So we could receive one page with international conferences and one page with our own continental activities and not have a paper overflow.

In Bioethica Forum, I am trying to inform the members of the Swiss Society for Biomedical Ethics of European conferences and sometimes of International conferences. Nevertheless I know that my list is never exhaustive, even on Swiss events. My sources are what I receive personally through mail and what I pick up from other journals.

- Dr Jean-Marie Thevoz
Fondation Louis Jeantet,
C.P.277, CH-1211 Geneve 17, Switzerland


From the editor, Canadian Bioethics Report

Thank you very much for your letter of July 23, 1993. I fully support your initiative regarding the timing of bioethics conferences. As you know, my list of upcoming conferences in the Canadian Bioethics Report section of Humane Medicine includes only those which will take place in Canada. I have to compile the list a full two months before it is published. However, I am quite prepared to send you and Christian Byk the list as soon as it is completed. The ones to be mentioned in the October number are attached.

I also agree with you that there are too many international conferences and, for that matter, societies (cf. my editorial, "The Internationalization of Biomedical Ethics," in the June, 1990 number of Synapse [VI/2]).

- John R. Williams, Ph.D.
Director of Ethics & Legal Affairs, Canadian Medical Association
1867 Alta Vista, Ottawa, Ontario K1G OG8, Canada


From the editor, Bulletin of Medical Ethics

I sympathise with your angry July editorial: I have sometimes made similar outbursts. But I think you have not been careful enough in your target selection: some of your complaints do not stand up to closer scrutiny. In your very first category, for instance, you complain about those who do not respond to the unsolicited sending out of books and letters. As far as I know, it is not common practice for journals to acknowledge receipt of all books for review. While it would be courteous to do so, as well as to respond to all unsolicited letters, it takes time and money. What you, as the sender, expect is that others should automatically devote their time and money to your interests, without having agreed in advance to do so. If you must talk in terms of ethics, rather than of courtesy and norms of civilised behaviour, then it is easy to conclude that your expectations as sender are more unethical than the non-responding behaviour of the recipients.

I have similar doubts about your, and Christian Byk's, ideas for preventing conference clashes. In one paragraph you complain about important conferences being on the same dates - because presumably you think people should not have to make a choice but be able to go to both, or to however many clash - yet in the next paragraph you wonder whether people should bother to go to them at all. You also need to think about the costs and benefits of your proposal.

On the benefit side, one or two conference organisers each year worldwide might choose a different date. But most will have a variety of unalterable constraints that determine when their conference will be. In turn that may allow a handful of delegates to attend two conferences rather than just one of two clashing conferences. But most people choose carefully which conferences to attend and do not have the time or money to go to many.

For all that you complain about receiving eight flyers for one conference, most organisers do not bother to send their information even to all relevant journals. Last year the Bulletin of Medical Ethics listed 144 relevant meetings in its diary, 82 in the UK and 62 elsewhere - many more than any other journal in the field: it was sent details of less than half those meetings and had to search actively for information on the others. To collate details of even 90% of proposed conferences, as much as two months before they happen, would take a great deal of time and effort. The cost of collecting details of all meetings in time to prevent clashes would be immense - and with that number of meetings some clashes will be inevitable, anyway.

I suggest you use you time for more useful pursuits.

- Dr. R.H. Nicholson
Editor, Bulletin of Medical Ethics,
31 Corsica Street, London N5 1JT, U.K.


From the editor, The Journal of Clinical Ethics

Our editor in chief, Edmund G. Howe, received your letter just as he was leaving for vacation. He shared several thoughts about your letter with me, which he requested that I pass on to you.

First, Dr. Howe supports your efforts to schedule international conferences so that they do not conflict with one another. He cited several instances in this country, in which national or regional conferences have conflicted.

Second, Dr. Howe agrees with several points that you raise in your editorial. It is important that bioethicists respond to other professionals in a manner consistent with their field -- and this includes responding to communications and taking the initiative to make others feel welcome at international meetings.

Third, Dr. Howe agrees with your comments regarding the lengthy manuscript review process of many journals. This is an issue that we look at continually at our own journal, and it requires ongoing attention by journal editors and staff.

Dr. Howe appreciates your contacting him. Please let us know how we can be of help in your efforts.

- Margaret E. Dorrier
Managing Editor, The Journal Of Clinical Ethics
12 South Market Street, Ste. 301, Frederick, MD 21701, USA


From the editor, Social Science and Medicine

I was interested to receive your circular letter of July 23 regarding better co-ordination among those responsible for organising bioethics conferences and meetings.

As you may be aware, the international and regional meetings for which I am currently responsible are not primarily bioethical. Nevertheless, it is true that we invariably endeavour to incorporate at least two such themes among the eighteen or so covered on each occasion.

When our series of international conferences first began, in 1966, an effort was made to select a date least likely to clash with other meetings which might interest our expected participants. Unfortunately, after our third meeting, it had become apparent that the international conference calendar was so full and the number of national associations so prolific that the factor of avoiding any clash could no longer be taken into account, it had ceased to be practical.

Notwithstanding the above, I am sure our future planning committees would wish to take into consideration any list of conferences in the field of bioethics that might be provided and we, for our part, would be delighted to inform whoever was concerned about the dates fixed for our own meetings, these being made generally two to three years in advance.

- Dr Peter J.M. McEwan
Chairman, Planning Committee, Thirteenth International Conference on the Social Sciences and Medicine, Glengarden, Ballater, Aberdeenshire AB35 5UB, Scotland


From the editor, Kos. Rivista di scienza e etica

Thank you very much for the opportunity to comment on your July editorial of the EEIN. With reference to the reflections put forward in the editorial I wish to make only a few comments.

I do not have any experience of not receiving answers to letters I write. I usually reply to all the letters I receive, and - maybe I am lucky - so do the others with me (until now, at least).

I do believe you a right in saying that there are too many bioethics conferences and too little (if any) coordination. I would also like to say that there are too many big conferences, which often look like great kermesses with too many (even if valuable) speakers and too short time for rational discussion and serious and thoughtful work. Besides, it is also true that too much money is spent in these international meetings, which could be organized with much more sobriety. However, I doubt that writing letters can be equivalent to meeting persons and discussing issues face to face. It is inevitable that one writes answers in the spare time, and actually cannot write large essays in reply to deep philosophical questions. Conferences are irreplaceable, if seriously organized. It would obviously be a good idea to coordinate these meetings, even if it may be difficult to have all the conferences planned in such advance that the organizers can have a complete view of all the conferences that are going to take place in the year. I perfectly agree, however, that something should be tried, and that the International Association of Bioethics should take up this task. By the way, the problem is not of particular direct concern to me, since my Department much more frequently organizes academic courses and other teaching activities, rather than big international conferences.

I am not sure that there are too many bioethics journals. Surely I do not know all of them, and maybe I am influenced by the situation in my country, where the journals are few. However, it is true that bioethics is an expanding area of research and it seems quite natural that new journals are published, so that also young researchers can find space to let their voice be heard. The question is, rather, that there must be serious guaranties that the material published be valuable and not the product of would-be experts, who have actually spent their lives in anything but bioethics, and who invent themselves bioethicists all of a sudden. This brings us to the painful problem of reviewers. I do agree that review times are often long and sometimes show scarce respect for the persons involved: however, it must also be said that a protest in this sense can be more pressingly raised with references to great international journals, that have large editorial boards and many more scholars aiding in the review process. The same cannot be said about other journals, that cannot rely but on a very small number of collaborators.

In the end, I am inclined to accept many of the observations put forward in the editorial and dampen the preemptoriness of many others. I certainly welcome the opportunity to share ideas on these 'ethical' issues. I thank you again for having consulted our journal.

- Prof. Paolo Cattorini
Scientific Institute H San Raffaele, Via Olgettina 60, Milano, Italy


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