Letter from Kyoto - Two layers of international bioethics

- Masahiro Morioka,

International Research Center for Japanese Studies, Nishikyo, Kyoto, Japan 610-11.

Eubios Ethics Institute Newsletter 4 (July, 1994) 43.

Darryl Macer, the editor of this newsletter, published a new book Bioethics for the People by the People (Eubios Ethics Institute, 1994). In the first part, "Universal bioethics: heritage and hope", Macer argues that we should share universal cross-cultural bioethics that maintains diversity. I agree with him that the coming international bioethics will need both the basic-and-universal layer and the diverse-and-cross-cultural one. The problem is what values and world view we should count as universal, and what as local. The Fukui Statement on International Bioethics, which we discussed at Fukui and Tsukuba in the early 1994, implies that fundamental human rights outlined in the United Nations Declaration of Human Rights are the most important moral criteria humans have to obey universally anywhere on this planet.

I agree with this, but if we fully accept it, bioethicists who tackle international bioethics will surely get involved in world politics on human rights, for example, year long negotiations between the United States and China. This is a new and tough problem for bioethics. Some Asian politicians say that only developed countries can claim fundamental human rights as moral and legal priority for every citizen, and that some developing Asian countries have not yet reached such a stage. They insist that these countries still remain at the stage of the European countries before the French Revolution, hence we have to wait until they experience their own political revolution and become economically affluent countries.

I am not sure whether their argument is right or not, but obviously international bioethics will have to take such global political issues into account. For years, the European community has sought common criteria for bioethics, but abortion regulations, for example, are still diverse among European countries. What happens when we seek common bioethical criteria in the Asian region? While European countries share one religious tradition and most of them are classified as developed countries, Asia has several major religious traditions and the development stages of Asian countries are diverse. Probably the most important bioethical issues in Asia are "war," "starvation," "malnutrition," etc..

I cannot help thinking that the urgent task of international bioethics is to find a way of stopping wars and of narrowing the gap between rich and poor countries. This must be the basic and universal layer of international bioethics. Hence, the statement of international bioethics, I think, should declare this point first, and fundamental human rights next.

Let us think again about two layers of international bioethics. The basic and universal layer includes such moral goals as stopping wars, narrowing the gap, acquiring fundamental human rights, and so on. It is our future task to make clear what other items should be counted at this universal level. The diverse and cross-cultural layer includes two groups of items arising from 1) "cross-cultural gap" among countries or traditions, and 2) "development gap" between rich and poor countries. For example, the place of the idea "self-determination" in Japanese bioethics would be different from that of the United States where "autonomy" is respected first of all. This is from a "cross-cultural gap." The medical priority for the Japanese would be completely different from that of Nepal where the infant mortality rate is more than ten times higher than Japan. This is from "development gap." As to "cross-cultural gap" we will probably have to try to respect each country's value system; but what is the definite meaning of the word "respect"? Does this mean to say nothing when two parties conflict? As to "development gap" we will probably have to try to aid developing countries financially; but what should we do if the recipient country has violated the fundamental human rights of suppressed people?

These are some of the hard problems future international bioethics will face.

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