Bioethics for the Deprived: Comments on Dhar and Macer

- Hisanori Higurashi and Darryl Macer
Institute of Biological Sciences,
University of Tsukuba,
Tsukuba Science City,
Ibaraki 305-8572, Japan

Eubios Journal of Asian and International Bioethics 11 (2001), 82.

It was good that the authors mentioned "socio-economic disparities", although perhaps the survey should have emphasized them more. One almost feels it was just a mention, and nothing more. When there are millions of people in the world with no medical services at all, isn't it a little sterile to be putting so much emphasis on bioethical questions which primarily affect people who can afford high-tech medicine like gene therapy? I am not blaming Pushpa or Darryl for this. I myself teach mainly bioethical issues which apply only to people in rich, highly developed countries, issues of organ transplantation, neonate intensive care, etc.

Indeed, the most recent version of the Helsinki Declaration, while giving lip service to the needs of disadvantaged populations, focused mostly on the ethics of testing new drugs, an issue which is of interest only to that minority who can afford drugs and who have access to a system which can deliver them.

As we have been doing in our Mother and Child Health Education Project, and "Health Ambassador" programme, for Dalit ("untouchable") women in villages in the Palar River Delta area of Tamil-Nadu, we need to develop ways to teach people to look after their own health -- and the health of their families and neighbors -- in the absence of medical services: how a pregnant woman should eat for the benefit of herself and her baby; how to deliver a baby safely, infant nutrition and infectious disease protection; preventing sexually transmitted diseases, especially AIDS; safe human waste disposal and safe drinking water; bioethics in the sense of open, non-preaching, discussions of things like community responsibility in times of need, etc. These are the kinds of things which many millions of people, maybe most of the people in the world, need: not gene therapy and cloning and stem-cell embryonic cultures, when millions cannot even get simple first-aid equipment, and would not know how to use them if they had them.

The Eubios family has been active in real bioethics of this kind. It was Jayapaul Azariah and I together who originally conceived the idea of our project in Tamil-Nadu. But we should be doing much more.

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