- Qiu Renzong, Ph.D. (President ABA, 2002-2004)
#2121, Building 9, Caoqiao Xinyuan 3 Qu, Beijing 100054, China
Eubios Journal of Asian and International Bioethics 14 (2004), 3-4.
My colleagues and I just organized the Beijing International Conference on Bioethics. Apart from Chinese participants including those from mainland, Hong Kong, Taiwan and Macao, many came from Asia as well as from Europe, America and Oceania. The conference focused the ethical issues in biomedical and health research, in HIV/AIDS, in genomics and biotechnology with panel discussions on the informed consent in non-western cultural context, ethical lessons from Unit 731, ethical and policy issues in HIV/AIDS prevention and treatment, and the social responsibilities of geneticists/scientists. Asian bioethicists played a crucial role in this successful conference.
As I pointed out at the Inaugural Congress of IAB in Amsterdam in 1993, the development of bioethics not only depends upon the introduction and application of science and technology, but also upon economic increase, social change and political progress. Asia is a one of the regions where economy has been rapidly increasing, the social structure has been tremendously transformed, and the development and application of science and technology are catching up with advanced countries. Together with these positive developments bioethics has been made great progress in Asia, whether in North Asia or South Asia, in East Asia or West Asia since the founding of our Association. On the other, the development of bioethics in Asia is uneven. In the least developed countries or regions bioethics is still within sight but beyond reach. We have to make greater efforts in the bioethics of Asia.
The prospect of bioethics in Asia is positive. The 21st Century will be one of life science and technology. The development and application of life science and biotechnology will unavoidably raise a variety of bioethical issues. Especially, during globalization relying on domestic resources and international cooperation, genomics and biotechnology will be widely studied and applied in 21st century Asia. In these activities bioethicists in Asia will take greater responsibility for protecting human health and life, respecting human dignity, safeguarding human rights, and kindly treating other species and protecting the eco-environment.
Asia has a huge population and she is rich with human, animal and plant genetic resources. Also one of the biggest markets is being formed in Asia. So Asia will become an ideal place attracting many genetic institutes or pharmaceutical companies to come to develop and conduct biomedical and health research involving human subjects. In research human subjects are in a vulnerable position. The protection of their health, welfare and rights is an obligation of scientists and physicians who conduct the research, sponsors who support the research as well as bioethicists who review and monitor the research.
The epidemic of HIV, SARS and poultry influenza in Asia formed other center of ethical concern. The epidemic of these diseases involves ethical issues in the field of public health which may be different from those in clinical or research context. While SARS is a typical public health issue, HIV is special as some conventional public health measures are not valid sometimes, because people living with HIV are used to be stigmatized and discriminated. The successful prevention of HIV is related with proper treatment of those social groups in the marginalized position, such as homosexuals, drug users and sex workers. So ethical issues in HIV are more closely related with human rights issues.
The protection of patients' or human subjects' health, welfare and rights needs to be institutionalized through governmental regulations and legislature's laws. Developing such regulations and laws and implementing them are urgent issues facing Asia. It is a pity that in some cases few bioethicists are involved in developing and implementing these regulations and laws, and in other cases although there are much ethical debates on protecting patients and human subjects but there is no regulation or law on how to protect them in Asia. Developing these regulations or laws is a multi-disciplinary endeavor, however, the role of bioethicists in it is indispensable.
However, if we do a good job in all these activities mentioned above, we have to build our own capacity. The help and assistance from non-Asian colleagues are important, but we have to be independent and self-reliance. For example in China there are already more than 200 IRBs/Ecs, among them some worked well, but some didn't. Even in some governmental regulation it is not required that an ethical review committee should have a bioethicist as its member. Its members or even its chair don't know its function, and as a result they only did scientific review and did not do ethical review. The editor and members of the editorial board of a journal didn't know the role of the journal in protecting human subjects. Even medical ethics teaching staff in medical schools didn't know the situation in the research involving human subjects and did not have the expertise of ethical review. So the training of PIs, members of IRBS/ECs, medical ethics teaching staff and editors of journals is an urgent work as a part of capacity-building.
The first of a new series of training activity has been rescheduled in February 2004 because of SARS. As a PI of this first training project I have to stay in China to organize it and won't be able to attend Tsukuba ABC5 conference. These activities of capacity-building have been done in India and Thailand. I am looking forward to seeing such projects that would be more often done in Asia.
When Asian bioethicists participate in global dialogue, we found we share important values with non-Asian colleagues. You can find the values or principles such as do no harm, beneficence, respect and justice in Confucianism or Islamism as they are in western culture. However, these values or principles are rooted in Asian culture or philosophy. The philosophical foundation of these values or principles are different from western counterparts, and the application of them are also different. For example, in many Asian countries or regions, the ties between individual and her/his family or the community he/she belongs to are much closer than those in western countries. Hence, in the process of implementing the principle of informed consent the role of family and community cannot be neglected. This is what Chinese philosophers called "harmony does not mean identical" or "there are differences in similarities". In view of that I feel difficulty to accept such an overarching universal ethics or global bioethics. However, it does not mean that there is no value which we share with people from other cultures, or that it is impossible to form a common ground for a common action. It is what Chinese philosophers called "there are similarities in differences". Also I believe with the more communications between Asia and other continents shared values and common ground will increase or enlarge. But moral diversity exists not only in the world, but also within Asia or within each continent. It can be shown in the proceedings of ABC4, the papers at ABC5, or in a book titled "Bioethics: Asian Perspectives" edited by me and published by the Kluwer Academic Publisher as the 80th volume in the Book Series "Philosophy and Medicine". The later book's contributors are all non-western bioethicists. The moral diversity will benefit the development of bioethics in a global scale as well as in Asia. I am looking forward to seeing more work that will be done by Asian bioethicists in the field of cultural dimension of bioethics.
I wish for the success of the ABC5 conference in Tsukuba, and I wish all of you enjoy the conference.