It was the first time for us to visit the Middle East, the Western most part of Asia. The first two days were spent in Jerusalem, a disputed holy city for three major religions, Judaism, Christianity, and Islam. As a biologist the most striking thing was the most enormous rosemary bushes that covered many parks, despite the lack of rain. It did not rain any time during our visit, and the adaption of life to the arid conditions that is such a feature of life in the Middle East struck us. The parks in Israel were covered with black plastic irrigation pipes, the same that I have in my home in Japan. The environment plays a great role in the way people live, and moulds cultures and behaviours (see Issar, A.S., "Climatic change and the history of the Middle East", American Scientist 83 (1995), 350-5). It is impossible to separate environmental ethics from human relationships with each other, as the stress and/or the fruits of the environment , shape the society that emerges.
We were then to travel together with Frank Leavitt, our friend and associate editor of EJAIB, to his university, Ben Gurion University of the Negev (BGU), in Beer Sheba. Beer Sheba, was the home for us, and three of my research students, for two weeks. Situated in the Negev desert, it is a large city and growing to become a major city in the middle of an arid area. BGU has one of the most famous medical schools in Israel, and a hospital providing for the Southern half of Israel. Many of the patients are Bedoiuns, who live in the desert, and the students are also divided between Jews and Arabs, with most of the staff being Jewish. Many of the staff are overseas immigrants. We had a busy schedule from dawn to evening most days, meeting a wide range of persons, providing stimulating information and ideas. As discussed in EJAIB, Frank Leavitt suggested the idea of a Senpo Sugihara Asian Bioethics Centre, and during the visit we had the chance to meet with the Dean of the Medical School, the University President, and a Japanese company, to discuss such plans. It seems very likely that such a centre can be established at BGU, and this would aid the future exchanges between Japan and Israel, and the rest of Asia that lies between.
Everywhere we were welcomed, and I cannot mention here all the names of people we met. There were chances to meet supporters of the Eubios Ethics Institute from its early days as the network was being established, as I also could in Europe. The people make the journey more memorable and meaningful, and that is one essential part of personal bioethics. At times, for example in Cairo, there seems to be too many people, though Tokyo is more populated, but it has the luxury of money for buildings and for cleaning the city, which makes the population pressure more remote. In Israel, we could see most of the country, most universities, and meet many of the people involved in bioethics research and teaching. Medical bioethics is still at an early stage, but more accepted into university teaching than in Japan. Environmental ethics could be at an even more earlier stage than Japan, and also on kibbutz's, it was disappointing not to see harmony with nature.
The most memorable experience to observe human relationships were the two days over a Sabbath that we spent in Hebron, spending the Sabbath with Frank and his family. They are living in Kiriat Arba, a Jewish Settlement in Hebron, part of the West Bank that may soon be under Palestinian self-rule. The walk down to the Synagogue, the Cave of Makhpela, the burial site of Abraham and Sarah, and the Patriachs of the three religions, was accompanied by the constant presence of Israeli soldiers guarding the Jews on their weekly pilgrimage to the holy site. The mosque in the same building has been closed since Baruch Goldsmith, a Jewish doctor killed dozens of praying Muslems two years ago. Hebron, was in 1929 the site of a massacre of Jewish families, who had until then been living together with Palestinians. After that, the British occupiers ordered the Jews who survived to leave Hebron. A few stayed, and these were joined in 1967 with the occupation of the West bank by Israel, with more. Although there are cases of interfaith friendships, the presence of soldiers and the fear of extremists, makes coexistence tense!
Before visiting Israel I found it difficult to understand why the settlers would want to live there, as do many of the Israeli's we met on this trip. However, I now hope that they can continue to live there in the future, for it is in healing the wounds of family grief that there is much to learn for the peace process, that should be part of bioethics and human relationships. The shock of Hebron was that about one third or more of the Jewish men carried automatic rifles, or submachine guns, and almost all the others carried pistols. In New Zealand police do not carry guns, in Japan they do, but if they used them it would be in the main news. Throughout Israel one sees guns, but in the occupied territories one sees many more. We never saw any trouble when we were there, and my thought was the similarity of the superpower argument that a deterrent is necessary to keep the peace. We also thought we could understand the emotions more after the killing of Jews in the past (most moving was the Hall of Names in the Yad va-Shem Holocaust museum, where one page records of the victims of the Holocaust fill folders in a large room, stacked on shelves as a reference library). The sooner the guns can go the better, one day it may be possible, but before then Palestine will have to consolidate its power.
At the end of that visit to Hebron, we were joined by my students to go together to meet a few Palestinian students, and a colleague. These meetings are generally held "quietly" as all involved, and especially the Palestinians, may face problems if extremists learn of them. I appreciated so much the patience and efforts of these people for building bridges, and we enjoyed the meeting which continued many hours. To meet Palestinians was not so much of the lesson, as I know Palestinians living in other countries, and as we would later find many Jordanians were Palestinian. The point was to be there, and with Israelis and Palestinians meeting, a pleasant change to the media which points to the negative.
More was to come two days later in the evening when together with our newly made friend and Palestinian colleague, Frank, Nobuko and I, went to met the General who is the chief of the Army of Palestine, at the headquarters in Gaza, to discuss bioethics education. The discussion was one of the most interesting that we had all the trip, and gave me great encouragement for the progress of Palestine. We will develop the project as rapidly as possible, and details will no doubt appear in later issues of the journal. Gaza was peaceful, with no guns on the street (on show), a change from the surface of Israel, however, under the scene there continues to be a power struggle among Palestinians and delicate peace. The peace is made so much more delicate by the poverty, dirt, overcrowding and neglect that Gaza shows. Bioethics has a role to play, at a level much more challenging than the theoretical debates of whether future germ-line genetic engineering for curing baldness is justified or not.
I did not find the Middle East so hot in temperature, but the human relationships are often hot and strained. Desperate actions, may have caused years or centuries of regret and distrust. One has to break the cycle of mistrust and hatred. This journal is not the place for political discussions, but a forum for cross-cultural ethics. The deep religious zealousy of those in West Asia, what is called the Middle East from the European viewpoint, is the most important challenge to accommodate in modern universalism. The great importance placed on historical sites is seen also by some Christians, and also in other religions in other places we see religious Meccas. Of course the Holy Land had much meaning for me, as a Christian, and given the tremendous history of the place for movements of thought, however, I found the most "holy" or "moving" sites for me were away from people. The most beautiful place was Mt. Sinai, walking on the mountain at midday in the heat of the sun (though not climbing to the peak). The place was tranquil and the sky and rocks unreal, and I felt that if I were God and wanted to come to earth it would be the place (I still think so away from the heat of the day).
The cultural traditions of the people in the Middle East vary, from the over-"friendly" Egyptian taxi drivers to the quiet and hidden strict Moslem ladies from Gulf states. It would be easy to say universal ethics is incongruous as a description of people, even within this part of the world. But part of this apparent divergence is generated by prejudice and images brought by the media. As people there also said, probably the Jews and the Arabs are the closest cultures to each other; much closer than they are to Indians or Chinese, for example. In fact, there are Indian Jews living close to Beer Sheba, and Jews from all parts of the world returned to Israel. There are also many Muslems in China, so if we stop to think we realise our images of cultural uniqueness are distorted.
The images we see should be more complete. As explored in the International Bioethics Survey, inside every culture there is a broad diversity of ideas expressed about bioethical decision-making. Other every issue there is diversity, and similar diversity within the same range of comments was found in the countries surveyed. This diversity is universal, and is parallel to the idea of genetic diversity which finds about 85% of the differences between any human being's genome to be found inside every race.
One of the most interesting questions to test the extent of universal bioethics is to examine how religious beliefs, and personal familiarity with something like a disease, affect opinions and whether they alter the diversity. Some analysis of survey continues to look at these questions. The outside skin-deep differences may not mean that the bioethical decision-making processes are so different, and in fact, the great diversity of people appears to be universal.
Although the trip was historically moving, the message I felt was that while history helps mould culture, and thus the future, the promise of the world is in the people alive. This is true everywhere, and especially so in developing countries where the birth rates are high. The environment will affect their ethics, and we need to look at how. When I was in the ancient tombs in Egypt , some close to 5,000 years old witnessing one of the origins of civilisation, my impression was what can we do to help the people that surround such tombs? Many have to lose their respect in the endless bargaining and refusals by defensive tourists. Of course tourists bring in money, and an income, and as everyone who has bought a car or house knows, bargaining is part of life almost everywhere.
In this issue Frank Leavitt makes a comparison within triage, or crisis / emergency medicine, drawing upon experience in the often violent Middle East, and the responses to emergencies in Japan. The comparison is interesting for the study of society and culture, and quite topical given the scandalous disclosure in Japan recently that a 13 hour delay in rescuing survivors of a Jumbo jet crash on 12 August, 1985, in a region only 40 km from the Kanto plain, one of the most densely populated areas of the industrialised world (the plain around Tokyo) was un-necessary. The story followed an account by one of the US airmen in a California newspaper, that within 20 minutes his plane had located the burning wreckage, and that a US rescue helicopter was despatched and when it asked permission to lower ropes to send down rescuers it was strangely ordered away by American officials (from the Yokota airbase where the Jumbo jet had been trying to land), as a Japanese plane arrived and Japanese officials had reportedly given such advice (The Japan Times, (23 August, 1995), 2). However, it would be another 11 hours later that Japanese rescuers would come, and by then only 4 were left alive and over 400 dead. Many of these people died due to the delay.
The response to the January, 1995, Kobe earthquake is therefore all the more disturbing, because in this case 4 hours elapsed before the so-called self-defense force (the military) were allowed to start rescuing people, while the members of the local council cycled and walked to the necessary emergency meeting to declare the emergency. Of course the US forces helicopters could not be used for much longer. The contrast between bureaucracy and saving lives is great, and one has to ask whether people are different or cultures different. A "smaller" example was last year when a worker at Narita airport fell, and needed to be taken to a hospital to relieve head swelling, however, the emergency ambulances at the airport were not allowed to take him and the city had to send one, by which time he died. Does this mean West Asians value saving life more than East Asians in Japan? When one sees individual Japanese trying to save lives then one would answer no, they work as much as others in a crisis. The problem is how to organise people to work together - and does one have to wait until others say yes in order to help. Would chaos that would cost lives arise from individuals jumping in to save those in a disaster before the emergency services were allowed to start. The answer that Japan and other countries must reflect on is "no", especially if the existing trained emergency services and personnel were allowed to start as soon as something happened. A few hours later when a plan may be worked out, then they could redivert their attention to where it is most needed, but as many of the Japanese self-defense force personnel tearfully said, from the chief down, they would prefer to be saving lives immediately than waiting to be told when they could start. The law may also determine behavior, and a need exists for a law flexible enough to cope with emergencies.
Much can be learnt from such visits to different shores, which can replace the images the media gives us. On behalf of Frank, we hope that others extend visits between cultures, and can develop the interchanges within Asia, that the planned Sugihara Asian Bioethics Centre, and the Eubios Ethics Institute, are trying to promote. We hope more will add their ideas to this interchange. The coming two months promises more overseas exchange, and conferences, and we hope that the inaugural East Asian Bioethics Congress in Beijing, the first week of November, will allow for more experiences within Asia and the regions international relationships to be shared.
In this issue of the journal there are two papers discussing general features of bioethics, one by Jayapaul Azariah making a call for a change to a bioethical rather than a biophysical image of the world. The other by Yaman Ors calls for green to be added to the white and blue of the UN flag. There is also a thoughtful commentary by Margaret Lock on Masahiro Morioka's paper last issue on brain death in Japan. Questions of cultural diversity within and between cultures are of particular interest in EJAIB.
There is also a critique of the UNESCO International Bioethics Committee Declaration on the Human Genome, with an explanation at the end of the critique of the UNESCO activities. There have been several other critiques pass my desk, and I look forward to the discussion at the UNESCO meeting. The Declaration is rather general because of the politics of International agreements, however, some fundamental issues have been raised which mean decisions on the future usefulness of the Declaration will have to be made. There are other issues, such as gene patenting, which don't go away. The completion of the first of numerous complete genome sequences has made 1995 a major point in the history of genetics and bioethics (see Human Genome Project section). More to continue...