Eubios
Ethics Institute and the University of Tsukuba invite you to:
Bioethics in and from Asia:
The Fifth International Tsukuba Bioethics Roundtable,
and
Intensive Cross-Cultural Bioethics Course (TRT5)
20-23 November, 1999
20 November
9-12am Ethical Dilemmas of Biotechnology
Lessons from
seeking a balance of love, politics, ethics of need, and global food and
agriculture
Darryl Macer, University of Tsukuba, Japan
This paper will examine some of the conclusions reached from time spent at
the United Nations Food and Agriculture Organization (FAO) in 1999. A series of
interviews were conducted in July and August with persons across all divisions
of FAO, together with the assistance of Minkashi Bhardwaj, Fumi Maekawa and
Yuki Niimura. The study showed that although ethics was not openly discussed at
FAO until now, many of the programs and policies were founded from the
principles of bioethics. There are a number of international guidelines,
conventions and projects that are attempts to alleviate fod insecurity and to
lead to sustainable rural development. The results show how that we may not be
aware that the driving action of our work is based on love, or ethics, but we
still find our life moulded by it. Some of the key areas that need urgent
ethical reflection in the ethics of food and agriculture, including forestry
and fisheries, will be presented. It is high time for a proactive stance to be
taken by this intergovernmental organization in issues such as balancing the
interests of present and future generations in the conservation and management
of natural resources, in biotechnology questions and in the implications of the
rapid modernization of agriculture. The participatory approach should be
effected by stimulation of persons at all levels in recipient countries, and
this is based on the foundation of autonomy and justice. Political obstacles to
reaching a real recognition of the right to food need to be overcome if the
target of the World Food Summit to half the number of people who are starving
by the year 2015, is to be achieved. This impetus may come only by stirring the
conscience and love that is found in the hearts of people in all culture, into
some practical measures to enable global distribution of appropriate technology
that makes people more self-reliant. This and some of the other issues will be
raised.
Ethics and
genetic engineering
Kazuo Murakami, Emeritus Professor, University of Tsukuba, Japan
I have been engaged in bioscience and biotechnology including genetic
engineering for the last twenty years. During these studies, I feel
"Something Great" or "Great Nature" which inputs the
genetic code so rationally and beautifully in an unbelievably small space. I
think the existance and function of "Something Great" may be a base
for bioethics.
What's wrong
with genetic reductionism
Frank J. Leavitt, Chairman, The Centre for Asian and International Bioethics
Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva,
Israel Email: yeruham@bgumail.bgu.ac.il
Genetic reductionism, the attempt to explain all physical and mental
qualities of living organisms on the basis of their genes, is often attacked on
the grounds that (1) it ignores environmental and extragenetic biological
co-factors, (2) it denies free will, and (3) it denies the spiritual side of
life.
The first objection is correct but does not obviate the possibility of reducing
these co-factors themselves to molecular or even sub-atomic causes. The second
objection begs the question in assuming without proof that we really have free
will. Perhaps we can sometimes get free of some causes, but only to fall under
the influence of others. The third objection ignores the possibility that
continuing research into molecular and even sub-atomic factors in human life
may shed more and more light on what the soul really is. Although the
Platonic-Cartesian tradition saw the soul as a single, simple unified entity,
others -- particularly mystics like Rabbi Itzhak Luria (l6th century Israel)--
saw it as enormously complex and composed of "holy sparks" Perhaps
these "holy sparks" are best understood as the sub-atomic particles
of which we are composed. If so, then the distinction between the material and
the spiritual disappears.
Progress report
from a biotechnology and bioethics survey in Japan 1999
Mary An Ng, Tomoyuki Watanabe and Darryl Macer, University of Tsukuba, Japan
There has been much public concern expressed about the application of modern
biotechnology, especially genetically modified organisms (GMOs). One way to
explore these concerns is by use of surveys to seek people's hopes and
concerns. This paper will describe the development of a new survey being
conducted on the public and scientists across Japan in the coming months. The
results will be compared to previous surveys, especially those conducted by
Macer and collaborators in 1991, 1993 (International Bioethics Survey) and 1997
(Eurobarometer). Some example comments from preliminary results will be
described from surveys collected during a public science forum held in Tokyo in
September 1999, together with the analysis method for examining open comments
in general.
Revisiting the
Nuffield Council of Bioethics Report on AgroBiotechnology
Willy DeGreef, Novartis, Switzerland*
Developing
dialogue over Life and Biotechnology in a focus group in Japan
Fumi Maekawa & Darryl Macer, Eubios Ethics Institute, Japan
This focus group of ordinary citizens meets together in Tokyo to discuss
questions raised by biotechnology that face our life. We speak as individuals
and not as representatives of our employers or our specialities. Everyone is
given a chance to speak at every meeting in an informal atmosphere. We cover a
wide range of occupations and experience, but we work together to discuss and
learn about the environmental, ethical and social issues associated with the
use of biotechnology based on scientific knowledge and practical reality. The
group was formed in 1999 and met 6 times in the first year. We met in Tokyo
International Forum because of its central location. The group meets for two
hours between 5:15 to 7:15pm, usually on friday evenings. The people are working
in a range of fields including industry, media, farming, academia, and
self-employed persons. We had four meetings on GM food and labelling, and then
produced a consensus statement, which is being widely distributed . This
statement will be discussed. The next two meetings were on Intellectual
property and life, and farmer's rights in the age of biotechnology. Lessons and
the process of the group will be discussed.
Novartis Japan's efforts to gain public acceptance
Fumiyo Kitahara, Novartis K. K. Japan
Novartis advocates Labeling but we need to have 1) clear threshold value and
detection limits; 2) an authorized central agency for certification and
control; and 3) clarification of the purpose of the labeling, not safety issue
but the consumers' right to chose. Labelling does not resolve the issue of the
lack of high quality consumer information about GMOs and their use in food
products.
One of the events we organised to increase understanding was the Novartis Life
Science Forum 99 on GMOs and their Opportunities and Challenges, on September
29, 1999 in Tokyo. It was attended by 535 participants including 90 from the
media.
Novartis pursues biotechnology because it is one of the key technologies of the
21st century. We want to promote better understanding of gene technology
through: Media study meetings and Children's educational programs.
The role of the
media in the biotechnology debate in Japan
Yuri Oiwa, Asahi Shinbun, Japan
In the Japanese media, the science is not a priority for coverage. Politics,
economics and social issues receive more coverage and emphasis. Therefore, when
biotechnology related news are reported, they are usually in a social news
section or economic news section and not in a science section. This tendency
may have some influence on the debate over biotechnology in Japan.
In general, the Japanese media, especially quality papers have a long tradition
to put both pro and cons. This tradition itself is fine, but usually the
opposing opinion sounds more appealing to general readers.
People in the biotechnology business or related academic fields or
administration often criticize the role of media in not being scientific.
Except some tabloids or popular TV programs, that criticism is not deserved.
The most critical point is that consumers do not trust coorporations or
administrations or researchers from their experience. People in the
biotechnology should try to reestablish consumers trust.
1-4pm Ethical Dilemmas of Medical Genetics
Patents:
Understanding Morality as a ground for exclusion
Sivaramjani Thambisetty, India & Exeter College, Oxford, UK
Morality over the years has played many strange roles. In patent law it has
outlived its cousin "illegality" as a ground for exclusion of certain
inventions from patent protection.
Biotechnology has been potrayed as causing certain breaches in conventional
patent law doctrine. One of these, it has been pointed out is the move towards
taking the moral implications of the use and publication of certain inventions
into account.
This view seen increasingly in academic writings on the subject is misleading
and represents a fallacious view of the early development of patent law. A
study of the origins of the system shows no evidence of the ethically neutral
body of law that it is portrayed to be today. Taking morality into account is
not a novel develpment. An acknowledgement of this would strengthen the legal
basis of exclusionary measures in patent systems.
A Confucian
Perspective on ELSI: Genetic Determinism, Eugenics and Gene Therapy
Dr. LEE Shui Chuen
Director, Graduate Institute of Philosophy
National Central University , ROC
At the close of the Twentieth Century, genetics and biotechnology becomes one
of the two great achievements, the other is computer technology, which will
bring forth enormous impact for the human and non-human world in the next
millennium. It is not too far off the mark when James Watson said that the
future of humankind lies with genetic studies, which is often overly eulogized
as the ultimate panacea of all human maladies. It opens a new horizon upon our
self understanding and reveals some of our most intimate and important
information. However, the ethical problems related to the rapid development of
genetics become very pressing, and very close indeed as the completion of the
Human Genome Project is projected to be in year 2003, or in year 2001 as some
estimates. Starting from the employment of genetic engineering in the 1970's,
there have been vigorous debates on every genetic advancement. However, it is
not easy to have definite moral resolutions for many of these genetic
controversies, such as the cloning of Dolly, genetic experimentation on human
embryos, plantation of human organs in animal bodies, and a host of others.
In this paper I shall first give an outline of a Confucian bioethics as the
background and proceeds to give first an overall evaluation of the Human Genome
Project and then some critical comments on such issues as genetic determinism,
gene therapy, positive and negative eugenics from the Confucian perspective.
Though it is not expected that the introduction of Chinese or more precisely
the Confucian perspective on these issues could solve them all at one stroke,
farther still from reaching consensus by all parties. However, the Confucians have
their sayings and as this paper argues, their sayings originate from humanity,
they shall eventually get the ears of rational human beings.
The aging
gamete, an exploration of the ethics of sexual behavior and congenital
anomalies
Irina Pollard, Department of Biological Sciences, Macquarie University, Sydney,
NSW 2109, Australia
Culture is a potent factor affecting our biology, just as biological factors
put constraints on culture. There has always been a need to control human
fertility. The prevention of unwanted babies dates back over 4,000 years with
successive ancient civilizations recording recipes for abortifacients, vaginal
pastes and medical tampons. Modern insights connecting sex and sexually
transmitted disease probably dates from the use of the linen sheath in 1564
used as protection against syphilis. Because of the ovulatory (rhythm) method
of birth control's cheapness, there has been increasing pressure during the
1990s to make it a suitable contraceptive choice in the developing, overpopulated
world, where natural family planning is the sole method of fertility control
for some of the world's poorest couples. Therefore, it is in the interest of
couples, and the society they are living in, to be educated and unambiguously
informed about the relative risks and benefits of competing artificial
contraceptives relative to natural family planning. Major concerns are unwanted
pregnancies, fertilization with aged gametes resulting in possible genetic
defects, and exposure to sexually transmitted diseases. The presentation
reviews the existing literature documenting the gametopathy concept (1). In
essence, desynchronized ovulation and fertilization may facilitate reproductive
dysfunctions during pregnancy and increase the rate above normal of common congenital
anomalies in the children born as a result of natural family planning failures.
During irregular menstrual cycles when spontaneous ovulation occurs earlier or
later than estimated, the prescribed sexual abstinence does not precisely
coincide with peak fertility; that is, the synchronous presence of fresh
gametes at the fertilization site. As a result, desynchronized ovulation and
fertilization risks the union of "over-ripe" ova, surviving aged
sperm, or a combination of both. According to the principles of bioscience
ethics (2), it is unacceptable to withhold available scientific insights which
may prevent couples from making informed decisions about their sexuality and
give due respect for biological law.
1. Jongbloet, P.H. (1985). The aging gamete in relation to birth control
failures and Down syndrome. European Journal of Pediatrics 144;343-347.
2. Pollard, I. (1997). Bioscience ethics - A new conceptual approach to modern
ethical challenges. Eubios Journal of Asian and International
Bioethics 7;131-135.
Human
reproductive cloning prohibition in Japan
Ryuichi Ida, Kyoto University, Japan (Chair IBC, UNESCO)
Reproductive human cloning is prohibited in the Universal Declaration on
Human genome and Human Rights of UNESCO, as it is contrary to the human
dignity. Such a practice is forbidden by law in some countries or by government
decision in others. How is it treated in Japan?
The Sub-Committee on Human Cloning of the Bioethics Committe of Japan have been
discussing since 1998 on the possibility of prohibition of the application of
cloning technology to human being. The main questions are (1)the objects of
eventual prohibition, (2)the reason of prohibition and (3)the modality of
prohibition. It has almost reached to the conclusion.
(1)It is generally understood some kind of control, including eventual
prohibition, is necessary facing various social, ethical and legal issues which
derive from the human cloning. Only the reproductive human cloning should not
be permitted, while cloning of human tissue or cell may be acceptable.
(2)The reproductive human cloning is contrary to the human dignity and
susceptible to un-safety of the living entity produced through cloning of human
cell. The precise meaning of the human dignity has been discussed; the instrumentalization
of human being, the pre-setting of the genetic structure, and the violation of
right to be an individual are the elements constituting the human dignity.
(3)For the modality, two positions have long been opposing. Those who claim the
necessity of a legislation with possible punishment call for the effectiveness
of control and limitation. Those who wish to take a more moderate way, like
governmental guidelines, advocate the scientists' conscience on this matter.
In addition to the discussion in the Sub-Committee, the results of
questionnaire will be presented to show how Japanese intellectual people think
of the human cloning issue.
Challenges of
genetic engineering and the ethical response - On the ethics of human cloning
Park Ynhui, Pohan University of Science and Technology (Postech), South Korea;
President of Korean Association of Bioethics
Ethical challenges of cloning technique
To be ethical means to be concerned with, and care for, the well being of
others, and to respect them for their own sake. Cloning challenges ethical
responses. The challenge is in different order from that of traditional ethics,
both anthropocentric and ecocentric, which is about how to share good either
among other humans or living beings. The challenge is about creating/inventing
or fabricating them artificially.
Traditional arguments for and against cloning
Arguments for cloning include: Utilitarian argument - for whose benefit?
Anthropocentric argument - groundlessness of anthropocentrism. Arguments
against cloning include: Theological argument - particularly of its
metaphysical presupposition; Psychological argument - irrelevance of
psychological factors; Sociological argument - it is based on
egocentrism-ethnical, regional egoism.
Philosophical arguments against Cloning
Ethics is the matter of value. Value presupposes analytically a subject capable
of having experiences (perhaps only human fall into this category), without
which the very concept of value is unintelligible. All values are either /
instrumental / extrinsic or inherent / intrinsic. Treating others only as
instrumental purposes is contrary to the very essence of being ethical. Cloning
constitutes an activity if treating other human / animals as object with
instrumental values. The intent of human cloning human is logically
self-contradictory, hence wrong, and animal cloning is questionable.
Conclusion
There is a likelihod of cloning practice in the near future. The world becomes
weird and absurd if it is free from ethics. Can we continue to do anything
which is not absurd in such a world? Can we accept to live a life devoid of
value and meaning? If not, and if we are rational, can we fight against human
cloning in defending the last frontier of ethical Miginot of human cloning?
4:15-6pm Bioethics Education (1)
Importance of
bioethics in science education
M.Selvanayagam & Francis P. Xavier, Loyola Institute of Frontier Energy,
Loyola college, Chennai-600034, India.
As we are fast approaching the threshold of the new millennium, we are
astonished at the technological advancement humankind has made. But we are, at
the same time, saddened to experience the decline of ethics at all levels
especially social and moral value system in day -to- day's life due to the
influence of consumer attitudes which brings in selfishness and invidual
prosperity even at the expense of others. Since whatever happens in the society
outside is reflected in the educational system, consumer attitudes and
exploitation have affected science in general, and science education in
particular. Today much attention and emphasis is given to skill-learning in our
science education leading to money making without bothering to think that the
value system one should have is the leading principle in life whatever be one's
profession. The challenge to day, when ethical and moral values are vanishing,
is to teach science based on social values such as honesty, integrity,
fairness, impartiality, compassion etc, as the students of today are the
pillars of the nation of tomorrow.
The medium through which social and moral values should be incorporated in
education is through a fundamental course for the science students on
philosophy of science in the respective disciplines. The students should be
gently led along how initially science grew out of life expectations and
experience based on the welfare of the common good and not of a few
individuals. This eye-opener should be a window for the students through which
they would be able to see how social values originates from moral obligations
which in turn are rooted in the religious concept that God has created all
human beings equal and all should live in harmony transcending the narrow-mindedness
of caste, creed, nationality etc. The teacher, who first of all is convinced of
these truths, should make a genuine attempt to bring out the richness of such
values in micro as well as macro level evolution and the development of science
through the brief history of time. Thus in each student the teacher is not only
the desire to discharge their responsibility with such values. This would bring
out, in the course of time, the desired impact, namely, a generation of
students who would grow up into matured men and women for others having concern
and respect not only for their fellow human beings but also to the fauna and
flora. Thus the Mother Earth will become more inhabitable in which all created,
with human being as the crown of creation, could live in harmony, peace and
tranquility.
Bioethics
education: New Dimensions
Amit Krishna De, Indian Science Congress Association, India*
A study of
bioethics in Indian High School textbooks
Minakshi Bhardwaj & Darryl Macer, Eubios Ethics Institute, Japan
We can define bioethics as the love of life (Macer, 1998). Bioethics
involves the balancing of benefits and risks of choices. When we ask people
what comes to their mind when they hear the term "Bioethics", we can
see two distinct groups of answers. This was seen in the results of the
International Bioethics Education Survey. In Australia, New Zealand and
Singapore, more people wrote comments about how we should use life, that
science raises issues, or how we should apply biotechnology, i.e. somewhat
practical issues. However, in Japan and Tamil Nadu, India, the comments were
more general, with many about the respect for life we should have.
This paper will focus on presenting the results of text book key word analysis
in India, with comparisons to Japan. This study focused on years VI-XII, the
Secondary and Higher Secondary Schools. From VI-X General Science is taught,
and in years XI-XII Biology is offered as a special course. From year VI
private publications may be used but the CBSE syllabus must be followed. Inside
social studies, history, civics, geography, economics and political science are
taught. The keywords chosen for this textbook analysis were not all
encompassing, but can be considered as markers of the breadth of issues
discussed.
As a conclusion we have found some discussion of ethical issues in the
textbooks used for science and social science in India. Half of the objectives
of the Science Syllabus in India are related to the development of ethics.
There will clearly need to be better incorporation of ethics into textbooks for
these classes than that which exists today. We also could consider the mention
of bioethical issues in other subjects. We can hope for integrated ethics
education across the curriculum, and there is some evidence for this in
environmental education.
The Importance
of Medical Humanity in Medical Education
Michael Cheng-tek Tai, Chungshan Medical College, Taichung, Taiwan
The tremendous development of medical technology in the last few decades has
changed the face of medicine. Besides caring, medicine today can also cure and
even change a person's personality, looks and his genetic structure. We must
explore a medicine that is not just reponsive to the body of the patient, but
also to his feelings, his mind, his will, his imagination, his creativity, his
aspirations, his values, his capacity for making ethical choices-in short, a
medicine responsive to the whole life of the person who is a patient.
Rapid progress in the pharmaceutical field, in mechanical devices and medical
skills has raised new questions upon us, such as; where and when does human
life begin ? what is the moment of death ? what are the limits in the research
and manipulation of man ? what is the meaning and the destiny of man ? what
kind of biochemical, pharmacological, surgical, psychological and genetic
treatments affect the identity of the human person ? Undoubtedly, contemporary
medicine bears tremendous responsibility for man's meaning, his well-being and
the world in which he lives.
In the past, the doctor enjoyed freedom in his self-chosen relationship with
his patients to whom he offered his services and who, in return, honor him.
Today most countries' medical systems are socialized. The right to proper
medical care is recognized as part of the most fundamental human right. Such a
situation inevitably leads to a socialization of medical profession. The doctor
has become one of the various social servants working for the government's
health insurance bureau. Such a change brings us new concerns, such as
unnecessary physical tests, prescriptions and operation, the deteriorating
patient-physicians relationship, the unfair distribution of limited
resources.... etc
The nature of medical service, medical progress and its responsibility oblige
the medical professionals to re-think the purpose of medicine and to ponder on
how it can act responsibly. To achieve this goal, medicine cannot isolate
itself from the rest of academic world but must act in absolute solidarity with
other disciplines by initiating a sincere dialogue with behavioral sciences,
philosophy and theology_. Without this new attempt, medicine may lock itself in
an ivory tower seeing people only from a narrow diagnostic-prognostic angle.
This is the context and perspective in which medical humanity is set.
Because of the broad scope of medicine, preventive, therapeutic and planning
for the future, medical scientists must seek a holistic vision of man. The
modern physician can no longer approach biological and medical decisions
without being ready to raise fundamental human questions and search for answers
to them. He must take a courageous step towards an understanding of freedom
expressed in terms of social responsibility for the whole of humanity.
These new realities and changes compel medical educators to reconsider the
content of medical education. Is our goal simply to train a physician skilled
in treating diseases yet unaware of human predicaments and the complicated
social fabric that make a person what he is?
The main concern of medicine used to be human physical condition, as it was
believed that a person's illness was due to physical problems. But this
understanding has been challenged and a new understanding developed that moves
from a simple biomedical paradigm to psychosomatic and then biopsychosocial
emphases.
Bernard Haring, a well-respected theologian and ethicist suggested that
medicine has to pay attention from the present to the future, from an
individual personalism of the patient-doctor relationship to a
social-collective accountability of medicine and to the whole human society.
Robert Veatch, director of Kennedy Institute of Ethics also advocates a
medicine which treats not only diseases but also illness of the person. That
implies that medicine in the 21st century must be expanded from merely a
biomedically-oriented science to a holistic biopsychosocial emphasis. The
physicians of tomorrow must know not only how to treat physical diseases with
empathy but also to take his responsibility seriously as healers of whole
person to the whole Hunan society. To fulfil this mandate, the content of
medical education must be re-examined and re-structured.
An emphasis on medical humanity is one of the moves we must take to respond to
the new reality of medicine. Medical humanity, literally speaking, refers to
those humanity courses having to do with medicine based on a biopsychosocial
understanding such as medical sociology, biomedical ethics, medical psychology,
history of medicine, communication between physicians and patients...etc. In
reality, medical humanity, when properly planned and offered, will enable
medical students to develop a new understanding of life and a concern to social
justice. It is a design to help students develop a new value theory so that
they will become people-oriented physicians. But in order for students to
understand the basic human nature, more courses must be consider how social
customs, religious beliefs, and cultural traditions all effect our attitutes
toward health, life, and even death. Thus, a philosophy of life, religion and
cultural anthropology must also be introduced. Medical humanity covers a wide
spectrum of social sciences and humanity. The purposes of introducing these
courses are no other than:
to cultivate a holistic understanding of personhood
to enable medical students to know the human side of medicine and the effect of
environment and life-style on health
to provide students opportunities for continuing reflections on themselves as
they grow in medical knowledge
to foster a sense of " Medicine as Vocation"
to study ethical theories and their applications to the clinical
decision-making.
to promote a consciousness of physicians' social responsibility.
In one word, medical humanity attempts to equip students with a better
understanding of human beings so as to produce physicians of tomorrow who are
not only effective healers of diseases, but also restorers of human wholeness (
a person as a harmonious combination of body, mind and spirit) and promoter of
social justice.
In an Taiwanese expression : "a superior physician heals the ills of a
nations. An ordinary physician heals the brokenness of a person. An inferior
physician heals diseases."
"Medical education is to pass on a humanized medicine so that medical
students may understand, experience and grasp the humanistic philosophy of
medicine and thus establish their own value theory, ethical standard and
eventually their own life philosophy. Only when we reach this goal can we say
our education has succeeded". ( A quotation from Dr.B.S.Hsieh, Introduction
to Medicine. Taipei. Taiwan University
Medical College, 1997:85)
Ethical issues
related to an indigenous basic education project
Juana Aluning, The Philippines
On-line
biomedical ethics education in Korea
Koo Young-Mo, Institute of Philosophy, Seoul National University, South Korea
The Korea's first-ever on-line biomedical ethics education class began in
September 1999. The class, one of the 18 on-line lectures offered in the Fall
Semester, 1999 by Seoul National University Virtual Campus, allows the Korean
general public the opportunity to attend an SNU lecture. Although the
discussion sites are limited to the 48 selected students taking the
16-week-long course, any one can read the instructor's lecture on the Internet.
(http://snuvc.snu.ac.kr/class/h601 Of course, the instruction is in Korean
language!) The topics of this course include abortion, euthanasia, organ
transplantation, human cloning and etc. As one of the three instructors of this
unprecedented biomedical ethics education program in Korea, I report the
experiences that my team went through both in preparing for and running the
course.
Ethics can it be
taught?
D. Sultan Sheriff, Salem Medical School, India
21 November
9-12am Clinical dilemmas across cultures
Ethical issues
in wholistic health and healing
A.K. Tharien, Christian Fellowship Hospital, India
Health is essentially a function, a quality of life unfolding of a
personhood, which is dynamic, comprehensive, complete and forward looking. It
has moral, spiritual and ethical values. Health is "SHALOM".
Illness may be described as the disturbance of right relationship, within
oneself, with his neighbour with nature and his creator. Besides physical
factors, psychological factors like emptiness, fear, self centeredness,
resentment, guilty conscience are significant factors.
Healing is concerned with setting right any aspect of a persons life which fall
short of holistic health. Remedies may be physical, psychological, spiritual,
social or even political.
David Falton's study reveals that AMYGDALA and hypothalamus make up the LIMBIC
system which influences one's mid and emotion. James House in Michigan found
links between brain and immune system through the production of nuropeptides.
New phenomena of Pneumo psycho-neuro immunology has come out.
Ethics plays an important role in the process of healing. Treating patients as
persons and not as scientific object. Commercialiation of medical profession
both in treating patients and training of students have lost many ethical values.
Right of patients should be safeguarded. Tendency for scientific researchers
are ignoring human values. All social classes should have access to modern
investigation and therapy. Growth of science in isolation has brought in many
dynamos, as in factors like cloning, genetic manipulation and embryo experiment
etc. This have ignored the human values and human relationships.
A code of medical ethics must be followed by all health professionals and
hospitals.
Ethics of virtue
and Thai nursing students
- Khannika Suwonnakote, Prapis Chanpuelksa and Sangthong TerathongKum
Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital ,
Mahidol University,
Bangkok, Thailand
The objectives of this descriptive research are to develop a research tool to
assess ethical characteristics of Thai nursing students and to compare the
differences of ethical characteristics among nursing students of different
years of study in the bachelor nursing program.
A sample of 479 nursing students of Ramathibodi School of Nursing , Mahidol
University were selected to be in this study group in 1998. Using document
analysis of Ramathibodi undergraduate nursing curriculum , the nusing code of
ethics , declaired by Nurses Association of Thailand and Thai Nursing Council ,
13 ethical characteristics were selected as the essential ethics of virtue for
Thai nursing students and Ramathibodi students. The 52 -items questionaire with
4 - ratings scale of performance indicators was developed by the researcher
team to assess the 13 ethical characteristics. Face validity was used and its
alpa reliability coefficient was 0.9241.
The study revealed:
1. The 13 ethical characteristics of Thai nursing students of the undergraduate
level were Compassion, Kindness, Sacrify, Faithl , Responsibility, Endurance,
Endeavou , Shame, Justice, Union, Grateful, Economized, and Discipline.
2. Nursing students , in the average have frequently performed on 13 ethical
characteristics .
( Mean = 3.03 , Standard deviation = 0.27, Range = 2.69-3.54 . )
3. The results of comparison of all ethical characteristics among the student
groups by using the one way analysis of variance and Scheffe 's test, only the
fourth year students showed higher ethical characteristics than the third year
students . ( F= 4.165 , p< .01 ). Students in the first, the second years
did not show any statistically significant different from the third and the
fourth year students.
4. The results of comparison of each ethical characteristics among the student
groups by using the ANOVA and Scheffe 's test, it was founded that nursing
students at different years of study showed different ethical characteristics
on 7 characteristics as the followings: Compassion (F= 3.375, p < .01),
Union (F=3.401, p< .05), Discipline (F= 3.076, p
5. Six ethical characteristics of nursing students remained no statistically
different at different years of study, these were Sacrify, Faith ,
Responsibility, Endurance, Justice, Economized.
The results of this research study can confirmed the nursing students ' ethical
characteristics at satisfied level. However , the evidence of some ethical
characteristics differences among the nursing students at different year of
study should be further investigated for any specific changing pattern in a
longitudinal study . The cause-effect relation can be explored and useful for
the development of ethical characteristics in nursing students.
Anagogy of
Autonomy
Ann Lewis Boyd, Hood College, USA and Ole Doering, Germany
The philosophical and ethical concept of autonomy is herein examined, ex
post facto, using an existential lens to
examine the process of a personal friend's dying. Anagogy, defined as
interpretation of a word, passage, or text that finds beyond the literal,
allegorical, and moral senses a fourth and ultimate spiritual or mystical
sense, is intended to enlarge the understanding of the use of autonomy in this
individual case. The idea of personhood linked inextricably to reason is,
therefore, understood as empowering an individual to choose among various actions,
to define and redefine life goals, and to give priority to selected values and
moral tenants, which reveal a moral hermeneutic. Conditions and circumstances,
existentially exposed, limit choice in unexpected ways, such that the predicted
value of autonomy is vulnerable to misuse or misunderstanding. The intent to
respect the dignity of each person is central to the philosophy of Respect for
Persons ethics, and assumes that autonomy, as freedom of the moral agent,
occupies the dominant position of duty. The assumption is that the reality of
freedom is, in a practical sense, essential to being rational agents who can
thereby exercise rational choice. The moral law, law of freedom, involves the
autonomy of the will and an ultimate end to which all action is directed.
Defined as the highest good, morality unites virtue and happiness by ascribing
the ultimate end sought as God. The freedom to use rational will finds
principles within its own rational nature. The ability to create maxims is
autonomy of the will, which equates with the dignity of persons. My recent
experience as a companion to a personal friend with a terminal illness inspired
me to re-evaluate the concept of autonomy as it is too often interpreted in
modern ethical discourse as a individualistic right of choice as opposed to the
hermeneutic of dignity of person. This paper describes a shift of position in
understanding the paradox of autonomy in this existential context.
Thai nurses and
patients rights
Malee Lerdmaleewong, Ramathibodi School of Nursing, Mahidol University,
Bangkok, Thailand
The role of the advanced practice nurse is a patient advocate. Health care
providers should recognize and respect patient's rights which is one of the
indicators for quality assurance or hospital accreditation. The purpose of this
study was to examine Thai nurses' opinion in Ramathibodi hospital toward
patients' rights. A statement of patient's rights consisted of 10 items was
used as a research tool. Each item had a Likert scale which score rating from 1
strongly disagree to 5 strongly agree. Two hundred and fifty questionnaires
were sent to the sample in every nursing department, and 198 questionnaires
were returned (79% response rate). Data were analysed by SPSS/FW program.
The findings revealed that the sample consisted of nurse instructors, head
nurses, nurse supervisors, registered nurses, practical nurses and graduate
nursing students. The duration of work experiences ranged from 4 months to 31
years (average = 13 years and 8 months, SD = 9 years and 1 month). Most of the
nurses supported all items of patient's rights with strong agreement which the
mean scores ranged from 4.23 to 4.80. There were no statistically significant
difference in nurses' opinions with position or work experience. Recommendations
and further studies are discussed.
Age dependent
variation in bioethical issues with reference to AIDS and its cure
N.S. Kavitha & Jayapaul Azariah
In the present investigation, the queries regarding the ethical issues in
religion and life, AIDS and its cure, gene therapy, organ transplantation and
also on the environmental ethics and their importance were raised among the
educated persons.
An opinion survey was conducted among 2 groups of educated people: (1) Students
and (2) Teachers located in and around Madras. The participants of this survey
were 41 college students in the age group of 19 to 26, and 30 college
professors, in the age group of 26-40. In both the cases, they belong to
different religions such as Hindu, Christian and Muslims. A questionnaire was
administered, where the participants expressed their opinion on a five-point
scale (1) Strongly agree; (2) Agree; (3) Don't know; (4) Disagree and (5)
Strongly disagree. The frequency and the percentage of their opinions were
calculated.
Out of the 5 topics discussed, AIDS and its core were assessed for the present
investigation. Some of the significant points to this topic are: 1) The
majority of participants were well informed that AIDS is not a contagious
disease like common cold or tuberculosis. 2) College students perceived a
correlation between declining morals and increasing AIDS. 3) The community
feels that some social regulatory norms must be strictly maintained in order to
control the spread of AIDS. 4) Most respondents believed that reports of AIDS
patients must be kept in confidence but their spouses/ fiancees must be
informed. 5) The level of aspirations to discover scientific remedies for
curing AIDS is higher among the students. 6) The younger generation is of the
opinion that the premarital AIDS diagnosis is necessary.
It is interesting to note that the student community was better informed than
the teachers. Also, it is highly discouraging that, teachers did not recognize
the social factor of AIDS. It is encouraging that the educated community has
proper understanding in treating AIDS patients. However, more than 20% of the
teachers were ignorant in the area of informed consent. Hence it is necessary
to evolve suitable teaching modules in this area. The Indian community feels
that prevention of AIDS infection is better than its cure.
Emerging Health
Pluralism, Legal Debates and the Visions of Tomorrow
Dr. R. R. Kishore, Ministry of Health and Welfare, India
Diseases claimed nearly 50 million lives in the world, in 1996. (1) Ten million
children do not have health insurance in the United States(2) More than 76
countries spend less than 2% of their G.N.P. on public health. (3) Malnutrition
and communicable diseases are still the major killers and the poverty-health
nexus continues as ever before. Many biotechnological feats have been shelved
for fear of moral miscarriage as the ethico-legal paradigms on vital issues are
not clear. What is legal in one country constitutes an offense in the other.
The world slips into 21st century with loud thinking, utopian goals, and
health-starved people.
Fast advancing biotechnology, increasing quest for well-being, longer
life-span, changing life styles, demographic transition, wider human
interaction, growing commodification of human body, entry of corporate sector
in the health delivery system, greater institutionalization of services with
higher dependence on managerial and bureaucratic setups, evolving moral
concepts, lay adjudicators, judicial unpredictability, and a host of other
factors have imparted unique plurality to the concept of human health and in
today's milieu it carries far greater meaning and expectation than the earlier
times when it was confined merely to somatic intervention. In this scenario
medicine is not just a clinical science. It includes subtle appreciation of
social, economic, cultural and religious aspects of individual and societal
life. There have been many attempts at the national and international level to
evolve an ideal legislative strategy in order to address the problems emerging
out of advancing biotechnology but the conflicting perspectives and
multidimensionality of the issues involved continue to defy the solution. The
biggest challenge emerges out of the respect granted to the living matter which
being an end and the purpose per se is far beyond the discovery-invention,
sale-purchase, and profit-loss notions. Inspite of its biology and
chemistry being clear the living material is never seen as a physical object.
Life is the Absolute embodied. This is a universal perception, regardless of
cultural or religious affiliations, and is the biggest challenge in the process
of legislating the advancing biotechnology.
A new cultural era has begun in the field of health and medical care. Over 5000
different human diseases are known or suspected to have been caused from
defects in single gene. The screening of genes has become a practical
possibility and the potentialities of genetic intervention extend to humanizing
the animals and creation of new life forms. The transplantation technology
holds the promise of producing persons out of unborn mothers, besides replacing
the diseased organs. Humankind who have so far known only life and death are
face to face with third eventuality namely, the P.V.S. (Persistent Vegetative State).
On top of this is the "Utility" with its vast potential of making the
life worthless and misconceived, compelling one to search new meaning
in the objects and the phenomena. Erosion of individual's autonomy and the
possibilities of biological exploitation of human species have created new
ethical dilemmas contemplating highly evolved conceptual formulations. On the
economic front increasing globalisation and privatisation has disturbed the
individual - community relationship and a new social order is fast emerging
imparting enhanced vulnerability to the individual in the garb of accomplishing
'positive' social goals. The community perspective, founded on mutuality,
reciprocity, complimentarity and optimisation of resources, imparting freedom,
security and orderly conduct to the people for ages is rapidly disappearing. In
these emerging dimensions of life, biotechnology, and human relationship the
ancient and medieval doctrines are no longer able to hold the field and there
is an urgent need to functionalise aptly conceived juridical principles, which
throws a big challenge to the legal systems and the cultivators of law.
The medical and health care is no more a straight dealing between physician and
patient, based entirely on fiduciarism. Many players have descended on the
scene and, in today's milieu, medical and health care is a composite activity
involving many disciplines and faculties. The competing -- and sometimes
conflicting -- interests have enhanced the possibilities of litigation and the
judicial inconsistency has further compounded the situation. Conceptual
inadequacy on the issues like legal status of embryo/foetus, maternal rights,
abortion, surrogacy, withholding/withdrawing life support
from the terminally ill, privacy, confidentiality, informed consent, donation
and allocation of organs and tissues, end of life decisions, advance
directives, proxies, presumed/substituted consents, legal status of
incapacitated/incompetent individuals, trial of drugs and medical research on
human subjects, genetic intervention, and many more, has led to functional
exiguity which needs to be urgently overcome by addressing the following
essential issues
1. Definition of human health and health rights of the people
2. Minimum and maximum limits of health protection and promotion 3. Can the
health rights be curtailed, and if yes, under what circumstances and to what
extent?
4. Health obligations of individual towards himself, his family and the
community
5. Health obligations of the state towards individual and the community
6. Order of priority of human health amongst the manifold commitments of the
state
7. Inter-relationship between health care and other developmental activities
and core sectors in the context of human health
8. Health obligations of the developed and the developing nations towards each
other
9. Extent of personal rights in one's own tissues and genetic traits
10 Inter-relationship between the rights of the present and future generations
Health does not recognize boundaries, religions and political affinities and as
such the global village needs universal ethico-legal paradigms in order to
address the above issues. The saga of human endurance displays a continuous
quest to win over vulnerability and ignorance by pooling of knowledge, experiences
and resources and this creates a compelling need for entering into a continuing
trans-cultural dialogue.
References
1. Uton M. Rafei. "The Challenge of Health in the 21st Century", The
Times of India (New Delhi) 9.13, Col. 3-7 (26 November, 1997)
2. Steven Miles. The Role of Bioethics and access to US Health Care: Is
Bioethics one of Kitty
Genovese's Neighbors? Bioethics Examiner, Summer 1997, Vol.1, Issue 2 p.1
3. U. Chandler, "Improving World Health: A Least Cost Strategy"
(Worldwatch Paper 59) 5 (July 1984)
Cultural
determinism and patient autonomy
Y. Manickavel, Nepal
Cultural determinism is a strong undercurrent in shaping-up the political,
social, and spiritual nature of a community. In this essay cultural aspect
which influences the decision making process in the clinical treatment is
analyzed. Some of the positive aspects of this cultural determinism are
discussed against the autonomy principle of the so called Georgetown Mantra of
bioethics in the modern health care.
A survey of Korean
physicians' attitudes toward some medico-ethical problems
- Sang-Ik Hwang and Ivo Kwon,
Seoul National University, South Korea
In Korea there have been few studies conducted on physicians' perceptions and
attitudes toward the medical ethics problems, including especially informed
consent, euthanasia, artificial abortion and problems relating to human
reproduction. Therefore we administered a survey to find out the current
attitudes and perceptions held by Korean physicians in this particular area. We
sent a self administered questionnaire to 1,000 randomly selected members of
the KMA (Korean Medical Association). We received responses from 208 out of
them and analyzed the data.
The survey shows that more than half of the respondents thought it is possible
to withdraw the treatment from the hopeless patients if they or their proxy
demands, even to do PAS (Physician Assisted Suicide) in certain situation. 42%
of the physicians surveyed answered that the artificial abortion should be
allowed for the purpose of family planning. This phenomenon must be related the
high abortion rate in Korea and government supported family planning history.
On organ selling, 35% of them thought it permitted if non-critical to life like
kidney or cornea, while 58% prohibited in any case.
However, the professional ethics problems (fees and charges, advertisement,
gender discrimination) are more serious to Korean physicians rather than
biomedical issues. Many respondents were sorry for their peer's wronging and
said the current medical ethics education and their general capacity in this
field is far from satisfactory.
1-4pm Clinical dilemmas at the end of life in different cultures
Do the
Terminally Ill Elderly Have a Duty To Die?
Anne J. Davis & Emiko Konishi, Nagano College of Nursing, Japan
Over the past decades in the west, much discussion has centered on the right
to die. The latest specific focus within this discussion has included physician
assisted suicide. In Japan, discussions have focused more on disclosure of information
to the terminally ill. These discussions in Japan display certain assumptions
and values that differ from those underlying the right to die argument.
Both Japan and the industrialized countries of the west have a growing elderly
population who uses more health services than other age groups. Do these
societies need to discuss more about the terminally ill elderly person's right
to die and their duty to die? If so, what ethical justification would be used
to support the right to die and the duty to die?
Ethical dilemmas
on high tech units: What are they and how are they resolved?
- Eli Haugen Bunch,
Institute of Nursing Science, University of Oslo, POB 1120, 0317 Oslo, Norway.
E-mail: e.h.bunch@sykepleievit. uio.no
The purpose of this study was to collect empirical data on which situations
nurses and doctors identified as ethical dilemmas and how they were resolved in
high tech. units. The study was done at two high tech units at one of Norway's
university hospitals.
The method used for collecting data were field observations combined with
planned and spontaneous interviews with nurses and doctors. Data were collected
on neurosurgical intensive care from the fall of 1995 and from September 1997
on a trauma unit and are ongoing. The planned interviews with providers
explored ethical dilemmas in depth while spontaneous interviews occurred when
observations were unclear. Grounded theory as described by Glaser and Strauss
(1967) and Glaser (1978 and 1992) was used to analyze field observations and interviews.
A total of about 100 hours of field observations were collected along with
about 50 interviews.
Findings from field observations on the neurosurgical intensive care unit
(1995-1996) identified the core theme as "delayed clarification_ while the
second theme of assumed composure dominated the second unit (!997-1999).
Delayed clarification explained how providers and relatives needed time before
deciding whether to terminate treatment or not. The obligation to take the
needed time was identified as a critical factor. The process of delayed
clarification provided the actors with time and resulted in a type of consensus
before decisions were made. To obtain a clearer picture of when to continue
treatment also had a temporal dimension in terms of collecting and interpreting
clinical data continuously while assessing the patient situations.
Assumed composure, the second theme, dominated the intensive care and trauma
unit. On the surface, the unit was calm when in reality the majority of the
patients were struggling to survive and many died.
Ethical principles like beneficence, autonomy and justice were observed.
Beneficence was revealed through actions like doing good for all patients,
while autonomy was respected in terms of including patient/relatives in
decisions made. The principle of justice was identified in terms of staff never
questioning resources allocated for individual patients. The providers strived
to uphold veracity in that most clinical data and information were passed on to
the relatives. The physicians were careful to document all actions and included
nurses when talking with family member, sometimes they served useful as
witnesses to the conversations with the relatives.
Staff label situations as ethically difficult when patients are kept on
respirators awaiting organ donations, when providers must request organs when
they themselves question organ donations. When staff were requested to transfer
critical patients to other units due to the unit's trauma status, were also
labeled as ethically difficult.
Data analyses of field observation from the trauma unit (from October 1997 and
ongoing) have generated a core theme of "assumed composure".
Practically all the patients are on respirators and have a minimum of 4
machines hooked to the body. The noise level is high with the hissing from the
respirators and ticking from kidney or heart machines. Despite the complicated
technical equipment and the patient acuity levels, the unit appears composed
with clearly defined routines. The ethical principles of beneficence, autonomy
and justice are identified here as on the first unit.
Situations the nurses identify as ethical and problematic are when patients do
not follow the expected trajectory and linger on. When relatives requested
continued treatment and staff cannot see any beneficence in continuing were
also labeled as ethically difficult, as were situations when doctors on call
from other units changed treatment decisions and disagreed with the nurses
assessments of the situations. Data continues to be collected and analyzed.
Japanese
Religious Organizations' Views on Terminal Care
Noritoshi Tanida, Department of Internal Medicine 4, Hyogo College of Medicine,
1-1 Mukogawacho, Nishinomiya, Hyogo 663-8501, Japan.
Email: hcm4nai@hyo-med.ac.jp
Religion may be relevant to ethical problems such as the care of terminally ill
patients. Therefore, a questionnaire survey was conducted on the attitudes of
Japanese religious organizations toward the terminal setting to see if there
was any difference among them.
A total of 388 religious denominations, including 143 Shinto, 157 Buddhist, 58
Christian and 30 Miscellaneous religious groups who were listed on the Annals
of Religion 1998 as inclusive juridical persons were asked to answer questions
based on their religious faith. Questions were raised from a story of one
terminally ill patient regarding decision-making at each event in the disease
process. Answers were chosen from one of 5 items; "agree strongly,"
"agree," "neutral," "disagree," "disagree
strongly." Recovery and response rates of questionnaire were 73% and 43%,
respectively.
Results showed that Japanese religious groups tended to accept the idea of a
living will and the concept of "being natural." The introduction of
life-sustaining measures was greeted unfavourably when medicine became futile.
The trends between Kyoha-Shinto and Protestants, and those between
Shin-kyoha-Shinto and Catholic were similar regarding attitudes toward modern
medicine and life-sustaining treatments. Though there was only a small
difference in attitudes toward modern medicine among religious groups,
differences were observed in attitudes toward decision-making for
life-sustaining treatments. Christian organizations respected the patient's
decision, whereas Shinto and Buddhist organizations tended to leave the
decision to the family and doctor. The Catholic policy regarding extraordinary
treatment was approved of by about three fourths of Shinto and Buddhist
organizations.
The present survey indicated that the attitudes of religious organizations were
mostly modest and sensible. The general public will have a chance to think of
this important issue through different opinions from religious representatives,
if they speak of life and death publicly.
Spiritual care and
a practical suggestion
Alireza Bagheri, Center for Medical Ethics; #16, 4th Alley, Nemati St., Dolat
Ave. Pasdaran,19396 Tehran, Iran Email:Bagheria@yahoo.com
In this article three issues will be discussed:1) The necessity of spiritual
care as one of human needs; 2) The need to define spirituality on religious
grounds; 3) A practical suggestion.
If we review the evolution of medicine from the ancient times of
"Metaphysical theory of disease " to the development of
subspecialities in medicine called " Modern medicine" (1900), and
finally the " Health for all in 2000" slogan (1981), we find that
humankind has always tried to maintain the quality of health care, constantly
improving the health of his society.
In addition to our primary needs "physical living" which is fairly
fulfiled by the advancement of technology and medicine, we have higher demands
or spiritual needs, especially when terminally ill. Spirituality is a concept
that people from any nationality, culture and religion are living with and
appreciate the consequences of such a perception in their daily life.
Consideration of the spiritual dimension of the human being is appreciation of
our search for eternity and perfection. Consideration of all human dimensions
enable us to pay more attention to human factors which are less measurable than
other health indexes. In the WHO report, spiritual care includes forgiveness,
reconciliation and affirmation of worth. Also the word "spiritual "
is not considered the same as "religious", but it has been accepted
that the spiritual aspect of human life for many people includes a religious
component.
Therefore it is difficult or maybe impossible to present a definition of
spirituality without a religious ground. Can one believe in spirituality without
believing in metaphysics? How can one consider the creation as vain and futile,
and at the same time believe in spirituality?
"Spiritual" finds meaning in the light of nonmaterial world, (as in
the WHO report has been declared). Perhaps any author (religious and
nonreligious) conceives of spiritual care in a different manner but all of them
would accept that spiritual care brings peace and comfort to the patients. So
the third part of the article focuses on the purpose of using spiritual care as
a means to make peace and enhance adaptability and tolerance of the patients.
Presenting the patients with a positive dimension on the sufferings of human
life can be regarded as a helpful suggestion to achieve that goal.
Spiritual Care
Hui ying Li, Yamaguchi University School of Medicine, Japan
Human beings have benefited from well-developed medical technology. But
during this medical development, there are still so many dying people whose
treatment is unsatisfactory. Hence spiritual care will be increasingly valued
in hospices. The important point of hospice care is not only reducing physical
pain, but also comforting the spirit of the patient and family members. In a
comparison between hospice care in Japan and Taiwan, we realized the great
importance of religious spirit in the spiritual care of a hospice.
Concepts of
death and good death among Filipino indigenous communities
Leonardo de Castro and Peter A. Sy,
Department of Philosophy, University of the Philippines, Diliman, Quezon City
1101, Philippines
All too often, discussions of ethical issues regarding euthanasia or
assisted suicide take for granted a modern setting where biomedical technology
is made available to the patient. These discussions also presume, for the most
part, a homogenous cultural context where settlement can be arrived at by
appeal to objective standards or universally accepted principles. On many
occasions, religious perspectives also come into the picture but the related
discussions tend to focus on questions of autonomy and paternalism. It would
not do justice to the people involved if biomedical deliberation and
decision-making were to be limited to those issues and themes that have
acquired universal attention. Hence it is important, in dealing with Filipino
cases of euthanasia, to understand the concepts of good death that are imbedded
in the world views of various Filipino ethnic groups.
Filipino medical culture is characterized by diversities in worldview and
tradition. What is sometimes collectively called "Filipino indigenous
culture" is actually made up of pluralities, of differences in medical
traditions and religious beliefs. Thus we can see why the moral dilemmas
engendered by biomedicine require a search for categories, meanings, and
discourses that have the capability to restore a people from the alienating
tendencies of biomedical discourse. For this purpose, we need to take stock of
the rich indigenous concepts and practices that lend an understanding of the
Filipinos' collective culture and help them respond meaningfully to issues
brought about by biomedical technology.
Among many Filipino indigenous groups, death and dying largely belong to a
language different from biomedical discourse. In other words, death as
something that is technologically determined is insufficient where its
determination is hardly about precision but about something socially decisional
and transitory. This does not mean that there is no room for modern
biotechnology in indigenous bioethical discourse. In practical terms, what this
indicates is that caregivers should pay more attention to the culturally laden
moral reasoning involved in each case than to the technical non-traditional
criteria that usually come bundled with modern life-saving biotechnology. For
there is always a danger that the patients will be reduced to mere medical
projects when the problems addressed by the health care providers are not
defined in terms of the values that are meaningful from their own culturally
informed perspective. The suffering or death from which biomedical technology
hopes to redeem a person does not necessarily constitute an evil from the point
of view of the pertinent culture. We have to do more that explain death and
dying in terms of modern biomedical criteria if we want to avoid an alienating
experience for families or societies that are attuned to an entirely different
worldview and whose understanding of death is hardly the cessation of life.
Ethical issues
in the management of patients in a mere biological state
Atsushi Asai, Department of General Medicine and Clinical Epidemiology, Kyoto
University School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto,
615-8507, Japan
Many ethical issues have been raised regarding the appropriate care of
patients in mere biological state. In this paper, I would like to discuss and
analyze ethical beliefs that Japanese physicians expressed in this regard. My
normative position will also be presented.
Questions to be discussed will include sanctity of life, medical futility,
advance directives, a patient's wishes, dignity as a person, just resource
allocation, and social policy. The findings used in this article are based on
the results of a survey on 317 representative members of the Japan Society of
Apoplexy in 1997.
Two aspects of a
brain-dead being
Masahiro Morioka, CIAS, Osaka Prefecture University, Japan
Email: pbi01055@nifty.ne.jp
Japan's first heart transplantation was performed in 1968. This
transplantation was accused of murder, and heart transplantation from brain
dead donors has not been performed until this year. On February 28, 1999, in
Kochi prefecture, a man was diagnosed brain death. As he carried the donor
card, the physicians called the transplantation coordinator, and donor's heart,
lever, and other organs were removed. There have already been three transplant
caes from brain dead donors after the Kochi case this year.
People have been wondering why Japanese have refused brain death and
transplantation for 31 years since the first heart transplant. I wrote about
this elsewhere(1). Anyway, during this period, Japanese people have discussed
and debated on this topic repeatedly on the front page of nation wide
newspapers, weekly magazines, and TV shows. Numerous books on brain death and
transplantation were published, probably more than a hundred. Some of them
became a bestseller. During the discussion curious arguments were presented
which have not necessarily been argued in English literatures.
Among these, there is the problem of "the two aspects of brain dead
being." This theme was first presented by journalist Michi Nakajima's book
"Invisible Death"(1985)(2). She stated that most family members did
not accept the patient's death when he/she was diagnosed to be brain dead, but
that they for the first time accepted death and burst into tears when the
patient's heart stopped beating, and the body became cold. This book was widely
read and shocked people. Takero Sugimoto, a physician living in Kyoto,
experienced a brain death case when his 12-year-old son was diagnosed to be
brain dead. As a physician he perfectly understood the medical situation of his
son, however, as a father he could not accept his son's death. He could not
help thinking that his brain dead son was still alive and he continued
intensive care to his son. When his son's heart stopped, Dr.Sugimoto for the
first time realised his son was truly dead. In his book, "Uniform my Son
might Wear"(1986)(3), the discrepancy between "scientific
rationality" and "humane emotions" which simultaneously occurred
inside Sugimoto's mind was vividly descrived.
In 1989 I published a book, "Brain Dead Person,"(4) arguing that the
death of humans should be considered from the viewpoint of human relationships.
That is to say, the question whether brain death is human's death deeply
depends on the relationships that the brain dead person has had with each
surrounding person on the bedside. As in the case of Sugimoto, a father who has
had deep intimate relationships with his son may hardly accept his son's death
as long as the body is warm and moist. However, a physician who saw the boy's
body only a week ago may easily believe his death because the physician has
never had long intimate relationships with the boy. In that book I argued that
the essence of the concept "brain death" in terms of ethics lies not
inside the brain, but just in the human relationships the brain dead person has
had between him/her and the surrounding people. This theme "brain death as
human relationships" was widely discussed in 1990s.
After publishing that book, a medical student, 29 years old, became brain dead.
Her name was Yoshimi Fujiwara, whom I met twice when she was alive(5). She was
dead when I was in the United States. A year after her death, I met her mother,
Yasuko Fujiwara, and talked a lot about Yoshimi's brain death. In this case,
too, the mother and father did not accept their daughter's death when her brain
death was confirmed. They were taking care of her body on the bedside until her
heart stopped beating. When the father left the room, he stood by the door
calling his daughter "Do your best!" Her mother put perfume on her
daughter's brain dead body. They never thought their daughter was dead. And at
the moment her heart beat stopped, they realized death really occurred on their
daughter, finally accepting she would never come back.
I think there are two aspects, or realities, concerning human's death; one is
scientific/medical aspect that requires uniform criteria of death, while the
other is philosophical/relationship-oriented aspect in which human's death
depends on the human relationships between the dying patient and the
surrounding people. Of course both aspects are important, but I want to
emphasize the importance of the latter because our modern medicine and
"rational" bioethics sometimes miss the latter reality in which most
ordinary people actually live. Medical staff, particularly doctors, have to pay
special attention to the relationship-oriented reality. In my experience,
nurses easily understand what I mean, but doctors and "bioethicists"
are the last to accept this.
References
(1) I analyzed some of the theories in the following paper. Masahiro Morioka
"Bioethics and Japanese Culture: Brain Death, Patient's Rights, and
Culture Factors" EUJAIB 5 (July 1995):87-91. See the EUJAIB website, http://eubios.info/EJ54E.html
(2) Michi Nakajima "Mienai Shi(Invisible Death)" Bungei Shunju, 1985.
(3) Takero Sugimoto "Kita kamo Shirenai Seifuku(Uniform my Son might
Wear)" Yomiuri Shimbun, 1986. In some Japan's junior high schools, boys and
girls wear special uniforms.
(4) Masahiro Morioka "Noshi no Hito(Brain Dead Person)" Fukutake
Shoten, 1989.
(5) Masahiro Morioka 'Noshi to no Deai(Encounter with Brain Death)' in Yanagita
(ed.) "Shi no Hen'yo(Transformation of Death)" Iwanami Shoten, 1997:93-116.
Are the brain dead really unconscious?
Tetsuo Furukawa, Tokyo Medical and Dental University, Japan
Although lots of discussions have been done on brain death, the one
completely neglected so far is whether the patients diagnosed brain death are
really unconscious. Today organs are transplanted from the brain-dead on the
assumption that they are undoubtedly unconscious. However, there are several
phenomena suggesting that consciousness remains in some of the patients
diagnosed brain death. I will present some of the data and reconsider the
problem.
Many experimental studies were performed on various animals to delete the
brain. The symptom common to all these animals without cerebrum was: Input was
retained, but output was entirely or nearly entirely lost. Therefore, when
uncomfortable stimuli hurt them, they could hardly express their displeasure.
Even when surface EEG is flat, active waves may be recorded from nasopharynx or
intraventricular leads, which suggests that the brainstem may be still alive
even in brain death patients. Yanagida described a feeling only his family can
understand with his son in brain death. We clinicians observe similar phenomena
and we have nothing to deny the presence of such a feeling. Morphine is
injected to brain death or near death patients to take out organs. Why opium is
used to brain death patients, if they are totally unconscious? Diagnosis of
brain death is done by scientific method, but today's science cannot deal with
consciousness, which never means that consciousness does not remain in brain
death patients.
I am afraid that we mankind are comitting an unpermissible, grave sin.
4:15-6pm Bioethics Education (2)
The moral
development of physicians: Lessons from Czarist Russia and post-war Japan
Gordon Greene & Seiji Yamada, University of Hawaii, USA
Despite the many difficulties involved, it is imperative that medical
students be able to learn ethics in a fashion that is responsive to actual
clinical situations. To do this, clinical ethics can not be considered apart
from the realities of the individual, the family, the health care setting and
the social framework. In other words, students need to learn that moral issues
emerge within the context of actual occurences, not from applied principles.
Since 1996, we have been teaching a 6-week seminar on the patient/physician
relationship to third-year medical students, that being their first year of
significant exposure to clinical training within the four -year American system
of medical education. One of our objectives is to foster development of skills
for discerning this "context of actual occurrences" through guided
discussion of two works of fiction: a short story by Tolstoy (The Death of Ivan
Illich) and a film by Kurosawa (Ikiru).
The value of this use of fiction is many fold. In both cases we have a master
storyteller capable of taking the students inside two lives- that of a Russian
magistrate of the 1880's and that of a Japanese bureaucrat of the mid- 1950's.
The richness of detail in these works of fiction helps students to understand
not only the unique trajectory of lives, a key objective mentioned above, but
also provides a glimpse of the common foundations of human lives. From here,
the students often recognize that the "context of actual occurrences"
includes themselves and not just their patients.
By examining these two works in detail, one can generalize methods of using
works of fiction from all languages to foster a similar approach training in
clinical ethics.
How to teach
about AIDS in High School Ethics Class - to think how society should be and how
human beings should live
- Izumi Otani, Kokubunji High School, Tokyo, Japan
Email: KHA00347@nifty.ne.jp
I have been involved in developing and practicing bioethics education for
these ten years. Considering this experience, I want to propose a class program
that contains not only gaining precise information about HIV/AIDS but also
thinking with high school students how society and human beings should be in
this era when we have to deal and live with AIDS.
As the "present-day plague", HIV/AIDS has been discussed sometimes
with fear, sometimes with curiosity, and in many cases with prejudice. But
after several panics happened, in Japan AIDS education in health education
classes at elementary, junior high, and high school become popular, little by
little now. And as civics classes of high school, in 'present society' and
'politics and economics' classes, AIDS is taught as a medical accident. But
many worry that in this context the essential problems of AIDS have not been
discussed.
In this presentation, I want to report a teaching program of ethics in civics
taking AIDS as a main topic, with universal issues of HOW people and society
should be. It includes issues such as the cultural history of disease,
psychological structure of prejudice, information and panic, alienation and
evasion, politics of sexuality.
How to consider
the balance between environmentalism and liberalism in the class
Kazuo Inoue, Omiya-chuo High School, Japan
Based on practical experience in teaching bioethics in high school classes, I
will consider how to teach the balance between environmentalism and
liberalism/individualism. The numbers supporting each view are similar. There
can be sharp differences of opinion between both sides, so I believe it is
necessary to give students an opportunity to think or discuss the topic more
deeply by presenting them with viewpoints seeking the possibility of the
coexistence of the two.
Clinical
anthropology classes for education of bioethics
Shinichi Shoji and Katsuko Kamiya, University of Tsukuba, Japan
For education of bioethics, we propose using a Clinical Anthropology class.
This is an educational method considering humans through birth, aging, illness,
and death. This Clinical Anthropology class is conducted through presentation
of a concrete clinical case or scenerio, requiring decisions relating to birth,
aging, illness or death. The learning strategy of the Clinical Anthropology class
is as follows: this class is elective. The timing of this class is whole year.
The class is done once a week, 75 minutes each time and the total period is 30
weeks. The number of students who are enrolled for this class was 199, 259 ,
268, and 326 for 1996, 1997, 1998, and 1999, respectively.
Following breif presentation of typical opinions, essential information,
questions and answers, free discussion in small groups with or without tutors
is conducted, then general discussion, then presentation of tutors' private
opinions, and students write down their own words and opinion. At Tsukuba
University this program has been conducted as a course open to first or
second-year students of any subject.
The specific behavioral objectives of the Clinical Anthropology class are as
follows, 1) extract problems from information, 2) speak one's own opinion
clearly in plain language, 3) listen intently to other's opinion, 4) play as a
chairperson of small group discussion, 5) record abstract of discussion, 6)
present abstract of group discussion, 7) write sentences on one's own opinion.
Results will be discussed.
The UNESCO
Declaration as a tool to gather the Biology and the Law departments at the
University of Cergy-Pontoise
Florence Hardy, University of Cergy-Pontoise; Catherine Bourdon, University of
Lyon and Georges Kutudjian, Unit of Bioethics and Information Technologies,
UNESCO, France
The University of Cergy-Pontoise (France) was created very recently (1991).
Bioethics was not planned to be a discipline to be taught. However, in 1997,
students of a biotechnology course (4th year) implicitly requested some kind of
bioethics teaching when the cloning of Dolly was reported. Students attended
one lecture, and were very impressed by the universality of bioethics, "Everybody/tout
le monde is concerned". This community of young people is multiethnic
(originating from Europe, Asia and Africa essentially).
So, last year, we offered the biology students to work and discuss together
with law students around an international document: The UNESCO Declaration.
This small meeting was organized in three steps (1) a discussion session with a
biologist and a law specialist as teachers, (2) use of web sites, (3) the
lecture given by an anthropologist. Here, we report the lessons from this small
experience and the desire we have to pursue a project designed by students.
22 November
9-12 am Methodology in Cross-Cultural Global Bioethics
Enlarging the
Range of Bioethics Across Cultures
a Report about the Methodology of a Project on Aspects of Medical Ethics in
China
Ole Doering, Institute for Asian Affairs, Germany
This paper intends to contribute some new aspects to the discussion of
Methodology in Cross-Cultural Global Bioethics by introducing an
interdisciplinary, international research project in medical ethics, together
with its underlying theoretical and methodological framework. This project has
been conceptualized and organized by myself at the Institute of Asian Affairs
in Hamburg (Germany) since 1996, and it includes two symposia so far, held in
Hamburg and Shanghai, which will be focussed on in the presentation.
Advancements in the field of biomedicine have been plenty, prompting new
challenges which cannot be answered by means of isolated attempts only, neither
by disciplines nor by cultures or nations. This observation suggests that we
should seek for comprehensive approaches of humanity. The new complexity of
biotechnological achievements, together with the related chances and risks for
individuals and societies in our globalizing world, calls for an integration of
multidisciplinary and cross-cultural efforts to develop new approaches on all
relevant levels of scientific, cultural and ethical understanding, in order to
join capacities, and to make them available for the sake of ourselves, our
fellow humans and future generations. Creating not totally new ethical
perplexities, this complexity itself raises fundamental considerations which
amount to an intrinsic imperative of bioethics to transcend disciplines and
cultures.
This imperative is rarely acknowledged in a systematic and methodological way
by mainstream bioethicists. The project presented at the TRT 5 is meant to
explore the prospects of a "human bioethics" from a methodological
view.
The Concept of
"Third Cultures" in Intercultural Ethics
Richard Evanoff, School of International Politics, Economics, and Business,
Aoyama Gakuin University, Japan
E-mail: evanoff@sipeb.aoyama.ac.jp
The paper reviews the concept of "third cultures" as it has been
developed in the field of intercultural communication and attempts to show how
it can be applied to cross-cultural dialogue on ethics. The paper critiques
existing views of cultural adaptation, which suggest that it is the sole
responsibility of sojourners to adapt themselves to the cultural norms of their
host cultures, and argues to the contrary that host cultures also have an
obligation to adapt themselves to the needs of sojourners. The ethical norms we
initially bring with us to cross-cultural dialogue tell us how to deal with
people in the context of our own culture, not with people from another culture
whose norms are different. Cross-cultural encounters create an entirely new
context, however, in which the rules that will govern the relations between
cultures do not yet exist and hence must be created. The paper advances a
constructivist approach to cross-cultural ethics which suggests that if ethics
is indeed a matter of social construction, then there is no reason why ethical
principles and norms cannot be constructed across cultures as much as they are
within cultures. New ethical frameworks can be negotiated through a process of
cross-cultural dialogue which draws on, but does not remain bound by, the
ethical insights contained in any one tradition. Reaching agreement requires a
dialectical process of reflection in which the participants attempt to critique
existing ethical norms, to integrate positively identified norms in new ways,
and to create entirely new norms to effectively deal with mutually shared problems.
Ethical Decision
Making In the Dilemmas Related to Nursing Care
Aiko Sawada, Toyama Medical & Pharmaceutical University, Japan
Nurses are sometimes worried about ethical dilemmas in nursing care. When
they meet with such dilemmas, how do they solve them ? However, until now we
have not discussed much such a problem in spite of its importance.
Today, nurses in U.S. are interested especially in the concept of ' nursing
advocacy '. It means advocacy of patients' best interests and rights by nurses'
duties. In this concept, nurses tend to be called as ' patient advocate ', and
their main ethical responsibility exists in accomplishing it. This concept is
now introduced in the ethical code for nurses of American Nursing Association.
What kind of method can nurses as ' patient advocate ' have in order to solve
ethical dilemmas in difficult cases ? What should they do for the advocacy of
both best interests and autonomy of patient ? How can they achieve bioethical
decision making in ethical dilemmas ?
To solve these problems, Bioethical Decision Making for Nurses by Thompson J E and Thompson H O will be useful for
nurses. In this book, these authors present ten steps to ethical decisions: 1.
review the situation; 2. gather additional information; 3. identify the ethical
issues; 4. identify personal and professional values; 5. identify the values of
key individuals; 6. identify the value conflicts, if any; 7. determine who
should decide; 8. identify the range of actions and anticipated outcomes; 9.
decide on a course of action and carry it out; 10. evaluate the results
In this presentation, I would like to explain this theory model concretely
through dementia of an old woman's case in Japan. I would like to show how to
solve a dilemma and how to reach a ethical decision in this case with the
theory mentioned above. I am sure that we can make an ideal method of carrying
out ethical nursing care by reviewing today's issues of decision making in
nursing care.
Why Japanese
doctors performed human experimentation in China?
Takashi Tsuchiya
Department of Philosophy, Osaka City University, 3-3-138 Sugimoto,
Sumiyoshi-ku, Osaka 558, Japan
Email: tsuchiya@lit.osaka-cu.ac.jp
From 1933 to 1945, in China, Japanese doctors performed thousands of cruel
experiments on Chinese, Russians, Mongolians, and Koreans and killed all of
them. At the Unit 731 only, at least 3000 people were tortured and killed. In
addition, at 4 branches of the Unit 731, 4 other "Boeki Kyusui Bu
(Anti-Epidemic Water Supply and Purification Bureaus)," the Manchuria
Medical School, and military hospitals, similar human experiments and
vivisections were done. Those experiments and vivisections can be classified
under 4 categories: (1) vivisections for training newly employed military
surgeons; (2) intentional infection of diseases; (3) trials of unstandardized
treatments; and (4) knowing tolerance of human body.
These "factories of death" were run by military surgeons following
Lt.Surgeon General Shiro Ishii. But, except at military hospitals, most of the
doctors who performed human experiments and vivisections were academic
researchers, who had been lecturers or associate professors at Japanese leading
medical schools and were temporarily employed by the Japanese Army. Why did
they joined those "factories" and become murderers? Was it impossible
to stop the atrocities, or at least to avoid participation? I have found three
circumstances.
First, then in the Japan, there was prevailing pressure for their
participation. As it was in wartime and they lived in the fascistic country, it
was very common to cooperate with the army. They would be blamed as
"Hikokumin (traitors)" if they refuse to participate. They accepted
their fate without trying to resist it, even when they knew what they were
scheduled to do in China.
Second, they were ordered by their boss professors to go to China. In Japanese
medial schools, even now, professors exercise supreme power over their
students. Usually, there is only one professor in each department, and even
after taking doctoral degree, researchers devote themselves to the department,
hoping to be nominated as the successor. They cannot resist their professors if
they hate to abandon their academic carrier. Being in short supply of research
facilities at Universities in that wartime, professors werewilling to be
cooperative to the army and Lt. Surgeon General Ishii. The professors promised
Ishii to send their best disciples to the Ishii's factories, and in return
Ishii and the army supplied enough research equipment (andsometimes even the
data and chances of human experimentation) to them. Thisfact tells us that the
atrocity by human experimentation in China was impossible without support of
the leading medical professors, and that not only Ishii and the army but also
the Japanese medical profession is guilty of the crime. That is the reason the
term "Jintai Jikken" (experimentation with human beings) have been
under taboo in the Japanese medical profession since then.
Third, even for the reluctant researchers came from the Universities, the
Ishii's factories were so luxurious place. For example, the annual budget of
the Unit 731 was 10 million yen at that time (about 9 billion yen [about 86
million dollars] at the present value). The half of it was for research, and
another half was the labor cost for about 3000 employee. The salary was
considerably high, the dishes served there were wonderful. And the Unit 731 had
the most luxurious laboratories in Japan then. Surely, there were atrocities;
there was a hell. But for those who could concentrate themselves in research,
it was a heaven. There was no restriction on their research--- -they could even
treat human subjects truly as guinea pigs! In addition, there were patients
with diseases that they could hardly see in the homeland of Japan, for example,
epidemic hemorrhagic fever, plague, typhus, and severe frostbite. They could
produce brilliant scientific achievements for Japanese medicine, although these
achievements could not publish internationally. Owed to these achievements,
they could gain good positions in the Japanese medical academy after the war.
Right to rule
one's own life and body
Tsuyoshi Awaya, Japan
Recently, the situation to surround human life and body is changing
drastically. Technologies of life and body have been highly developed. Life is
becoming controllable, and body is becoming utilizable and changeable. And that
the technologies about life and body are changing the meaning, values, ethics,
etc. of the life and body.
For example, as for the commencement of life, technologies of artificial
insemination and in-vitro fertilization have been developed, and as for the
termination of life, technologies of life-prolonging treatment and life-support
treatment have been developed. As for the termination of life in particular, the
absoluteness and inviolability of biological life have begun to be doubted due
to the development of those technologies. Concretely speaking, the issue of
euthanasia and death with dignity has come under closer scrutiny.
As for the utilization of the body, technology of organ and tissue
transplantation and biotechnology have been developed, and as for the
transformation of the body, the technology of artificial body and the
technology of organ and tissue transplantation have been developed. In particular,
as for the technology of organ and tissue transplantation, the issue of
thorough utilization and commodification of the body (organ, tissue, cell,
gene) have come under closer scrutiny due to the development of those
technologies.
By the way, there is an issue of the information about life and body, for
example, the issue of DNA testing. Here, I propose "the right to control
one's own." To whom does life, body, and their information belong? My
life, body, and their information belong to me. I own them. I have the property
right of them. I have the right to control my life, body, and their
information, and you have the right to control your life, body, and their
information. As technologies of life and body have been highly developed, and
life is becoming controllable and the body is becoming utilizable and
changeable, as mentioned above, I think the establishment of the right to
perfectly control the life, body, and their information is needed urgently.
Concretely speaking, It is desirable that international convention about the
right to control one's own is concluded and the right is placed in the
constitutional law of each country.
The right to control one's own is divided into three categories. They are the
right to control one's own life, the right to control one's own body, and the
right to control one's own information about the life and body. The right to
control one's own information is recognized as the right of privacy in many
countries. In Japan, it is recognized as one of the right to pursue happiness
on the constitutional rights. I describe the right to control one's own life
and the right to control one's own body below.
The right to control one's own life is divided into two parts. They are the
right against life infringement and the right to dispose one's own life. The
right against life infringement is the result of both of the property right of
life and the inviolability of life, which is derived from human dignity. This
right against life infringement is almost established in many countries. The
right to dispose one's own life is the result of both of the property right of
life and the possibility to dispose life, which is derived from the principle
of autonomy. The principle of autonomy is derived from individualism and
liberalism. However, this possibility to dispose life comes into conflict with
the impossibility to dispose life which is derived from human dignity. Here is
just an ethical dilemma. This right to dispose one's own life has been hardly
established in the world currently. I think the establishment of this right is
needed through overcoming the ethical dilemma. This means recognition of the
right to determine one's own death (the right to suicide), which is the
extension of the so-called right to die.
The right to control one's own body is divided into two parts. They are the
right against body infringement and the right to dispose one's own body. The
right against body infringement is the result of both of the property right of
body and the inviolability of body, which is derived from "human body
dignity." This right against body infringement is almost established in
many countries.
However, recently, this right against body infringement has begun to be
partially attacked by the human experiment, including clinical test of medicine
with human being without informed consent, removal of organs from executed
prisoners in China without consent, organ theft in India, removal of tissues
and cells in USA without consent, etc. In Japan, the case of insertion of a
catheter to the living kidney donor (patient) without consent in Kansai Medical
College and the case of removal of organs and tissues from the dead without
consent for the investigation of environment hormones in Tokyo coroner office
occurred.
Usually these are treated as simply ethical issues: violation of informed
consent, but I think those should be treated as a legal matter: issue of the
right against body infringement. Concretely speaking, it should be treated as
the issue of bodily injury or theft on the criminal law.
The right to dispose one's own body is the result of both of the property right
of body and the possibility to dispose body, which is derived from the
principle of autonomy.
I would like to study the fundamental issue why the property right of life and
body can be brought up, and to analyze the relationship between the property
right of life and body and the self-property right on the philosophy of law in
the near future.
2-6pm Methodology in Cross-Cultural Global Bioethics
Global bioethics
and Potter's criticism of the concept of human progress
Ivan Segota, University of Rijeka, Croatia
Van Rensselaer Potter II, the 88 year old American oncologist, did not only
"coin" the term bioethics 30 years ago, but I think he is its real
"father", since bioethics, after its initial narrowness in the frames
of medical ethics, today regains Potter's global dimension as "a new
science ethic required for long term human survival." Already in 1962 -
nine years before the term ethics was created- Potter was questioning the
concept of human progress and where the advances in science and technology were
leading Western Culture, as well as, what kind of future humankind was facing
and if humans have any possibility of choice. Today, when approaching the end
of his life, he warns that "the medical ethics presently carried on with
bioethics as its label is a short-term tactic" and that " global
bioethics calls on medical ethicists to consider the original meaning of
bioethics and to extend the thinking and activiites to public health issues
world-wide."
Besides presenting Potter's brief biography, the author provides Potter's
original understanding of bioethics and of his recent terms: " global
bioethics", "bridge bioethics" and "deep bioethics",
as well as the historical background in which first visions of bioethics
developed in the United States in the early 1960s.
Bioethics: What
kind of Discipline?
Bioethics: What Kind of Discipline? - A Dilemma
Insok Ko, Institute of Philosophy, Yonsei University, South Korea
Bioethics today seems to have two jobs to carry out that are intrinsically
related to each other but not to be easily integrated into one and the same
task. On the one hand, bioethics as a branch of applied normative ethics is
expected to play the role of a problem solver, or at least of a mediator that
helps us to balanced solutions to the emerging practical problems entangled
with the progress of bio-medical sciences and technologies. On the other hand,
bioethics includes a set of open philosophical discussions on various
fundamental questions. For instance: What is life? What is birth and death (especially
of a human being)? Do we have right on other lives (including other biological
species)? Are there circumstances under which manipulation of life is
justified? It is to note here that the unceasing debates on those fundamental
questions, such as the definition of life, killing, etc., and further on the
foundation of normativity would keep bioethics from giving prompt answers to
concrete problem situations. This constitutes a dilemmatic situation for
bioethics. Neither of the two aspects of bioethics -philosophical reflections
on the fundamental concepts and criteria on the one hand and timely reactions
to practical problem situations on the other- is dispensable, while it seems
hard to fulfill both tasks satisfactorily at the same time.
If bioethics would not fail to do its function as normative ethics that is
urgently needed in our societies, it should assume some standpoint as
(tentatively) accepted for the discussions on the matter. I suggest for such a
starting point a following motto, seemingly harmless but certainly not
indisputable: "For the sake of effective survival of human-kind".
Transcendental
evolution of Trans-cultural Ethical Systems into an holistic ambience
R.N. Sharma, National Chemical Laboratory, India
Human society has spawned many ethical systems in different regions and times.
Some of these have diffused into the fabric of humankind, and stabilised as
major religions. Whereas the underlying principles of all are unifying and
universal in the embodiment of love, compassion, peace and spiritual
uplift/salvation; historical, geographical and socio-economic factors have
distorted their form and content into anachronisms totally incompatible with
progressive human aspirations. Deep thinking, and conscious, concerted efforts,
as well as high courage are needed to transform the common as well as
distinctive tenets of these systems into an holistic paradigm. The latter would
then be able to blend the diversity of human religious beliefs into a morality
which would, of necessity, be anthropocentric. However, such a universal,
trans-global cultural and spiritual unitary Ethics would have a pragmatic
conceptual ambience capable of assimilating diverse streams of thought for
universal transcendental evolution of a primordial Human Nation co-existential
with other Life as well.
Is Monotheistic
Theology an Obstacle to Universal Bioethics?
Avi Gold, Ben-Gurion University, Be'er Sheva, Israel
The first time I spoke on this topic was at the bioethics conference in
Be'er Sheva, Israel, last summer. More recently, I developed the topic further
at the bioethics conference and student seminar in Chennai in January 1999.
Since then, six months have passed, and I have had some time to think over the
topic further. I have been examining more sources and discussing the content of
these talks with many people of several religious backgrounds: Jewish,
Christian, Muslim, Buddhist and most recently Hindu. Now, I would like to
present an updated paper on monotheism in the context of universal bioethics,
and specifically the tradition of the Seven Laws of Noah, and their relevance
to this topic.
Initially, the question asked was: Is Monotheism an Obstacle to Universal
Bioethics?
In the context of universal bioethics, the discussions are often quite secular,
but if bioethics are to be universal, then religion must be taken into account.
Millions of people worldwide are members of various religious groups, and their
attitudes towards bioethics and opinions must somehow fit into the scheme of
universal bioethics. Religious systems which are polytheistic are more
accepting of multiple approaches, so I focused on monotheistic religions to see
how they could function with a universal bioethics model. As a representative
of monotheistic religions, I concentrated on Judaism, although obviously the
same issues need to be examined in other religious traditions as well.
Judaism is a monotheistic religion, and in it there is a strict belief in One
God. Numerous laws and regulations exist in the Torah, and other Jewish scriptures,
prohibiting the worship of multiple gods, and distancing from contact with such
practices. It is therefore interesting to see how Judaism deals with the
outside world, and with various groups which do not share its theological
system. This, of course, has implications for universal bioethics in a world
which includes many different religions and faiths.
The rabbis over the centuries have had to deal with this very issue. It is not
an issue which came up only in modern times. In various contexts, various
policies were practiced, but two details must be kept in mind: 1) It was always
held to be important that tradition be maintained, even in difficult situations
(and this is still the case). 2) It was (and is) recognized that interaction
with the outside world is necessary. Complete isolation was rarely possible,
and when possible, it did not really provide a long-term solution.
Some would advocate discarding traditional practice and its theological system
in order to eliminate barriers from international contact and interaction.
While this approach holds appeal to some, obviously tradition cannot be
maintained in this way, and if the purpose was preserving tradition, then this
approach is self-defeating. Others attempt the path of discarding the outside
world in favor of preserving tradition. This approach has been taken by some,
but it is clear that total isolation is not an option in the long term,
especially in the 21st century.
Therefore, some other approach must be examined. The rabbis of the Talmud
mentioned a tradition which contains within it just such an approach to the
outside world. This is the tradition known as the Seven Laws of Noah, a
tradition which appears in the Talmud and in a few other ancient Jewish
sources. I think the framework of the Seven Laws of Noah has tremendous
potential as a method of approaching the outside world, and that it has a great
value within the context of universal bioethics.
The topic of the Seven Laws of Noah and their function has been discussed in
detail in various sources, although until modern times, most of the discussion
has been mainly theoretical. It is now, in recent decades, that various people
are considering how this tradition can be translated into practice, outside the
realm of theory.
Briefly put, the tradition of the Seven Laws is as follows: After the Great
Flood which destroyed the world, and with it, all of humanity except for Noah
and his family, God gave Noah and his family seven laws. These seven laws were
to serve as the basis for human society, and to be followed always by all of
Noah's descendants (i.e. all of humanity). The seven laws are: 1) Prohibition
of idolatry; 2) Prohibition against cursing God; 3) Prohibition of murder; 4)
Prohibition of adultery and other illicit sexual relations (such as incest,
etc.); 5) Prohibition of theft; 6) Prohibition of "ever min ha-Hai"
(against eating a live animal or eating a part of an animal while it is still
alive) ; 7) Commandment to set up courts of law
The importance of this framework of seven laws is in at least two things: 1)
Since it is defined as applying to all of Noah's descendants, and all of
humanity is included in this definition, this framework can be used as a way of
viewing the world as a whole in its most inclusive manner. Because, we are all,
descendants of Noah. So, no matter what religious systems exist, all of
humanity has a common link as descendants of Noah. If the world is viewed from
this angle, some of the foreignness of the "other" disappears. 2)
These laws are, for the most part, moral definitions, and so it is interesting
to examine this framework of moral principles within the discussions of
universal bioethics, and within discussions of genoethics, as defined by Prof.
Shinagawa (1).
Obviously, there are details to be discussed in each of the Seven Laws, but in
general, the basic principles of these can be found in cultures and traditions
worldwide.
The one law of the seven which causes the greatest issue is that of idolatry.
Therefore, this law must be examined carefully, because it holds a key to
multi-religious discussion. The next question which follows then is: What is
the meaning of idolatry in the context of the Seven Laws of Noah? As is usually
the case, there is disagreement as to exactly how this law should be
interpreted. However, according to some rabbis, there is a distinction between
what is considered idolatry within the Seven Laws and what is considered
idolatry for purposes of Jewish observance. The main difference is in the
concept of "shittuf". This word does not have a standard translation
in English, but I would recommend "associationism". I have already
suggested a Japanese translation for this term as "rensou-shinron".
(2) The basic meaning of "shittuf" is connecting someone or something
with God, either in worship or in oaths. By practicing "shittuf", one
makes use of an intermediary to reach God, rather than approaching God
directly. The difference between this and idolatry is that in practicing
"shittuf" one affirms the existance of the One God, while in idolatry
the many gods believed in are taken to have independant authority. The
discussion of "shittuf" in rabbinic literature was primarily a
discussion of the status of Christianity, whether the issue was belief in a
trinity or prayer to saints. Either way, according to those who distinguish
"shittuf" from idolatry, a Christian is engaging in shittuf and
therefore is not an idolater. The question then is: What about the status of
other religions in terms of this "Seven Laws" framework? After all,
the main discussion in rabbinic literature about other religions is on
Christianity. Other religions are hardly ever mentioned. The way to approach
other religions is by the same set of guidelines. If the theological framework
in a given religion is purely monotheistic or engages in "shittuf"
then such a framework would not be idolatrous within the Seven Laws. This is
why it was a special challenge for me in India. In January 1999, when I
presented in Chennai, the audience was multi-religious, and for the first time,
it was possible for me to discuss the Seven Laws with Hindus. I found a high
degree of agreement, and indeed Hindu scriptures speak of an underlying Unity
in the universe. Whether or not they use the term "God" is
irrelevant, because terminology is culturally-based anyway. The description of
God in Jewish sources is a Unity over everything without shape or form, and
this fits well the Hindu descriptions.
However, even in the case of a religious system which does not practice
"shittuf", but rather idolatry itself, there are still principles
existing within Jewish sources that allow for co-existance.
The most important of these is the Talmudic statement "minhag avotam
beyadam". (3) This means "the traditions of their ancestors are in
their hands". This statement was said about the various nations living in
other lands outside Israel. In other words, despite the fact that some of these
religious systems are contrary to the Jewish concept of God, nonetheless, the
rabbis stated that those nations received their traditions from their
ancestors, and so it was seen as an internal matter for those nations. So
coexistance with other systems can exist, even when the starting point is a
strict monotheistic system.
In conclusion, I would like to say that monotheism need not be an obstacle to
universal bioethics, and that the Seven Laws of Noah provide an interesting
framework for discussing universal bioethics from a monotheistic viewpoint.
(1) Prof. Shinryo Shinagawa, An Essay on the Standardization of Ethics, Journal
of Health Care, Medicine and Community No.
12, November 1997, pp. 42-53
(2) Personal correspondence to Prof. Shinagawa, Oct 25, 1998
(3) Babylonian Talmud, Tractate Hullin, 13b.
The role of
cultural determinism in the practise of allopathy medicine in Nepal
Dsouza Johnson Gerard Savio Alphonso and V.Manickavel, College of Medical
Sciences, Kathmandu University, Nepal
Universally Medical Councils and World Medical Associations code of conduct
prevents the association of physicians with drug dispensing. This paper
attempts to reason out for a way of Co-practise, especially because of the
traditional beliefs and cultural determinism of doctor, patient and pharmacists
relationship.
The role of
cultural determinism in the health care delivery in Nepal
Krishna sagar sharma and V.Manickavel, Nepal
Nepal is the only Hindu kingdom in the world and Hinduism is the state
religion. The over wholming majority of population, 90%, (1991) has been and
continue to be Hindu. Buddhism the second largest religious group (5%) and a
minority is Tibetoneplese, then Muslim (3%) and Christian and others (2%) of
population .
Medicine in old days are purely depended on the Hindu cultural facts. Going on
quest of fact first reference to the modern system of medicine or to allopathic
practitioners in Nepal is 1966/67. The conclusions of a study of the real
situation are:
1. Different medical system can co-exist . Each whilst having its own expertise
will generally cater for the commor ailments.
2. People may adopt behavioral aspects of medical systems without fully
understanding the theories involved.
3. people's actual health behavior in situation results after considering the
probes and cons that exist.
4. Another factors the costs of health behavior in relation to what people can
afford and to the quality of services that they will get.
5. PHC as such failed to appreciated to the values of the villagers and the
perceived needs. Whilst authorities stressed on health education the villagers
wanted modern curative services .
6. PHC Implementers view the rural culture disparagingly as a barrier of health
education.
7. More attention needs to be paid to the villagers' ideas, about health care
and the existing traditional cares.
8. Modern concept of health care delivery system by involving more village
health workers and health volunteers is failed, because such poor villagers can
not expend their time without money.
23 November
9-12am Animals and Bioethics
Thinking about
animal rights
Sang-yong Song, Hallym University, Chunchon, South Korea
Animal rights are quite a recent discovery though there were some
forerunners who considered them seriously. What prohibited us from thinking
about them earlier? Let us examine theological and philosophical factors among
others for neglecting them.
According to Lynn White, Jr. a historian of medieval technology, the rise of
technology in the Latin West in the Middle Ages was accelerated by the new
attitude toward nature. A common feature of the religions in the ancient Greece
was the belief that all natural objects possessed spirits. The Judeo-Christian
religion, however, maintained that spirit was separate from nature and ruled
over it from without. Only man possessed spirit. By destroying pagan animism,
Christianity made it possible to exploit nature in a mood of indifference to
the feelings of natural objects. Man and nature were two things, and man was
master.
In Europe there were societies in which the axeman or the slaughterer, before
taking up his axe or knife, would first have begged the tree's or the animal's
pardon, explaining the necessity which forced him to destroy it. Such an
attitude was not necessary for Jews or Christians, for nature was not sacred.
St. Francis of Assisi, the greatest radical in Christian history proposed what
he thought was an alternative Christian view of nature and man's relation to
it. He tried to substitute the idea of the equality of all creatures for the
idea of man's limitless rule of creation. However, the Judeo-Christian view of
nature combined with the idea of conquest of nature in the modern era resulted
the negligence of animal rights.
Descartes is the most important philosopher concerning animal rights. Animals,
in his view, are thoughtless brutes, automata or machines. Humans are also
machines, but they are distinct from animals in that they have soul, i.e.,
"ghost in the machine". Animals are, like clocks not conscious. The
belief in animal consciousness, according to him, is a prejudice to which we
are accustomed from our earliest years.
It was La Mettrie who challenged Descartes. He denied the fundamental
difference between humans and animals. The superiority of man over animal was
attributed to the surprising effect of education. He said : "Man is not
moulded from a costlier clay ; nature has used but one dough, and has merely
varied the leaven." Descartes had regarded linguistic behaviour as a kind
that only humans can engage in. La Mettrie was anxious to show that apes are
able to speak. Inspired by Amman's work in teaching deaf-mutes to speak, he
asked : "Why then should the education of monkeys be impossible?" La
Mettrie is remembered as a philosopher who extended beast machine to man
machine. But he demolished the Cartesian dualism between man and animals.
Later evolutionary theory provided a significant different approach to the
question of animal awareness than one offered by Descartes. Darwin emphatically
denied a privileged status to human beings. For him there was no fundamental
difference between man and mammals in their mental faculties. Thus wrote Darwin
in The Descent of Man : "The difference in mind between man and higher
animals, great as it is, certainly is one of degree and not of kind."
Evolution provided a theoretical basis for attributing a mental life to
animals.
Reflections on the Judeo-Christian view of nature, the downfall of Cartesian
dualism and the establishment of evolutionary theory give powerful support to
animal rights. There is a sign of increasingly favourable climate for animal
rights.
Morality in nature
-A new approach to thinking about altruism
Michael C. Morris, Faculty of Systems Engineering, Dept. of Environmental
Systems, Shibaura Institute of Technology, Fukasaku 307, Omiya-shi, Saitama-ken
330-8570, Japan
Altruism is defined as any act which raises the Darwinian fitness of the
recipient at the expense of the giver. Previous generations of biologists have
assumed that altruistic animals and plants are acting for the good of the group
or species as a whole.
This idea has given way to the view that altruism can be explained solely in
terms of Darwinian selection pressure favouring genes "for" altruism.
Altruistic individuals are therefore acting in the self interest of their
genes, whether they are consciously aware of this or not.
Many people feel uncomfortable with this view. In this presentation I review
the Darwinian mechanisms used to account for the evolution of altruism. I also
propose that in some cases, Darwinian selection pressure alone would act
against the evolution of altruism because of the selection of "cheat"
alleles.
My conclusion is that the presence of altruism and cooperation in general is
part of an overall design plan for living systems. Current education in ecology
emphasises the role of competition as an evolutionary driving force. The
benefits of competition in promoting economic efficiency also appears to
predominate political thinking today.
A new emphasis on the role of co-operation using scientific examples may help
us realise a more just society. We would learn that "nature red in tooth
and claw" has a gentler side, and may be obeying the wish of a beneficent
creator that all living things "love one another as I have loved
you".
Some comments on
logic and ethics of the whaling and anti-whaling movements
Shinryo Shinagawa, Hirosaki, Japan
Besides a brief history of whaling and anti-whaling movements, four general
issues will be discussed on the logic and ethics of these movements. Whale
problems have been so specific and confused because whales have no national
borders; they migrate freely across and through the waters of national
jurisdiction. Too many questions remain unsolved on the biology and behaviour
of whales. Whales are important animal protein resources and a cultural
component for the people with a long history of whaling. Whales are endangering
other precious fish resources and likely threaten the food/ population balance
in many countries. Whales are becoming one of the symbols of the environment
protection movement.
On whaling today there are four main options: 1) Sustainable whaling, including
sustainable pelagic, should be accepted. 2) Small type coastal subsistence
whaling should be accepted. 3) Scientific research whaling should be promoted.
4) Whaling should be prohibited absolutely.
Why is killing whales wrong? 1) Life is always intrinsically sacred (But the
whale is eating an enormous great number / amount of fishes.); 2) The whale is
with high intelligence (But there may be other animals with higher intelligence
than whale.) 3) The whale is not a fish but a mammal (But cows, pigs, and sheep
killed and eaten also in anti-whaling countries.); 4) The whale is the largest
creature on the globe (But the larger is not necessarily better than the
smaller since the larger needs more oxygen and water, and consumes more food.)
My personal views on whaling and the whale are: Whale/ human relationship
should be restudied not only eco-sentimentally as well as eco-potentially but
from view points of demography and traditional diet culture. Methods of
whaling, more exactly killing of the whale, should be more humanized.
Scientific pelagic research whaling should be promoted for the development of
whale biology and marine science. Definition of coastal whaling should be
widened to the "200-mile zone". Both Scientific pelagic research
whaling and coastal whaling should be sustainable, if necessary under the
supervision of IWC (International Whaling Commission). Whale biology is one of
the most important specialties in marine biology. And, studies in euthanasia,
sterilization, and contraception of whales are all urgently necessary. IWC
should be more globalised. In other words, I hope the IWC becomes more neutral
and it is possible to cover all whaling countries.
1-5pm A Healthy Global Environment
A comparative
study on the values represented in Japanese primary school songs
Shoichi Kuroda, Japan
The subject of this study is to select values of Nature, Society and Humanity
represented in Japanese and Korean Primary School Songs Words and to find how
they reflect the environment, with comparisons by area and time. In Western
areas like Europe and USA, there are a few if any school songs, except for some
private schools. But, they are popular in Asia particularly in Japan, Korea and
China. The existence of school songs is said to be the Culture of Japan.
In Japan, every public and private school has their own school songs in spite
of the fact that there have not historically been any kind of guidance directed
by the authorities concerned, even during World War. School songs have typical
characteristics which generally celebrate a natural view and history of their
neighbour and state their educational spirit which may proudly include a
historical big figure.
As a whole, school songs words seem to be affected by the values dominant in
the area and time, and I have studied 7000 in total. The songs words have
already been analyzed by some other papers limited from the view point of the
landscape structure and educational spirit and/or objective. In school songs
words, the latter is often personified in the former. Compared with other
papers mentioned above, the subject study includes not only the above analysis
but also classifying the school songs words connected with history, culture,
society, ideas and morals.
For this study, statistical analysis was performed using a computer for a
selection of words in the school songs. Environmental factors included
landscape [ Nature(landmarks, praise of others, air personified expression and
educational expression); cityscape and industrialized(both landmark, praising
other); animals and plants(praising others, personified expression and
educational expression); seasonalities like weather (praise others, personified
expression and educational expression); five senses, e.g. colour (praised
others). Except for five senses, all other factors were studied in terms of
history, culture and society, ideas and morals. Human relations factors were
also studied including teachers, forefathers, fellowship, sexuality, man oriented,
woman oriented, and youth; with respect to history, culture and society, ideals
and morals. Other associations of these factors were also identified.
In the paper I will present here, areas are classified into five characterised
groups where one city is selected respectively as listed below:1) Urbanized:
Yokahama city; 2) Industrialized: Yokkaichi city; 3) Suffered A-bomb: Hiroshima
and Nagasaki cities; 4) Harbours prosper: Kobe and Yokosuka cities. The era is
divided into two, before and after World War II. The latter is further divided
by ten year intervals. A total of 253 school songs were analyzed, excluding
Korea as shown [ for each city there are two numbers (before and after the
war)]: Yokohama (5, 38); Yokkaichi (1, 28); Hiroshima (13, 44); Nagasaki (10,
47); Kobe (8, 35); Yokosuka (0, 24); total (37, 216).
According to the analysis by area, the moral ideals and the hope for future are
frequently found in the personified expression of the songs words as indicated
[For each city there are two variables (morals and future; using a three point
scale of most, many, few): Yokahama (most, many); Yokkaichi (few, few);
Hiroshima (many, many); Nagasaki (most, few); Kobe (few, few); Yokosuka (many,
few).
The major concern of the total songs words by area included three ideas (peace,
world, self) to the following degrees: Yokohama (many, many, many); Yokkachi
(many, many, few); Hiroshima (most, many, many); Nagasaki (many, few, many);
Kobe (few, most, few); Yokosuka (many, most, any).
Extra regional concerns included for example, industrial complex ideas in
Yokkaichi, history in Hiroshima, culture in Nagasaki, mind and development in
Kobe. Trends over time will be presented. For example landmark gradually
decreases over time, while praising others and fellowship increases. Overall
school songs that are not appropriate in the current environment in terms of
the word meaning are still to be found. it is recommended that school songs
words are adopted or utilized in education for environment and ethics purposes.
A Bountiful
World for Posterity? Why Care?
Rick Weisburd, University of Tsukuba, Japan
A Bountiful World for Posterity - Why Care? Richard Weisburd, University of
Tsukuba, Institute of Biological Sciences
Many people are concerned about environmental degradation that will persist
long beyond the lifetimes of those humans living today. Yet many other people
seem to not care about environmental quality in the world we leave for our
descendants. Why do some people care? From where in our biology or culture does
such caring arise? Exploration of this question might yield insights that
facilitate coming together as a global society to deal with our environmental
predicaments in a rational, coordinated and effective way.
Let us consider and discuss the various possible motivations to care about
environmental quality on the Earth after we, as individuals, have died:
Among the possible sources of caring about posterity are the following:
Biology - Evolution
a. Selfish genes -- success is propagation into the future with increasing
numbers of descendants. Are we hard-wired to perceive Darwin's 'struggle for
existence' as crossing generational boundaries?
b. Biophilia - love of life. An evolved affinity for other members of our own
Quarternary biota. Clearly an association with an entire biota can cross
generational boundaries.
c. Altruism - We inherited a rich natural world; in fairness, our descendants
deserve no less of an inheritance.
Socialization -- Culture
d. Religion & Spirituality - Most religions recognize beauty and grandeur
in nature as an aspect of the divine. As the divine is generally considered to
be eternal and sacred, preserving nature can be seen as a spiritual imperative.
e. Secular Education - Environmental education provides a perspective on our
world that can lead to shifts in attitudes and values of societies over time.
f. Art - As expression of beauty often derives inspiration from nature, so to
can works of art inspire caring about nature.
g. Law - Although the timeframe considered in legislative processes is usually
too short to prevent some serious long-term environmental degradation, laws do
alter behavior and can restructure societies. Clearly new laws will be needed
to translate ethical imperatives related to the environment into changed
behaviors and condition.
h. Peer pressure & Fashion - The importance of fashion in shaping behavior
should not be underestimated. Marketing works effectively to change behavior,
often by appealing to fashion consciousness.
Please consider your own culture and beliefs. Where do you think caring that
extends beyond your own lifetime comes from?
Some
perspectives on a healthy global environment
Aruna Sivakami, University of Madras, India
A healthy global environment produces all round development and happy human
faces in all the parts of the world. This requires balanced and sustainable
economic development so as to benefit all people of all societies and all
nations in the world. But human development is not a concomitant effect of
economic development. When the links of economic growth and human development
are understood and appreciated and properly understood and implemented, with
policies and programmes and perseverance and determination, they can become
mutually reinforcing and the economic growth would effectively and rapidly
improve human development expressed as healthy and happy human beings. Thus
human development perspective has moved into the mainstream of healthy global
environment and development debate.
But this requires a drastic change in international and global production and
consumption relations and patterns that are conducive for human development.
Human development paradigms, which aim at enlarging all human choices, must aim
at enlarging and improving consumer choices too, but also be expressed in ways
that promote human life, in short "Love of Life". Globalisation
should reverse and minimize human impacts of environmental damage, particularly
the unequal impacts on the poor people and ensure environmental sustainability.
The future need not be gloomy if only declared countries cut down their demand
on energy and control environment, prevent loss of biodiversity and other
international environmental problems that aggravate the burden on the poor with
a host of health problems. In all experiments on human life, ethics and moral
should be adopted and observed scrupulously.
All this raises a number of important policy questions and ethical judgments on
the part of developed countries on behalf of humanity. Addressing all these
issues will result in effective and healthy global environment. This paper
describes and analyses different problems related to it and recommends proper
perspectives humankind should have for a humane world.
Agriculture and energy in Japan - 2000 to 2050
Tony Boys, Shion Junior College, Japan
e-mail: aboys@po.net-ibaraki.ne.jp
Energy will perhaps never be as cheap and abundant in Japan as it is today.
But the era of cheap and abundant energy (primarily oil) is drawing slowly to a
close. In twenty to thirty years' time it will probably not be possible to rely
as we do today on cheap and abundant energy sources to help grow, process and
transport food, or to make fertilizers and other agricultural chemicals. Japan
will have to rethink its agricultural policies, and its eating habits. By
looking at agricultural and lifestyle statistics over the last 120 years, it
should be possible to discern what Japan needs to do to carry out the
transition (return) to a sustainable way of life.
Degradation of
keratinous wastes by environmental friendly technology
N.S. Kavitha, Hilda Azariah
Centre for Advanced Studies in Botany, University of Madras, Guindy campus,
Chennai - 600 025 (India)
An enormous quantity of keratinous waste materials such as feathers, hairs
and nails are thrown into the surrounding habitat. Decay of keratin wastes in
nature, causes ill health to the environment, as they harbour pathogens and
produce foul odour. Hence the ethical value of the ecosystem is challenged.
In the present investigation, an attempt was made to clean up the environment
by ecofriendly technology. About 15 species of keratinophilic bacteria were
isolated. These isolated species were identified and characterized based on their
biochemical properties. Among the 15 bacteria, the highly potent Bacillus
pumilus, Bacillus laterosporus and Bacillus licheniformis were used for their
keratinolytic potential. The major component of feathers, hairs and nails are
keratin, is an insoluble fibrous protein. Keratin are not degradable by
proteolytic enzymes such as trypsin, pepsin and papain because of their high
degree of cross-linking by cystine with disulfide bonds (-S-S-), hydrogen
bonding (-S-H-), salt cross bridges and hydrophobic interactions.
The keratin degrading enzymes from these three species of Bacillus were
purified and used for the degradation of keratinous wastes. With the help of
such ecofriendly technology the keratinous wastes could be degraded. The
catabolic products such as protein, amino acids, cysteine and cystine were
released during degradation. Changes in pH and percent utilization of keratin
wastes suggest the possible waste disposal in the ambient environment.
Hence, it is possible to degrade the keratinous wastes accumulated in the
ecosystem and clean up the environment by using keratinophilic bacteria.
Environmental Ethics of Chlorine in Marine Biome
Dr. Jayapaul Azariah,
Director, School of Life Sciences, University of Madras, Guindy Campus, Chennai
600 025, India
Email: jazariah@md3.vsnl.net.in
Modern science considers the oceans and its wealth as a natural resource.
Oceanic water has been used as an industrial resource. Electric power
generating plants are mostly situated along the coast line due to free availability
of a massive volume of sea water. Such power stations use sea water as a cheap
source of coolants in nuclear /thermal heat exchangers. Any such industrial
application of sea water in power plants has an inbuilt and hidden cost.
Therefore, it is to be understood that there is no development with any
destruction.
Realizing the importance of the health of the oceans, the UN designated the
year 1998 as the year of the oceans since signs of stress are already visible
in the marine biome.
The present paper takes into account (i) the total volume of sea water present
in the biosphere, (ii) the number of nuclear power plants already existing and
proposed to be constructed (iii) the extent of industrial use of sea water in
relation to the units of power generated, and (iv) the amount of chlorine added
annually to sea water as an antibiofoulant agent so as to assess the health of
the oceans as the sea water passes through the once through flow system in
power plant situations.
The paper points out that under the current scenario of nuclear power
generation, it will just require a mere one and a half years for the global sea
water to be chlorinated. Since chlorine has the property of combining with
humic substances, formation of trihalomethanes (THMs) is inevitable. These THMs
are known promoters of carcinogen and currently there is no information on the
metabolic pathway and movement of THMs in the marine biome. As far as the Bay
of Bengal is concerned there is growing evidence to suggest that the sustainability
of the marine ecosystem is on the decline. Chlorination is considered as one of
the main reasons. Before the sustainability of the global marine biome is
destroyed it is suggested that NGOs like the All India Bioethics Association
(India) , Eubios Ethics Institute (Japan), Center for Asian and International
Bioethics (Israel) and Eco-Ethics Center (Germany) must evolve a global program
to impart marine science education with moral and ethical content.
Secretariat: Darryl Macer, (B515) Institute of Biological Sciences,
University of Tsukuba, Tsukuba Science City, Ibaraki 305-8572, JAPAN
Tel: Int+81-298-53-4662
Fax: Int+81-298-53-6614
Email < asianbioethics@yahoo.co.nz
>.
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