Guido Van Steendam, Ph.D.

Director, International Forum for Biophilosophy, Craenendonck 15, 3000 Leuven, Belgium

Email: Guido.VanSteendam@cs.kuleuven.ac.be

- Makoto Nakagawa and Darryl Macer

Institute of Biological Sciences, University of Tsukuba, Japan

One medical application of genetic engineering that has been widely discussed is gene therapy. Gene therapy has been discussed for several decades and used as in attempts at experimental therapy in clinical trials for a decade. The attitudes that the public have to this therapy has been surveyed through the use of opinion surveys in 1991, 1993, 1995 and 2000, in Japan. This paper presents the results of these surveys and examines the open comments that people made in response to being asked whether they would personally use gene therapy if they were suffering from a fatal disease.

There is little difference between the public and scientists in attitudes to gene therapy at the same time, but there is a significant drop in support from 1993 to 2000. Scientists in 2000 were twice as more likely to say "very unwilling" compared to 1991. This decrease is also seen in another question presenting a range of cases for gene therapy. Public respondents who were against using gene therapy to cure a usually fatal disease, like cancer increased from 5% to 18%. Rejection of enhancement remained strong, however to improve the intelligence level that children would inherit, we see a drop from 49% very unwilling to only 22% now.

The overall results find that the most common reason given to support gene therapy was saving life, and the most common response for disapproving were that it is unnatural or that it presented risks to health. In this paper we want to look at some of the key words resulting from this analysis and see whether the concerns have changed over time.

Juergen Simon, Ph.D.

University of Lueneburg / European Academy for Environment and Economy, Research Center Biotechnology and Law, Lueneburg, Germany

Email: simon@euroacademy.com

The principle of human dignity is a regulative fundamental starting point for the Bioethics and the law of Biotechnology. This is the conception of Germany and many other countries. But because of the different handling of artificial insemination, embryo research, predictive diagnosis, preimplantation genetic diagnosis, germ-line gene therapy, human cloning and actually embryonic stem cells in the various countries there has to be found out if the protection of human dignity has not become an unfounded formula which can be used for all kind of argumentation. In Germany, in juridical and ethical controversies the formula of the protection of human dignity will help to displace each opposite conception from the bottom of the Constitution. Finally human dignity can be understood as flexible and dynamic ãgeneral clause" to help changed point of views to come to stay and to contribute to a social consensus.

This argumentation neglects the active part of human dignity, the development of personality in form of autonomy and free self-determination of the individual person. Both sides, protection and autonomy, and the regulative aspects should be treated in the lecture.

Dorothy Wertz, Ph.D.

Shriver Centre, Boston, USA

Email: DWertz@Shriver.org

A pioneering study in 1984 of ethical views of 683 geneticists in 19 nations by Wertz and Fletcher demonstrated that 62% of geneticists were sufficiently interested in ethics to respond to complex, lengthy ethical questions presented as case vignetts in a mailed anonymous questionnaire. A larger study in 1995 included 2901 geneticists (63% of those asked to respond) in all 36 nations with ten or more practicing medical geneticists. Both studies had some weaknesses: they left out much of the developing world where there are few geneticists. Some questions were based on ethical problems experienced primarily in North America and Europe; language translations were perhaps not always cultural translations.

Nevertheless, the 1995 survey provided some global outlines for discussion. Some major findings: A growing trend toward respect for patient autonomy is threatened by purposely biased counseling that the patient may not realize is biased. In most nations (except in North America, the UK, Australia and South Africa, which are influenced by UK traditions), the majority of geneticists would provide intentionally slanted information after prenatal diagnosis, most of it pessimistic, so that the patient would what the counselor thought best without the counselor suggesting it directly,. Most patients have little recourse if biased information is presented as medical "fact." Globally, geneticists hold a pessimistic view of disability, even in countries with good services for people with disabilities. There is still no consensus about balancing the needs of genetic families with needs of individuals for privacy.

- Baoqi Su & Darryl Macer

Beijing Capital Medical University; and Masters Program in Environmental Sciences, University of Tsukuba, Japan

Email: subaoqi@hotmail.com

Since the 1980s China has been in transition and has undergone rapid social and economic change and development. We will explore the issue of healthy babies. This is a very broad topic, covering not only issues from the Chinese eugenics debate, as it relates to genetic screening, sterilization, and marriage laws, but generally maternal and fetal health. China's one child family policy may be on factor in gender biased and sex selection. There is evidence of neglect of female babies that may be an indirect consequence of small family size. Earlier survey questions regarding genetic screening and gene therapy suggest positive support for eugenics among a significant portion of the population, especially in China, as well as India and Thailand. The 'Mothers and Infants Health Care Law' of 1995 will be discussed. Healthy babies is a very broad topic, covering not only issues from the Chinese eugenics debate, as it relates to genetic screening, sterilization, and marriage laws, but generally maternal and fetal health. There are also non-genetic interventions being used to reduce birth defects. One of the simplest remedies that is now being introduced is prenatal and preconception folic acid, to lower the risk of spina bifida; and neural tube defects).This will also consider treatment of sick babies (Down�fs syndrome or Trisomy 21).

- Philip Webb

Human Genetics Commission, UK

Email: PAWebb01@aol.com

UK Government Review: Last year the UK Government carried out a public consultation on developments in the biosciences and also reviewed the advisory and regulatory framework for biotechnology. The public consultation found that: a) people have a low awareness of scientific and technological advances b) although people see medical advances as being of greatest benefit they are suspicious of all advances in biotechnology where they cannot identify direct benefit to humans c) people see effective regulation as being extremely important d) Government advisory bodies are generally a trusted mechanism for decision making but should be broadly based e) there is a demand for as much public information as possible and Government advisory groups would be a trusted source

Need for a New Approach: The Government concluded that a new approach was needed and decided to set up a new, comprehensive strategic advisory structure for biotechnology that took much greater account of the views of the public, environmentalists, ethicists, the industry, medical practitioners, patients and consumers. As a result, the Human Genetics Commission (HGC) and its sister body, the Agriculture and Environment Biotechnology Commission (AEBC) were set up.

The Role of HGC is to consider the potential impact of developments in genetics for humans and healthcare - in particular, the ethical legal and social aspects of such developments.

Broad Membership is reflected in the wide range of disciplines and backgrounds from which membership of the Commission has been drawn, including ethicists, law, industry, patients, consumers, social scientists, geneticists and other healthcare professionals. I was particularly pleased to be appointed to the HGC, having previously served more than three years on the Advisory Committee on Genetic Testing. As well as being a member of the Human Genetics Commission I Chair the Sub-Group on Genetic Testing, that considers the technical, social and ethical impacts of such testing.

What will the HGC do? The Human Genetics Commission will look at the �gbig picture of where developments in human genetics are heading and what regulatory and advisory frameworks are needed now and in the future. It will need to be aware of what is happening internationally aswell as nationally in order to advise Government Ministers effectively.

How will HGC work? HGC will carry out its work in an open and inclusive manner, so it can quickly gain public respect and confidence. A crucial part of its work will be to promote public debate through public meetings and the media and to consult widely using a range of different approaches and techniques including papers, questionnaires, focus groups, polls and conferences.

HGC Workplan: After much consideration and public consultation, the HGC has developed a workplan and top of the list is the storage, protection and use of genetic information. This will form a major part of HGC�fs work over the next year and to enable this to happen effectively, a Working Group has been set up to take this forward.

In this presentation I have given you just a few of the many complex and important issues facing us now and in the future. To carry out public consultation and produce guidelines for all those involved in the storage protection and use of personal genetic information is a huge task, but I am certain it will be done well and be of great benefit to society !

Yanguang Wang

Center for Applied Ethics, Chinese Academy of Social Sciences, Beijing, China

Email: Email: Ameliaw@ihw.com.cn

The 21-century could be named as the era of Genetics knowledge and technology. Ethical, legal and social implications of the genetics knowledge and technological applying create many issues for Bioethics. Predictive and therapeutic knowledge following genotyping for drug metabolism and genetic disorders will allow individuals to gain access to safer and more efficient medicine and to provide them with individualized health risk profiles. Thus, genetic information contributes to individual self-determination and health literacy.

However, new moral risk included risk to privacy and family relations, exploitation and discrimination come associated with genetics knowledge. Thus, Preliminary policy recommendations will be presented for the protection of individuals, cultural, and societies. A questionnaire including physician ethics and carrier ethics for an empirical study among the Chinese was made. Questions include that "Must the physician ask carrier to inform all members of family?" "Does the physician has moral rights and a legal obligation to inform all members of family?" "Do carriers have the obligation to inform family?" "Do minor genetic disorders warrant disclosure and so on. From the Chinese evaluation by responding on a scale from strongly agree to strongly disagree, Chinese views on genetic information have been revealed.

Fumi Maekawa and Darryl Macer

Institute of Biological Sciences, University of Tsukuba, Japan

Contact Email: Macer@biol.tsuukuba.ac.jp

A report on the methods being used to assess the development of bioethical reasoning skills in students at the University of Tsukuba, after ten years of bioethics classes. One of the central questions of bioethics education is does education actually work? What impact does education have on the minds of the receivers, and providers? In order to examine the styles of education, we are conducting a long term analysis of the homework and comments that students gave in all the bioethics classes of Darryl Macer, since 1990, in the University of Tsukuba. This work is still in the early stages, but we want to share some results and to discuss the methodology and get your feedback.

To examine whether students are becoming more discerning about technology, the most objective records we have is a complete set of photocopies of all homework made. We then look at the common ideas and thoughts expressed in student reports. Overall there are well over 6000 homework reports to analyze. We will just present the results of a set of 12 persons who, as second year students, took the Bioethics and/or Bioethics and Genes class in the year before the compulsory English discussion classes, to give an example.

Shinichi Shoji, M.D. and Katsuko Kamiya, Ph.D.

Institute of Clinical Medicine, and Institute of Community Medicine, University of Tsukuba, Japan

Email: sshoji@md.tsukuba.ac.jp

Clinical anthropology class is an educational method characterized by 1) to consider concrete clinical scene which must make the immediate judgment that is related directly to birth, aging, illness, or death, 2) to consider as a problem of self at first, 3) the discussion of the small group by various people, and 4) to consider life of the self and the significance. Course was started multidisciplinary subject the clinical anthropology for the general student of all major fields in fiscal 1996. The enrolled student number increases year by year, and 400 persons are exceeded in fiscal 2000, and 30 seminar rooms are used. Actual class progresses as following, presentation of the scene, presentation of representative opinions, information of necessity minimum necessary for the judgment, questions and answers, small group discussion, general discussion, presentation of tutors private opinion, and writing students own opinion.

Purpose: The change of the consciousness of university student by this class is examined.

Object and method: The questionnairing was carried out to the student of the attendance in the last class in fiscal 1999. The representative opinion of each problem was raised, and just before class and present idea was described.

Result: The opinion of the student significantly changed in before and behind of the class for following problems, the utilization of the surrogate mother, the positive euthanasia, that other child is produced as a candidacy for the donor of the bone marrow transplantation to the child, the fetus was proven with the Down syndrome, the organ transplantation of the child of the self who becomes brain death, the sterilization of the sister of the self with the intelligence lowering, and the emergency operation of the self of the HIV positive. The opinion did not changed significantly for following problems, the nurture for the organ transplantation of an anencephalic infant of the self, the mercy murder, the birth of the child of the woman homosexual, and man and woman sexual selection.

Conclusion: The opinion of university student changes according to the theme in before and behind of the clinical anthropology class.

Miyako Tachibana

Haneda High School, Tokyo, Japan

Naoki Shiraishi,

Adachi-shinden High School, Tokyo, Japan

Email: naokis@aay.mtci.ne.jp

Over the past decade I have been trying to introduce bioethics to senior high school biology students (the last 3 years of secondary school). I hope to help students make biologically right judgments to bioethics questions after understanding. I will focus on the classes and surveys conducted in these classes on the topic of brain death. There are differences between two schools I have taught at, and the factors relating to this will be discussed.

- I. C. Verma, M.D., Ph.D.

Senior Consultant and Head, Department of Medical Genetics, Sir Ganga Ram Hospital, New Delhi 110060, India

Email: icverma@del1.vsnl.net.in

Genetic disorders cause a great socio-economic burden in India, due to the accelerating demographic switch from infectious and nutritional to non-communicable disorders, a high birth rate, large number of consanguineous marriages, and lack of rehabilitative facilities. For reducing this burden genetic counseling is the most important method, in the absence of satisfactory therapy for most genetic disorders.

Genetic counseling can be defined as the application of genetic knowledge to help the individual patient or a community. Predictive testing and counseling are a specialized category. Counseling involves diagnosis of the disorder and its inheritance, and conveying the information to the proband best suited in his socio-economic context. Thus the ethical issues involved in genetic counseling and predictive testing vary in different countries.

An important ethical issue in genetic counseling in India, as in many other countries, is its denial to the poor and deprived. This is due to lack of information, as well as their high cost. Secondly while in the West, non-directive genetic counseling is the hallmark, in India due to the poor knowledge of the people in science and in probabilities they want directive counseling. The choice regarding the final course of action they keep with themselves. In making that choice women have less say. Prenatal diagnosis of genetic disorders is easily accepted due to the burden of treatment of genetic disease as well as approval accorded to abortion by the government. For example, in India there is a much greater demand for prenatal diagnosis in hemophilia and albinism, as compared with the western countries.

In India, the presence of a son in the family is highly desired, especially in business communities, and in those families where there is already a child with disability or genetic disease. If the couple already have one daughter, another daughter is not desired and if the fetus is female such couples readily opt for abortion. One feels sympathetic with their views, although the Government has thought it fit to pass legislation not to allow sexing of the fetus for social reasons and has banned the abortion of a female fetus. This measure has, however, been only partially successful in stemming such abortions.

Predictive genetics involves testing and counseling of someone who is currently normal, but at risk of inheriting the mutant gene as in autosomal dominant disorders. The situation is trickier in testing for genetic susceptibility disorders such as Alzheimer�fs disease, diabetes mellitus, coronary artery disease, hypertension, and inherited cancers. There are limitations and risks of susceptibility testing as one deals with probabilities, not certainties.

We have counseled about 50 subjects from families with Huntington disease, myotonic dystrophy and spinocerebellar ataxias. Benefits of such testing are that a negative test creates sense of relief, and eliminates the fear of being affected in the future. A positive test on the other hand may cause great worry, and result in depression and even suicide. It does however relieve uncertainty, and can lead to informed decisions about the future. One cannot apply the usual criteria laid down in the west, as the situation is vastly different in India. There are very few geneticists for one. Secondly distances are large and patient may come for the test once, but may not be able to come for the subsequent counseling after the result is known. One often has to explain all this on the telephone. Indians are fatalists and are willing to accept the apportioning of the genes as a fate willed by God. As most people live in joint families there is tremendous support by the other family members in the hour of need.

Of 17 families with Huntington disease three families refused the diagnostic test in the symptomatic subject saying that if there is no treatment then why test. International guidelines suggest that after counseling there should be a gap of at least one month for the asymptomatic persons to decide whether they really want to go through with the diagnostic test, when the counselee has come from a distance of 1000 km to have the tests it is difficult to adhere to such advice. Ten affected subjects after counseling immediately expressed the desire to test their offspring to enable them to plan their future. In this group of patients all the families, except three, opted not to have predictive testing in the offspring, after the pros and cons of this course of action were explained to them. In a family where the father was a doctor one daughter came for asymptomatic testing. She was to go to USA, and wanted the test in order to plan her future. She was found not to carry expansion of the triplet repeat, and was thus assured that she would not get the disease in the future. This brought great relief to her. Subsequently the other sister, who is married and is working as a physician in the USA, also opted for the test. She turned out to be carrying the expanded allele, and is therefore likely to develop the disease. She is now planning a pregnancy, and would like to have genetic testing in a future pregnancy. She said she would not like to have this test in USA and would come to India for the test, in order to avoid any possible discrimination by the insurance companies in USA.

One 50-year-old subject was one of many in large family who were affected with spinocerebellar ataxia. Initially the disorder remained undiagnosed. Then suddenly with new information that became available it was identified that the family had SCA type 12. He had two children �\ one 21-year-old daughter and one 19-year-old son. He was very keen to know their results. They lived in another city and there was no medical geneticist in that city. Although I resisted initially, then I gave in and provided him the results of the analysis in his two children.

Privacy of the person tested has to be respected, and the knowledge gained has to be protected from family members, insurance companies or employers. Very few people in India are presently insured for health. Whatever little health insurance is available, will not provide coverage if the disease is congenital (i.e. present from birth, which includes all genetic diseases). The geneticists, genetic societies and patient groups must lobby to prevent this discrimination by the insurance companies.

It will be some time for the Indian doctors to become familiar with the new scenario brought in by the molecular technologies, and utilize it for the benefit of the people. However, genetic testing remains a delicate issue and needs to be tackled with care and sensitivity.

- A.K. Tharien, M.D.

Christian Fellowship Hospital, Oddanchatram, Tamil Nadu, India

Email: cfhospital@eth.net

AIDS and the entire spectrum of diseases connected with HIV infection is pa pandemic that threatens progress in human rights and society. India has more people infected with HIV than any other country in the world. In India about 80% of the transmission is by sexual contact. This paper will discuss the Indian situation, and a variety of ethical issues faced by persons with HIV.

- Kaustuv Nayak

Department of Zoology, Loyola College, Chennai-600 034, Tamil Nadu, India

Email: Kaustuv_Nayak@ hotmail.com

The rate of HIV infection is very high in India. AIDS patients and others infected with HIV face discrimination of various sorts the world over, and high cost and the long- term nature of treatment aggravate quandaries that occur to a lesser degree in other serious diseases. Major battles revolve in particular around ensuring access to therapies and testing new ones in an ethical manner.

Fear of contagion has some times led to discrimination against HIV infected people not only by the public but also by medical personnel. Yet discrimination is only one of the ethical issues that HIV has raised for medical professional and the society. Disclosure of HIV positive status of a patient will only lead to stigmatization and social ostracizes. The rate at which science and technology is advancing brings into our view the ethical and social issues are concerning AIDS vaccine trials.

Though the alarming situation with respect AIDS infection demands the need in the future to go for mass screening tests, how the society and patient will react to open disclosure of HIV infection needs careful study. The trauma a �epatient�f under goes under the cases of false positives he is also looked into.

The protection of human rights is essential to stop the spread of HIV, and to ensure that every one has access to information and education about it to the means of preventing infection to an environment supportive of behavior change. To be ethical our responses must be both honest and humane.

Annabelle Rajaseharan, M.D.

Annabelle Rajaseharan, Archana Bhaskaran, Priyavarthini, Parvathavarthini

Institute of Pharmacology, Madras Medical College and Research Institute, , Chennai, India.

The entry into the medical college seems to be the most attractive of all choices open to those who want to become professionals. However the exodus of doctors is ever increasing despite the implementation of more stringent laws. The reason why medical students work towards their goal, while still undergraduates, may be complex. Their value preferences in view of the future what they want for themselves and what could possibly be their goals were analyzed. A survey of the relative value preferences of Medical students like their urge to earn, do research, have good amiable working conditions ,a challenging job, preference to teach, was done with the help of a modified questionnaire constructed by our national experts in behavioural sciences.

The paper summarizes the analysis of ethical values among medical students with special reference to the Indian ethical scenario.

Ralph Seewald, Ph.D.

The Netherlands; and at Kyushu Institute of Design, Fukuoka, Japan

Email: seewald@rms.kyushu-id.ac.jp

Both in the West and in Japan anthropologists have commented on the reluctance of the Japanese to accept organ transplantation as a standard form of treatment. The assumption is that elements in the Japanese culture; like the Japanese folk religion, view of the dead body, and distrust in the medical profession make it very difficult to see organ transplantation as an acceptable medical treatment. I will report the results of a survey on the attitudes of Japanese nurses toward brain death and organ transplantation; and the beliefs of Japanese nurses about bodily remains as related to organ transplantation.

Masahiro Morioka

Integrated Arts and Sciences, Osaka Prefecture University, Gakuencho, Sakai, Osaka 593, Japan

Email: PBI01055@nifty.ne.jp

- Ivan Segota, M.D.

Medical Faculty, University of Rijeka, Croatia

Email: ivans@medri.hr

The appearance of the first Encyclopedia of Bioethics, 1978, which gave a definition of bioethics ("Bioethics is the systematic study of human conduct in the area of the life sciences and health care, insofar as this conduct is examined in the light of moral values and principles") and soon after a capital bioethics work "Principles of Biomedical Ethics", 1979,by Beauchamp and Childress, made an essential link between bioethics and ethical principles, especially with their four main principles: Autonomy, Nonmaleficence, Beneficence and Justice. However, the criticism of their and encyclopedic principlism followed and it eventually resulted in the fact that a new definition of bioethics in the second, revised edition of Encyclopedia of Bioethics, 1995, did not mention principles as essential guidelines of bioethics ("Bioethics is the systematic study of the moral dimensions - including moral vision, decisions, conduct and policies - of the life sciences and health care, employing a variety of ethical methodologies in an interdisciplinary setting"). The author in this paper discusses both definitions in the light of the criticism of principlism and the replies to that criticism by Beauchamp and Childress, and Warren Reich, as the editor-in-chief of the both editions of Encyclopedia of Bioethics.

Jacqueline Simon, Chemical and Biological Warfare Project, Stockholm International Peace Research Institute, Sweden

Email: jsimon@sipri.se

This presentation will address the role that ethics, and ethical codes more specifically, can play in scientific professions involved in research applicable to chemical or biological warfare. Both biological warfare and biotechnological advancements are hot topics in the media of late, but there is little awareness of the links between the two issues. The application of biotechnological advances to warfare has rarely been discussed outside security studies, and ethical issues are rarely raised in the security forum. There is a need to bridge this gap and to increase awareness among researchers of the ethical implications of their work.

This issue remains important despite the existence the Chemical Weapons Convention and the Biological and Toxin Weapons Convention as both international treaties allow for research for defensive or prophylactic purposes. The problem is that much of this research and technology, especially in the field of biology, is dual-use �\ that is it can be used for peaceful or hostile purposes. As a result we cannot rely upon regulations to ensure that chemical or biological weapons are not created or used, we must also attempt to influence the individual researchers who perform this research.

A survey of the various professions involved in applicable research reveals a dearth of ethical codes in these professions. Moreover, there is an absence of ethical content in the education that these researchers receive. In addition, there is a lack of education on the international legal and normative prohibitions that apply to certain types of research. Steps to remedy this situation and increase awareness about this important issue will be the focus of this presentation.

Alireza Bagheri, M.D.

Iran; currently, Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan

Email: bagheria@yahoo.com

Biomedical advancement and the discovery of new methods in diagnosis and treatment of the diseases are due to of medical research. No doubt, that all of these new methods are not free of risk, furthermore that animal testing might not guarantee the same results in human subjects. Therefore all of these new treatment methods might be tested on human subjects. Today developing and revising of ethical codes in biomedical research and the establishment of bioethics committees in order to protect of human subjects is one of the world`s more important priorities in biomedical research systems.

As are cultural, social and religious considerations which are important in the establishment of such codes. some differences related to the afore-mentioned factors exist among different countries. In this paper the influence of religious and cultural issues to develop of ethical codes and also the role of bioethics committee will be surveyed.

Christine Thayer, Conservatoire National des Arts et M_tiers, Paris, France

Email: thayer@cnam.fr

As the general public in Europe struggles to come to terms with the complex problems of oil spills and food contamination within the context of a modern industrial society, governments have felt obliged to respond to the anxieties felt by voters. The first reaction has been to seek inspiration elsewhere, and in this case, the example of the American Food and Drug Administration with its Centre for Food Safety and Applied Nutrition seemed like a useful model.

This paper seeks to analyse the reactions in France and the United Kingdom to these issues and to examine in some detail the background to the setting up of, and the powers and modus operandi of the new agencies. The analysis will take place against the background of the European Union�fs action in this field. The possible role for a European Food Safety Agency, as proposed recently by Romano Prodi, President of the European Commission, will also be examined.

M.K. Tadjudin, Chairman, National Accreditation Board for Higher Education, Jakarta, Indonesia.

Email: tadjudin@ban-pt.or.id

Globalization has a great impact on political and economic structures, lifestyles, even to communities, families, and personal identity. The frontiers between State, Market, and Culture have been breached and may cause instability. For me the keyword in globalization is sharing, preferably through networks. If only the aspects related to competitiveness is put forward, then the developing countries will suffer. According to he Brundtland Commission Report "Our Common Future", development is sustainable only, if we ensure that present development is not the result of a mortgage of the future.

Ethics is concerned with what is morally good and bad, right and wrong. Although most concepts of what is morally good and bad, right and wrong are universal or global, there some concepts which are different in different societies. Most of the developing countries are nation-states and in the era of globalization these nation-states, which are mostly welfare-states and poor, is being attacked by globalization in the form of multi-national corporations or non-governmental organizations. They are being pressured to privatize, transform itself into a free-market system, and adopt global standards of ethics.

Bioethics is especially concerned with biological research and the applications of that research. Most of the basic research in biology, even those using materials from the developing countries is done in the developed world and because of its commercial value the intellectual property rights are strongly protected. Some traditional technology have also been researched and the results patented. This may cause people in the developing world to be unable to use their traditional technology legally because that technology is now protected by patents. The big question on bioethics applied to developing countries is whether we should adopt an "ethic of outcomes" principle which assumes that we have a moral duty to produce good outcomes for people irrespective of who has been responsible, or an "ethic of responsibility" which assumes responsibility only for past wrong doings caused by ourselves. If we believe that it is our duty to relieve poverty in the developing countries, irrespective of past wrong doings, then the general approach should be an ethic of outcomes.

- Wardatul Akmam

Lecturer in Sociology, University of Rajshahi, Rajshahi, Bangladesh.

Currently, Ph.D. student, Institute of Agricultural and Forest Engineering, University of Tsukuba, Japan. E-mail: akmam@jsrsai.envr.tsukuba.ac.jp

From a sociological point of view, illness and mortality are products of certain socio-economic, socio-demographic and socio-psychological factors like income, occupation, education, and social class. In my paper, I reflect on the relationship between maternal education and the survival and health of children in developing countries, with special reference to Bangladesh. My aim is to find out the ways in which maternal education influences the survival and/or health of children in these countries. Also, I focus on the question, whether maternal education can be used as a strategy for reducing child mortality, and what its limitations, if any, might be. Moreover, I suggest some possible interventions based on the facts revealed by the studies carried out so far in this field.

In the course of discussion, I want to reflect on these issues: (1) the extent to which the function of maternal education can be attributed to overall socio-economic conditions, (2) the mechanisms through which maternal education can help reduce child mortality, (3) the relative importance of general education and health education for children�fs survival and health, and (4) maternal education as a strategy for children�fs survival and health. It has been found that even though education is very much intertwined with overall socio-economic status, it does have a perpetuating effect on the survival of children in Bangladesh, if not equally so, in other countries. Although health education may be effective for short-term purposes, it cannot be a substitute for general education. Maternal education is important to better ensure children�fs health and survival, provided that the people have sufficient income and the appropriate environment and facilities, to put their knowledge to use.

Briama N'bemba Balde and Vasco Ambal Alberto,
AGECARE (NGO), Guine Bissau

M. Selvanayagam, Fr. Francis P. Xavier S.J and Ramya Peter

LIFE, Loyola college, Chennai-600034, India

Email: selvam@xlweb.com

Human life affects other organisms and the environment and its always will. We can see the effects of human activity everywhere in the world, from the atmosphere to the ocean from the poles to the tropics and from the coastal lowlands to the highest mountains. The amount of land that we use to live in and grow our food, the amount of resources we use and the substances and wastes that we produce, can be easily seen.

At no time in the past has nature been more dynamic than today because humans are rapidly changing it. In the midst of growing awareness of environmental change and damage we should be aware of the need for sustainable living. Sustainable living involve not just efficient agriculture but also minimizing our energy use and pollution.

In the long-term the most important approach is a lasting change of human attitude to those that are compatible with sustainable life. We need life style change, we cannot isolate any environmental problem from the whole crisis of modern life. The environment is influenced mainly by human behaviour, national and international development, economic and politics. This paper will focus on the most important change required for sustainable living namely, life style change and bioethical maturity.

June Levinsohn

P.O. Box 303, Putney, Vermont 05346, USA

Email: june_levinsohn@hotmail.com

Soon after the French and Spanish landed on the Caribbean island of Hispaniola 5 centuries ago, it soon become known as the 'pearl of the Antilles' because of its abundance of natural resources, wonderful climate, and lush tropical beauty .Today, its composite environmental/ecological problems constitute a primary national emergency with eventual international environnental consequences. A land that was once 94% forested is now almost completely desertified, with 3% forest cover remaining. No suprise, either, that Haiti is the most impoverished country in the Western hemisphere as it continues to lose ground, literally and figuratively, its scant remaining topsoil washing easily off the bare hills by heavy seasonal rains. This presentation will look at the (unfortunately) uniquely human causalities behind this disaster - political, cultural, economic - and its continued, cumulative downhill course - using the rural mountain settlement of Jansolm , Commune de Jeanrabel, Section Nord-Ouest , as illustrative of what we have all come to know so well - that everything is inter-dependent/inter-related . A short look at an American-orchestrated 'intervention' , the total annihilation of the rural peasants' principal security, the native Kreyol pig, should underscore how short-term 'profit' for some is little more than long-term misery for others.

Rev. E.W. Christopher

Pastor, The House of Prayer, No. 2, Sardar Patel Road, Chennai 600 113. India.

The only people to have enjoyed a healthy global environment were Adam and Eve. It is stated that Adam lived for a astounding period of 950 years (Gen 5:5). In the Old Testament it is reported that people who lived before Noah lived for a longer time. The life expectancy was in the order of 800 plus years. However, life expectancy of people who lived during the post Noah's was drastically reduced. The Bible states that the life span of modern man is about "three score and ten" years (Ps.90:10). The secret of such longevity of people was the prevalence of a healthy environment without much pollution. However, the present day man always goes in search of the earlier utopian environment, which is fast becoming a rare phenomenon. It is possible to regain the erstwhile situation during the post civilization era or post western Christian era?

One of the principal reasons for such a situation is that of human interference with nature. A decline in life span, as recorded in the Bible, may be traced to anthropogenic activities like interference with the ecosystem, uncontrolled exploitation of natural resource, rapid and unplanned industrialization, various types of pollution and the absence of environmental auditing. Incidence of wars in different parts of the globe and acute famines are yet another major cause for concern. It is known that such undesirable change in the ecosystem and total environment affects public health.

Public health related pollution areas are water pollution both chemical and pathogenic microorganism, deforestation and acid rain, oil spillage, automobile exhausts (carbon monoxide and lead) and radiation due to nuclear explosions and accidents.

The paper stresses the need for a change in the outlook of human beings. It is recommended that peoples attitude should change from a mere materialistic way of life to spiritually mined life style. The paper examines some spiritual principles that enabled human beings to mind the environment and ensured public health. The paper also recommends that spiritual cosmic outlook of life may reduce the incidence of life destroying technological practices and enhance the sanctity of human life.

Sayoko Kanamori, Tomokazu Kawashima & Mutsuki Kuwabara

College of Biological Sciences, University of Tsukuba, Japan

The results of a survey among young people on their attitudes to recycling and the environment, to pets and animals, and of their behaviour during animal loving week are presented. We also want to know whether animal loving week is used as a method of making school students appreciate animals in other countries, in addition to Japan.

Michael Morris, Ph.D.

Faculty of Systems Engineering, Dept. of Environmental Systems, Shibaura Institute of Technology, Fukasaku 307, Omiya-shi, Saitama-ken 330-8570, Japan

Email: michael@sic.shibaura-it.ac.jp

Environmental courses in Japanese educational establishments are often taught by foreigners with limited Japanese language ability. Barriers to communication mean that it is often difficult to teach the subject in any depth. One solution to this problem is to publish environmental text books in simple English. Another is to give practical, rather than classroom based courses. I have had various positive comments from students after using this approach at Shibaura Institute of Technology. Students have learned to grow crops on the campus field, to observe the behaviour of woodlice, and have been on field trips to various local and artificial ecosystems. This approach does not need a great deal of language ability, but has been effective in getting students to actually become aware of what is under their noses. Overseas teachers concerned about language barriers should therefore not be discouraged from teaching in Japan.

- Natarajan Rajalakshmi, Ph.D., S. Poonguli, Ph.D., Hurjit Singh

Department Of Economics, University of Madras, Chepauk, Chennai 600 005, Tamil Nadu, India.

Email: rajall@hotmail.com

Health and development are closely inter-linked. A poor state of health slows down economic development and insufficient economic development perpetuates a bad state of health. Health is a pre-requisite as well as an integral part of development.

Ethics of health and water pollution problems and diseases related to water pollution are main focus of this paper. The human environment has been defined as the aggregate of all social, biological and physical or chemical factors which comprise the surroundings of man. Environmental hazards relate to the chemical, physical and biological changes in the environment through contamination or modification. The chemical nature and biological behaviour of air, water, soil, food and waste as they are affected by man�fs agriculture, industrial and social activities.

The study of the input of water pollution and health reveals series lacunae. A sample taken from the hand pump of a house showed the worst possible contamination and impurities. The most probable number of coliform bacteria per 100 ms. water was alarmingly high at 34,800 where it should have been zero. Similarly, the total colonies per ml. on agar at 37^oC was 1,850 where it should have read zero for disinfected water and 10 for non-disinfected water used for rural distribution.

The water was not found feasible chemically with high iron content at 4.50 mg/l (permissible limit 0.3 mg/l) for drinking water. The report said, �gThe water has picked up turbolity and iron due to some leak in the distribution line�h. Though necessary in required quantity, such high iron content can cause malabsorption syndromes, anemia, eosonophilea, vitamin deficiency and in extreme cases paralytic illness.

Massive improvement can be made in health, economic efficiency, and equally through better provision of sanitation and water. The key is firmly in the hands of governments and policy makers.

Dipankar Saha, Agriculture Research Service Scientist, Indian Council of Agriculture Research, IGFRI, Jhansi-284003, India

E-mail: dip@igfri.up.nic.in

C.R. Hazra, Agriculture Commissioner, Ministry of Agriculture, Govt. of India, Krishi Bhawan, New Delhi-110001, India

Individuals in every spheres of life as well as organizations in many fields, by their values and the sum of their actions, will have to shape the world environment of the future. For the past two decades various institutional developments have proceeded in parallel and close associations with the evolution of international policy and philosophy on environmental issues. But a major share of responsibility lies ahead on the part of the individuals, communities, associations and societies at large in order to achieve the goal of protecting and improving the environment for future. At community level, individuals can create awareness among other individuals and communities by educating them in the field of environment and particularly the extent to which the natural resources could be harnessed so that they can meet the needs of the coming generations. How to inculcate this sense of responsibility and awareness amongst the people on the Earth is another major issue that emerges in the context of environmental bioethics. While individual circumstances and priorities differ, the ethic of care for "People" and the "Earth" has to be universal. By recapitulating the word of Prof. Rane Dubos, the late well known bacteriologist i.e. "think globally act locally" can help in bringing about a desirable ecological state of affairs. Exposition of newer ecoparadigm enforcing us that the age-old features is not supposed to be kept under an oblivion. The ecolinguistics expatiate the bioethical resolutions play a havoc when multiple demands on resources call for solutions and conflicting objectives of different users and interests groups are in oscillation. Agriculture being into the crux of Indian economy and that too specifically the range resources mobilisation has become altogether a different dimensions with respect to environmental resources conservation as well as its multifold productivity regeneration. A multianalogised microwatershed developmental module in Indian semi-arid tropics is proved to be authentic in multi-resource range management wherein the biosystems' goal functions can be perceived to be governed by multiple decision makers. This paper is an exposition of diversified reflections with a multianalogous perceptive network of microwatersheds microcosm for greening the range lands with the help of rural resources development clearly depicting also the adopting principles of ecorestoration and developing principles of ecolinguistics. For us, responsibilities , limits and restraints must be self- directed rather than externalized . This is our global duty towards the environment; let us make it a part of not only our local culture and tradition but also an integral part of universal consciousness, vision and acceptance. But, in order to raise the human spirit and create a world wide family or community of ecologically sound and sustainable order ,an universal charter of environmental bioethics is required.

The Government Nominated Committe is above the Elected Municipality in Tikapur - Radha Kandel Koirala,
Coordinator : Women , Environment & Sanitation Program, Tikapur Municipality , Kailali , Nepal
Email: kandelradha@hotmail.com

Tikapur Municipality is located in the farwestern region of Nepal. It is situated in the western bank of river Karnali on its eastern parts & the other side of the river is Bardia National Park. Before 1996 it was just a Village Development committee.

In Nepal Tikapur is the only planned and new settled municipality. Forty years before there was a dense forest with wild animals. The government constituted a committee which sold the land to the people . All over Nepal this is the only town which is developed in a planned way & it is now the main market to the surrounding villages especially the local Tharu tribes. Due to the well managed modern school, the town became a educational center of the region.

Tikapur municipality is 14 k.m south from the national highway or the east west highway. Most of the roads in the municipality are muddy , only few kilometers is graveled. The link road to the highway also black-top. In the rainy days the municipality become an island. The mayor Mr. R.P. Sanjyal personally and the municipality board time and again demanding the blacktop road, with the government of Kathmandu. After a long process the bridge construction is over .

Last month in the municipality council meeting mayor Mr. R.P Sanjyal presented the programs and policy . The municipality is mobilizing its resources to uplift the Badi community women who are involved in flesh-trade. In the same way the municipality is planning to settle with employment to more than 400 land-less Kamaiya's who were recently freed by the government from bonded laborer. The municipality is planning to provide clean and hygienic water to the people. Most of the villagers, out of the town have no habit of using toilet. Under a sanitation policy , we are encouraging the villagers to use toilets.

When there was a dense forest , population was very low and the life was very natural . Now everything has changed but people in villages are not changing their habits . So we are facing different types of environmental and sanitation problems.

The main problem it faces now is power centralization. The government has nominated Tikapur Development Committee. All the land, financial resources and transportation are under this committee. The elected municipality has not been delegated any power till this date .

The municipality board, its council and Federation of Nepalese municipality time and again has demanded to dissolved the nominated body and hand-over all the powers to the elected body according to the newly promulgated Local Government Act 1999. We want full autonomy to the elected local government . After the reestablishment of democracy in Nepal ,everything is changing but in a slow pace. The leader or their parties , they do not want to delegate power to the elected authority. They are chanting the slogan of democracy but the behavior is very undemocratic. They want to rule through their pocket men over the people. They are not respecting the law in reality . Local Development Ministry is time and again giving assurances only . The nominated committee is under the Physical Planing Ministry and whoever is in power nominates the ruler in Tikapur Development Committee . The corruption & malfunctioning is so high but the taxpayers are unable to take any action to the centrally nominated committee.

Tikapur municipality is planning to develop itself according to the concept of the Park and People. In its eastern part which is the bank of river Karnali it is planning to develop forest and wild-life.In the urban area , there is a plan to develop it as an educational center. But all the resources are under the centrally nominated committee's hand. The elected municipality is handicapped. Its plans and programs are only the dreams and to fulfil them into reality will only be possible after the heavy pressure on government of Nepal from the international democratic society. By which I hope that it will change its nature of authoritarian and anti-people centralized power policy.

European Approaches to a Healthy Environment

Christian Byk

IALES, Paris, France

POSTERS (On display in Tsukuba and Tokyo)

Yanguang Wang

Center for Applied Ethics, Chinese Academy of Social Sciences, Beijing, China

Email: Ameliaw@ihw.com.cn

The purpose of this study is to determine if there were significant changes in the AIDS prevention policy and ethical issues in China. The methods used in collecting and analyzing information are from the data published, the files and laws promulgated by the government of the Peoples Republic of China, the investigations made by scholars and so on.

A short history of the AIDS epidemic including the first case reported, the three phases divided in ensuing 15 years of AIDS epidemic in China, the styles of AIDS epidemic in China has been given in the first part of this study. A review of AIDS prevention policy including the work of a network of Anti-epidemic Stations and Monitoring centers charged with responsibilities for the control of AIDS, the laws and regulations issued, the Chinese medium plan and multisectoral medium- long-term plan elaborated for the prevention and control of AIDS has been given in the second part of this study. An analysis of the AIDS prevention policy and ethical issues about HIV/AIDS population, the AIDS prevention policy and ethical issues about drug users, the AIDS prevention policy and ethical issues about homosexuals and prostitutes has been given in the third part of this study. The conclusion is that there are significant changes in Chinese AIDS prevention policies and ethical issues marked from intolerance to tolerance.

- V.R.Manoj.

University of Madras, Chennai, India

Email: vrmmail@satyam.net.in

Bioethics refers to the right and wrong in life, or the love of life. Our aim is to create a world where new advances in technology and its challenges can be met with a prepared state of mind. Such a state of mind requires the presence of proper information, which demands awareness. Once this is achieved, then an "informed decision " could be taken which would fulfill the need for preservation of what we pursue in Bio-ethics. Once a mass audience is captured through awareness consisting of proper information, then the true power of the communities can be realized. Therefore, the power of information and the need for awareness should not be underestimated.

How can this awareness be brought about? Or what are the attributes of a proper awareness program? Awareness is incomplete without proper knowledge. There is now a need to increase the pace of awareness because of the sheer volume of new innovations and discoveries with challenges every day, whether it is the uncovering of the human genome or cyborgation. There is an immensity to the world of information that often impedes there searching scrutiny if mankind is to maintain mastery of it's own creative outpouring. Such a level of volume demands Information technology to play its role in Bio-ethics awareness.

But is this medium free from flaws? What are the issues that surround the judicious use of this medium? This paper shall try to answer some of these questions in explaining the role of bio-ethics awareness. This paper shall follow the following sequence:

1. The layman: the common people: what are his views as an individual and as a group? The importance of community.

2. The power of information and the need of a good awareness program. What are the attributes of an awareness program?

3. The prevailing relationships between media and people / communities. A study of it's impact on society and culture.

4. The role of information technology in meeting these challenges and demands.

5. Special mention of role of Internet as a major player.

6. The challenging issues of using information technology.

7. Conclusions .

Water use social behavior - a theosophical awareness and approach

Pastor, The House of Prayer, No. 2, Sardar Patel Road, Chennai 600 113. India.

In the Garden of Eden, there were rivers and there are other innumerable reference to water, rivers, springs and rain in the Bible (Jermiah 17:8, Ezra 17:10, Psalm 1:3),. The first evidence of urbanization is the creation of a city by Cain, the son of Adam who named it after his son Enoch (Genesis 4:1-2). Later the people who lived during the post Noah's flood built a city and a tower to reach up to the heavens (Genesis 11). The process of urbanization still continues.