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by Academician Rem PETROV, Vice-President of the Russian Academy of Sciences
This term - 'bioethics" - was coined in the early 1970s by B. Potter. It is not coming into common usage as fast as we would like to. Anyway, this word is not entered in many of the encyclopedical dictionaries published in Russia, Great Britain and the United States over the last five years. And the very interpretation of bioethics is still ambivalent. Some view it as "a trend in philosophy and ethics toward comprehending the moral-ethical dilemmas brought to life by the advance of medicobiological sciences in the last three decades of the 20th century, especially by the employment of most up-to- date technologies in clinical practice" (from the article "Bioethics" carried by the philosophic-encyclopedical dictionary "Man"; Moscow, Nauka Publishers, 2000).
Needless to say, bioethics is largely concerned with the medical aspects. But these are a sequel to a broader and global problem - that of safeguarding human rights and dignity in this age of revolutionary breakthroughs in biology.
A BIOLOGIST'S VIEW
Now I would make bold to characterize bioethics as a sum total of concepts and mind sets aimed at moral improvement of humankind, protection of the rights and dignity of every inhabitant of the planet in the context of the revolutionary pace of the life sciences, in particular, of molecular genetics and gene engineering, and the decoding of the genome of man and animals.
Bioethics also takes in such things as transgene plants and animals, and foodstuffs obtained from genetically modified organisms. This matter involves a variety of factors - say, whether such products are harmful to the biosphere or not (the problem of toxicity), and how they bear on the human rights - e.g. those related to tradition, religion and the like. Environmental and ecological aspects are just as important.
Let me cite a couple of examples, by no means hypothetical ones. Suppose we are growing a gene-engineering potato strain enriched with protein (for instance, with egg albumin introduced into the potato genome). Now should we warn vegetarians that by consuming potato tubers like these they will be getting animal protein into their system?
Another example. \\e are cultivating cabbage, lettuce or some other plant that might contain resistance genes, i.e. genes implanted into such cultures to boost their resistance to untoward factors of the environment, herbicides including. This innovative technique would be quite suitable to plant-growers and make it much easier for them to get rid of weed. But what if a super-hardy strain like that starts proliferating and ousting native species beyond field and plantation? That could be bad for the natural, normal ecology.
In a nutshell, we need some checks and balances for suchlike developments, and appropriate bodies in charge - maybe national bioethical committees or international agencies similar to the International Atomic Energy Agency (IAEA). I hope in the near future an International Bioethics Agency (IBA) will be among the influential world organizations of such kind.
FROM GENEVA TO OKINAWA
Ten years ago UNESCO outlined global objectives for bioethics. At the initiative of the then UNESCO Director General Federico Mayor a special division was set up within the framework of this organization to take up bioethics (International Bioethics Committee, IBC). Together with the other IBC members, I was involved for a number of years with the drafting of a
basic document - The Universal Declaration of the Human Genome and Human Rights - with much enthusiasm and responsibility. This Declaration was unanimously endorsed on November 11, 1997, by the 29th General Conference of UNESCO, with Russia one of the signatories.
Before outlining the key planks of this document, I would like to touch upon the historical origins of bioethics that does combine indeed human rights, medicine and the life sciences, all in one.
Recall the Hippocratic Oath, a doctor's pledge to do everything "for the benefit of my patients according to my ability and judgement, and not for their hurt or for any wrong". Do no harm - such is the message. The medical ethics still abides by such precepts, even though they had to go through the acid test of history to assert themselves...
Physicians of the early 18th century had factual evidence at their disposal that variolation (inoculation with the virus of smallpox) could protect one from this disease. And then, in 1721/1722, the Prince of Wales (later, King George II of Great Britain) approved by way of "experiment" the first vaccinations against smallpox, with test subjects chosen from among convicts condemned to death. Such ethic is impermissible and atrocious to us, but 280 years ago it was approved by the Royal Scientific Society anyway.
For thousands and thousands of years cardiac arrest was considered to be proof positive of death, the moment of death. The situation changed after the year 1953 when the immunologists Frank Burnet (Australia), Peter Medawar (Britain) and M. Hasek (Czechoslovakia) discovered the phenomenon of immunological tolerance, and it became possible to transplant all the various tissues and organs - skin, kidneys, heart and so on. But when things came to the heart transplant, surgeons had to take out a donor's heart still alive and throbbing so as to have the operation come off successfully. And thus the very notion of "death" had to be reconsidered: the moment of death was no longer registered by cardiac arrest (for the heart could be reactivated) but by the arrest of cerebral activity, by cerebral death (brain death is zero bioelectric activity).
So we see that moral and ethical values are prone to evolutionary changes, with humankind moving toward moral improvement. This is particularly true of our time when we are tackling problems related to the decoding (mapping) of the human genome, gene transfer for treatment (gene therapy), the possibility of human cloning and the like. All these problems, like that of the protection of the biosphere, have a direct bearing on the rights of man and human community*
Bioethical problems have attained to particular poignancy with the imminent advent of a postgenomic era in the wake of the decoding of the human genome. There will be problems galore, legal snags too. Say, the matter of insurance policies - can I qualify, for insurance, if I happen to have a gene that is bound to cause a grave disease in the end? Who is let into the history of my genome? I or the company that has mapped this or that segment of my genome? I must say that some companies are trying to patent the genome segments they have mapped. This bioethical issue has stepped beyond the boundaries of science and even commerce - it was discussed by the heads of state of the Big Eight during their Okinawa meeting in 2000. The possibility of human cloning is just as acute.
HUMAN GENOME, COMMON PROPERTY OF ALL OF HUMANITY
UNESCO is doing an important work in the field of bioethics, and the significance of this work is increasing with every passing year. And so is the role of the Universal Declaration of the
* See: Yu. Lopukhin and B. Yudin, "Bioethics in Russia and for Russia", Science in Russia, No. 5-6, 1993. - Ed.
Human Genome and Human Rights. At this point I wish to comment on some of the articles of this document.
The gist of Article I: Human genome is at the core of intrinsic community among all representatives of humankind, and it is a token of recognition of their inalienable dignity and variety. Human genome epitomizes common property of humanity.
The philosophically peremptory message of this article validates both equality and diversity of each and everyone within the human commonwealth. Because in the course of its million-year history all of mankind has been developing by tapping from a "single basket" of genes that have been "passed down" from generation to generation, thus accounting for the infinite diversity of the human individual. According to the data for the year 2000, the human genome comprises 30,000 genes. The "common basket" of their variants has for millions of years been forming the diversity of equally worthy people. The genome of any human individual does belong to all of humanity, for no one can tell from whom he inherited his body's genes a million years ago. And no one can tell who will get Ms genes (the same genes) thousands of years from now. The genome is the common wealth of all and everybody.
The second article comes as a logical follow-up to Article I: Every individual has the right to respect for his dignity and Ms rights regardless of Ms genetic characteristics.
Article 4 is all-important: Human genome in its natural condition should not be a source of profit-making. This means that a mapped (described, "discovered") genome segment cannot be patented by a particular researcher or research company and thus become an object of commerce, profiteering and the like. This stance was reaffirmed by the leaders of the Big Eight at their meeting in Okinawa, Japan, in 2000.
The final article - Article 7 - of the Declaration's section on the rights of persons concerned deals with the subject of confidence: The confidential character of genetic data which are related to an individual whose person can be identified and which are subject to processing for scientific or any other purposes should be protected by the law.
BIOETHICS: HUMAN RIGHTS - FREEDOM OF SCIENCE
Section С of the Declaration is concerned with human genome- related research. It sets forth principles for the protection of human rights in the course of research work. This is a balance, or symmetry, of such rights and interests: on the one hand, a patient or a healthy individual subject to examination should have his rights protected; and, on the other, a research scientist should likewise enjoy such kind of protection of his rights in his scientific pursuits, and should not be hamstrung by sundry injunctions.
That is to say, bioethics should incorporate ethical principles of the development of biology as a science, while a total ban is nonethical at all. Here's what the Declaration says to this effect: No studies relevant to the human genome and no applied studies in this field... should prevail over the respect for human rights, the basic freedoms and human dignity of particular individuals or, in appropriate cases, of groups of people. Not permissible is a practice running counter to human dignity, such as the practice of cloning with the aim of the reproduction of a human individual. Let me stress this point: reproduction of a human individual. This is not to mean that we should put the lid on research in the field of cloning or keep from looking into opportunities opening up to biology and medicine along this path. A ban should apply to the making of man by this very biotechnological technique. Some countries have already adopted laws prohibiting the cloning of man. Other countries (USA and Russia among them) have imposed a five-year moratorium on this work.
Although the cloning of human cells and tissues is a less ticklish bioethical problem, it still calls for public and legislative controls. The British Parliament, for instance, has legalized the cloning of stem cells of human embryos. This bill particularizes the modes of obtaining such cells from embryos not older than 14 days from the moment of conception.
Section D of the Declaration regulates conditions of scientific activity. It calls upon states to take steps toward the unhampered conduct of scientific studies with due account of the Declaration's principles. For this purpose they should further a setting up of independent multidisciplinary committees on bioethics and promote their integration within a global network.
At this - dual - significance of bioethics I would like to end my article. Bioethics equally concerns itself with human rights and advancement of science to man's benefit. With UNESCO, bioethics is the first stage of an orderly transition to the ethics of SCIENCE at large. UNESCO has a division involved with bioethics, the Department of the Ethics of Science and Technology (it is headed by George Kutukjian). UNESCO Director General, Koitiro Matsuura during his visit to Moscow in 2000 made a report on the UNESCO strategy today in which he named the Ethics of science, the Ethics of cultural and religious relations, the Ethics of international relations among the key areas of activity.
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In our country the National Bioethics Committee set up by the Russian Academy of Sciences has been at work for more than ten years now. We have adopted a law on gene engineering. Coming into effect are the laws and the government's decisions on gene therapy, on a five-year moratorium on human cloning, among other enactments. Our committee is collaborating with the Biomedical Ethics Committee operating under the auspices of the Russian Federation's Health Ministry, with the International Bioethics Committee of UNESCO, with European and many national committees.
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