Bioethics is increasingly a globe-spanning endeavor. Since the inauguration of our annual “Special Section: International Voices,” there has been inexorable progress toward closing the informational “tectonic gaps” that separate bioethicists and prevent a truly international exchange of ideas and practices. This gap narrows each year as new reporters come on board to share the inner life of bioethics in their countries and as our continuing contributors keep us up to date on subsequent developments.
Our Special Section is introduced this year by two papers providing historical and background information so that we may better understand the state of bioethics in the Spanish-speaking world and in South Africa.
In their paper “Iberian Influences on Pan-American Bioethics: Bringing Don Quixote to Our Shores,” Pablo Rodríguez del Pozo and Joseph J. Fins inaugurate efforts to expand CQ's coverage of Spanish bioethics. The authors paint a portrait of the field by reviewing historical and philosophical foundations as well as the teachings of leading Spanish bioethicists, including the potential impact of their work.
“Bioethics in South Africa,” by Solomon R. Benatar and Willem A. Landman, recounts the unique developments that have given bioethics in South Africa its own dimension. They emphasize that South African bioethics, standing at the intersection of the concerns of both developed and developing worlds, is characterized by issues, such as resource allocation, HIV/AIDS, and medical research, that reflect the country's particular historical, geographical, and social conditions.
The problems and pitfalls of developing and legislating health policy are taken up in the next two papers. Cheryl Cox Macpherson's paper, “Healthcare Development Requires Stakeholder Consultation: Palliative Care in the Caribbean,” argues for the value of consulting and collaborating with local stakeholders when designing development programs. She demonstrates that when conducted systematically and with sensitivity, stakeholder consultation is an effective means of partnering with governments and others to determine needs and sustainable responses in different settings.
Individual healthcare preferences in cases of incapacity is the subject of Alister Browne and Bill Sullivan's essay on “Advance Directives in Canada.” The authors describe the similarities and differences among the wide variety of legislative approaches to advance directives in Canada and evaluate how legislation should be written and whether there should be a policy to encourage all persons to have advance directives in their life planning.
Exploring the delicate balances and tensions between science and society is the topic of two subsequent papers. In Peter Herissone-Kelly's paper, “The Prohibition of Sex Selection for Social Reasons in the United Kingdom: Public Opinion Trumps Reproductive Liberty?” the author recounts the sometimes heated exchange between philosophers John Harris and Thomas Baldwin as to whether the United Kingdom's Human Fertilisation and Embryology Authority's recommendation, partially guided by public opinion, that all use of regulated sex selection techniques for social reasons be prohibited is an illegitimate infringement on citizens' reproductive liberty or justified on the basis of possible harm to the selected children. Tanja Krones' report, “The Scope of the Recent Bioethics Debate in Germany: Kant, Crisis, and No Confidence in Society,” surveys the major features that underlie the current clash between opposing forces shaping the current German bioethics. Opposing camps in the debates are described as either “techno-skeptics,” who have a strong mistrust of technology, or “techno-optimists,” who believe in progress through technology and science and society's ability to foresee and control potential risk. The ensuing conflicts are played out against a high level of public sensitivity to the horror of Nazi Germany and the continuing cautiousness for development that might have the potential for violating human dignity.
“Ethicalization in Bioscience—A Pilot Study in Finland” is an early report on continuing research in which bioscientists are invited to discuss how they view the impact on their own work of growing public ethical debates and external regulations and assessment procedures. In this initial phase, authors Matti Häyry, Jukka Takala, Piia Jallinoja, Salla Lötjönen, and Tuija Takala speak with Finish bioscientists and extend invitations for international collaboration to expand the project.
The final papers in the group focus on issues in research ethics. Sven Ove Hansson and Barbro Björkman's paper, “Bioethics in Sweden,” summarizes two recent cases in Swedish biomedical research ethics involving control over individuals' biological information. In both cases, bioethical principles and arguments for privacy protection were nullified when access to research data was requested for purposes other than the medical research for which they were collected. In response, the authors call for more careful consideration of the relationship between the ethical review system and the legal system and conclude by putting forward some tentative proposals for reform.
In their report, “Scientific Misconduct in Japan: The Present Paucity of Oversight Policy,” authors Brian Taylor Slingsby, Satoshi Kodama, and Akira Akabayashi provide an overview of several recent high-profile cases that have led to scientific misconduct becoming a central public topic in Japan. The authors consider factors that may be influencing the increase in reported cases of misconduct and point to a paucity of ethical standards within the Japanese scientific community as well as a lack of an apt process of conflict resolution. They conclude with a call for further action to address the risk to scientific research in Japan and the entire international scientific community.
As demonstrated in these international reports, understanding the future of the field of bioethics requires knowing the world we are living in—and, increasingly, that world is a single space.
