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discussing bioethics at unesco

ICJW Representative Gabrielle Voignac reports on the 19th session of the International Bioethics Committee of UNESCO, held at UNESCO Paris Headquarters from Sept. 11 to Sept. 14, 2012.

The two main topics on discussion were : 
1. Principle of Non-Discrimination and Non-Stigmatization
2. Traditional Medicine and its Ethical Implications

1. Non-Discrimination, Non-Stigmatization
These are fundamental human rights principles and components of the right to health. Article 2 of the Universal Declaration of Human Rights (UDHR) states that everyone “is entitled to all the rights and freedoms without distinction of any kind, such as race, color, sex, language, religion, political opinion, national or social origin, property, birth or other status”.

In bioethics, it is a matter of resolving ethical issues related to medicine, life sciences and associated technologies. It is recognized that lack of access to medicines for economic reasons is a clear case of discrimination, contravening the provision of Article 2 of the UDHR, and Articles 11 and 14 of the Universal Declaration on Bioethics and Human Rights.

Nevertheless, there are other forms of economic discrimination and stigmatization. More than one third of the world’s population has no access to essential ones.

Neglected Diseases

More than one billion people worldwide are affected by Neglected Diseases for which treatment options are inadequate, toxic or non-existent. Neglected Diseases have received little attention and resources despite their magnitude and impact on economic development and quality of life.

Biobanks

The term “biobank” refers to collections of biological material (blood, tissues, DNA etc.). They can be small or gigantic (the United-Kingdom Biobank contains samples from half a million people). The main problems arisen which seem unsolved are consent, pediatric biobanks, remuneration of participants. Another concern is about the safety of the personal and genetic data and access to them. This problem of biobanks activity must be regulated.

HIV/AIDS and right to healthcare

It is important for research that universally accepted principles allowing culturally relevant approaches be implemented. All the researchers both from developed and developing countries should collaborate at every stage of the study. It is of foremost importance to apply guiding principles of informed consent in international research projects. Confidentiality of data has to be protected throughout the project. Vulnerable people will need special justification and protection.

Nanoethics

Nanoethics is the branch of applied ethics that studies the ethical, economic, environmental, legal and social issues raised by advances in nano-technologies (matter at the atomic, molecular scale). Most nano-technology activity still takes place in industrial world. Nano technology can provide solutions for energy generation and storage, water treatment and air-pollution remediation. At the same time, though, many nano-materials may become a threat to the environment and the living organisms.

The more immediate and realistic concerns relate to discrimination of individuals “enhanced” through these technologies. Individuals who may not have access to nanobiomedical advances or who may not want to take advantage of such technologies, may also be stigmatized, discriminated against, and even, very theorically, “enhanced” by force. Persons with disabilities would be most vulnerable to these latter risks.

The increasing miniaturization and effectiveness of inexpensive surveillance devices may lead to wider and highly intrusive methods of gathering data and controlling people by powerful individuals, corporations and governments, with the potential to severely erode people’s privacy, confidentiality and human rights generally.

Neuroscience

The most obvious source of discrimination from neuroscience seems to be the misinterpretation of data from neuro-imagery. However, the application of neuro-technologies is in its infancy. There is time for reflection. Every effort should be made to encourage on-going forums in the field of neuro-ethics to incorporate discrimination and stigmatization in their range of concerns.

Organs, tissues and cells transplantation and trafficking

The demand for transplants has grown faster than the supply of available organs. The problem of organ trade is an international problem. As a result, black markets are increasing and organized organ trafficking is expanding worldwide.

Transplant commercialism targets impoverished and otherwise vulnerable donors. The main objective is to elaborate and show how unethical organ, tissue and cell transplantation as well as organ trafficking may discriminate and stigmatize individual organ donors and vendors especially in poor countries.


2. Traditional Medicine and its Ethical Implications

As a practice embedded in theories, beliefs and experiences, traditional medicine has been used in some communities for hundreds or even thousands of years. It can be perceived as a fundamental feature of their own identity and is often closely intertwined with lifestyle, cultural frameworks and social regulations, as well as domestic legislation.

In other countries, such health practices have been introduced only recently. In both cases, however, the crucial challenge to address remains that of recognizing and improving those and only those medical practices which are the most suitable to protect, restore or promote health. In many developing countries, traditional medicine is the only affordable healthcare for the poorer population for whom modern treatments are far beyond their means. 

One of the main challenges of traditional medical practices is distinguishing between real traditional healers and so-called charlatans who can physically and psychologically harm those patients they claim to treat. Traditional health practices cannot be distorted to prevent people from receiving an effective treatment. It cannot allow practitioners to keep patients from receiving life-saving treatment by claiming to have effective, even miraculous means to cure serious and acute illnesses.

Traditional and modern medicine can coexist if bridges are built between the two. The differences between modern and traditional medicine are rather assets that can lead to complementary, even synergy, for the benefit of the people. Traditional medicine may be a precious resource, provided its place in respect to modern medicine, can be clarified.

The commitment to promote health and access to safe, effective and quality health care for every human being relies on the same idea of medicine as the system of diagnostic and therapeutic tools progressively made available to fight against disease, prolong life and improve its quality and the well-being of people.

Empowerment of populations will help individuals to choose the best treatment offered by both systems of medicine, and such a choice should always be available. Governments are called upon to adopt appropriate legislation for assessing, licensing and accrediting traditional practices and drugs, and to cooperate, strengthen internationally agreed regulation. They are also called upon to study, elaborate and adopt appropriate educational methods and tools for the teaching of traditional practices.