21/10/05

Sparks fly over UNESCO bioethics pact

Stem cells: the declaration has implications for developing nations doing stem-cell research Copyright: MIT / Daniel G. Anderson.

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The governing body of the United Nations Educational, Scientific and Cultural Organisation (UNESCO) has approved a controversial declaration setting out guidelines for protecting individuals against potential harm from bioscience developments.

The text, adopted this week (19 October) in Paris, has sparked a huge debate. It is widely seen — by both supporters and critics — as a vehicle for persuading developing countries to adopt policies outlawing research involving human embryos, itself part of a wider campaign against human abortion.

The Universal Declaration on Bioethics and Human Rights addresses ethical issues related to medicine, life sciences and "associated technologies as applied to human beings", taking into account their social, legal and environmental dimensions.

According to UNESCO, the declaration provides "a coherent framework of principles and procedures that can guide Member States in the development of national policies, legislation and codes of ethics".

The UN agency says the declaration "meets a genuine and growing need for international ethical standards in this area", and explains that it "can help ‘globalise’ ethics in the face of the increasingly globalised sciences".

Welcomed by religious groups

Much of the declaration covers relatively uncontroversial issues. Indeed some clauses, such as those covering the need for informed consent and emphasising sharing the benefits of research with participants, have been widely welcomed.

At the heart of the document, however, is language that addresses — usually implicitly — the use of embryos in research. This is particularly significant for developing countries, given that a number of them — such as China, India and South Korea — are developing sophisticated capabilities in areas such as stem-cell research that might use human embryos.

This part of the text, and the declaration’s stress on the need to defend "human dignity", for example, have been widely welcomed by conservative religious groups deeply opposed to abortion or embryo research. So too has the statement that "the interests and welfare of the individual should have priority over the sole interest of science or society".

An advisor to the US delegation at the Paris meeting wrote on the website Christianity Today, "These resonant assertions of the centrality of human dignity and the limitations of science give us hope and ammunition."

The UK-based group Comment on Reproductive Ethics (CORE) has said, in response to an earlier draft of the declaration, that "the primary concern of bioethics today is the question of the moral status of the human being at whichever stage of development".

Josephine Quintavalle, the group’s founder and spokesperson, says, "CORE is very pleased that the UNESCO declaration has been passed with the total agreement of its members. We attended some of the sessions when the text was under discussion and frankly did not imagine that we would see such an encouraging outcome."

The Vatican has also urged support for the declaration, which essentially backs an anti-abortion position. In a debate on the declaration earlier this month, Vatican representative Francesco Follo said that a bioethical system should respect "man and his intrinsic dignity", warning that medical researchers were being tempted "to treat the human person as simple laboratory material".

Condemned by academics

Many in the professional bioethics community have been less impressed. They argue that the recommendations in the declaration are too vague, and seek to impose unwarranted ideological constraints on areas of research that could have important medical and social benefits.

"It is remarkable that a policy document that is clearly untenable in crucial areas has been approved by the UNESCO general assembly," says Udo Schuklenk, co-editor of the journal Developing World Bioethics, which recently published several articles attacking a draft of the declaration (see UNESCO guidance on ethics and human rights slammed).

He adds, "What is problematic, to me as a professional in the field of bioethics, is that as professionals we might be tainted by a document that so clearly should not be called ‘bioethics’ in the first place."

Richard Ashcroft, reader in biomedical ethics at Imperial College London, is similarly concerned. He says it is strange that the document was adopted without being amended after near-universal criticism of the draft declaration by academics.

According to Ashcroft, it is still questionable whether the document was needed at all, and whether what it says is meaningful or helpful in raising ethical standards in science and healthcare worldwide.

"It now remains to be seen what, if anything, is done with it, nationally and internationally – especially in those countries it was meant to help the most," he says.

Not the first attempt

The declaration is the third text on bioethics to be developed and adopted by UNESCO. The first, the 1997 Universal Declaration on the Human Genome and Human Rights, was adopted in 1998.

This was followed by the International Declaration on Human Genetic Data, approved in 2003, which sought to set ethical standards for collecting, processing, storing and using human genetic data contained in biological samples (such as blood, tissue, saliva and sperm).

Three programmes have been set up to promote the content of the texts. In particular, a Global Ethics Observatory is currently in development to bring together a collection of databases on bioethics experts and institutions, ethical committees, and legal and regulatory texts.

In addition, UNESCO has established a programme to assist bioethical committees, as well as an ethics education programme intended "to list available educational opportunities and reinforce capacities in member states".