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UNESCO's declaration on bioethics and human rights is too weak to be of value, and could harm the world's poor if developing countries accept it, says Richard Ashcroft.

The 1948 Universal Declaration of Human Rights, created shortly after the bloodshed of the second world war finally ended, is a landmark in human civilisation. It provides a universally accepted and authoritative statement against which to judge the treatment by states, institutions, corporations and individuals of all people, anywhere in the world.

Bioethics, despite its concern with issues that have profound implications for our lives, has not often been thought of in a human rights context. By the same token, human rights theory has rarely been concerned with bioethical issues. This disconnection has recently been heavily criticised by many health activists, and we are beginning to see some convergence between the two. [1,2]

But achieving this convergence is proving difficult to negotiate. One problem is the differing scopes of bioethics and human rights.

Rights unravelled

Bioethics concerns not only the ethics of medical care, but also the ethics of our use of animals and our relationship to the environment. Identifying our duties to uphold and promote human rights and to preserve our natural environment, even including duties we may have to future generations, is notoriously difficult.

Whereas bioethicists see notions of what makes us human as topics for analysis and discussion, human rights specialists take them for granted.

Human rights theorists have therefore got into great difficulty trying to sort out whether abortion promotes human rights or is a direct attack on them. And if genetic engineering, nanotechnology and cybernetics allow our bodies to be changed significantly, would these altered people inherit human rights? And where would this leave unaltered people? [3]

Photo Credit: UNESCO

21st century declaration

The recently drafted declaration by the United Nations Educational, Scientific and Cultural Organization (UNESCO) on bioethics and human rights tries to resolve these issues (see Ethics, science and human rights come together). But it has not succeeded.

The declaration does not represent significant progress in reaffirming human rights principles in the context of 21st-century concerns about biotechnology, the restructuring of health services or the natural environment. Its central concerns are with medical care and biomedical research. 

Some points are merely simplifications of some of the principles set out in the Declaration of Helsinki, which provides ethical guidelines for medical research. Others present principles of social justice and solidarity relevant to bioethics, and of benefit-sharing in biomedical research and development.

An example of how the declaration is disappointingly vague and lacking in force is in its section about the environment and future generations. This says next to nothing about animals or the natural environment — nor, pertinent even within a narrow human rights framework, our obligations to future human generations.

The stronger statements within the draft declaration seem to be inherited in a loose form from existing international ethics guidelines. Most of its principles are stated in a very weak form — concerns such as the impact of life sciences on future generations are to be given "due regard".  Yet there is no explanation of what this term really means.

Costly exercise

The drafting of this declaration has been a major exercise, involving representatives from many countries, in what must have been an expensive and time-consuming process. Sadly, what has survived the negotiation process is too limited to be prescriptive in any effective way, as the drawn-out process of fine-tuning the document has left a consensual framework that necessarily skates over many central but controversial issues. 

And despite the criticism it has drawn from some ethicists (see UNESCO guidance on ethics and human rights slammed), others have welcomed it as guidance to countries, especially developing ones, that currently lack effective bioethics or human rights legislation. 

If the declaration is cited at all in litigation or policymaking, it will probably be as evidence that standards weaker than those in some existing international guidelines (such as the Helsinki Declaration) are legally and internationally acceptable.

If this happens, then it is conceivable that in some cases, the vulnerable of the world could be worse off than before. If, as appears likely, a meaningful consensus about prescriptive standards in bioethics cannot be reached at this point, the world would be better off without a declaration that prejudges debates by setting a 'lowest common denominator' standard.

Some human rights statements have been criticised for setting aspirational goals rather than defending decent minimum standards. UNESCO's declaration makes the opposite error. 

Bioethics and human rights must be reconciled. But this declaration will not help that effort, nor will it help the global poor.


[1] Farmer, P. (2005), "New malaise: Medical ethics and social rights in the global era," in P. Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor, Berkeley, CA: University of California Press, 196-212.

[2] Mann, J. M. et al. (eds) (1999), Health and Human Rights: A Reader, New York: Routledge.

[3] Bostrom, N. (2005),  In defence of posthuman dignity, in Bioethics,19:202-214.

Richard Ashcroft is reader in biomedical ethics at Imperial College London, United Kingdom.

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