Eubios Ethics Institute, University of Tsukuba, IUBS and the Asian Bioethics Association welcome you to the:

Abstracts - Eighth International Tsukuba Bioethics Roundtable (TRT8)

15-18 February, 2003, Japan


To TRT8 program and registration


Venue : (15-16 Feb) Room 4A411, Institute of Medical Sciences; (17-18 Feb), A106, Institute of Biological Sciences, University of Tsukuba, Tsukuba Science City

Internet site provides updates on this information:


Abstracts as of 13 February, 2003

15 February (Venue 15-16 Feb. in 4A411 in Institute of Medical Sciences)
am. Bioethics and a Human Idea Map

The Behaviourome and Proposal for an Integrative Human Idea Map
Darryl Macer, Ph.D.
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: Macer@biol.tsukuba.ac.jp

One of the most interesting questions before a thinking being is whether we can comprehend the ideas and thoughts of other beings, and conversely whether they can also read our mind. I would argue that we have already the means to embark upon a human mental map with the goal of describing the diversity of ideas a human being makes in any given situation or dilemma. I call this the behaviourome or human mental map. Such a map is not of a physical structure but a map of ideas.
There are several uses of such a project to make a human mental map. These include:
1) To understand ourselves, and whether the number of ideas is really finite.
2) To compare mental maps and idea diversity between persons and species.
3) To aid in policy making to make policy that respects the diversity of people in a culture, and globally. This would help develop bioethics for the people by the people.
4) If we can make individual mental maps, this would offer persons assistance when making moral decisions. This would give them a chance to consider all their ideas, and to make a more considered moral choices. This would also be useful in the testing and implementation of better bioethics education.

This introductory paper will present the first edition of a human mental map and call for an international collaborative project involving people from many cultures, disciplines and walks of life, to build together a human mental map.

Macer, DRJ. The next challenge is to map the human mind. Nature 420, 121, 2002.
Macer, DRJ. Finite or Infinite Mind?: A Proposal for an Integrative Mental Mapping Project. Eubios Journal of Asian and International Bioethics 12 (2002), 203-6.

Choose Between Cooperation and Annihilation: A Mental Mapping Project Towards a more Generously Directed Altruism
Irina Pollard, Ph.D.
Dept Biological Sciences, Macquarie University, Sydney 2109 Australia
Email: ipollard@rna.bio.mq.edu.au

The fundamental design principles of Nature are based on cooperation, biological feedback, adaptation to changing conditions and promoting ecological diversity. Common human survival themes should, therefore, also echo this pattern and include more cooperation and less conflict, living within our ecological means, and living in harmony with the environment and ourselves. We have long had sufficient mind-power and with recently acquired scientific understandings and renewed bioethical awarenesses, are now facilitated to increase our survival fitness - if we choose. What is required is to mature emotionally and catch-up to our mind's vast potential by ethically managing our own fitness as a species. When it comes to, for example, killing thousands, even millions, of our own and other species in futile ideological competition, fueled by the random horrors of terrorism and coordinated warfare, we can no longer accept this as being a necessary and inevitable part of life. Our innately flexible intelligence can rescue us because within our collective biological nature exist strong survival instincts such as justice, empathy, love and respect for the freedom and lives of others. It is the further refinement of these positive biological instincts that can provide us with the necessary assets in the present struggle for adaptive survival. However, the global community must agree on forward-thinking bioethical standards when applying the contributions from science and technology. It is essential, therefore, to consider modern scientific and technological applications alongside some measure of ethical consensus. We need, as a society, to keep track of powerful technological developments despite the benefits associated with these gains. The present paper seeks to draw together bioscience-bioethics* in order to heighten general awareness of current bioethical issues raised by biological research and its applications. Thus, the enriched sum of us, irrespective of background, can come to both an informed opinion and make decisions in the spirit of intelligent altruistic cooperation. A bioscience-bioethics cooperative friendship alliance, based on Nature's model, is proposed to extract wisdom from human diversity, beliefs, attitudes and values.

* Pollard, Irina (2002). Life, Love and Children: A Practical Introduction to Bioscience Ethics and Bioethics. Kluwer Academic.

Multiple Facets of the Fantasies of the Asian mind
Jayapaul Azariah, Ph.D.,
Founder President, All India Bioethics Association,

New No. 4, 8th lane Indiranagar, Chennai 600 020, India.
Email: Jazariah@yahoo.com

Human personality is divisible into many components: some divide it as Body , Mind and Soul while others divide it into Body, Soul and Sprit. It is also possible to recognize five interrelated components of human personhood. They are (a) Physical (b) Mental (c) Moral (d) Emotional (e) Spiritual. Such a five partite human personality is essential for personality development.

Mind is like a plant, planted in a mud pot or a fish in a aquarium tank. Their growth in terms of size is strictly dependent on the space-capacity of the container. Smaller the given space the smaller is the organism. So is the mind. The scale of perception of the world around us conditions mind. Asia is generally recognized, as the spiritual center of the world while the West is technology oriented. Spiritual and mechanistic worldviews are the two containers that contain the mind. But where is this mind of the humans? Is it in the body component or in the soul or in the spirit? Is there any difference between the Western and Asian minds? If so what is due to?

Aurvedic dictum is "You are the product of the food". In this sense food is related to the body and mind. If mind is "memory" then where is the mind? How does food condition the mind? If mind is that which thinks then is it right to say that perception, feelings, a will to do and consciousness are the outworking of the mind? Does mind grow and age? Are ideas created? Does mind produce an ideology? Mind is a double-edged sword! We generally say that the best definition of pollution is "Out of sight - out of mind". But mind can interpret it as "out of sight" = invisible; "out of mind" = insane "? Solutions offered by the mind can also be problems! Then one has to think again and reframe the solutions.! What are the technologies by which mind can be controlled to think in the positive direction that can provide a viable solution?

The Asian mind is circular. It thinks of cycles and in circles. The way of life is characterized by cycles of birth and death. The body is taken through a cycle of fasting and feasting. Should the mind think linearly? Can the mind be subjected to fantasy? Is the ancient Indian concept of "Maya" a fantasy idea? Mind has the function of forming images and ideas. For the preservation of peace in this world what is needed is the development of a mind with a visionary fantasy.

Arguments of the great philosophers that our thoughts are not in our brains
- Dr. Frank J. Leavitt
Chairman, The Centre for International Bioethics
Faculty of Health Sciences
Ben Gurion University of the Negev, Beer Sheva, Israel
Email: yeruham@bgumail.bgu.ac.il
Any project to produce a "Human Idea Map" on the basis of brain research ought to take seriously the question whether our thoughts are really in our brains. I shall present an argument, based on such great philosophers as Descartes and Berkeley, to the effect that our thoughts are not at all in our brains.

I shall then outline some possible further implications which might be drawn from the conclusion that our thoughts are not in our brains. It might be that our thoughts are in our souls, and that brain research is irrelevant to the study of thought. Or it might be that the truth is what philosophers call "psycho-physical parallelism", according to which our thoughts are in our souls but are reflected by parallel events in our brains. Or it might be that -- as the philosopher Berkeley thought -- no physical objects really exist. So our brains would exist only in our thoughts, rather than our thoughts existing in our brains.

How to assess people's views of biotechnology: Lessons from Japan
- Masakazu Inaba and Darryl Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: dj_xis@digital.design.co.jp, Macer@biol.tsukuba.ac.jp

This paper presents the results of the analysis of data of Japanese attitudes toward specific applications of biotechnology from survey responses. Interviews were conducted to more deeply explore the reasons behind the attitudes. Examples will be shown from analysis of comments in interviews and mail response surveys to determine attitudes of the general public and scientists toward biotechnology. Analysis reveals some attitudes are shared among the public and scientists in 2000, while the frequency of these concerns may vary. The two most acceptable of the four medical applications were medicines produced in genetically modified microorganisms and a transgenic cancer mouse for research use. These were perceived to bring benefits by about two thirds of the public and 85% of the scientists. The least acceptable application was xenotransplantation, which even 14-18% of the scientists considered to be unnatural. Embryonic genetic diagnosis was more acceptable than xenotransplantation, however, more respondents saw ethical concerns with this application. The results of two agricultural applications show similar compositions of respondents' attitudes to that of toward genetic diagnosis in the series of questions with diverse reasons. Some preliminary results of the 2002-2003 mail response survey will be presented, and the trends over time will be discussed.

Idea diversity and cultural borrowing
- Tim Boyle,
Tsukuba Christian Center, Japan; and USA
Email: za3t-byl@asahi-net.or.jp

Cultures have been adopting ideas from each other and then adapting those concepts to their own needs since the beginning of history. While such recent interchange is abundantly documented, that in ancient times is less clear. Nevertheless, some intriguing and little-known circumstantial evidence points to the flow of such basic concepts from very ancient times.

I will briefly introduce two lines of evidence pointing towards such ancient interchange. The first could perhaps be more accurately summed up in the concept of common origins rather than later exchange. Over 200 ancient flood accounts have been documented from every region of the world. Many of these have very similar themes to that recorded in the Bible. While other interpretations are, of course, possible, one logical conclusion that can be drawn is that they have a common origin in the stories of an actual flood. I will introduce several Chinese characters along with other circumstantial evidence that points to common stories handed down to the authors of the Bible and to the ancient Chinese scribes who designed the characters.

The other aspect of my talk will point to a still ancient but much later age when the "Silk Road" provided the means for extensive cultural interchange to take place in ancient Asia. Specifically, I will point to evidence showing the spread of Christian concepts that were incorporated into Chinese and Japanese culture as the result of their spread along the Silk Road during the First Millenium AD.

Our difficult future: How should upgraded humans treat high-efficiency humanoid robots and gene-enhanced animals?
- Tsuyoshi Awaya, Ph.D.
Department of Legal Medicine and Bioethics, Graduate School of Medicine and Dentistry, Okayama University,
2-5-1, Shikata-cho, Okayama,Japan 700-8525
Email: t-awaya@nifty.ne.jp

Humans will be upgraded by means of the technologies of gene enhancement, cyborgization, etc. in the future. And high-efficiency humanoid robots and gene-enhanced animals with high intelligence and feelings (or something similar) equal to or more than humans will be produced by means of the technologies of robot, computer, gene enhancement, etc. in the future.

How should upgraded humans treat them at such time? Of course, initially, humans can choose not to allow their appearance, keeping in mind their potential danger. But so far, humans are not likely to choose not to allow their appearance.

As far as we allow their appearance, the choice of humans not to treat them as human or as equal to human for the reason that they are not human biologically will become impossible. That is to say, the need to give rights as humans or the same rights as humans to some robots and animals which satisfy certain conditions will come out. In other words, it will become impossible for humankind to continue keeping them out of the circle of coexistence and co- prosperity.


pm. Cross-Cultural Global Bioethics [Cultures of geography and vocation]
Ideas of the Chinese Mind
- Baoqi Su
Center for Bioethics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Email: subaoqi2005@vip.sina.com

The traditional Confucian culture has long been a representative of Chinese culture, and it has directed social, political, educational, and moral actions in Chinese society for more than two thousand years. The ancient Chinese medical ethics was also established on the foundation of Confucian ethics. Confucianism has impacted deeply on the shaping and development of the ideas of the Chinese people. This paper starts with examining Confucian ideas of "a moral person". According to Mencius, people with capacities of humanity (ren), righteousness (yi), propriety (li), and wisdom (zhi) are regarded as a virtuous person. Confucius' concept of a moral ideal person is expressed of a Junzi (the moral person or the superior man).

Confucian conception of "person" is the key to many moral dilemmas of practical medical issues in contemporary Chinese society. Some of its important implications, such as moral status of fetus, abortion, healthy birth and eugenics, physician-patient-family relationship and other issues, including death and euthanasia, reproductive technology, gene therapy, and finally "medicine as an art of humaneness" are explored in the second part of this paper.

The basic Confucian idea is ren, which means "loving people" The golden rule is: "What you do not wish for yourself do not do to others". The paper concludes Confucian views in facing new bioethics issues brought about by recent advances in medicine could be seen as offering important contributions to the ongoing development of Chinese society. The Confucian thoughts should not be ignored even though the solutions of contemporary China's bioethics dilemmas cannot be found only in the historical dimension.

Ideas of the Japanese Mind: An Outline of Japanese Ethics, Morals and Religions
- Shinryo N. Shinagawa, M.D.
Emeritus Professor of Hirosaki University School of Medicine,
32-3 Fujimicho Hirosaki, Japan, 036-8223
E-mail: shinryo@smile.ocn.ne.jp

Six topics will be presented. They are: 1. A short prehistory of Japanese people; 2. A short cultural history of Japan especially from a viewpoint of foreign impacts on Japanese culture including ethics and philosophy; 3. A short history of religions in Japan; 4. Main characteristics of religions in Japan; 5. Main characteristics of ethics and morals in Japan, and 6. Christianity in Japan.

The Influence of Taoism at the End of Life
- Dena Hsin-Chen Hsin, and Darryl Macer
Taichung Medical College, Taichung, Taiwan

Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: hchsin@hotmail.com

To comprehend the ideas and thoughts of the human mind is not only an interesting research goal, but it often can be an effective and ethical way to solve the problems we face, and are enduring in our worldly realities. Some of these dilemmas are the life and death issues of human society.

With the remarkable advances in medical technology, the end of life often becomes a very complicated situation. Every clinician is obliged to make a decision of how to help in the dying process and to protect human dignity in an ethical and morally defensible way. To gather the ideas from people maybe a good start to making more ethical decisions with the patients in their care. To understand the context of people's values and attitudes should continue to build a social consensus which may facilitate the decision making process. Many people may agree that cultural restraints and experiences of the past are subjects to dominate their actions, however, in the end of life issues, people may not easily take action by their own judgment. Thus with the goal of promoting a higher humanity in the dying process, we need a strong conceptual framework to help people make decisions which they and their family will recognize to be the right ones.

People in Taiwan may adapt ancient Chinese philosophy like Confucianism, Buddhism and Taoism as their value system. In the study of Taiwanese seniors' attitude toward life and death, we have perceived that many seniors in Taiwan accept Taoist philosophy as their attitude toward their declining life. Based on the comments given during the interviews, elderly people simply explained death as a return to the nature (In Chinese, Hwe Guei Tzyh Ran ____), or life should return to its source like ten thousands things (In Chinese, Wann Wuh Guei Gen____). As Taoism describes human life as something with no form, nor substance(____) in the beginning, then somehow there is a form or a shape of human body, then life, and later it returns to the nature again, people can easily accept this process as normal in motion like the four seasons. Also as a cosmetic view of Taoism that life and death should be even in the motion of natural cycle, the sequence, like day and night, should be up to Heaven and beyond the interference of man. With this kind of Taoist thinking, it will provide a defensive attitude towards our declining life that is Wu-Wei, actionless actions and just follow nature. We hope an in-depth thinking of Taoist philosophy will recall the original aims of medicine and uphold the truth that the value of human life should transcend from quality of life to quality of death.

When compared to the results of the question on the images of life in Australia, Japan and New Zealand by senior persons, we found that the idea to let life follow its natural course was also a major comment in other countries (Australia, 25%; Japan, 34%, New Zealand 20%, and Taiwan, 39%), so although the basis of this thinking in Taiwan may be called Taoism, once we start to explore the ideas of the human mind a thought process which can be labeled in one culture as Taoist, might have another label in another culture. If ideas are universal, then we could conclude that Taoist thinking is found in people in different cultures, not only Chinese. If Taoist thinking is not only found in the Chinese mind then we can appreciate it even more.

Kagandahang Loob and Organ Donation: An Excursion into the Filipino Mind
- Leonardo de Castro, Ph.D.
Dept of Philosophy, University of the Philippines, the Philippines
Email: decastro@skyinet.net

It is generally thought that organ donation ought to be an altruistic act that is performed out of the goodness of one 's heart and without expectation of reward or personal benefit. This idea fits the Filipino concept of "kagandahang loob" (good will) and is, in that sense, a constituent part of the Filipino mind. However, this characteristic feature of the Filipino mind is being put to the test by the practice of selling human organs for transplant. Is kagandahang loob losing its grip on the Filipino mind because of the practice?

The unregulated sale of human organs can be expected gradually to erode this essential feature of the Filipino mind. However, providing compensation to organ donors in a regulated setting can have a more acceptable outcome. There are conditions under which compensated organ donation can actually strengthen the bonds created by kagandahang loob between donors and donees.

The transfer of money to organ donors by organ recipients does not necessarily constitute a sale and is not indicative of a looming commercialization. Compensation for donors, handled properly, can minimize the avenues for the exploitation poor donors. It can also contribute to the emergence of a long-term relationship that is in keeping with other defining features of the Filipino mind. For one thing, it confirms the level of appreciation that is proportionate to the sacrifice made by the donor and conveys the message that his kagandahang loob is not being taken advantage of. It also keeps going the cycle of kagandahang loob and utang na loob (debt of good will) that dominates the Filipino mind.

A global idea of human dignity
- K. Chamundeeswari
Sheffield University, UK; UNU, Tokyo
Email: chamu@ias.unu.edu

Human dignity in today's world has to be conceived of in conjunction with human solidarity. There are certain bioethical issues that concern an individual predominantly while there are others which concern the society as a whole. Those questions which concern the society has to be considered on the most fundamental and basic conception of human dignity. The reason being that human dignity itself demands such an approach. As far as the concept of society goes, the human genome by virtue of being the common heritage of humanity in that it is present in each and every one of us, 'society' is obviously the global society or the entire humanity.

Human dignity is the quality of humanness. It is the inherent worth of every human being. This is the most fundamental and basic conception of human dignity that has to operate in the context of the global society. The issues of bioethics chiefly relate to global health issues. The health of peoples around the world is varied. While the population of Africa is suffering from numerous preventable diseases and malnutrition, the people of Europe and Americas are infinitely healthier. Human solidarity demands that the healthy express solidarity with the suffering. For example - a decision to ban federal funding for reproductive cloning will be in keeping with human solidarity and dignity if taken on the basis that money will be better spent on ameliorating the condition of the stricken of the world.

Therefore the bioethical decisions relating to questions affecting humanity has to be decided on a fundamental and threadbare/commonplace definition of human dignity. Participation of global stakeholders in bioethical decisions is lacking and a mechanism must be developed wherein all voices can be heard.

Bioethics and the Right to Privacy - a Human Rights Approach
- Rok Lampe, L.L.M.
University of Maribor, Faculty of Law, Mladinska ul. 9, 2000 Maribor, Slovenia
Email: rok.lampe@uni-mb.si

The European Court of Human Rights (ECHR) in Strasbourg is the highest judicial body of all members of the Council of Europe and the most effective guarantee for the protection of human rights in international law. Founded by the European Convention for the Protection of Human Rights and Fundamental Freedoms (1950), that is also the primal International Document on protection of human rights on the regional (European) level. The practice of the ECHR must be understood as precedents that set a minimum standard of human rights that must be also guaranteed by member States. Art. 8 of the ECHR guarantees everyone the Right of Privacy as a basic Human Right. The ECHR reached the crucial "bioethical" decisions concerning abortion ("Bruggemann and Scheuten v. FRG ") right of transsexuals ("Christine Goodwine v. VB", "I v. VB"), as well with termination of life on request and assisted suicide ("Pretty v. U.K.") on the ground of the Art 8 (Right to privacy). On the other hand the Council of Europe also tried to harmonize the European laws concerning crucial bioethical questions, with general rules set in the Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine (1997) and also with its Additional Protocol (1998). Although the Convention (1950) primary tries to establish an effective system of protection of human rights against the States, the practice of the ECHR allows them a wide margin of appreciation. The Convention from 1997, thou imposes stricter obligations on States concerning respect of person's dignity and privacy in medicine and biology.

Transforming ideas into policy making- thoughts, values and global governance
- Minakshi Bhardwaj, Ph.D.
Eubios Ethics Institute, Tsukuba Science City 305-8691, Japan
Email: bminakshi@hotmail.com

Each society has its own ethics and its on set of values that are developed over thousands of years. At the level of governance these values are interpreted, articulated and transformed into policies that may be reflective of the ethical values of the people. Governance is process of decision-making and the process by which the decisions are implemented. It is the complex mechanisms, processes, relationships, and institutions through which citizens and groups articulate their interests, ideologies, exercise their rights and obligations and mediate their differences. This paper tries to discuss some of the ethical issues in policy making in developing countries, and how values, ideologies and different cultures affect the governance at global level. The role of ethical principles in shaping ideas of people at the level of global governance will be discussed.

Reception


16 February
am. Mental maps, relationships and the clinical dilemmas

Clinical Bioethics: The Principle of Autonomy and Underage Patients (Comparative Analysis: Croatia, USA, Germany and Great Britain)
- Ivan Segota and Iva Sorta-Bilajac,
Department of Social Sciences, Medical Faculty - University of Rijeka, Brace Branchetta 22, 51000 Rijeka, CROATIA
Email: ivans@medri.hr, ivasortabilajac@yahoo.com

The bioethical principle of autonomy, on which the doctrine of Informed Consent is based, is the context for a discussion about certain bioethical question, which emerges in clinical practice of several countries. We will discuss here the right of underage patients, as well as the adults, to give their consent for a certain health-care treatment that they are exposed to. The question contemplates at what age they should be heard, and who, if not them, has the right to decide instead: parents, legal guardians, medical doctors or state-institutions?

In this paper this question is considered through the analysis of pediatric practice in four countries: Croatia, USA, Germany and Great Britain, and directly connected with the problem of vaccination and revaccination of underage patients. Namely, implementing of vaccination in pediatric practice is a very effective state-administrated prevention measure in health-care. But, in doing so, the interest of a child, the interest of a parent or legal guardian, and the interest of the public health should be taken into consideration. The question, that directly imposes itself and reaches up to the field of clinical bioethics, is: how much should the public health affect the individual's decision-making autonomy? Can the fact that vaccination is an irrefutably useful prevention-form in the field of public health overpower the right of a parent to decide about a certain health-care treatment - in this case vaccination - in the name of his underage child? What attitude should the state take in case that the parents decide contrary to that matter and so this decision could have significant consequences on the health of the entire population?

In this contrastive analysis, besides the common bioethical views, the attention is also paid to certain specific bioethical approaches in the mentioned countries, which can be very stimulative for further bioethical deliberation of the relationship between Informed Consent and underage patients in pediatric practice of several countries.

Bioethics education in medical school
- Noritoshi Tanida, M.D.
Department of Gastroenterology, Hyogo College of Medicine,, 1-1 Mukogawacho,, Nishinomiya, Hyogo 663-8501, Japan.

We started a compulsory "medical ethics" course for first-year students in 2000. The course has the general objective being "to understand the basis of bioethics thinking and to acquire the basic capacity to solve clinical problems of patients." The course consists of 14 school hours. Group discussion regarding 2 clinical cases took place during 11 school hours, and during the rest of the course lectures were given to the whole class on several topics in ethical issues. Identical short ethical tests were carried out on the first and last day of the course. The grade was evaluated by adding the scores of the last short test and the results of reports submitted after group discussions, and the course attendance rate. The results showed that the scores of the last short test correlated with the results of the reports of the second case, but not with those of the first case. Logistic regression analysis indicated that the contributing factors for the grade differentiation were the scores of the last short test and the attendance rate of students, where the attendance rate was an independent contributing factor. Furthermore, the scores of the last short test, but not the first short test, correlated with the acceptance level. These results indicated that the present ethics course was useful for the students to increase reflectiveness regarding ethical thinking. Several issues also become evident including: (1) evaluation method, (2) balance between case study and lecture, (3) relationship with other materials, (4) long-term effect.

Urgent "lifesaving" clinical research
Koichiro Itai, MA, Assistant Professor, Department of Philosophy and Ethics, School of Medicine, Miyazaki Medical College, Miyazaki
Email: koichiro@post.miyazaki-med.ac.jp

- Atsushi Asai, MD, MBioeth., PhD., Associate Professor, Department of Biomedical Ethics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan

No matter how far medicine advances, incurable disease will inevitably exist; and the dying patient's last resort will likewise look to medical research. In this report, we examine a case concerning the use of experimental medical therapy on a critically ill child. We discuss the ethical argument pertaining to the recommending of experimental medical therapy to the family of a dying patient. Under the circumstances of having to face the impending death of one's own child, parents of a terminally ill child are extremely vulnerable to suggestion and often loose the ability to make a composed decision. Moreover, there exists the possibility of not only patients, but also medical staff and researchers, to fall into therapeutic misconception. Likewise, for the terminal patient and his/her family. Experimental medical therapy is often the only hope, which is, however, always accompanied by a factor of uncertainty and is considered to be merely an unapproximated gamble. The proposing of experimental medical therapy can result in being cruel by shattering the parent's expectations of saving their child. We examine the issues involved in proposing an experimental medical therapy to patients who are in dire need of a last hope; and conclude that, in times of emergency, we must take great consideration in recommending an experimental medical therapy as an "innovative treatment". In extreme circumstances where an individual's life is on the line, doing nothing can be quite trying; yet, what is right is not necessarily doing something, but rather making the right decision.

The Model of Organ Procurement in Japan
- Alireza Bagheri, M.D. and Shinichi Shoji, M.D.
Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba 305-8575, Japan ; Iran
Email:bagheri@sakura.cc.tsukuba.ac.jp

Organ replacement therapy is a part of medical practice in today's world and many countries have adopted required guidelines and regulations. Establishing the basis on which the organs can be removed, is still one of the issue of debate. The critical disparity between supply and demand in organ replacement therapy, even with existence of social acceptance and special law which allows surgeons to perform organ transplantation turns attention towards the importance of the appropriate model of organ procurement which be able to expand donor pool and increase the retrieval organ rate by moving potential donors to actual ones.

In Japan organ transplantation law which was enacted in 1997, allows organ procurement from brain death as well as non-heart beating cadavers in a restricted conditions, such as the necessity of the donor's written consent and the family's consent. In Japanese model which was established under current organ procurement policy, organs from only 22 donors have been provided so far.

This paper examines different models of organ procurement which have been applied by different countries and in doing so concludes in which model, Japanese system can be placed.

The Ideas and Conflicts in Abortion Choices
Masayuki Takahashi and Darryl Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: Macer@biol.tsukuba.ac.jp

Abortion is one of many subjects in Bioethics, but like some other moral dilemmas there is no definite solution for this problem. It is also difficult to persuade anyone who has an opposite view from one's opinion with good reasons. At the same time, the way these issues are resolved depends on cultures and religions that each country has. This is still an interesting area to study the importance of human life, and research might help someone who is in a dilemma over this problem. Today abortion is legalized in almost all countries in the world. However, the rate of Japanese abortion has been higher than most other industrialized countries. This is probably due to what we rarely have good opportunities to take sex education here. In fact, today many Japanese have incorrect information. Of course, there are some reasons why this situation has not improved for a while. In Japan, many women who aborted their fetus tend to go to a temple and pray for their aborted fetus through Mizuko. Mizuko may be important for recovery from an abortion in Japan.

A random nationwide survey of Japanese citizens was conducted from Nov. 2002-Jan. 2003, via mail. Three questions were asked about abortion. The response were: Do you think that a pregnant woman can abort her fetus if it is under 4 months from the fertilization? (Yes19.4% No36.4% Don't know38.0%) Do you think that a pregnant woman can abort her fetus under 4 months from the fertilization if it has some congenital disease? (Yes42.6% No14.0% Don't know35.7%) And do you think that a woman has the right to abortion (Yes51.2% No7.8% Don't know37.2%)and what do you think of aborting a fetus with Down's syndrome?

Religious differences were compared between people who had no religion (48%) and Buddhist (46%). There was no significant difference in the results for abortion between these two groups. The response from Christians was different from the above two groups but the number of Christian respondents are low. The people who said they were Buddhist or had no religion expressed similar ideas about bearing a child who has Down's syndrome. People who answered "Yes" said it depends on the decision of the pregnant women, it's a women's right, it's really hard to raise the baby and live together with because we have little financial assistance from the government. They also said to take care of an undesired child. They also seem to be against having a child who has a congenital disease. However, some of them said that they have to decide whether or not to bear a child afflicted with Down's Syndrome, given current knowledge of the disease.

On the other hand, one person said that she knows a woman who had the child and they are living happily with each other. This sort of opinion is positive for having children who have a heavy disease, but there were many negative opinions from both groups. From the results of my questions, it can be see that many Japanese tend not to choose to have children with serious diseases, and about half the people find it difficult to make a definite decision about such matters.

Neglected Bioethical Issues In The Management Of Human Mycoses
- Chandra Jeet Singh and Suresh Kumar Sharma
Department of Botany, K.R. (P.G.) College, Mathura -281 001 INDIA
E- mail: singhcj1@rediffmail.com

The mycoses are among the most ubiquitous of all infectious diseases that plague mankind around the world and especially India for its warm, humid tropical climate, crowded living and poor socio-economic conditions. The general lack of adequate medical care permits fungal infections, once acquired, to develop and desseminate unabated and to reach life threatening or disabiling states, before coming , if ever, to medical attention. Extensive advances made in the management of these infections have left several glaring questions of ethical nature to be answered.

During the developmental phases of a chemotherapeutic agent, clinical trials with animals or patients are essential pre-requirements for verifying its safety and efficacy. Why animals should be included in such research, if they are morally equivalent to human beings? And if not animals, do patients receive adequate informations to make informed choices about risks to themselves? Further, the successful treatment for several mycoses involves surgical removal of fungal balls from the lesions, amputation of the affected organs as for maduromycosis or complete removal of the cornea as for oculomycosis. In such cases, who decides on the amputation of a leg or the removal of cornea or an ablative surgery? Do doctors get consent by coercion, persuation or true informed consent? Are patients offered satisfactory artificial organs to maintain the function of the amputated organs? Is the absence of recurrence guarrantted?

In such critical situations, what should be the best choice for a doctor: Confronting with the ethical challenges or confronting with the disease? What regulatory criteria may be evolved to enable both scientific and ethical society flourish simultaneously would be the subject of this presentation.

Problems over home hospice care and solutions from viewpoints of nursing in Japan
- Setsuko Morishita, M.D. and Sumiko Takanami, Ph.D.
Nursing department, College of Medical Technology,Hokkaido University, Sapporo,060-0812, Japan
Email: snh@cme.hokudai.ac.jp and staka@cme.hokudai.ac.jp

In this paper, authors looked at the current issues of home hospice care in Japan and thought about factors that have impeded the development of home hospice care and solutions. Under current situations where hospice and palliative care has still not been understood well among people, laws related with medical professionals put limitations on medical acts done by medical professionals except physicians in patient's home, and few physicians have visited a patient's home, authors could suggest the following. First, physicians and nurses should help the patient and family understand what home hospice care is and select home hospice care as one of their options. For that purpose a physician has to give enough information on the disease and/or the prognosis to patients and/or families and a nurse has to support the patient in making decisions how to live their remaining days. Secondly, under articles 17 and 20 of the Physician Law and article 37 of the Public health nurse-Midwife-Nurse law, a nurse should play the role as a key professional to put providing hospice care for patients in the home into practice, following physician's directions and collaborating with physicians. Thirdly, medical and nursing education should include the end of life issues, further clinical programs are necessary for physicians and nurses to learn how to care for patients in the terminal stage. Finally, medical professionals are expected to understand the basic principle of hospice and palliative care and to participate in providing hospice and palliative care.

The differing cultures of nursing and medicine - the need for an ethics of collaboration
- Joan Liaschenko, RN, PhD, Center for Bioethics and School of Nursing University of Minnesota
John Song, MD, MPH, MAT, Center for Bioethics and School of Medicine University of Minnesota
Jane Stein-Parbury, RN, PhD, Faculty of Nursing University of Technology, Sydney

Email: jliasch@umn.edu

Health equity
- Yukiko Asada,
Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
Email: yasada@wisc.edu

The field of bioethics has developed focusing on ethical issues of medicine centered around individual relationships, for example, between a patient and a physician. Bioethics no doubt will continue to contribute in this traditional way, yet there may be a promising area of expansion. Some researchers, both inside and outside of the field of bioethics, have begun to realize that there are abundant ethical issues in population health. These include concerns about privacy and confidentiality in population health data use and inequality in health status and utilization of health care. This presentation focuses on one such ethical issue at the population level, health equity, and calls attention to this exciting new territory for bioethics.


pm. Bioethics Education and Creating a Framework for Ideas in the Mind
Implications of Curriculum Changes for Bioethics Education in Japan
- Naoki Shiraishi
Adachi High School, Tokyo, Japan
Email: naokish@mub.biglobe.ne.jp

Measuring the Impact of Viewing a Video "Designer Child"
- Shigeko Tsuboi
Kawaguchisiritu Kawaguchi High School, 1-11-39-103 Kitaharadai, Kawagutishi, Saitama 333-0815, Japan
E-mail: s.tby@nifty.com

It is a report of implication with a chapter "Genetics" in Biology subject which is for the second grade students' select curriculum. There are rare experiments about Genetics at the High School. In order to teach Genetics I use a VTR "Desighner Child" as a teaching material. This researches how the students have been made an Impact by watching the VTR. I use Questionaire in order to analyze the Impact. The questionnaire also are involved in Bioethcal Issues. Then I try to analyze how to develop their ideas about Bioethics.

Mary Ann Chen Ng (The Philippines) - Reflections on learner autonomy in bioethics education
This paper explores the relationship of some fundamental principles of bioethics as it affects learning from the learner's point of view. It seeks to state questions about methodology, the role of the researcher, the teacher, the learner, and the contextual schema and its relationship to autonomy, authority, legitimacy and equality in bioethics education. The main point is that when one talks about bioethics education it is necessary to look at subjective issues that have a personal bearing on learner outcome and development. Strategies that fail to consider such factors need to be identified and addressed for more authentic and holistic forms of learning.

AIDS and the Vulnerable Population In India
- Aya Tanabe
Tokei University Medical School Isehara, Kanagawa Prefecture. Japan
Email: ayatanabe@hotmail.com

In this paper, I shall discuss an issue of widows and deserted women in India. It is mainly based on a case of a widow who was suspected to be HIV positive, but did not know about the grounds for suspicion. I learned about the case while conducting a health and health services survey, in Velhe Block, Pune district, India with Frank Leavitt in August 2001. He has been discussing whether she should be told the fact or not, from his bioethical perspectives. I want to consider the possible background of her becoming infected with HIV, and the vulnerability of widows and deserted women in the community.

Problems to be discussed include: In a village where we did our survey, most of male population aged about 18 to 30 go to cities such as Mumbai or Pune to get money incomes. It is reported that nearly fifty percent of sex workers in those cities are HIV infected. HIV is often brought to villages by migrant workers. _
It is comparatively easy for men to remarry when they lose their wives or divorce from their wives. _ Women have less chance to be examined for HIV and get treatments for social reasons. _ Widows are strongly discriminated against. Deserted women become objects of contempt. That makes keep them away from social activities and closes their chances to support themselves, other than by prostitution..

Deserted women are forced to be sexually opened to men in the community, possible because of the strong discrimination against them. Though this wicked custom, HIV can spread through the whole community.

Ethical Issues in Public Health in the Cameroon
- Michael Kune Njohjam
C.I.D.C, P.O Box 18632, Douala, Cameroon
Email: cidc_dis@yahoo.com

Ethical issues in the Public health in Cameroon still need to be given recognition and carefull attention.A country with about 70% of the population unable to read and write ,united by many ethical issues that reflect differences in culttures,politics, wealth,religion,values etc would need the courageous effort of the administration,researcher,community leaders and social meetings leaders to keep to ethical norms.Poverty and ignorance need to be improved upon by the government,religious leaders, non governmental bodies, in order to estabish a comprehensive health care service system that combines public health, medical care and the community.

Clinical anthropology - Its extension of learner andeducational effects
- Shin'ichi Shoji 1), Katsuko Kamiya 2), Sachiko Ochiai 3)
1) Institute of Clinical Medicine, University of Tsukuba, 2) Institute of Social Medicine, University of Tsukuba, 3) Center for Arts & Humanities, Ibaraki Prefectural University of Health Science, Japan
Email: sshoji@md.tsukuba.ac.jp

Clinical anthropology class is a new educational method for humaity and bioethics education. This is maily composed of 1) presentation of a concrete clinical case relating human birth, aging, illness or death, that needs a quick own decision, 2) presenrtation of minimum essential information and typical opinions about the theme, 3) questions & answers in class room, 4) discussion in small groups , 5) presentation of some groups of discussion abstract, 6) general discussion, 7) presentation of tutors' own opinions, 8) describing student own opinion within 240 Japanese letters. This course is elective for all university students. This course started from about 200 enrolled students in 1997 and exceeded 400 enrolled students in 2001. Object of learner extended from medical studnets, to students of other health system, graduate students of medical sciences, general university students, general scitizens, and junior high school students. Effects of education was evaluated by series of questionnaires for general university students. In 2001 three questionnaires was done at the end of each term using lecture evaluation scale. From analysis of the factor structure in the scale, three factors were extracted. These are 1) interest in a human, 2) power to decide independently, and 3) realization of own will and growth. From 2nd term to 3rd term, these all three factors elvated significantly. These data suggest this course's educational effects are maily in enhancement of these three abilities.

Drafting a Korean Charter for Scientists and Engineers Sang-Yong Song and Young-Mo Ko et al.
Seoul, South Korea
Email: ethics65@netsgo.com

In a follow-up effort to respond to recommendations raised by "Science Agenda - A Framework for Action", the conference document of the World Science Conference (Budapest, Hungary 26 June - 1 July 1999), the Korean government's Ministry of Science and Technology has had the 14-member interdisciplinary research team prepare a 6-page-long draft of the Charter for the Scientists and Engineers. In this presentation the draft of the charter, consisting of 8 chapters, 25 articles and fifteen 15 clauses, is explained in comparison with the 115 world's existing ethical standards which the International Council for Science(ICSU) collected for analyses.

Some key values stated in the draft of the charter include: social and environmental responsibilities, sustainable development, socio-ecomomic development, public interests, equality and diversity, democratic development, inter-Korea cooperation, researcher's integrity, welfare of human subjects, consideration of animal subjects, ethics committee, whistle-blowing & institutional responsibility, and ethics education.

Policy and law may make biotechnology R&D as orphans
- Kazuo N. Watanabe, Ph.D.
Gene Research Center, University of Tsukuba, Japan
Email: nebechan@gene.tsukuba.ac.jp

International standardization of transboudary movement of genetically engineered organisms has been discussed at The Cartagena Protocol on Biosafety1 to the Convention of Biological Diversity. CBD was one of consequences after the Rio Summit in 1992 which major contents were confirmed at the World Summit on Sustainable Development (WSSD) in August-September, 2002 at Johannesburg. The Protocol agreement at Montreal at 4 am in January 29, 2000. Yet, further discussions and agreement must be made in various components on the details in each Article within the Protocol. Now over one hundred nations signed on the Biosafety Protocol and forty-three Parties had ratified so far as of February 7, 2003. Particularly EU member countries have been discussing vigorously to adopt the directive(s) toward ratification processes. Thus, it may be very close future to make the transboundary movement of LMOs (Living Modified Organisms, = GMOs defined in the Biosafety Protocol)) under the internationally standardized documentation and instruction.
This international regulation would make better understanding of handlings, marketing / uses and also upstream R&D, and furthermore, better understanding of Genetically engineered crops by public. However, there is also a possibility of regulating the present R&D unnecessary. Indeed, the current international and domestic regulations and plans in many countries may deter the R&D including academic research associated genetic engineering, and this may make even further lack of control of GMOs due to the lack of scientific knowledge established by such basic research. Government policy, regulations and funding on genetic engineering should be strategic to have accountability to balancing the industrial development and public understanding.

Moral responsibility in changing the mind and bioethics education
- Fumi Maekawa and Darryl Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: minpu76@yahoo.co.jp, Macer@biol.tsukuba.ac.jp

The importance of bioethics education has been emphasized for a long time, from international institutions such as UN, to the students themselves. Attempts to introduce bioethics into school education are an on-going process in Japan, as in many countries. Some fundamental questions regarding education arise. Do we know if bioethics education actually helps people resolve bioethics dilemmas? Does knowing more sides of an issue help us resolve the practical dilemmas when we face them?

If we present an "idea map" about a certain moral dilemma to someone, to enable them to think of more ideas and issues, can it really enhance their decision-making, or is it a type of "mind control", or paternalism? These are cautions that will have to be embedded in the design of the mental map and the use of it.

Some example analysis will be presented from a bioethics lecture held in the University of Tsukuba. This class was entitled "life and culture" and was open mainly to first year undergraduate students from different fields of majors. A short survey concerning bioethics and prenatal testing was distributed before and after the series of three lectures on bioethics. In addition, students handed in keywords and opinions about each lecture, and an extended report on prenatal testing. These were analyzed in order to investigate any opinion changes through the course of education on one of the controversial issues of bioethics.


pm.Environmental Ethics and Human Ideas (1/2)
Ecotourism in Mongolia
- Undarmaa Tuvshinbat
GoWest, Mongolia
Email: ibgundra@yahoo.com

The Animals Came Dancing - Native American and European Rationalizations for Killing Wildlife - Do the Animals Really Care?!
- Mike Vandeman (USA)[Presented by Frank Leavitt]

The Modeling of Sustainable Development and its Relevance to a Human Ideas Map for Bioethics
- Morgan Pollard
School of Resource Science and Management, Southern Cross University, Lismore, NSW, 2480, Australia
Email: mogsdogs@hotmail.com

'Sustainable Development' and 'Bioethics' are broad concepts, umbrella terms within which a multitude of subsidiary terms and concepts are associated. Although they represent distinct philosophical fields with their own ideas and emphases, the two in fact have considerable overlap and remarkably similar overall goals. Both are concerned with the decisions leading to biological (i.e. human and ecological) welfare and wellbeing. Any conceptual model of sustainable development would likely include numerous bioethical principles, even if not explicitly stated as such, and similarly any map or model of bioethics would implicitly assume philosophical aspects of sustainability theory. In the interests of goal-oriented collaboration and coordination, it is useful and perhaps essential that existing principles, philosophies, terminologies and models within each field are compared, contrasted and combined. The present paper briefly outlines some central concepts and models from sustainable development theory, and gives some examples of how the philosophies of sustainability and bioethics can form a mutually beneficial symbiosis.

Reception

17 February (Venue A106 Institute of Biological Sciences, Second Cluster of Colleges)
9am-10:30am.Environmental Ethics and Human Ideas (2/2)

People's ideas and need for safe water: a case of arsenic-affected people in Meherpur District, Bangladesh
- Wardatul Akmam and Yoshiro Higano
Institute of Agricultural Sciences, University of Tsukuba, Japan; and Bangladesh
Email: akmamprottoya@hotmail.com

Water, in Bangladesh is considered as a source of life, although the same phenomenon can also bring about death, if it comes in the form of floods and deluges, or if it is not safe for human consumption. What then is safe water, and what are people's ideas about safe water? We raise these questions in the context of a major environmental and health concern in Bangladesh at present- the contamination of ground water by arsenic, owing to which at least 35 million people are exposed to various arsenic-related diseases such as melanosis, keratosis, gangrene, and worst of all-cancer of the skin, lung, kidney, liver and bladder, making it the world's worst mass poisoning in history. People in Bangladesh have been made used to drink water from tube wells in order to be safe from water-borne diseases such as diarrhea and cholera by the continuous efforts made by the Bangladesh government and other world organizations such as UNICEF and World Bank. However, since 1993, a large number of these tube wells have been found to be contaminated with arsenic beyond the permissible level (0.05 mg/liter).

Adopting the definition of an 'idea' given by Dr. Darryl Macer (i.e., "an idea is a mental conceptualization of something, including physical objects, an action or behavior that was made or could be made in the future, or a past, present or future sensory experience"), the purpose of the proposed paper is to develop some hypotheses on people's ideas regarding safe water on the basis of a sample survey carried out in three badly affected villages of Meherpur District in December 2000.

Ethics Violation in Cashew Factories of Kerala, India
- V.R. Prakasam, Ph.D.,
Dept. of Environmental Sciences, University of Kerala, Trivandrum
Email: prakasamvr@satyam.net.in

In Kerala state of India there are 412 factories in which about 3.5 lakhs of workers are engaged in processing of cashewnuts by heat process. The separation of kernel from the shell is carried out through roasting, shelling and peeling. The majority of the cashew workers are women. They handle the roasted nuts with naked hands and spent most of the time in the smoky environment of the factories. This has produced dermatitis, asthma and bronchitis among the workers. Protective measures are not observed in factories. Further households around the factories are also exposed to a diluted dose of cashew nut smoke which might lead to health hazards. The fact is that not only the workers are poorly paid but they are also victimized to toxic effects of cashew processing. The question asked is whether it is exploitation or ethics violation at the expense of health risks of workers.

Bioethical Maturity in Agriculture and Related Industrial System : Analogies on Bast Fiber Crops and its Environment from India
- Dipankar Saha1, C.R.Hazra 2 , Jayapaul Azariah 3, Amitava Saha 4 , A.K.Mahapatra5 , S.K.Hazra6 and H.S.Sen7
Agriculture Research Service Scientist, Indian Council of Agricultural Research, Central Research Institute for Jute and Allied Fibers, Barrackpore, Kolkata-700 120, West Bengal, INDIA
Email: sagdip@ejobs.every1.net

Perceiving the ethics of human beings, the very reasons behind their humanness and their relationship with other biotic and abiotic components of the ecosystem through the evolutionary process or in other words the understanding of human mind acting behind any system modalities (both individual and biosystem as a whole) can be a tool in perceiving, analyzing, interpreting and implementing the accumulative bioethical insight. Propagating those insight again into any existing chain of agricultural production through commercialization per say may be considered as a tool again for routing the gradually resolved thought boxes existing within the ambience of any modalities. This may lead us to reconcile the agricultural bioethics thereby the environmental ethics as a complimentary domain of cogitation. It is to be understood also in this context that when medical bioethics used to be inwardly focused, agricultural bioethics, however, is much more outwardly focused having intricate relationship with the environment.

Perhaps most surprisingly, very rarely some introspection has been done on bioethical statehoods in agricultural affairs related to farming, environment and industries as a cognitive triad. The flurry of interest in codes of ethics was triggered by different factors in different areas of science. The agriculture and its associated domains yet to touch the chord sensibly excepting in some cases likely in United States, The American Society of Agronomy officially adopted a statement of ethics in late 1992 and that too in the areas of research modalities.

Explicitly agricultural technology ought to be productive, environmentally sound, safe, resource conserving and socially benign or positive in its impression. The opinion flux lie in the relative magnitude of importance to be associated to these themes, especially in a situation in which there are potential trade-offs. In articulating these an analysis of regional reflection from India related to a particular agro-industrial crop i.e; bast fiber crops and its associated production system need to be synthesized. In resolving the ethical disputes it is better to have the "scientific theo centrism" which can be regarded as a "pragmatically tuned " approach in realizing bioethical decision profile lying within the human mind in facilitating bioethical resonance in the arena of food, agriculture and environment.

Ecological feedback drives the evolution of ideas and living things, which carry them
- Rick Weisburd, Ph.D.
Institute of Biological Sciences, University of Tsukuba, Japan; and USA
Email: weisburd@biol.tsukuba.ac.jp

What is a human idea? The mind creates ideas to experience, feel, express, or process perception of things both physical and abstract, sensed and intuited, real and imagined. Ideas may be the fundamental unit of mental processing of information. However, ideas and the abilty to process them are not limited to humans, and might not be limited to living organisms. Even chemicals like nucleic acids might be thought of ideas. With a determined number of possible bases at each position (4), for any given nucleotide length, there is a fixed number of possible nucleotide sequences. Although the number of possible DNA ideas (unique nucleotide sequence) increases exponentially with increases in sequence length, it cannot become infinite unless a nucleotide sequence of infinite length is possible. Perhaps like the number of possible DNA ideas, the number of possible human ideas, is finite. Nevertheless, the number of such possible ideas is so vast that we cannot conceive of any cell, computer, or mind that could consider them all. Thus, trying to characterize all possible ideas might be futile. A more sensible approach might be to characterize and classify ideas based on their utility to humans.


11:00-13:00. Intergenerational Ethics, Genetics and Evolution of Ideas
Concerns about prenatal screening in Japan
- Yoshinobu Eto and Darryl Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: Macer@biol.tsukuba.ac.jp

In Japan, a variety of biotechnologies such as IVF or Surrogacy are getting more familiar to people, and the birth of a cloned child that is a frequent topic in the media has forced public attention, because of its possibility to serve an alternative choice for people who could not have a child. Face to face interviews on Biotechnology and Bioethics using a questionnaire were conducted in Tsukuba among 47 persons. The results will be discussed with comparisons to trends in opinion in Japan.

Many people had heard of genetic engineering and reproductive technologies, but the majority were worried about those applications. About prenatal screening of the fetus for a fatal genetic diseases, almost the same number of people said "yes" as "no" from its benefit and danger. The results will be compared to other surveys in Japan. Many people didn't support gaining a longer life span by genetic engineering, though this issue had not been discussed well. In cases of reproduction and genetic enhancement, introduction of technologies for treatment of diseases was more acceptable than application for individual improvement.

Reproductive Cloning - from a contemplative Sikh viewpoint
- Gursatej S. Gandhi, Ph.D.,
Department of Human Genetics, Guru Nanak Dev University, Amritsar 143 005, India
Email: jrgandhi@sancharnet.in

The path to spirituality does not require renunciation-rather a normal family life has been propounded by the Sikh Gurus with the birth of a child an added blessing. Guru Amar Das ji, the third guru, composed and recited a hymn on "Bliss" when his grandson was born. In the light of this background, the issue of reproductive cloning, which is taking the world by storm is discussed! A strong religious belief garnered from the Holy Scriptures relates the moment of conception as the entry point of the soul. A natural question arises as to the whereabouts of the soul and its entry in the reproductive cloning process.

The Sikhs are an enterprising community and though farming was an original occupation, now they are involved in various professions and businesses. It is a hard working sect with affluence and influence. Religious sentiments are strong in the rustic but with the transient opulence from the west among the economically stable, no strictures are adherent. Medical practice and the viewpoint of a doctor are taken for granted with newer treatments casually accepted. Both the Sikh clergy and politick relate in a similar fashion as the public. The issue of cloning individuals is rather far from their comprehension. In the literate circles, the need of a child far outweighs any religious overtures, leave aside the relationship dilemmas cloning is bound to pose. Biologists are not too strong on religion and the common consensus is that religion should not hinder science.

Views on cloning from a developmental biologist
- Hideko Urushihara, Ph.D.
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan

Politics and Public Policy in the Regulation of Embryonic Stem Cell Research: A Comparison of Japan and the U.S.
- Dr. Steve Collins
Program in Interdisciplinary Arts and Sciences, University of Washington, Bothell, WA 98011-8246, USA
Email: swcollin@u.washington.edu


14:00-18:00pm. Human genetics in communities and ethics
Ethical issues of newborn mass screening
- Ichiro Matsuda, M.D.
Hokkaido Health Science University, Ezu Institution for Developmental Disabilities, Japan

Since 1979, we identified more than 15 000 babies affected with one of the tested diseases. The outcome for patients is generally favorable if adequate treatment is given. Recently we are faced with ethical issues such as: whether or not written informed consent should be required more precisely, under what condition the residual blood spot will be used for another research purpose other than originally designed, and whether or not a cost/effectiveness is positive.

The paradigm for newborn screening is not only to benefit the newborn but also to support their families. For implementation of the screening, bioethical considerations are of the greatest importance.I will discuss ethical issues of voluntary versus mandatory screening, and economic aspects of the policies. It will be concluded that for the diseases preventable or treatable in the early stage, mandatory screening will be acceptable, but parents should be given full information about the screening and have the opportunity to refuse to have their newborn tested. This refusal should be documented in writing. However, it must be noted that health professionals have a duty to attempt to persuade parents to consent to having child screened. . Where there is uncertainty as to benefits for the child being tested, the screening should not be carried out, if informed consent is denied.

Community Engagement and the Hap Map Project in Japan
- Eiko Suda and Darryl Macer
Eubios Ethics Institute, Tsukuba Science City 305-8691, Japan

The Haplotype Mapping Project (HapMap) is an international collaborative project collecting blood samples from people from various parts of the world. It will collect samples from around 100 people from each of about 10 major racial, ethnic, or geographic groups. It will not collect names or health information, and researchers will only know what group each sample came from. There will be no benefit to the donors, except the future promise of medical research results.

The project raises ethical issues in the way that the samples are collected, the way the samples are sent to a central repository in the USA and then stored as cell lines for access by researchers around the world. While elaborate procedures have been considered to protect the participants who donate samples, there are concerns that the samples may be used to label broad ethnic groups in the future. For example, in future studies, researchers may find that certain genetic variations show up more often in people from one group than in people from other groups, and that these variations are more common in people with a certain disease. When these findings become public, some people could think less of a particular group, or more of another group.

The project also involves creating a community advisory group in each area, which will be available for ongoing consultation after the samples have been collected and used for research. The ethical issues faced as we were conducting this project in Japan and some reflections made with lessons for genetic sampling projects in the future in Asia will be presented. Different concepts of research method, community engagement, and the differences of cultural, social and ethical background in different areas between collaborators and participants will be also considered. The description of focus groups of ordinary people that will be made as one of the important steps in the process of sample collection to establish community engagement in Japan to discuss about issues regarding Japanese participation in such an international genetic study, including depositing Japanese samples abroad, will be made.

Selected results of a national random public survey which reveal people's attitudes towards genetic studies will also be presented to show the Japanese current situation surrounding genetic studies. About 45% of ordinary people showed positive attitude to donation of their blood for a DNA bank if samples will be made anonymous. Among the 30% who answered "don't know", we could find comments about the shortage of sufficient information about science and the process of sample collection. Considering such factors, there seems to be a positive attitude to DNA donation in Japan. They also showed by their comments the preference to contribute to science, medicine and helping others. On the other hand, the survey found increasing distrust and concerns about protecting privacy or other abuses of genetic information. A number of people preferred to actually receive feedback and a benefit to themselves from the participation to the research, even if it will be not anonymous. The current situation regarding community engagement in international genetic research, and the future of DNA donation and databases in Japan, will be discussed.

Promise over Privacy: The Social Perception on the Protection of Genetic Information in Korea
- Jeong-Ro Yoon, Ph.D. (KAIST) and Sung Kyum Cho (Chungnam National University)
School of Humanities and Social Sciences, Korea Advanced Institute of Science and Technology, Kusong-dong, Yusong-ku, Taejon, 305-701, Korea
Email: jryoon@kaist.ac.kr

The protection of genetic privacy is an important issue in the human genomics research and its clinical application. The institutional apparatus for the genetic privacy protection has been a thorny issue in the bioethics regulations in Korea. The Korean ELSI project, in which both authors participate, has proposed to develop a set of research ethics guideline and models for education, communication, and public participation focusing on the protection of genetic privacy. In an effort to support this project, a social survey on 1100 people with the age of 16 or over across the nation was conducted in October 2002 over the telephone.

The survey results show that the potential benefits accruing from the utilization of genetic information loom larger than the concerns over privacy violations in Korea. The privacy awareness for a variety of personal information is not well developed, and the genetic information seems to be no exception. Koreans are rather permissive of the utilization, without prior consent, of genetic information and blood sample, unless personal interests in specific circumstances such as employment and insurance are at risk. A closer look at the responses show that the permissiveness toward the genetic privacy is not well-reflected and coherent outlook, resulting rather from the lack of information. This observation is supported by our analysis of media coverage of the biotechnology issues. These findings suggest that priority be given to the task of the production and effective delivery to the public of balanced information on diverse aspects of human genomics research in order to raise the public understanding.

A historical and ethical analysis of leprosy control policy in Japan
- Michio Miyasaka, Ph.D.
School of health Sciences, Niigata University, 951-8518, Japan
Email: miyasaka@clg.niigata-u.ac.jp

This study explored a historical and ethical analysis of leprosy control policy in Japan. The policy included a century-long history of isolation and sterilization of leprosy patients. Patients were isolated in remote leprosaria, even after it became evident that the disease was rarely contagious and could be effectively treated. Male patients had to be vasectomized before they were allowed to marry, and female patients were enforced to have abortion and even infanticide, notwithstanding the disease was not inheritable. My analysis focused on ethical and historical aspects including (1) medical paternalism; (2) patient's right movement; (3) public ignorance and stigmatization; and (4) social justice. Medical paternalism played an important role throughout the policy. Japanese leprologists who advocated the isolation-sterilization policy believed that they were doing what is of benefit to patients. Furthermore, leprosarium directors were empowered to arrest and punish patients without court order, and were doubted to be responsible for the death of 22 persons at Jukanbo, a confinement facility. On the other hand, patient's right movement was organized and developed autonomously in leprosaria, but confronted public ignorance and stigmatization. As a matter of social justice, the recent Jukanbo Reconstruction Movement was mentioned.

Ethics Committees in Japan
- Takashi Tsuchiya
Associate Professor, Department of Philosophy, Faculty of Literature and Human Sciences, Osaka City University, Osaka 558-8585, JAPAN
Email: tsuchiya@lit.osaka-cu.ac.jp

In this paper I will introduce a recent nationwide survey of ethics committees in Japan in which I participated and summarize its results first.

Then I try to interpret them by discussing characteristics of current policy and historical background in human research in Japan. Because of lack of consistent and systematic policy on human research, research institutions struggle with confusion of roles of review committees and burdens of administration. Most small hospitals don't have any ethics committees. Once research plan being approved, its actual performance is scarcely monitored. These may result in insufficient protection of research subjects. Societal resources to supply qualified external committee member being poor, public consciousness of issues in human research is needed. But research institutions are not active in education and public disclosure. Firstly Japanese government must establish comprehensive philosophy, systematic policy, and effective standard of ethics committees for research review. This must be done on the basis of serious historical review of past research abuses, which is only way to find firm principles of research with human subjects.

What genomics tells us about nature and humanity? A Japanese perspective
- Kazuto Kato, Ph.D.
Institute for Research in Humanities, Kyoto University, Sakyo-ku, Kyoto 606-8501, Japan.
E-mail: kato@zinbun.kyoto-u.ac.jp

Rapid progress of human genome research presents us so-called ethical, legal and social problems. Obviously, it is important to tackle them by having discussions with wide variety of people and by preparing necessary regulations. However, in order to decide how much new technology in the field of biomedicine we will accept in the future society, we need to carefully examine what we can learn about nature and humanity from modern bioscience including genomics. For example, as we know more about genomes of diverse organisms, we have started to appreciate the fact that they are historical existence. This means that they have contradictory features such as efficiency and uselessness within the same system. Knowledge from modern biology also tells us that we humans share many things with other organisms, but at the same time have unique features such as extensive use of technology. I will discuss implications of genome research and modern bioscience from the point of view of Japanese genome researchers. I will also present an attempt to share such discussions and knowledge in genomics with general public in Japan by the event called 'genome square' which was held in the November 2002 in Tokyo, Kyoto and Fukuoka.

From cultural to genetic identity? Biological concepts and society
- Margaret Sleebom, Ph.D.
Leiden University, The Netherlands
Email: m.sleeboom@wanadoo.nl

In this paper I would like to discuss the issue of genetic essentialism and its socio-ethical consequences from an anthropological perspective. Genomics will provide genetic information to large human groups for a variety of multifactorial disorders. Susceptibility screening (e.g. for cancer, cardiovascular diseases, neuropsychiatric diseases) will require analysis of multiple genes as well as environmental factors. Knowledge of the completion human genome and the functions of its sequences will make every individual a potential candidate for genetic testing, and consequently for genetic counselling. Though prevention and cure of diseases are the goals of biomedical research in genomics, the burden of the knowledge may lead to socio-psychological complications. It may have adverse effects on personal image, social standing, ethnic identity, employment prospects, and insurability. In other words genetics will provide the individual with a new genetic identity.

Increased public and political concern about new developments in new genetic technologies have led to scrutiny of their introduction into the health care system. This scrutiny I believe is related partly to a fear of genetic reductionism, that is, a fear of the loss of individual and cultural identity and, as a consequence, socio-genetic marginalization. The concept of socio-genetic marginalization draws attention to the effects of the practice of relating the social to the (assumed) genetic make-up of people, even when the relevance of such connection is doubtful. For, as will be made clear, it is the cultural (including the spiritual), socio-economic and political context, which endows genetic information with meaning. I discuss the role of symbols in the translation of basic concepts in genetics, such as 'genetic analysis' from scientific research into the language of popular debate.

When did 'bioethics' begin in each country? A proposal of a comparative study
- Masahiro Morioka
Professor, CIAS, Osaka Prefecture University, Gakuencho, Sakai, Osaka, 599-8531 Japan
International Network for Life Studies http://www.LifeStudiesNetwork.com
Email: pbi01055@nifty.ne.jp

Some people say that bioethics began in the USA and has spread around the world, but other people insist that bioethics has existed throughout the ages in every region. Which is right? Probably it depends on the definition of "bioethics."
(1) If we define "bioethics" as a kind of philosophy or ethics of life and death, we can find a great deal of literature from ancient times in every region. From this perspective, "bioethics" can be seen as a contemporary version of philosophy or ethics of life and death.
(2) If we define it as medical ethics, we can also find various ideas on ethics of medicine. There have been European, Chinese, Islamic, Hindu, Jewish traditions, etc. We have had a variety of discussions about euthanasia, abortion, healthy life, the use of medication, and so on.
(3) If we define it as environmental ethics, we have also had various traditions throughout the world.
(4) If we define it as the discussion of ethical issues arising from contemporary "advanced biomedical technology," such as organ transplantation, selective abortion, IVF and gene therapy, we can find such discussions from the 1960s to the present.
(5) If we define it as the civil movement that claimed the rights of patients, women, and the members of minority groups, then again, such movements have appeared since the 1960s in many countries.
(6) If we define it as an "academic" research and discussion, the United States of America would probably be one of the earliest countries to have institutionalized it as an academic discipline. Bioethics as an academic discipline emerged from the late 1970s to 1980s in the USA, but what about other countries?
I would like to propose a comparative study of the history of bioethics among countries or regions. Probably many interesting ideas and discussions will be found through the research. Isn't TRT the best place to discuss this topic?
In Japan, bioethics as (1)(2)(3) has existed from ancient times. The discussion of ethical issues arising from contemporary "advanced biomedical technology" began in 1968 when organ transplantation from a (pseudo) brain dead person was performed. In 1972, the Eugenic Protection Law Revision Bill was presented to the Diet, and ethics of selective abortion after amniocentesis began a heated political issue. In this year, women's liberation groups and a disabled group started movement against the revision, and they discussed a number of "bioethical" issues, though they did not use the word "bioethics." They discovered the problem of our "inner eugenic thought," which has become one of the main topics in today's Japanese bioethics. Hence, bioethics as (4)(5) began in the early 1970s in Japan, and in my view the crucial year was 1972.
Academic research started in the mid-1980s and we "imported" bioethics literature from English books and journals. Japanese Association for Bioethics was established in 1988. Academic Books and papers on bioethics began to emerge in this period. Hence, bioethics as (6) is considered to have begun in the late 1980s in Japan. It is interesting that the criticism of "bioethics as an academic discipline" has existed from the beginning. (For example, the subtitle of my first book published in 1988 was "Beyond Bioethics.") It is important to looking for alternative ideas to "bioethics as an academic discipline" in each country. It should also be noted that the journal of Eubios Ethics Institute was first published in 1991 at Tsukuba, and we have had eight TRT international conferences here.

Reference:
Masahiro Morioka, Disability Movement and Inner Eugenic Thought: A Philosophical Aspect of Independent Living and Bioethics, Eubios Journal of Asian and International Bioethics 12 (May 2002), 94-97.
Debora Diniz, Dirce Bellezi Guilhem and Volnei Garrafa, Bioethics in Brazil, Bioethics 13:3/4, (1999):244-248.
Research project on Cultural Issues in Bioethics << http://chinabioethics.netfirms.com/bioethics/main/sino_germ/20021120081138.htm>>


18 February (Venue A106 Institute of Biological Sciences, Second Cluster of Colleges)
9am-10:30am. Formulation of Mental Mapping Project Goals and Methods (Part 1)

11:00-14:30pm. Field trip to Space (NASDA) and Museums

15:00-17:00pm. Formulation of Mental Mapping Project Goals and Methods (Part 2)


Posters A Holistic Model of Ethical Behavior Based upon a Meta-perpectival hierarchy of Virtues, Values, and Ideals
- John E. LaMuth
P.O. Box 105, Lucerne Valley, CA 92356 USA
Email: values@charactervalues.com

A bioethical control on food marketing - alarming the consumers with Computerized Automatic Synchronous System
- Bing H. Tang, Department of Education & Research, Department Department of Surgery Changhua Christian Hospital, Changhua,500,Taiwan
T. Hsiao, Department of Computer Science and Information Engineering, Da-Yeh University, Changhua 500, Taiwan
Email: drtang1942@yahoo.com

Traditional mechanism for food marketing has been depended upon traditional manpower management in order to protect consumers' health. Nevertheless, this said mechanism is very easy to fall into the deficits of manpower management and results in the overlooks by consumers to tell exactly the dates of manufacturing and the expiration dates of food. This study is focusing on ethically presenting food to consumers, by uniformly controlling the marking processes, in combination with timely photosensitive labels to alarm both consumers and sellers with the changing in color of labels to make sure that food products are within the edible and/or drinkable period of time or not. On the other hand, it also can save managers any wasting of any manpower in term of quality control of food.

How to overcome the bioethical problems of the aging process
Bing H. Tang, Departments of Surgery, Neurosurgery, Department of Education and Research, Changhua Christian Hospital. Changhua 500, Taiwan
H. Chou H, Departments of Geriatric Medicine & Neurology, Chun-Shan Medical University, Taichung , Taiwan
Email: drtang1942@yahoo.com

The elderly is not at any stage in life which can be accepted as a time of preparation for death. Aging is not a disease, and should not be so treated. Today, our problem is the inability in locating a significant location the public domain for suffering and toward the end stage of life. Humans are all sensitive to their dignity and special requirement; therefore to set any limits to cut down the extra cost of the life supporting system is fair. It is very important for the elder to decide the quality of life to live, and the elder should have control of his or her own dying.

For any aging process( including but not limited to disease process ) of the elderly, there is certainly a differential diagnosis between two different types of cares, namely the life extending one and the life improving one. I do feel that any arbitrary cut-off of the life supporting system is discriminatory. I also realize that, financially, it is impossible to satisfy both the elderly and the young. A mild policy should be planned and formed between the aforementioned two extremes, then I am certain it will beneficial to both the elderly and the young, and to the society and the community. Indeed the challenge is ahead of me.

Bioethical problems of fetal tissue transplantation
Tang B, Department of Surgery, Department of Education & Research Changhua Christian Hospital, Changhua,500,Taiwan
Ting H,, Department of Rehabilitation Medicine Chung Shan Medical University, Taichung,Taiwan
Email: drtang1942@yahoo.com

The debate concerning the transplantation of "human fetal tissue" is a critical issue. According to Time magazine, fetal tissue transplants could be used to treat: leukemia, diabetes, memory deficits, Alzheimer's disease and Parkinson's disease just to name a few. The controversy, however, covers the clinical and ethical questions of human life. The clinical research establishment has received an abundance of ethical theory to bear on the moral responsibility of clinical research. Philosophers appeal to a number of ethical principles. Three of those principles are essential in the transplantation of human fetal tissue research: the principle of respect for persons (autonomy), justice and beneficence. In the case of human fetal-tissue transplantation research where the primary source is an elective abortion, the respect for persons, justice, and beneficence cannot play a serious role, for the safeguards are still inadequate because elective-on-demand abortions are being done by the thousands and are reinforced by clinical researchers who claiming that fetal-tissue is curing or ameliorating diseases.

The Animals Came Dancing - Native American and European Rationalizations for Killing Wildlife - Do the Animals Really Care?!

- Michael J. Vandeman, Ph.D.
California, USA
Email: mjvande@pacbell.net

19 February: informal network building, bioethics project meetings.


Secretariat for all meetings:

Prof. Darryl Macer
Institute of Biological Sciences,
University of Tsukuba,
Tsukuba Science City 305-8572,
JAPAN

Fax: Int+81-298-53-6614

Email: asianbioethics@yahoo.co.nz


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