Wednesday, September 21, 2005

What the world needs now: another bioethics declaration

This June, UNESCO unveiled a Universal Draft Declaration on Bioethics and Human Rights. The two central objectives of the Declaration are: (1) to state universal principles that lay a foundation for humanity’s response to dilemmas raised by science and technology, and (2) to ground these universal principles in human rights law in order guide states in the formulation of national legislation and policies in bioethics. Despite these lofty aims, the publication of the draft Declaration seemed to go unnoticed in bioethics circles. Perhaps this is to be expected: no one expects universal truths during summer vacation.

But the bioethicists are back from the beach, and some are less than thrilled with what UNESCO has produced. This month’s issue of Developing World Bioethics is devoted, in its entirety, to an examination of the draft Declaration and to speak of a ‘mixed review’ might be a bit charitable. The editorial draws first blood by calling the Declaration an obvious attempt on the part of UNESCO to muscle in on the authority of the World Health Organization on issues pertaining to the ethical regulation of biomedical research. UNESCO, writes the editorial, is an organization with little credibility among in the wider bioethics community and is best known for holding ineffectual (but costly) meetings and producing colorful booklets. Given its weak track record and dubious expertise, the predictable result is a Declaration that fails to state universal principles, redundantly lifts phrases from existing documents, is out of touch with some current bioethics debates, and offers misleading points of ‘guidance’. One thing is sure: Article 10 of the draft Declaration is a truly devastating piece of bioethics parody. “The fundamental equality of all human beings in dignity and rights is to be respected so that they are treated justly and equitably.” The deadly serious tone makes it all the more amusing.

The Declaration does not fare much better among some of the contributors to the September issue. David Benatar wonders out loud if the draft Declaration, should it be made official, would itself have a favorable risk/benefit ratio: will it do the world more good than harm? Matti Hayry and Tuija Takala ask why the concept of ‘dignity’ is repeatedly and uncritically used in the draft Declaration, despite recent concerns that the concept has no clear meaning. According to John Williams of the World Medical Association, the draft Declaration fails in both of its major objectives: it neither offers clear or helpful ethical guidance nor does it have the power to place new obligations on states. Commentators elsewhere echo these objections and concerns.

Other contributors are more positive. Loretta Kopelman is encouraged by elements in the Declaration that can counter ethical relativism and its negative effects on women and vulnerable populations worldwide. Ruth Macklin finds merit in the draft Declaration’s incorporation of considerations such as benefit sharing in research and the requirement that each country conduct ethical review of biomedical research within its own borders. So it looks like there will be a Universal Declaration on Bioethics and Human Rights, like it or not, and whether the world needs it or not.