Ethics dialogue between rich and poor countries is overdue.
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EuropaBio, the European Association for BioIndustries, represents 40 companies operating world wide and 14 national association (totaling around 600 small and medium-sized enterprises) involved in the research, development, testing, manufacturing, marketing, sales and distribution of biotechnology products and services in the fields of healthcare, agriculture, food and the environment.
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Two ethical issues facing Institutional Animal Care and Use Committees [IACUCs] today are assessing scientific merit and the use of alternatives in research proposals. This study evaluated 3 IACUCs using a 19-question survey, with a 77.8% response rate. Although 76% of members answered that scientific merit should be more dili-gently assessed if more than slight pain is caused, 14% believed that assessing scien-tific merit is not the role of the IACUC. Nearly 86% agreed that the search for alterna-tives should be more diligent for protocols that incur more than slight pain to the animals involved. Some members believed that alternatives were not actively enough sought after, while others believed no viable alternatives existed. Additional guide-lines are needed to clarify these issues.
The significance of the binomial "ethics" and "public health" is firstly described. Several definitions are given. A few characteristics making bioethics (concerning mainly individuals) different from ethics in public health (concerning populations) are described. The authors point out how bioethics has been investigated more deeply than public health ethics. Synergy between the two is desirable and efforts should be made in order to promote integration. The importance of research and training in public health ethics and of data exchange with other branches of learning are underlined. A list of national and international institutions dealing with public health ethics is given.
In June 1992, a national mail survey was directed to 204 state inpatient psychiatric institutions. This study was implemented following the 1992 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement that hospitals put in place some means with which to address ethical issues. The goals of the study were: 1. to examine state mental hospital characteristics and their response to the JCAHO requirements; 2. to describe healthcare ethics committee (HEC) composition, function, and role; 3. to study patient and family access to a HEC; and 4. to discover ethical issues most frequently addressed. The survey response rate was 71%. Of the 145 responders, 62 had HECs in place, and 53 were in the process of implementing HECs. There were no differences between JCAHO accredited institutions and non-accredited facilities with regard to having HECs. Physicians accounted for 22% of HEC membership, followed by nurses (15%), and administrators (12%). Twenty-six percent of facilities systematically notified patients about existence of the HEC; 71% of facilities had no patient request for HEC services in the last year. A patient's danger to others, and resuscitation policy were issues most frequently (23%) heard by HECs.
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This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy-the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius' teachings. However, Confucius' emphasis on the filial piety, family values, the "love of gradation", altruism of people, and the "role specified relation oriented ethics" will inevitably influence the "specification" and application of these bioethical principles and hence tend to grant "beneficence" a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of "first among equals" are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian "doctrine of Mean" (chung-yung) and a balanced "two dimensional personhood" approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing "giving beneficence a priority" or "asserting autonomy must triumph".
Local review of research by ethics committees in the UK has long been held to be an important right of the local research ethics committee and, even with the introduction of the European Clinical Trials Directive, the governance arrangements for research ethics committees continue to allow for local review of multicentre studies. There is no requirement for local review in either the European Union directive or in the guidelines on good clinical practice, and there is little evidence of it anywhere else in Europe. The idea that there can be "local", as opposed to "central" ethical issues in research is an interesting one, which raises important issues about the nature of research ethics and ethical review. The aim of this paper is to argue that there are no such things as local issues in research ethics, and suggest that those questions currently addressed as local issues properly belong within the research governance framework.
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