Asian Bioethics: Challenges and Prospects in the Coming Decade

1. Asian Bioethics: Challenges and Prospects in the Coming Decade Leonardo D. de Castro, Ph.D. University of the Philippines Vice Chair, UNESCO International Bioethics Committee Secretary, International Association of Bioethics

2. UNESCO GLOBAL ETHICS OBSERVATORY Mongolia Kazakhstan • North Korea Kyrgyzstan Tajikistan Myanmar Lao PDR • Papua New Guinea Turkmenistan Afghanistan Nepal L DE CASTRO UNIVERSITY OF THE PHILIPPINES

3. The challenge of identity The challenge of regional integration – growing together The challenge of poverty What is Asian about Asian bioethics? How do we maintain our identity? How do we face the problems that concern us all? How do we use bioethics to break the bonds of poverty? Challenges of Asian Bioethics L DE CASTRO UNIVERSITY OF THE PHILIPPINES

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6. ASSERTING UNIQUENESS L DE CASTRO UNIVERSITY OF THE PHILIPPINES

7. ASSERTING ASIAN ASCENDANCY L DE CASTRO UNIVERSITY OF THE PHILIPPINES

8. AN ASIAN PERSPECTIVE L DE CASTRO UNIVERSITY OF THE PHILIPPINES

9. AN ASIAN PERSPECTIVE L DE CASTRO UNIVERSITY OF THE PHILIPPINES

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13. AN ASIAN PERSPECTIVE L DE CASTRO UNIVERSITY OF THE PHILIPPINES

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15. ASIAN PERSPECTIVES L DE CASTRO UNIVERSITY OF THE PHILIPPINES

16. AN ASIAN PERSPECTIVE L DE CASTRO UNIVERSITY OF THE PHILIPPINES

17. OBSTACLES TO ASIAN INTEGRATION? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

18. SOME UNIVERSAL CONCEPTS? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

19. WHAT IS ASIAN ABOUT ASIAN BIOETHICS? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

20. HOLISTIC HARMONY? • “the essence of the Asian ethos is . . . ‘a holistic harmony’ in contrast to the modern European inclination to dualistic individualism.” (Sakamoto, 1999) L DE CASTRO UNIVERSITY OF THE PHILIPPINES

21. RESPONSIBILITY-ORIENTED? • The standard [Western] ethical framework is inadequate in other aspects. It always talks about rights, but much less about responsibility, and the principles seem to be put forth a priori and applied to any cases, regardless of the context of their application. (Wang, 1997) L DE CASTRO UNIVERSITY OF THE PHILIPPINES

22. RELIGIOUSITY OR SPIRITUALITY? • In contemporary Western bioethics discourse, the abortion debate has been closely associated with the discussion of personhood . . . . In summary, while Confucianism does not hold an absolute prohibition on abortion as does the Roman Catholic Church, the general attitude of Confucianism toward abortion is not as significantly different from those of other major world religious-moral traditions such as Judeo-Christianity, Islam, and Buddhism as usually assumed. (Nie, 2002) L DE CASTRO UNIVERSITY OF THE PHILIPPINES

23. The Western principle of autonomy is an individual-oriented principle. It requires that the patient, as long as being competent, have the final authority to make clinical decisions for himself. In contrast, the East Asian principle of autonomy is a family-centered principle. The principle implies that the entire family, rather than the individual patient, should have the final authority over clinical affairs. (Fan, 1997) FAMILY-CENTERED? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

24. PATERNALISTIC & HIERARCHICAL? • . . . paternalistic and hierarchy-oriented behavior patterns are deeply ingrained in the Japanese medical system. • rhetoric drawn from Confucian tradition was used to . . . reinforce that tendency in doctors. • But . . . tradition can be modified and enriched, (Hamano, 1997) L DE CASTRO UNIVERSITY OF THE PHILIPPINES

25. IMPORTED? • It is fair to say that biomedical ethics in Japan developed in the wake of the West, particularly that of the United States. The first phase of Japanese biomedical ethics, as we define it, was largely “an importation of Western biomedical ethics.” (Akabayashi and Slingsby, 2003, p. 261) L DE CASTRO UNIVERSITY OF THE PHILIPPINES

26. IMPORTED? • Use of DNA samples from the Republic of Tonga to study diabetes. • Urge Australian researchers and the government -- to consider responsibilities beyond our shores where research is aimed at benefiting our populace. (Ankeny, 243) L DE CASTRO UNIVERSITY OF THE PHILIPPINES

27. WHY ASK ABOUT ASIAN BIOETHICS? • Rock-bottom questions about life and death require rock-bottom reflections about the origins of our values and the foundations of our respective cultures L DE CASTRO UNIVERSITY OF THE PHILIPPINES

28. GROWING TOGETHER: COPING WITH COMMON ISSUES L DE CASTRO UNIVERSITY OF THE PHILIPPINES

29. ORGAN DONATION AND TRANSPLANTATION L DE CASTRO UNIVERSITY OF THE PHILIPPINES

30. Given the rapid advances in transplant technology, the capacity of doctors to perform successful transplants has also improved considerably. This has led to even greater demand, thereby putting a lot of pressure on the supply. As a consequence, the illegal sale of human organs has also flourished. L DE CASTRO UNIVERSITY OF THE PHILIPPINES

31. Transplant murder? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

32. Cultural change cannot be legislated L DE CASTRO UNIVERSITY OF THE PHILIPPINES

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36. Donor-middleman: L DE CASTRO UNIVERSITY OF THE PHILIPPINES

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38. Understanding values in context L DE CASTRO UNIVERSITY OF THE PHILIPPINES

39. Kidney Donor or Kidney Seller? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

40. Prisoners and organ transplants • Death convicts • Premature declaration of death • Kidneys for life? L DE CASTRO UNIVERSITY OF THE PHILIPPINES

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