Transcript The developments of Bioethics in Lithuania – Problems and Future

The developments of Bioethics
in Lithuania – Problems and
Future Perspectives
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
How to evaluate the developments?
Legal documents
 Publications on bioethics
 Institutions
 Public debate

Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Legal documents relevant to bioethics

International:



CoE Bioethics
Convention and APs
EU Directive on Clinical
trails
National:

e.g., laws on patients
rights, biomedical
research,
transplantation…
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Lithuanian publications on bioethics
EURETHNET database:





1990-1999 2000 2001 2002 2003 -
Bioethics in Europe and
Lithuania, September 2005
40
10
19
30
65
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Institutions

Academic centers



teaching bioethics and biolaw at Kaunas Medical
University, Vilnius University, M. Romeris University
Lithuanian Bioethics Society, 2002
Committees:



regional RECs,
HECs
LBEC:



Established 1995
Part time positions for the chairman and secretary
To deal with negligence cases
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Lithuanian Bioethics Committee


Gradual growth of the institution
Shift from “negligence cases body” to policy
making institution:


E.g., field of biomedical research, health
legislation
International cooperation and networking
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
International cooperation and networking:

Council of Europe



EU






‘European Programme for Teaching Bioethics in Healthcare Institutions’
(EHBP)
PRIVIREAL - ends in 2005. This project has aimed to analyse how European
countries deal with Directive 95/46/EC
‘BioTethed’ ethical problems raised by new biotechnologies
UNESCO


DEBRA meetings 1998, 1999
2004 ‘Training in Research Ethics’
11-12 November, 2002 the International Conference on Bioethics in Eastern
and Central Europe
13 - September, 2004 Regional Bioethics Information Centre
ESPMH conference, 2003
Baltic-Nordic network on research ethics
 Planning meeting - November 2005
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Public debate and Problems!
Bosch “The Garden of Earthly Delights”,1504
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Topics of public debate I


Prisoner participating in a clinical trial: should the law be
followed?
Advertising “embryonic stem cell therapy”: cheating or last resort
measure?
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Topics of public debate II




Compensation of the early prenatal testing for genetic
syndromes or nerve tube abnormalities: eugenics or
equitable access?
Two draft laws on IVF has been in the Parliament for
more than 1 year: is donation of gametes justified?
Law on sex change: draft blocked in the Parliament
UN debate on “therapeutic cloning”: should the country
which does not allow TC, seek to forbid it at the
international level?
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Bioethics I (Encyclopedia of
Bioethics, 1995)
the systematic study of the moral dimensions
– including moral vision, decisions, moral
conduct and policies – of the life sciences
and health care, employing a variety of
ethical methodologies in an interdisciplinary
setting
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Bioethics II (O’Neil, 2002)


Bioethics is not a discipline … It has become a
meeting ground for a number of disciplines,
discourses and organizations concerned with
ethical, legal, and social questions raised by
advances in medicine, science, and biotechnology”
Philosophy and ethics, law, sociology,
biomedicine,… each discipline offers different
paradigm of interpreting phenomena..
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Bioethics III (R.Baker)

“The first generation” bioethics as a protest
movement inspired by


Rejection of metaethics
Egalitarianism and urging clinicians to accept
the voice of the patient
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
What is bioethics?!

The scope:
Narrow – “red bioethics”
Wide – “green bioethics”



Multidisciplinarity:




Philosophy/ethics/….
Law
Medicine
…
 “Academic” vs. “public policy”
 Religious vs. secular
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Scope


Should the “Red” and “Green” bioethics be
dealt with by one institution/committee?
How to establish a “multi-institutional”
organization?
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Multidisciplinarity



Biomedical professionals sometimes think of bioethics as an
obstacle to the progress of biomedical science (e.g., stem cell
research or ethical review of biomedical research projects in
general)
Philosophers criticize bioethics as being a populist and simplistic
application of normative ethics (e.g., “Georgetown mantra”,
“infraethics”, etc.)
Lawyers might be unsatisfied by dilemmatic character of
bioethical discourse not resulting in any clear policy or legal
framework. This opinion might be seconded by biomedical
professionals as well.
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Public policy vs. academic
scholarly activity

There is a deep conflict between


the goals and constraints of the public policy
process and
the aims of academic scholarly activity (Dan
Brock, 1997)
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Academic activity
•


to follow the argument wherever it leads and regardless
of the consequences (primary commitment to knowledge
and truth)
(particularly philosophers) to question and critically
examine all assumptions.
Policy-makers



are concentrating on the consequences for public policy
and the people affected by it
the agenda of public policymakers is limited by political
realities – not everything can be open to criticism and
modification.
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Critique of the CoE Bioethics
Convention


“Philosophical reflections” (G.Hottois), “ethical
perspective” (M.Duwell)
vagueness and escapism from the most pressing
bioethical (conceptual and normative) issues:




“Individual”, “person”, “human being”, “everybody”,
“beginning of human life”,
Human dignity?
“Equitable access to health care”
“Previously expressed wishes” etc.
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
3 D for Bioethics

Dialogue between different professional
groups
Dialogue between academics and policy
makers
Dialogue between different worldviews

Is it possible? I hope, yes. However,


Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė
Bioethics: story about chocolate and garlic

“Philosophy is fine, and
science is fine, but
combined they are the
mixture of garlic and
chocolate” (Bleuler,
1921)
Bioethics in Europe and
Lithuania, September 2005
E. Gefenas, A.Čekanauskaitė, V.
Lukaševičienė