Bioethics and health

The Ninth Asian Bioethics Conference
Keynote speech by the Minister of Health of the Republic of Indonesia
Yogyakarta, Indonesia, 5 November 2009


At the outset, let us praise Allah for His blessing so that we can gather here attending this very important conference, the Ninth Asian Bioethic Conference. On this occaion, I would like to convey my sincere gratitude for your presence. Your attendance in tis meeting indicates our collective efforts and serious intention to foster the resposible implementation of bioethics in Asia. Your attendance in this forum provides opportunities to revisit and review the practices of bioethics in Asia, explore lessons to be learned, and using these lessons, build on a roadmap for the way forward in our deliberations, with one ultimate goal – the Asian equiable scientific contributions i making a better world for us to live.

On this valuable occasion allow me to provide you with two international cases, which I have experienced since my ascending to the current ministerial post. Since the beginning of the year 2007, I started raising an international debate on the WHO mechanisms for sharing of human avian influenza viruses. As an organization which governs health care of the wold, WHO needs a fair, transparent and equitable mechanism. On the contratry, since avian influenza hit in Indonesia, we have been experiencing unfair, non-transparent and inequitable mechanisms in virus sharing which has been linked to vaccine prouction. Affected countries, which are usually represented by developing and poor countries, are requested to send H5N1 virus from avian influenza victims to WHO-CCs under a surveillance framework. This means developing and poor countries are requested manatory release of their viruses, but once these viruses arrive at WHO-CCs, affected countries do ot have any right about the destiny of the shared viruses. The moment when developing or poor countries need vaccines, they have to purchase them at high prices, and, one of the financial consequences is that they may need loans from other developed countries.
I have at least three points of unfair, non-transparent and inequitable WHO’s mechanisms which need to be taken as lesons learned by this conference.
1. By the time Indonesia needed urgently to procure Tamiflus (soon after the Karo cluster hit Indonesia), they were all stockpiled by the developed countries.
2. Unfairness on H5N1 sequence data information, DNA sequence for risk assesment and vaccine production was held exclusively by a number of scientists within WHO-affiliated institutions and were not freely accessible by other scientists. I have corrected this practice by making H5N1 sequene data accessible by public.
3. Several companies offered me vaccine and diagnotic kit, which were developed from the Vienamese strain of H5N1.

The existing mechanisms can lead to serious economic complications. If we still continue implementing the current mechanisms, then what will happen is that poor countries will become poorer, and the industrialized countries will become richer. This incresing gap is not favourable to the world peace and human welfare, and will contribute to the delay in the achievement of MDGs. With respect to sharing of benefits, Indonesia holds the notion that benefits for developing countries should be a structured responsibility raher than a ‘charity’ or ‘good will’ of developed countries, where vaccine manufacturers are located. This should be the mechanism in place for benefit sharing if we want to achieve a balanced developed and developing countries and cut the vicious cycle of poverty and infectous diseases in the developing countries.

There is another case with bioethical concern. Monopoly of viruses has occurred in the case of smallpox. The lead Indonesian vaccine manufacturer, BIOFARMA initiated the production of smallpox vaccine in 1962. Indonesia was declared free from smallpox by WHO on 25 April 1974. Then, the world was declared free from smallpox in May 1980. WHA resolution stated that by year 1982, the world must be freed from smallpox virus, and urged member states to destroy their smallpox with its vaccine production facilities. Based on this resolution, smallpox virus and smallpox vaccine production facilities Indonesia were destroyed in 1984. In 2005, there was WHO’s announcement that the world was threatened by ‘smallpox biological weapon’. Therefore, member states are advised to stockpile smallpox vaccines by purchasing them at high price. This is another case of unfair and inequitable international health mechanisms -- Indonesia does not have smallpox virus anymore, and has to purchase smallpox vaccine at high price.

The above two cases of unair international health mechanisms have also raised bioethical issue. By simple definition, bioethics is the study of ethical problems raised by productions, uses, and biotecnological of micro-oranism, plant and animals in agriculture, pharmaceutical industry or food production. Hence, the essentiallity of bioetics is the ethics of biotechnology or and the ethics of life sciences. Bioethics has two basic principles:
1. Reflecting the ability of positive aspects of professionalisn, and
2. Avoiding negative behaviour.

By virtue of its definition, and in view of the current biological and health challenges, bioethics has apparent broad scope. There should be a new outlook to respond to the paradigm shift for the future good practice of bioethics. Bioethics should not be looked only within the framework of scientific undertakings of scientists. Policy makers are challenged to understand the implications of bioethical conducts on the overall scientidfic and health development. With the current virus sharing practice, how can we define a public health success when that having a global capacity is less than 5% to produce human influenza vaccines, and technology access and transfer have not been made available to develping nations. This stockpile program failed to meet the challenge faced by the global influenza pandemic preparedness.

Furthermore, we are now gathering here in the period of global financial crises with some knowledge about their snowball effects, and with very little knowledge on how this will eventually negatively affect the short-term, medium term, and long-term helath development in out region.

Finally, I would like to congratulate the Indonesian Institute of Sciences for its able leadership in organizing productive discussions of this conference. This is part of the overall milestones of our efforts to make a healthy world. Global health will not be achieved whenever health inequalities exist. In one way or another, health inequalities exist due to unfair, non-tranparent and inequitable international health mechanisms, which have underlying bioethical concerns. The Asian Bioethics Association is a good avenue to revisit and review the practices of bioethics in Asia, explore lessons to be learned, and using these lessons, build on a roadmap for the way forward in our bioethics deliberations. This will be achieved through this conference.


Minister of Health of
the Republic of Indonesia

Dr. Siti Fadilah Supari, Sp.JP(K)

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21 January 2009

A BIOETHICAL PERSPECTIVE ON FOOD SECURITY POLICY IN INDONESIA

Dr. ANTON APRIYANTONO
Minister of Agriculture of the Republic of Indonesia

Yogyakarta, 3 – 7 November 2008

It is an honor to me to deliver a lecture with a title “A BIOETHICAL PERSPECTIVE ON FOOD SECURITY POLICY IN INDONESIA”. As you are already aware, like the rest of the world, Indonesia will face new challenges in the 21st century. The foremost challenge is to feed its growing population using a relatively constant, if not shrinking, agricultural lands. This may sound like a classic problem that has been with us all along, but in this century, this challenge will be compounded by a more severe global climate change and the volatile price and availability of fuels.
Indonesia is the fourth most populous country in the world, with only the 15th largest area. A large portion of that area housed a vast rainforest, which its importance to the world's climate condition is unquestionable. This fact has put us straight into an ethical problem. The easiest way to increase agricultural productivity is by increasing the planting area. But increasing the agricultural area may sacrifice some of the rainforest, which can have a long-lasting impact on the future generation in Indonesia and the rest of the world. The global scope of the impact also reminds us of why this conference we are having now is important, because the inhabitants of the world need to collaborate to solve a problem that in the long term will affect everyone living on this planet.

Research and development in science has produced numerous breakthrough in supporting agricultural development. Other than the green revolution, science has also provided us with new technologies to unlock the secret of the genomes of every organism important in agriculture, which opens the possibility for the development of new plant varieties with improved yield and qualities. There is no doubt that we need to develop and invest in science. But science alone cannot answer all of our problems. Science may inform us that clearing several hundred hectares of rainforest for rice plantation will give us several tones of rice grain at the cost of increasing global temperature and rising sea level by several magnitudes. But science does not tell us whether we should cut the trees or keep the forest. The decision to clear the land for the rice or keeping the forest for environmental reason is an ethical decision.

That is one of the reason we cannot separate ethics from science. Without ethical considerations, application of science have the potential to cause harm to human welfare and dignity. On the other hand, discussing ethics without considering available scientific facts is rarely productive. Ethics and science must go hand in hand, and this is especially important for a democratically elected government who is constantly required to make decisions and policies in the interest of the general public.

One of the most important human rights is access to food. A sound policy on food security is required to assure that the basic right of every citizen to obtain food is fulfilled. Indonesia currently has a population of around 237 million people, with 1.3 % population growth each year. It is the task of the government as well as community together to assure food availability for all people.

The basic premise of every food security program is that there should be enough food available and that everyone should be able to access it. The Indonesian Ministry of Agriculture attempts to reach this target through the following approaches: First, strengthening the food supply by optimizing available resources in a sustainable manner; Second, improving the food distribution system to ensure food availability for all people across times and regions; Third, encouraging more diversity and balance in food an nutrition consumption; and Fourth, preventing and resolving food scarcity.

The implementation of these policies addresses multiple factors to ensure its success. In order to improve production, the total area of cultivated land, whether it is irrigated or rain-fed, needs to be expanded with careful considerations regarding the environmental impact. Existing land needs to be conserved, and prevented from being converted into real estates or other agriculturally non-productive uses. Some lands will need to be rehabilitated to normalize its productivity. Water supply will also need to be managed through environmental conservation of water supplying area like rivers and other water sources, while existing irrigation channels will need to be maintained and improved.

On the agronomic side, productivity is increased by developing improved varieties and more efficient cultural practices. New technologies and better farming practices are constantly introduced by strengthening extension systems and promoting collaboration between farmers. Investments in agricultural and food sectors are also encouraged. These need a set of sound and comprehensive policies.

One important consideration in creating agricultural policies is that at the end of the day, those policies will have an impact on the lives of human beings, who do not only need physical fulfillment, but also psychological fulfillments. To be effective, those policies will also need participations of the general public. Policies that hurt the mental well-being of the people or ones they find disagreeable with their cultural or religious values will most likely fail. Some of those values that are proven wrong can be amended by public education. But some values, like religion, are considered to be set in stones, and people will adhere to them until the end of their lives. In this case, compromises will need to be made. This is why a discourse in bioethics is important, in order to accommodate all points of view and to find a consensus solution that works for the common good. Although agriculture may simply be viewed as a food production system, its application and impact is not without controversies.

As an example, a relatively recent phenomenon in Indonesia is shifting consumption pattern toward rice as the staple food. People from many regions in Indonesia traditionally consumed a more diverse diet because their environment is not always suitable for growing rice or the supply of rice is not always available all year round. The changing preference for rice has caused a decline in the cultivation of other food crops and putting an enormous pressure on the national rice production and distribution system. As a result, when there is a slight disturbance on the system, many regions with little or no rice-growing capability are under threat from high price of rice and even starvation, because alternative food crops have been neglected or abandoned due to the low demand associated with them.

This problem illustrates the impact of individual preferences on their own food security. Is it ethical to deny people from following their own preference even when it can potentially harm them in the long run? The answer can vary depending on where we are, but in Indonesia we choose the path of public education because we believe that people can make the right choice when they are fully informed on the consequences.

The above example also illustrates that development of agricultural systems will need to observe local custom and belief observance. Customs and norms are often built from ancient experiments which resulted in a tradition adapted to local conditions. Careless intervention of these cultural norms and values not only hurt the feeling and dignity of the people, but can sometimes lead to disastrous consequences from the application of ill-adapted technologies. Similarly, changing local diets and farming practices to fit an over-generalized national policy can potentially harm the food security of that region. Thus, new policies should respect and carefully consider local customs and religious values.

Another inherent problem in creating agricultural policies for food security is the contradiction between improving farmer's income and maintaining low food prices for the general public, in which a large portion still lives under the poverty line. As a consequence, improving farmer's income should not be achieved by increasing the prices of agricultural products, but by other means such as by increasing land holding size through cooperative farming or by improving agricultural productivity.

Increasing productivity, however, does not always guarantee a higher profit for farmers, as it is often accompanied by decreased prices. Therefore once increased productivity is achieved, the govern-ment needs to intervene market to prevent price of agricultural products from falling below the commercial threshold during the harvest season. Conversely, price should not increase too much when available food stock is low, when even farmers themselves become a consumer since their own stock is already depleted and the next harvest is yet to come. This role of the government should be done in such a way that regulates and maintains the national food supply to ensure food availability all year round at a reasonable price.

One of the driving forces behind the increased productivity is improved crop varieties developed by classical breeding and genetic engineering. Genetically modified organisms (GMO) have been under a lot of public scrutiny lately, mostly because many views that these organisms have no precedent in nature and therefore may carry some unknown risks that can harm humans and the environment in general. Such concern is valid, and the government needs to address this problem to ensure public safety while at the same time prevents irrational resistance of a potentially useful technology.

To have a productive and rational debate on the issue, concerns that could be solved by scientific studies need to be separated from those involving legal, philosophical, and moral concerns. Scientific questions such as whether transgenic corn would produce allergic reaction or not can usually be answered in a clear cut manner using a correct scientific experiment. Current method of food safety tests and environmental safety tests for GMO before any commercial release of GMO in Indonesia are the result of well-formulated scientific questions regarding the potential risks of genetically modified organisms. On the other hand, there may not be a ‘correct’ answer to questions related to legal, philosophical, and moral dimension of GMO. Answers to those questions may result from a consensus or a decision by those holding the authority over the issue.

Some concerns regarding GMO, albeit valid, apply equally to organisms obtained from nature or selected through conventional breeding. Natural herbicide-tolerant mutants can also transfer their genes to wild relatives, yet few people seemed concerned if those so called ‘natural’ organisms were released without proper environmental and food safety tests. This shows that there is an underlying fear toward a new technology rather than a serious concern toward environmental safety. Attributing universal risk only toward GMO gives a wrong impression toward genetic modifications, making it appears as a dangerous and malevolent technology. In a way, GMO that passed those safety tests may actually be safer than their natural counterparts, where safety tests are not as rigorously enforced when they are released.

Similar concerns were shown over the use of synthetic chemicals, from fertilizers to food additives, on agricultural products. As in the case of GMO, it should be demonstrated that no hazard will occur on the environment and human health if those chemicals are used. In other word, our attention should be focused on the safety part, rather than the adjectives synthetic versus natural.

Another important component in Indonesian agriculture is the extensive use of livestock. Livestock are kept to supply the need for animal proteins and raw materials for clothing and other necessities. They are also an integral part of our traditional farming system and a necessary component of many traditional and religious rites. But they also become the object of needless sufferings, from inhumane rearing system, transportation activities, to slaughtering practices. Efforts are continuously made to eliminate these misconducts. Moreover, even our traditional and religious teachings emphasized the need to speed up the slaughtering process and encourage the use of the sharpest blade to prevent prolonged suffering of the animals.

Respect and compassion toward other living things should not be confined to animal livestock, but also extend toward all living things in our ecosystem.

After all, our life depends not only on our livestock and plants that we cultivate, but also on other living things not directly connected with our lives. This is because nature is a complex web of interdependent systems. Disruption of one system can affect other systems and eventually return to haunt us. We have learned how careless introduction of rabbits and cane toad to Australia had caused ecological disaster; therefore most countries now have quarantine procedures and strict rules regarding introduced species.
However, we seem less concerned about the other side of the coin: which is the loss of native species due to extinction caused by human activities. Numerous species have perished due to habitat encroachment or environmental damage and pollution caused by human activities. Some of them may produce unknown exotic compounds that cure diseases. Some may disrupt the life cycle of our agricultural pests. Some may not matter to us, because their place in the food chain is not connected to ours. But even that can be misleading. Snakes normally found in rice fields may amount to nothing but nuisance to us, only when we have a great mice infestation on our field that we realize how useful they are. In other words, there are a lot of things that we miss or lost simply because our present knowledge has not understood impact of their presence. We can only hope that we do not grasp their significance when it is already too late.

That is one of the reasons why we take serious steps in conserving nature and maintain biodiversity. Some of the biodiversities can be preserved by our ongoing germplasm collection and conservation program, while others can only be saved by preserving their habitat from human encroachment. It is a very difficult task because sometimes we have to confront people with a more urgent need of feeding their family. Educating them on this issue can be challenging, because the negative effects of their actions are often uncertain, too abstract, or can only be felt in the distant future. It is clear that such program needs to be implemented along with a population control program, which is carried out by encouraging families to have two children or less.

At last but not least, finally, I would like to underline that the development of national policies on agriculture will not be free from controversies; therefore it must be based on solid scientific groundwork and bioethics. The issues can be complex, therefore active discussions by various stakeholders need to be encouraged to achieve a consensus that works for the common good.

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7 January 2008

Bioethics in Science and Technology Development In Indonesia

Bioethical issues have become an increasing focus of publics attention since recent years, with debate continuing to rage over issues including genetic modification, ainmal/human cloning, and even ‘designer babies’. The Asian Bioethics Association (ABA) Constitution (2002) on Article 2 stated that “Bioethics is an interdisciplinary study of philosophical, ethical, social, legal, economic, medical, therapeutic, ethnological, religious, environmental, and their ralated issues arising from biological sciences and technologies, and their applications in human society and biosphere.” Most important is that the principles of bioethics must be agreed by all scientists, community, people and individual concerned, because bioethics is expected to be used as guideline for scientists in performing research, development, and application of science and technology.

Inclusion of human responsibility to other living organisms and protection of environment, biosphere and biodiversity has made the UDBHR (Universal Declaration on Bioethics and Human Rights) a comprehensive bioethics document, since it concerns not only with human beings but also with other forms of living organisms. The UDBHR includes also 15 principles of bioethics related to: (1) Human Dignity and Human Rights; (2) Benefit and Harm; (3) Autonomy and Individual Responsibility; (4) Consent; (5) Persons without the capacity to consent; (6) Respect for Human Vulnerability and Personal Integrity; (7) Privacy and Confidentiality; (8) Equality, Justice and Equality; (9) Non Discrimination and Non Stigmatization; (10) Respect for Cultural Diversity and Pluralism; (11) Solidarity and Cooperation; (12) Social Reponsibility and Health; (13) Sharing of Benefits; (14) Protecting Future Generations; (15) Protection of the Environment, the Biosphere and Biodiversity.

Three major issues on medical biotrechnology are stem cell experiment, human cloning technology and organ transplantation, which have been discussed intensively by researchers and also the public media. Embryonic Stem Cell (ESC) experiment, for example, is a much debated issue in biosciences research. Some people argue that ESC experiment has the potential to treat disease and relieve suffering, to justify research across a whole range of possible sources of stem cells including embryo. Moslems, for instance, believe that soul wil be entered to fetus only after 120 days old. They suggest that fetus younger than 120 days could not be regarded as human beings. Following this belief, there appears to be acceptable to use fetus in those range of ages for medical research purposes. Fortunately, researchers show that in the future, it will be possible to re-program Adult Stem Cells (ASC) with the full potential of ESC, without morally contestable need to create an embryo.

Bioethical Issues on Animal Biotechnology
The main issue of animal biotechnology is asociated with experiments to make Genetically Modified (GM) Organisms, which should also comply with bioethics principles. An interesting illustration is the use of bovine somatotrophin (bST) hormone on cattle for stimulating their milk production. The hormone bST is produced by recombinant DNA (rDNA) technology in Escherichia coli, and was in fact the first GM product to be used in animal agriculture. By injecting cows with bST every two weeks, farmers can expect an average increae in milk yield of 12-15%; and although slight changes in nutrient content can be produced, their overall concentrations in bulked milk are probably unaffected. However, because higher metabolic demands may lead to increased rate of illness, there is an increased risk that the welfare of injected cattle will be diminished. The treatment also leads to an increased in milk concentration of insulin-like growth factor-1 (IGF-1), which is a potent mitogen. If the increased milk concentration on IGF-1 was physiologically significant and if it were to remain biologically active at the level of the gut mucosa, it might pose a public health threat to people consuming the milk or dairy products. On the other hand, is it ethical to make GM cattle which are endangering their own wefare?

Bioethical Issues in ood and Agriculture
The Food trap is the other evidence to support the importance of bioethical issues in biosciences research. The food trap points out to the trap of being net importing country for agricultural products, like Indonesia. Indonesia is the second largest sugar importing country and also for wheat, grandparent stock of chicken, and milk. Because of its dependence to international markets, Indonesian food systems faced some problems such as availability and sustainability of the local or indigenous agricultural products. Moreover, the issue of transgenic food in agricultural products has also arisen in this country.

Indonesian Standpoints on Some Bioethical Issues
Indonesia’s perspective of bioethical issues has been examined by the Indonesian National Bioethics Commision (INBC), established on the 17 September 2004 by a Joint Declaration between the State Minster of Research and Technology, Minister of Health and Minister of Agriculture. The INBC has concluded that stem cells research, development and its application in Indonesia are important to be encouraged. Setting up bioethical policies and regulations are essential, by observing the universal bioethics principles and intenationally acceptable rules as the guide for Indonesia’s policies development.

The second main issue concerns with Genetic Resources, subtances found in every living organism including animals, plants, microbes whether they are terrestrial or marine based. These genetic resources regulate specific nature and mortality of these organisms, and can be transmitted to their decendants, and also a part of the biodiversity known as germplasms.

There are five issues of bioethical on genetic resources including accessibility and utility of the resources, traditional knowledge, biodiversity, biosphere and environment. Therefore, managing the genetic resources of Indonesia has to be based on national interests and regulated according to national regulations. International conventions or declarations, such as the CBD (Convention on Biological Diversity), the Manilla Declaration Concerning Utilization of Biological Resources, and the UNESCO Declarations, such as Universal Declaration on Human Genome and Human Rights (UDHGHR), International Declaration on Human Genetic Data (IDHGD), and also Universal Declaration on Bioethics and Human Rights (UBHR), are already ratified or acknowledged.

The case of transgenic Bt Cotton is one example of GM crop practices in Indonesia The introduction of Bt Cotton to the farmes, however, has threatened local variety of common seeds in South Sulawesi. Unfortunately, no accurate information of the risk of Bt Cotton has been disseminated to the farmers. Learning from the GM crops problems, INBC highly recommends to ensure the protection of local variety seeds and to ensure the safety and availability of transgenic seeds. It is reommended to develop science and technology to increase the availability of agricultural products as well as to meet food safety requirement. There is also a need to ensure the protection of local or indigenous variety of agricultural products or food.

A key strategy for sucessful implementation of bioethics principles is to strengthen national capacity and to improve cooperation between scientists and scientific institution, as well as between the scientific community and the industrial community, under the guidance and coordinaton from the government. This type of three parties’ collaboration is well known as the ‘triple helix of ABG’ (academicians, business sectors, and government bodies). Harmonization and integration of bioethics principles into research, development, and application o S&T activities would ensure the achievement of sustainable human development.

Harmony with Nature is a must!
If we did wrong, then Nature would be destroyed
In order to sustain Nature, it must be treated in an appropriate manner,
in order words, we have to live in harmony with Nature.
It can be done, by using good ethical guidelines.

Yogyakarta, 3 November 2008
State Minister for Research and Technology of the Republic of Indonesia,
Kusmayanto Kadiman

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25 December 2008

Season's greetings. Best wishes for a happy, healthy and productive New Year 2009.

Indonesian National Bioethics Commission (Komisi Bioetika Nasional)

Replace with the rest of it or fulltext.

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18 December 2008

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Prof Sahin Aksoy: the first session of the ABC9

Bioethics in Asia: Healthy and Productive Life with Nature


Sahin AKSOY MD, Ph.D.

Professor, Chair, Department of Medical Ethics and History of Medicine
Harran University Faculty of Medicine, Sanliurfa, TURKEY
sahinaksoy@yahoo.com



Asian Bioethics, as an alternative or different approach to Bioethics has been long discussed and a significant amount of literature and information has gathered with the contribution of Asian Bioethics Association, its respectful members and EUBIOS Journal of Asian and International Bioethics. Today it is apparent that there is an Asian perspective on not only Bioethical issues but also almost every social, political and scientific issue.

Asia is a huge continent consisting of countries and communities from different social, ethnic, traditional and religious backgrounds. There are brown, yellow and white races. There are modern, urban, rural and traditional societies. There are Muslims, Hindus, Buddhists, Confucians, Taoists and Christians. These are the ones I remember at first instance. Despite all these differences there is something common in contrast with Western way of thinking, is being communitarian. In Western way of thinking, which had turned an agent of moral imperialism for a long time, ‘individualism’ and its following concept ‘autonomy’ is fundamental motto.





The full paper is available here.

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ABC9: the two best student prizes

During the last Asian Bioethics Conference, not many of the participants were aware that student presenters were judged for their presentations. The two best student prizes are "BIOETHICS GOES TO SCHOOL: module design for high school students in Indonesia" by Sherly Kurnia Dewi from Atma Jaya Indonesia Catholic University, Indonesia and "Survey Research and Ethics" by Noriko Kataoka from Kumamoto University, Japan.

The abstracts of their presentations follow.

"Bioethics goes to school:
module design for high school students in Indonesia"

Sherly Kurnia Dewi (third year student),
Biotechnology Faculty, Atma Jaya Indonesia Catholic University,
Jalan Jenderal Sudirman 51 Jakarta 12930 Indonesia,
Email: sherly.kurnia@mhs.atmajaya.ac.id

Elizabeth Citra Wening Prasanti (fourth year student),
English Department Faculty of Education, Atma Jaya Indonesia Catholic University,
Jalan Jenderal Sudirman 51 Jakarta 12930 Indonesia,
Email: elizabeth.citra@mhs.atmajaya.ac.id

Abstract

Advancing technology often create dilemma when faced with religion and folk culture. The technology sometimes also can harm the environment. Bioethics is a multidisciplinary knowledge to moderate these problems. Bioethics contains not only biology but also sociology, anthropology, economy, religion, environmental issues, psychology, and philosophy. If someone has studied bioethics for a long time, they can use bioethics to solve problem in a better way, thus it is important for us to study bioethics from an early age. In Indonesia, bioethics is taught in university. In high schools, bioethics is taught in integration with biology. The objective of this module is to teach applied bioethics to high school students. This module has four subjects: basic bioethics, environmental and biodiversity bioethics, design baby experiment issue, and euthanasia. To make the learning exciting, this module contains games, drama, and case study. The design module would be tested to high school students on July.
Keywords: bioethics teaching, high school students

and

"Survey Research and Ethics"

Noriko Kataoka
Kumamoto University
gray_little_man@hotmail.com


Abstract

Faced with evermore advancing medical technologies, bioethicists are asked to provide insights but the difficulty faced by bioethicists is that there is a wide gap between ethics, which tends to appreciate universal values more, as a discipline and the real situation, in which values appear to be in a constant flux. However, values are not so much changing over time but what is changing is the emphasis placed on each value. This presentation suggests incorporating survey research into the discipline of ethics as its method. This will allow for adjusting abstract top-down approaches and concrete bottom-up approaches to formulate effective approaches to current bioethical issues. I will first present results from a survey conducted on attitudes towards end-of-life care in Kumamoto, Japan as an example. Then, I will argue how such attitude survey contributes to the field of ethics as a new method.

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