Bioethics and International Human Rights

See Ocloo E. , “Chronic Undernutrition and the Young,” Proceedings of the Nutrition Society, 52 (1993): 1–17.

See Blackhall L. , “Ethnicity and Attitudes Toward Patient Autonomy,” JAMA, 274 (1995): 844–45; and Murphy S.T. , “Ethnicity and Advance Care Directives,” Journal of Law, Medicine & Ethics, 24 (1996): 108–17.

See Pellegrino E.D. , “Intersections of Western Biomedical Ethics and World Culture: Problematic and Possibility,” Cambridge Quarterly of Healthcare Ethics, 1 (1992): 191–96.

Engelhardt H.T. Jr. , “Understanding Faith Traditions in the Context of Health Care: Philosophy as a Guide for the Perplexed,” in Marty M.E. Vaux K.L. , eds., Health/Medicine and the Faith Traditions (Philadelphia: Fortress Press, 1982): 163–84.

Norris P.F. , “Culture and Religion: Their Role in Ethics,” Health Care Ethics USA, 4, no. 1 (1996): At 5.

See generally Veatch R. , ed., Cross Cultural Perspectives in Medical Ethics (Boston: Jones and Bartlett, 1989).

“Human Rights Took a Beating in 1992: Group Condemns 110 Nations for Torture,” Chicago Tribune, July 9, 1993, at 2.

See “UN Paper on Rights is Criticized,” Chicago Tribune, June 3, 1993, at 20.

See “Human Rights Watch Looks Within,” The New Yorker, 64 (1993): 53–54.

See id.

See generally Finkielkraut A. , The Defeat of the Mind, trans. by Friedlander J. (New York: Columbia University Press, 1995).

Without secular protections, religious bigotry all too often results. Consider the Rushdie affair. Salman Rushdie wrote The Satanic Verses, which was highly critical of the Prophet Muhammed, and sexually offensive to Moslem leaders. Rushdie was condemned to death by Iran and the Ayatollah. This led to international withdrawals of embassies by Western European countries. Internal debates about the freedom of the press and the freedom of expression occurred especially in England and the United States. Workers at mall-based book stores were threatened by calls and bomb scares. And the book was kept off the shelves. Full-page advertisements were taken out by Waldenbooks defending its decision to sell the book. Similar advertisements were taken out by Moslems defending their religion and their religious sensibilities. A similar occurrence involved the writings of Taslima Nasrin of Bangladesh, a physician and nonbeliever who is critical of Moslem views of women and marriage. She is now in hiding in Sweden. As she said of her own life, “They've taken everything from me … my innocence, my youth, now my freedom.” See Weaver M.A. , “A Fugitive from Injustice,” The New Yorker, 70 (1989): At 60. Much of the Western reflection on the Rushdie and Nasrin affairs betrayed a note of cultural superiority. We admonished fundamentalist Moslems because they had not entered the golden era of responsible, international citizenship. Amnesty International took up the authors' causes. Protests were lodged by Western governments with Iran and Bangladesh. Some countries threatened to cut off economic assistance. Yet, not that long ago, the power of Christianity was allied to the state for almost 1,000 years, during which time many persons were tortured and killed, put on racks and burned at the stake, for being different or refusing to follow Christianity. We escaped the “medieval and violent darkness” of Christianity, in the words of one commentator, “by depriving Christian religious authorities of political and legal power over the community.” See Dyer G. , “The Secularizing Evolution that Includes Islam,” Chicago Tribune, Mar. 20, 1989, at 13.

“Human Rights Watch Looks Within,” supra note 9, at 54.

A report of blows exchanged at a news conference at the 50th session of the United Nations Commission on Human Rights demonstrates just how difficult the process of developing a human rights basis for international and intercultural bioethics will be. A representative of the Sudanese National Islamic Front had just finished an extended interruption of a report on conditions in the Sudan, when he was attacked by a rival group member. In the words of a columnist, this “disorderly exchange at the usually somber commission lifted the thin veneer of decorum over the confrontations between victims and perpetrators….” The most heinous violations of human rights occur in the areas of the world we ignore most. See Brown B.A. , “Human-Rights Abuse is ‘Business as Usual’ in Much of the World,” Chicago Tribune, Apr. 15, 1994, at 19.

Early-sixteenth-century Spanish theologians Francesco de Vitoria and Dominic Suarez both proposed an international law based on the laws and customs of countries (jus gentium) and on laws that transcend individual nations (jus naturale). These ideas were codified by Grotius at that time. Human rights spread more widely with the American Revolution, and most explicitly with the French Revolution's Declaration of Individual and Civil Rights (August 24, 1789). There was tremendous progress during the next two centuries, continuously extending human rights, even into international law.

See Possenti V. , “Human Rights and Human Nature,” Contemporary Philosophy, 17 (1995): 4–10. Vittorio Possenti distinguishes two traditions in human rights, the secular and the religious, the latter deriving human rights from a law built into human nature by a Creator God. Thus Thomas Aquinas, in the latter tradition, can derive human rights from inclinations of human nature—persistence in being, union between man and woman, generation and education of children, social character of human nature, and the desire for the truth. From these he argues for fundamental human rights respectively to life, to have a family, to procreate and educate one's children, to have a place in society and a useful job, and to develop one's own intelligence in a search for truth. See Aquinas , de lege, in his Summa Theologiae, 1,2ae, QQ 93–105.

Evolutionary biology is the notion that the specific nature of, for instance, a horse or a human being evolves and changes over eons.

See Atlas T. , “China Dismal on Rights, U.S. Admits,” Chicago Tribune, Mar. 7, 1996, at 1, 16.

See Boudreau D. , “International Medical Community Condemns Death Row Donations in China,” Nephrology News & Issues, 29 (1995): 1–2.

See Anonymous, “China: BBC Wrong About Inmate Organs,” Chicago Tribune, Nov. 24, 1994, at 28. In this wire service story, Chinese officials said that the British Broadcasting Corporation's (BBC) documentary on use of prisoners' organs was fabricated. The BBC claimed that 90 percent of executed criminals are organ donors, while the Chinese said that they are rarely donors, and only with prisoners' or their relatives' consent.

See Schmetzer U. , “U.S. Trade Visit Spurs China Dissidents,” Chicago Tribune, Aug. 27, 1994, at 1, 6.

See Boudreau , supra note 19.

See Anonymous, supra note 20.

See Levine R.J. , “Informed Consent: Some Challenges to the Universal Validity of the Western Model,” Law, Medicine & Health Care, 19 (1991): 207–13.

See Thayil J. , “Kidneys for Sale,” Asiaweek, Apr. 22, 1994, at 40–49.

Gostin L. , “Informed Consent, Cultural Sensitivity, and Respect for Persons,” JAMA, 274 (1995): At 844–45.

See Marshall P. Thomasma D. Jhabar A. , “Marketing Human Organs: The Autonomy Paradox,” Theoretical Medicine, 17 (1996): 1–18.

Other strategies included birth control pills, intrauterine devices, and the like. About 90 million children are born each year, contributing to urgency.

Rowley S.M. , “Count on Controversy at Population Forum: Religious, Cultural, Economic Clashes Abound on Eve of UN Session in Cairo,” Chicago Tribune, Sept. 4, 1994, at 3.

Regarding efforts to reach a compromise with the Vatican on reproductive statements at the Egyptian conference, U.S. Vice President Al Gore remarked that there likely would never be “full agreement [with the Vatican] on contraception and the American woman's right to choose.” Rowley S.M. , “U.S., Vatican Seeking Compromise on Abortion,” Chicago Tribune, Sept. 7, 1994, at 1, 12. Although the Vatican recognizes the difficulties women have carrying a child to term, it emphasizes counseling, free medical care, social support, and adoption. About women's challenges today, the Vatican says, “Such difficulties do not warrant the violation of the right to life.” Id. at 12.

See Evans J.R. , “International Challenges and Opportunities in Health,” Journal of Law, Medicine & Ethics, 21 (1993): 10–15.

Colwell R.R. Pramer D. , “Back to the Future with UNESCO,” Science, 265 (1994): At 1047.

Ironically, within scientifically based civilizations, there is an increasing rapprochement between science and religion. See Somerville M. , “Genetics, Reproductive Technologies, Euthanasia, and the Search for a New Social Paradigm,” Social Science and Medicine, 42 (1996): Ix–xii.

Rowley S.M. , “Stirring Call to Empower Every Woman,” Chicago Tribune, Sept. 6, 1994, at 1.

This commercialization extends to animal body parts. A good example is Baxter Healthcare Corporation's alliance with a biotechnology company to produce pigs with hearts and other organs that can be readily transplanted into human beings. DNX Corporation, the partner, has already used pig livers to filter the blood of human patients with terminal liver disease, and has bioengineered pigs with human hemoglobin as part of their blood. This is now an experimental therapy. After all, if we can eat pigs, and already use their heart valves for transplant, the reasoning goes, why not use them to save lives in other ways as well?

See News and Comment, “Rules on Embryo Research Due Out,” Science, 265 (1994): 1024–26.

Cross-species fertilization includes creating human beings using cow eggs and the like. Pigs and cows have already been created with human immunosystems. The creation of research embryos has not been ruled out in the United States, nor has human cloning, although these have been condemned by political leaders and other countries. See Neikirk W. , “Senate Opts Not to Vote on Proposed Cloning Ban,” Chicago Tribune, Feb. 12, 1998, at 4; and Beck J. , “Cloning is Not the Path to Immortality,” Chicago Tribune, Jan. 15, 1998, at 23.

See generally FitzGerald K. , “Proposals for Human Cloning: A Review and Ethical Evaluation,” in Monagle J. Thomasma D. , eds., Health Care Ethics: Critical Issues for the 21st Century (Gaithersburg: Aspen, 1997): Ch. 1.

See “Canadian Commission Issues Recommendations on New Reproductive Technologies,” Professional Ethics Report, 7 (1994): 1, 7.

See id.

See Gergen K. , “Social Understanding and Conceptions of the Self,” in Stigler J.W. Shroder R.A. Herdt G. , eds., Cultural Psychology (Cambridge: Cambridge University Press, 1990): 569–606.

See Bahm A.J. , “What Philosophy Does the World Need?,” Contemporary Philosophy, 17 (1995): 1, 12–13.

See id.

See, for example, how Anthony Powell developed this idea in his writings. See Treglown J. , “Class Act,” The New Yorker, Dec. 18. 1995, 108–11, esp. 110.

That is, as Jacques Derrida argues, the opposite of “what is” is not “what is not,” but rather the difference itself. This approach keeps the individual rooted in circumstances, family, society, and culture. See Derrida J. , “Differences,” in his The Margins of Philosophy, trans. by Bass A. (Chicago: University of Chicago Press, 1982): 1–27.

Derrida goes on to note that, by emphasizing difference, one deconstructs all efforts of establishing a kingdom. In his thinking, there can be no capital letters, not even I. No one perspective, for instance, autonomy, could govern our ethics. Rather the individual would be defined by his/her cultural context. In the post-modern view, even being as Is-ness is simply a choice. Being's privileged place does not rest on some objective truth, but on a choice to emphasize being over nonbeing. Applying that to Western emphasis on the individual, autonomy is not a side constraint of all ethics, but simply a choice to overemphasize human difference to the exclusion of our immanent ties to all things that are.

See generally Engelhardt H.T. Jr. , Bioethics and Secular Humanism (Philadelphia: Trinity Press International, 1992).

Parens E. , “The Pluralist Constellation,” Cambridge Quarterly of Healthcare Ethics, 4 (1995): At 197.

See “Conference Resolves Dispute Over Rights,” Chicago Tribune, June 20, 1993, at 14.

See Washington Post News Service, “U.N. Parley Backs Human Rights Office,” Sacramento Bee, June 26, 1993, at A10.

See Marshall P.A. Koenig B.A. , “Anthropology and Bioethics: Perspectives on Culture, Medicine, and Morality,” in Johnson T. Sargent C. , eds., Medical Anthropology: Contemporary Theory and Method (Westport: Praeger, 2nd ed., 1996): 349–73.

See generally Loewy E. , Suffering and the Beneficent Community: Beyond Libertarianism (New York: State University of New York Press, 1991).

See generally Engelhardt H.T. Jr. , The Foundations of Bioethics (New York: Oxford University Press, 1986).

See generally Yearley L.H. , Mencius and Aquinas: Theories of Virtue and Conceptions of Courage (Albany: State University of New York Press, 1990).

See generally Engelhardt H.T. Jr. , The Foundations of Bioethics (New York: Oxford University Press, 2nd ed., 1995); and as co-editor of Christian Bioethics: A Non-Ecumenical Journal.

See Poteat W.H. Langford T.A. , Intellect and Hope: Essays in the Thought of Michael Polanyi (Durham: Duke University Press, 1968): At 18.

See Winston D. , “New Virtues for a New World of Diversity,” Chicago Tribune, July 7, 1995, at 8.

Dunne J. , The Way of All the Earth (New York: MacMillan, 1972): At 1.

Bawer B. , “St. Francis of Assisi,” in Elie P. , ed., A Tremor of Bliss: Contemporary Writers on the Saints (New York: Riverhead Books, 1995): At 7.

Cotliar S. , “Arab Americans Cope with Bias in Suburbs,” Chicago Sun-Times, Feb. 6, 1995, at 4.

A brief note about traditional Chinese xenophobia bears on this point. Chinese xenophobia is so entrenched that the story is told of the 200-year-old diplomatic failure of the British mission there. The British Crown sent Lord George McCartney to Peking in 1792 to exchange ambassadors and to improve how the Chinese were treating British merchants. McCartney was accompanied by huge warships and a retinue of 100. Yet the Emperor of the Ming dynasty treated the British as vassals, as he would Mongolians and Tibetans, and the gifts they brought as tribute. When McCartney arrived in Peking, according to Alain Peyrefitte, as a representative of King George III, he was herded together with many other subordinates to bring tribute for the Emperor's birthday! The British simply did not understand the degree to which the Chinese regarded their empire as the center of the world (even though by then it had become quite poor and backward), or the degree to which the Chinese scorned business and businessmen. See generally Peyrefitte A. , The Collision of Two Civilizations (London: Harvill, 1993).

Taylor C. , Sources of the Self: The Making of the Modern Identity (Cambridge: Harvard University Press, 1989): At 518–19.

See generally Finkielkraut , supra note 11.

Perkins H.S. , “Cultural Differences and Ethical Issues in the Problem of Autopsy Requests,” Texas Medicine, 87, no. 5 (1991): At 72.

Marshall P.A. , “Anthropology and Bioethics,” Medical Anthropology Quarterly, 6 (1992): At 62.

See generally Koch T. , “The Gulf Between: Surrogate Choices, Physician Instructions, and Informal Network Responses,” Cambridge Quarterly of Healthcare Ethics, 4 (1995): 185–92.

See Agich G.J. , “Authority in Ethics Consultation,” Journal of Law, Medicine & Ethics, 23 (1995): 273–83.

Brueggemann W. , “‘Othering’—Random Thoughts on Covenant,” Explorations (World Alliance of Interfaith Organizations), 9 (1995): At 8.

See Freeman W.L. , “Making Research Consent Forms Informative and Understandable: The Experience of the Indian Health Service,” Cambridge Quarterly of Healthcare Ethics, 3 (1994): 510–21; and Carrese J. Rhodes L. , “Western Bioethics and the Navajo Reservation,” JAMA, 274 (1995): 826–29.

See Marshall P.A. Thomasma D.C. Bergsma J. , “Intercultural Reasoning: The Challenge for International Bioethics,” Cambridge Quarterly of Healthcare Ethics, 3 (1994): 321–28.

See generally Dewey J. , Logic, The Theory of Inquiry (New York: Holt, 1938).

See generally Lasch C. , The Revolt of the Elites and the Betrayal of Democracy (New York: Norton, 1995).

See generally Annas G.J. Grodin M.A. , eds., The Nazi Doctors and the Nuremburg Code: Human Rights in Human Experimentation (New York: Oxford University Press, 1992).

See Samei E. Kearfott K.J. , “A Limited Bibliography of the Federal Government-Funded Human Radiation Experiments,” Health Physics, 69 (1995): 885–91.

See Chen Y.-F. , “Japanese Death Factories and the American Cover-Up,” Cambridge Quarterly of Healthcare Ethics, 6 (1997): 240–42.

See generally Gelpi D.L. , ed., Beyond Individualism: Toward a Retrieval of Moral Disclosure (Notre Dame: University of Notre Dame Press, 1989).

See Rorty R. , Contingency, Irony, and Solidarity (Cambridge: Cambridge University Press, 1989): 60–61; and Martinez S. , “Indifference Within Indignation: Anthropology, Human Rights, and the Haitian Bracero,” American Anthropologist, 98 (1996): 17–25.

See MacIntyre A. , Three Rival Versions of Moral Enquiry (Notre Dame: University of Notre Dame Press, 1990): At 225.

See Lundin R. , “Diversity and Desire,” in his The Culture of Interpretation (Grand Rapids: Eerdmans, 1993): 7–30.

See generally Good B.J. , Medicine, Rationality, and Experience: An Anthropological Perspective (New York: Cambridge University Press, 1994).