Tuesday, July 12, 2005
In the relatively short history of the relatively new discipline of bioethics, historical perspective can be difficult to come by. Thus, it is anybody's guess whether the recently published UNESCO's Universal Draft Declaration on Bioethics and Human Rights (24 June 2005) will prove to be the seminal document its authors intend it to be. Here's the full text (I'd be interested to know if anyone else thought it was fairly bland):
Paris, 24 June 2005
Universal Draft Declaration on Bioethics and Human Rights
The General Conference,
Conscious of the unique capacity of human beings to reflect upon their own existence and on their environment; to perceive injustice; to avoid danger; to assume responsibility; to seek cooperation and to exhibit the moral sense that gives expression to ethical principles,
Reflecting on the rapid developments in science and technology, which increasingly affect our understanding of life and life itself, resulting in a strong demand for a global response to the ethical implications of such developments,
Recognizing that ethical issues raised by the rapid advances in science and their technological applications should be examined with due respect to the dignity of the human person and universal respect for, and observance of, human rights and fundamental freedoms,
Resolving that it is necessary and timely for the international community to state universal principles that will provide a foundation for humanity’s response to the ever-increasing dilemmas and controversies that science and technology present for humankind and for the environment,
Recalling the Universal Declaration of Human Rights of 10 December 1948, the Universal Declaration on the Human Genome and Human Rights adopted by the General Conference of UNESCO on 11 November 1997 and the International Declaration on Human Genetic Data adopted by the General Conference of UNESCO on 16 October 2003,
Noting the two United Nations International Covenants on Economic, Social and Cultural Rights and on Civil and Political Rights of 16 December 1966, the United Nations International Convention on the Elimination of All Forms of Racial Discrimination of 21 December 1965, the United Nations Convention on the Elimination of All Forms of Discrimination against Women of 18 December 1979, the United Nations Convention on the Rights of the Child of 20 November 1989, the United Nations Convention on Biological Diversity of 5 June 1992, the Standard Rules on the Equalization of Opportunities for Persons with Disabilities adopted by the United Nations General Assembly in 1993, the ILO Convention 169 concerning Indigenous and Tribal Peoples in Independent Countries of 27 June 1989, the International Treaty on Plant Genetic Resources for Food and Agriculture adopted by the FAO Conference on 3 November 2001 and entered into force on 29 June 2004, the Recommendation of UNESCO on the Status of Scientific Researchers of 20 November 1974, the UNESCO Declaration on Race and Racial Prejudice of 27 November 1978, the UNESCO Declaration on the Responsibilities of the Present Generations Towards Future Generations of 12 November 1997, the UNESCO Universal Declaration on Cultural Diversity of 2 November 2001, the Trade Related Aspects of Intellectual Property Rights Agrements (TRIPS) annexed to the Marrakech Agreement establishing the World Trade Organization, which entered into force on 1 January 1995, the Doha Declaration on the TRIPS Agreement and Public Health of 14 November 2001 and other relevant international instruments adopted by the United Nations and the specialized agencies of the United Nations system, in particular the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO),
Also noting international and regional instruments in the field of bioethics, including the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine of the Council of Europe, adopted in 1997 and entered into force in 1999, together with its additional protocols, as well as national legislation and regulations in the field of bioethics and the international and regional codes of conduct and guidelines and other texts in the field of bioethics, such as the Declaration of Helsinki of the World Medical Association on Ethical Principles for Medical Research Involving Human Subjects, adopted in 1964 and amended in 1975, 1989, 1993, 1996, 2000 and 2002 and the International Ethical Guidelines for Biomedical Research Involving Human Subjects of the Council for International Organizations of Medical Sciences adopted in 1982 and amended in 1993 and 2002,
Recognizing that this Declaration is to be understood in a manner consistent with domestic and international law in conformity with human rights law,
Recalling the Constitution of UNESCO adopted on 16 November 1945,
Considering UNESCO’s role in identifying universal principles based on shared ethical values to guide scientific and technological development and social transformation, in order to identify emerging challenges in science and technology taking into account the responsibility of the present generation towards future generations, and that questions of bioethics, which necessarily have an international dimension, should be treated as a whole, drawing on the principles already stated in the Universal Declaration on the Human Genome and Human Rights and the International Declaration on Human Genetic Data, and taking account not only of the current scientific context but also of future developments,
Aware that human beings are an integral part of the biosphere, with an important role in protecting one another and other forms of life, in particular animals,
Recognizing that, based on the freedom of science and research, scientific and technological developments have been, and can be, of great benefit to humankind in increasing inter alia life expectancy and improving quality of life, and emphasizing that such developments should always seek to promote the welfare of individuals, families, groups or communities and humankind as a whole in the recognition of the dignity of the human person and the universal respect for, and observance of, human rights and fundamental freedoms,
Recognizing that health does not depend solely on scientific and technological research developments but also on psycho-social and cultural factors,
Also Recognizing that decisions regarding ethical issues in medicine, life sciences and associated technologies may have an impact on individuals, families, groups or communities and humankind as a whole,
Bearing in mind that cultural diversity, as a source of exchange, innovation and creativity, is necessary for humankind and, in this sense, is the common heritage of humanity, but emphasizing that it may not be invoked at the expense of human rights and fundamental freedoms,
Also bearing in mind that a person’s identity includes biological, psychological, social, cultural and spiritual dimensions,
Recognizing that unethical scientific and technological conduct has had particular impact on indigenous and local communities,
Convinced that moral sensitivity and ethical reflection should be an integral part of the process of scientific and technological developments and that bioethics should play a predominant role in the choices that need to be made concerning issues arising from such developments,
Considering the desirability of developing new approaches to social responsibility to ensure that progress in science and technology contributes to justice, equity and to the interest of humanity,
Recognizing that an important way to evaluate social realities and achieve equity is to pay attention to the position of women,
Stressing the need to reinforce international cooperation in the field of bioethics, taking into account in particular the special needs of developing countries, indigenous communities and vulnerable populations,
Considering that all human beings, without distinction, should benefit from the same high ethical standards in medicine and life science research,
Proclaims the principles that follow and adopts the present Declaration.
Article 1 – Scope
a) The Declaration addresses ethical issues related to medicine, life sciences and associated technologies as applied to human beings, taking into account their social, legal and environmental dimensions.
b) The Declaration is addressed to States. As appropriate and relevant, it also provides guidance to decisions or practices of individuals, groups, communities, institutions and corporations, public and private.
Article 2 – Aims
The aims of this Declaration are:
(i) to provide a universal framework of principles and procedures to guide States in the formulation of their legislation, policies or other instruments in the field of bioethics;
(ii) to guide the actions of individuals, groups, communities, institutions and corporations, public and private;
(iii) to promote respect for human dignity and protect human rights, by ensuring respect for the life of human beings, and fundamental freedoms, consistent with international human rights law;
(iv) to recognize the importance of freedom of scientific research and the benefits derived from scientific and technological developments, while stressing the need that such research and developments occur within the framework of ethical principles set out in this Declaration and that they respect human dignity, human rights and fundamental freedoms;
(v) to foster multidisciplinary and pluralistic dialogue about bioethical issues between all stakeholders and within society as a whole;
(vi) to promote equitable access to medical, scientific and technological developments as well as the greatest possible flow and the rapid sharing of knowledge concerning those developments and the sharing of benefits, with particular attention to the needs of developing countries;
(vii) to safeguard and promote the interests of the present and future generations; and
(viii) to underline the importance of biodiversity and its conservation as a common concern of humankind.
Within the scope of this Declaration, in decisions or practices taken or carried out by those to whom it is addressed, the following principles are to be respected.
Article 3 – Human Dignity and Human Rights
a) Human dignity, human rights and fundamental freedoms are to be fully respected.
b) The interests and welfare of the individual should have priority over the sole interest of science or society.
Article 4 – Benefit and Harm
In applying and advancing scientific knowledge, medical practice and associated techologies, direct and indirect benefits to patients, research participants and other affected individuals should be maximized and any possible harm to such individuals should be minimized.
Article 5 – Autonomy and Individual Responsibility
The autonomy of persons to make decisions, while taking responsibility for those decisions and respecting the autonomy of others, is to be respected. For persons who are not capable of exercising autonomy, special measures are to be taken to protect their rights and interests.
Article 6 –Consent
a) Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice.
b) Scientific research should only be carried out with the prior, free, express and informed consent of the person concerned. The information should be adequate, provided in a comprehensible form and should include the modalities for withdrawal of consent. The consent may be withdrawn by the person concerned at any time and for any reason without any disadvantage or prejudice. Exceptions to this principle should be made only in accordance with ethical and legal standards adopted by States, consistent with the principles and provisions set out in this Declaration, in particular in Article 27, and international human rights law.
c) In appropriate cases of research carried out on a group of persons or a community, additional agreement of the legal representatives of the group or community concerned may be sought. In no case should a collective community agreement or the consent of a community leader or other authority substitute for an individual’s informed consent.
Article 7 – Persons without the capacity to consent
In accordance with domestic law, special protection is to be given to persons who do not have the capacity to consent:
a) authorization for research and medical practice should be obtained in accordance with the best interest of the person concerned and in accordance with domestic law. However, the person concerned should be involved to the greatest extent possible in the decision-making process of consent, as well as that of withdrawing consent;
b) research should only be carried out for his or her direct health benefit, subject to the authorization and the protective conditions prescribed by law, and if there is no research alternative of comparable effectiveness with research participants able to consent. Research which does not have potential direct health benefit should only be undertaken by way of exception, with the utmost restraint, exposing the person only to a minimal risk and minimal burden and, if the research is expected to contribute to the health benefit of other persons in the same category, subject to the conditions prescribed by law and compatible with the protection of the individual's human rights. Refusal of such persons to take part in research should be respected.
Article 8 – Respect for Human Vulnerability and Personal Integrity
In applying and advancing scientific knowledge, medical practice and associated technologies, human vulnerability should be taken into account. Individuals and groups of special vulnerability should be protected and the personal integrity of such individuals respected.
Article 9 – Privacy and Confidentiality
The privacy of the persons concerned and the confidentiality of their personal information should be respected. To the greatest extent possible, such information should not be used or disclosed for purposes other than those for which it was collected or consented to, consistent with international law, in particular international human rights law.
Article 10 – Equality, Justice and Equity
The fundamental equality of all human beings in dignity and rights is to be respected so that they are treated justly and equitably.
Article 11 – Non-Discrimination and Non-Stigmatization
No individual or group should be discriminated against or stigmatized on any grounds, in violation of human dignity, human rights and fundamental freedoms.
Article 12 – Respect for Cultural Diversity and Pluralism
The importance of cultural diversity and pluralism should be given due regard. However, such considerations are not to be invoked to infringe upon human dignity, human rights and fundamental freedoms, nor upon the principles set out in this Declaration, nor to limit their scope.
Article 13 – Solidarity and Cooperation
Solidarity among human beings and international cooperation towards that end are to be encouraged.
Article 14 – Social Responsibility and Health
a) The promotion of health and social development for their people is a central purpose of governments, that all sectors of society share.
b) Taking into account that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition, progress in science and technology should advance:
(i) access to quality health care and essential medicines, including especially for the health of women and children, because health is essential to life itself and must be considered as a social and human good;
(ii) access to adequate nutrition and water;
(iii) improvement of living conditions and the environment;
(iv) elimination of the marginalization and the exclusion of persons on the basis of any grounds; and
(v) reduction of poverty and illiteracy.
Article 15 – Sharing of Benefits
a) Benefits resulting from any scientific research and its applications should be shared with society as a whole and within the international community, in particular with developing countries. In giving effect to this principle, benefits may take any of the following forms:
(i) special and sustainable assistance to, and acknowledgement of, the persons and groups that have taken part in the research;
(ii) access to quality health care;
(iii) provision of new diagnostic and therapeutic modalities or products stemming from research;
(iv) support for health services;
(v) access to scientific and technological knowledge;
(vi) capacity-building facilities for research purposes; and
(vii) other forms of benefit consistent with the principles set out in this Declaration.
b) Benefits should not constitute improper inducements to participate in research.
Article 16 - Protecting Future Generations
The impact of life sciences on future generations, including on their genetic constitution, should be given due regard.
Article 17 – Protection of the Environment, the Biosphere and Biodiversity
Due regard is to be given to the interconnection between human beings and other forms of life, to the importance of appropriate access and utilization of biological and genetic resources, to the respect for traditional knowledge and to the role of human beings in the protection of the environment, the biosphere and biodiversity.
Application of the Principles
Article 18 – Decision-Making and Addressing Bioethical Issues
a) Professionalism, honesty, integrity and transparency in decision-making should be promoted, in particular declarations of all conflicts of interest and appropriate sharing of knowledge. Every endeavour should be made to use the best available scientific knowledge and methodology in addressing and periodically reviewing bioethical issues.
b) Persons and professionals concerned and society as a whole should be engaged in dialogue on a regular basis.
c) Opportunities for informed pluralistic public debate, seeking the expression of all relevant opinions, should be promoted.
Article 19 – Ethics Committees
Independent, multidisciplinary and pluralist ethics committees should be established, promoted and supported at the appropriate level in order to:
(i) assess the relevant ethical, legal, scientific and social issues related to research projects involving human beings;
(ii) provide advice on ethical problems in clinical settings;
(iii) assess scientific and technological developments, formulate recommendations and contribute to the preparation of guidelines on issues within the scope of this Declaration; and
(iv) foster debate, education, and public awareness of, and engagement in, bioethics.
Article 20 – Risk Assessment and Management
Appropriate assessment and adequate management of risk related to medicine, life sciences and associated technologies should be promoted.
Article 21 – Transnational Practices
a) States, public and private institutions, and professionals associated with transnational activities should endeavour to ensure that any activity within the scope of this Declaration, which is undertaken, funded or otherwise pursued in whole or in part in different States, is consistent with the principles set out in this Declaration.
b) When research is undertaken or otherwise pursued in one or more States (the host State(s)) and funded by a source in another State, such research should be the object of an appropriate level of ethical review in the host State(s) and the State in which the funder is located. This review should be based on ethical and legal standards that are consistent with the principles set out in this Declaration.
c) Transnational health research should be responsive to the needs of host countries, and the importance of research to contribute to the alleviation of urgent global health problems should be recognized.
d) When negotiating a research agreement, terms for collaboration and agreement on benefits of research should be established with equal participation by those party to the negotiation.
e) States should take appropriate measures, both at the national and the international level, to combat bioterrorism, illicit traffic in organs, tissues and samples, genetic resources and genetic-related materials.
Promotion of the Declaration
Article 22 – Role of States
a) States should take all appropriate measures, whether of a legislative, administrative or other character, to give effect to the principles set out in this Declaration in accordance with international human rights law. Such measures should be supported by action in the spheres of education, training and public information.
b) States should encourage the establishment of independent, multidisciplinary and pluralist ethics committees, as set out in Article 19.
Article 23 – Bioethics Education, Training and Information
a) In order to promote the principles set out in this Declaration and to achieve a better understanding of the ethical implications of scientific and technological developments, in particular for young people, States should endeavour to foster bioethics education and training at all levels as well as to encourage information and knowledge dissemination programmes about bioethics.
b) States should encourage the participation of international and regional intergovernmental organizations and international, regional and national non-governmental organizations in this endeavour.
Article 24 – International Cooperation
a) States should foster international dissemination of scientific information and encourage the free flow and sharing of scientific and technological knowledge.
b) Within the framework of international cooperation, States should promote cultural and scientific cooperation and enter into bilateral and multilateral agreements enabling developing countries to build up their capacity to participate in generating and sharing scientific knowledge, the related know-how and the benefits thereof.
c) States should respect and promote solidarity between and among States, as well as individuals, families, groups and communities, with special regard for those rendered vulnerable by disease or disability or other personal, societal or environmental conditions and those with the most limited resources.
Article 25 – Follow-up action by UNESCO
a) UNESCO shall promote and disseminate the principles set out in this Declaration. In doing so, UNESCO should seek the help and assistance of the Intergovernmental Bioethics Committee (IGBC) and the International Bioethics Committee (IBC).
b) UNESCO shall reaffirm its commitment to dealing with bioethics and to promoting collaboration between IGBC and IBC.
Article 26 – Interrelation and Complementarity of the Principles
This Declaration is to be understood as a whole and the principles are to be understood as complementary and interrelated. Each principle is to be considered in the context of the other principles, as appropriate and relevant in the circumstances.
Article 27 –Limitations on the Application of the Principles
If the application of the principles of this Declaration are to be limited, it should be by law, including laws in the interests of public safety, for the investigation, detection and prosecution of criminal offences, for the protection of public health or for the protection of the rights and freedoms of others. Any such law needs to be consistent with international human rights law.
Article 28 – Denial of acts contrary to human rights, fundamental freedoms and human dignity
Nothing in this Declaration may be interpreted as implying for any State, group or person any claim to engage in any activity or to perform any act contrary to human rights, fundamental freedoms and human dignity.