09050-Prelims.qxd 06/Aug/03 5:02 PM Page i REGIONAL PERSPECTIVES IN BIOETHICS 09050-Prelims.qxd 06/Aug/03 5:02 PM Page ii 09050-Prelims.qxd 06/Aug/03 5:02 PM Page iii The Annals of Bioethics Regional Perspectives in Bioethics Edited by John F. Peppin Director Center for Bioethics, Pain Management & Medicine Des Moines, Iowa and Mark J. Cherry Department of Philosophy Saint Edward’s University Austin, Texas 09050-Prelims.qxd 06/Aug/03 5:02 PM Page iv Library of Congress Cataloging-in-Publication Data Applied for First published 2003 by Swets & Zeitlinger Publishers Published 2018 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN 711 Third Avenue, New York, NY 10017, USA Routledge is an imprint of the Taylor & Francis Group, an informa business Copyright © 2003 Taylor & Francis. The Open Access version of this book, available at www.taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license. Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. ISBN 13: 978-90-265-1952-9 (hbk) Although all care is taken to ensure the integrity and quality of this publication and the information herein, no responsibility is assumed by the publishers nor the editors for the publication and/or the information contained herein. Published by: Swets & Zeitlinger Publishers www.szp.swets.nl ISBN 90 265 1952 4 09050-Prelims.qxd 06/Aug/03 5:02 PM Page v Contents ACKNOWLEDGEMENTS ix PREFACE TO A NEW SERIES Annals of Bioethics: A Forum of Foundational, Clinical and Emerging Topics xi Mark J. Cherry and Ana Iltis INTRODUCTION: BIOETHICS AS A GLOBAL PHENOMENON xiii H. Tristram Engelhardt, Jr. PART I: NORTH AMERICA 1 Bioethics in Canada 3 Nuala Kenny 2 United States Perspectives on Assisted Reproductive Technologies 21 Scott B. Rae 3 Conceptual, Normative, and Policy Issues in U.S. Health Care Allocation 39 B. Andrew Lustig 4 Ethics Committees and Consultation in the United States 55 Brendan P. Minogue PART II: SOUTH AMERICA 5 Bioethics in Argentina 71 José Alberto Mainetti, José M. Tau, Guillermo C. Morello, Hécto H. Pinedo and Mirta Matínez 09050-Prelims.qxd 06/Aug/03 5:02 PM Page vi vi CONTENTS PART III: EUROPE 6 Bioethics in France 93 Anne Bernard and Anne Fagot-Largeault 7 Crossing the Rubicon? The Medical Ethical Debate in Germany in 2001 117 Kurt W. Schmidt 8 Bioethics in Switzerland 135 Fabrice Jotterand 9 Bioethics in Greece: A Regional Approach 147 T. Garanis-Papadatos and P. Dalla-Vorgia 10 Bioethics in Italy since 1997 163 Maurizio Mori 11 Bioethics in the UK 193 Ruth Chadwick and Michael Parker 12 Bioethics in Denmark 209 Jacob Dahl Rendtorff PART IV: ASIA 13 Turkish Perspectives in Bioethics 227 Sahin Aksoy 14 Bioethics in Bangladesh 235 Hasna Begum 15 Bioethics in China 239 Ya-li Cong 16 Bioethics With Chinese Characteristics: The Development of Bioethics in Hong Kong 261 Gerhold K. Becker 17 The Long History of Indian Medical Systems and Current Perspectives in Health Care Bioethics 285 Jayapaul Azariah 18 Bioethics in the Philippines: An Overview of Developments, Issues, and Controversies 301 Leonardo de Castro 09050-Prelims.qxd 06/Aug/03 5:02 PM Page vii CONTENTS vii 19 Japanese Bioethics 321 Darryl Macer PART V: NEW ZEALAND 20 Bioethics in New Zealand: A Historical and Sociological Review 341 Jing-Bao Nie and Lynley Anderson NOTES ON CONTRIBUTORS 363 INDEX 365 09050-Prelims.qxd 06/Aug/03 5:02 PM Page viii 09050-Prelims.qxd 06/Aug/03 5:02 PM Page ix Acknowledgements The development of this volume benefited through the kind efforts of many. In particular we would like to thank Eugene Boisaubin, Joseph Boyle, Ruth Groenhoet, Henk Ten Have, Kazumasa Hoshino, Loretta Kopelman, Anne M. Fagot-Largeault, José Alberto Mainetti, Maurizio Mori, Edmund D. Pellegrino, Ren-Zong Qiu, Michael Rie, Hans-Martin Sass, W. David Solomon, and Griffin Trotter, who were discussion partners that aided in review- ing and focusing the essays. In addition, a number of individuals must be thanked in par- ticular who contributed significant time and energy to the volume: Ana Smith Iltis, Fabrice Jotterand, Lisa Rasmussen, Fr. Allyne Smith, Matthew Lomanno, and Robert Perez. A very special debt is owed to H.Tristram Engelhardt, Jr., who, in addition to having unfailingly and tirelessly supported this project’s development, contributed a splendid introduction. We also wish to recognize the on-going kindness of Saint Edward’s University, School of Humanities, the Department of Philosophy, and the Center for Ethics and Leadership, especially Louis T. Brusatti, William J. Zanardi, and Phillip M. Thompson. Each has been instrumental, though in different capacities, to the success of this project. John F. Peppin and Mark J. Cherry 09050-Prelims.qxd 06/Aug/03 5:02 PM Page x 09050-Prelims.qxd 06/Aug/03 5:02 PM Page xi Preface to a new series Annals of Bioethics: A Forum of Foundational, Clinical and Emerging Topics Bioethics has become a truly international phenomenon. Through foundational philosophi- cal, religious, and cultural perspectives, clinical case studies, and legal analysis, the Annals of Bioethics documents, reviews, and explores emerging bioethical viewpoints as well as the state-of-the-art of this global endeavor. In so doing, the Annals is, perhaps inadvertently, as much on the nature and depth of our contemporary moral and cultural conflicts as it is on biomedical ethics. Bioethics is grounded in and has implications for the religious, political, and legal elements of cul- tures. As a field of inquiry, bioethics has coveted an international political forum. Secular Western bioethics in particular lays claim to a universal account of proper moral deport- ment, including the foundations of law and public policy, as well as the moral authority for national and international institutions to guarantee uniformity of practice, secure basic human rights, and promote social justice. Bioethical expertise is widely sought in the fram- ing of public and institutional policy. Witness, for example, the broad advisory role of the President’s Council on Bioethics in the United States, as well as the European Bioethics Convention, which sought not merely to explain or analyze moral issues but to justify politi- cal resolutions. Similarly, bioethicists regularly provide testimony as expert witnesses in courts of law. They present themselves as experts of moral rationality and principles of moral probity, including permissible standards of evidence and inference. Religious and cultural moral diversity runs deep; it strides the divisions that separate regional, religious, and cultural biomedical and moral perspectives. This series illustrates the ways in which the national and international political landscape compasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations, and commitments. The various volumes explore, document, and criti- cally appreciate diverse moral, cultural, and religious viewpoints representing the various regions of the world, from mainland China and Hong Kong, Taiwan, Japan, India and East Asia more generally, to Europe, the Middle East, Australia and New Zealand, to South America and North America. Moral perspectives range from Orthodox Christianity, Roman Catholicism, and contemporary Protestant Christianity, to Orthodox, Conservative and Reformed Judaism, to Islam, Buddhism, Confucianism, Hinduism, and so forth, to secular liberal egalitarianism. The goal of the series is to document and review the often widely 09050-Prelims.qxd 06/Aug/03 5:02 PM Page xii xii PREFACE TO A NEW SERIES varying bioethical perspectives reflected throughout the international community’s regions, religions, laws and policies. The Annals of Bioethics compasses updates in moral theory, normative health care practice, case studies, and public policy. The series begins with three foundational volumes: Regional Perspectives in Bioethics; Religious Perspectives in Bioethics; and Legal Perspectives in Bioethics, which establish an initial framework. Future volumes will document and assess legal, religious and cultural responses to specific aspects of the fast paced developments in health care and medical technology. Future areas to be explored include such contentious issues as abortion, euthanasia, prenatal genetic screening, parental discretion regarding treat- ment of neonates, genetic engineering, sex reassignment surgery, reproductive technologies, and cloning, as well as the permissible foundations and limits of biomedical ethics and health care policy. Biomedical policy must be created to span a diverse set of individuals, cultures, and communities. Political struggles regard the structure and content of what will become the prevailing medical, moral, and social ethos. Such discussions concern not merely which policies will best achieve the desired objectives, but which objectives are themselves desirable; that is, which moral understanding should be established (e.g., pro-choice or pro-life; indi- vidual versus family or community oriented consent), utilizing which school of practice (traditional Chinese or Western medicine, allopathic, homeopathic, naturopathic, or chi- ropractic health care, and so forth), at what standard of care (e.g., guaranteed equal access for all, or with regional variation, or varying levels of access depending on insurance cov- erage). There exists a significant plurality of fundamentally different,