Eubios Journal of Asian andInternational Bioethics
EJAIB Vol. 29 (3) May 2019www.eubios.info
ISSN 1173-2571 (Print) ISSN 2350-3106 (Online)
Official Journal of the Asian Bioethics Association (ABA)

Copyright ©2019 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

Contents

page

Editorial: Gene-editing Ethics and the Disasters ofTerrorism - Darryl Macer
81
Developing a regulation matrix for human germline
gene editing - Bang-Ook Jun
82
Heritable gene editing: Whose burden is it?
85- Oana Iftime, Ştefana-Maria Petruţ
Revisiting the proposal of Asian principles of bioethics- Michael Cheng-tek Tai
89
Albert Einstein in 1935 on Electrosmog and Fake News- Hans-Martin Sass
93
Bargaining with positivism: Science’s nexus tophilosophy - Jan Gresil S. Kahambing
95
Debunking the perceived loss of the Committee on
Publication Ethics (COPE) moral compass: conspiracy
theory, or a genuine cause for concern?
99- Jaime A. Teixeira da Silva
Silence in Violence: A curse or a Goodwill?
109- Afsheen Amir Ali Hirani , Nasreen Rafiq, Shyrose
Sultan, Zainish Hajani, Samreen Siraj
Istanbul Communiqué on Looking Beyond Disaster 113

Editorial: Gene-editing Ethics
and the Disasters of Terrorism- Darryl Macer, Ph.D., Hon.D., MPH
Email: darryl@eubios.info
There has been some responses to the call made in the
Bangkok Statement on Human Gene Editing and Human
Genetic Engineering1, and the papers in the January 2019EJAIB that followed the Bangkok Summit meeting, for theestablishment of ongoing forums for ethical assessmentof clinical uses of germ-line gene editing.
Aninternational commission has been convened by the U.S.
U.S. National Academy of Sciences (NAS), and the Royal
Society of the U.K., with the participation of science andmedical academies around the world, to develop aframework for scientists, clinicians, and regulatory
authorities to consider when assessing potential clinicalapplications of human germline genome editing.2 They
are planning to issue a report in 2020.
In this issue of EJAIB there are two further papers on
gene editing, from Bang-Ook Jun and from Oana Iftimeand Ştefana-Maria Petruţ, which add to the discussion. It
is important that we have persons from more diverse
1

EJAIB 29: 1-4.

2 http://www.nationalacademies.org/gene-editing/international-

commission/index.htm

countries on bodies that examine gene-editing, and weshould see more bodies considering this.
The
Commission announced above has two thirds of its
members from the USA and UK.
Also in this issue is an interesting discussion of Albert
Einstein’s comments on fake news by Hans-Martin Sassmade in 1935. This is a topic often discussed nowadays.
Michael Tai revisits a discussion on Asian bioethics
outlining principles that are important to consider when
we consider ethical dilemmas, such as gene-editing. It is
critical for wider range of views to be involved in thedebates. The Asian Bioethics Association may also takeup this issue in the 20th Asian Bioethics Conference to beheld in Dhaka in November 2019. Jaime Teixeira da Silva
discusses the morality of COPE and some of thequestions that many persons have about the procedures.
In March 2019 our hometown, Christchurch, was thesite of a terrorist attack by a racist Islamophobe who
killed 51 persons in two mosques who were praying.
Sectarain violence continues, and in April we saw theEaster Sunday terrorist attacks in Sri Lanka of persons
praying in churches. All violence needs to be condemned.
As discussed in the March 2019 editorial we convened
the Tenth Youth Looking Beyond Disaster Training
Workshop in April 2019 in BETIM, Istanbul, Turkey. At
the end of this issue is the Istanbul Communiqué on
Looking Beyond Disaster, which includes an importantcall to combat these evil attacks. Youth unemployment
in Nigeria is also discussed in this issue, andradicalization can make easy pickings of persons without
a balanced education and with no jobs. Bioethics needs
to take a more holistic approach, and please join the
Legacies book project, and conferences in USA and Japanthat we will hold to work against these evils.
Editorial address, and all correspondence to:Prof. Darryl Macer, Ph.D., Hon.D.
President, American University of Sovereign Nations (AUSN),
Email: darryl@eubios.info
EJAIB adopts and complies with the Committee on Publication
Ethics (COPE) Publication ethics and malpractice policy. All
potential authors should have read these guidelines and bysubmission of an article for publication you acknowledge thatyou have complied with this policy. Violations will be handled
in proportion to the intention and seriousness of the violation.
Registered address of EJAIB: P.O. Box 16 329, Hornby,
Christchurch 8441, New Zealand82

Eubios Journal of Asian and International Bioethics 29 (May 2019)

Developing a regulation matrix forhuman germline gene editing- Bang-Ook Jun
Department of Biology, Gangneung-Wonju National
University, Korea
Email: jun.bangook@gmail.com

Introduction

A genome editing technique called CRISPR/Cas9
has revolutionized scientific research. It's abiological cut-and-paste tool derived from themicrobial adaptive immune system. It works byfinding the taget by target DNA-guide RNA basepairing and using molecular scissors to snip thattarget, either deleting, repairing or replacing theaffected gene.3
It is only five years since CRISPR/Cas9 wasinvented, but the technology has proven to be
powerful. It may be widely used in basic biology
such as regulation of transcription or in vivo
chromosome imaging, somatic cell gene therapy
through mutation gene correction, germline genecorrection to prevent inborn genetic disorders,plant genome modification without introduction offoreign genes, extinction of disease vectors andinvasive species, and resurrection of extinct
animals.4
On the other hand, this powerful technique,however, can lead to adverse effects due toimmature clinical applications, enhancement of
human genes rather than therapeutic purposes,
escape from regulation of gene edited plants, andecosystem destruction.5
In particular, what confuses us the most is acontroversial modification of human embryos.
Seven experiments on germline gene editing havebeen conducted so far.
First case
In April 2015, when the public opinion that humanembryos should not be edited arose, Junjiu Huang, a
researcher at Sun Yat-Sen University in Guangzhou,
China, attempted to edit germ cells for humanembryos in a world first.6 To avoid accusations of
3 Doudna,

J. A., & Charpentier, E. (2014). The newfrontier of genome engineering with CRISPR-Cas9.
Science, 346(6213), 1258096.
4 Jun, B.O. (2017). DNA Revolution, CRISPR genome scissor.
E-sang Books: Seoul, Korea. 332p.
5 Jun, B.O. (2016).
Ethical Questions Raised by
CRISPR/Cas9 Genome Editing. Personalism Bioethics
6(2), 2016. pp.
6 Liang, P., Xu, Y., Zhang, X., Ding, C., Huang, R., Zhang, Z.,
et al. (2015). CRISPR/Cas9-mediated gene editing inhuman tripronuclear zygotes. Protein & Cell, 6(5), 363372.

violatingethicalboundaries,
they
used
tripronuclear zygotes for experiments.
The team’s goal was to successfully repair a beta
globin gene that, when mutated, caused a fatal
blood disease known as beta-thalassemia. As Huang
himself admitted, the research was not so
successful. Of the 71 embryos that survived
applying CRISPR/Cas9 from among 86 embryos, 54
were examined, 28 of which were successfully
spliced, but only four of which had the intended
replaced genes. Furthermore, even these embryos
showed a mosaicism mixed with modified cells andnon-modified cells. Off-target mutations were also
observed in other sites.
However, the researchers acknowleged that thelow efficiencies and high number of off-target
mutations could be specific to the abnormal
embryos used in this study. The researchers also
added that the reliability and specificity of thetechnology should be further improved. Judging
from these findings, the clinical application of thetechnology is thought to be immature.
Second case
In May 2016, a team of researchers at Guangzhou
Medial University in China conducted a proof-ofprinciple test to determine if genetically modified
early embryos could be genetically modified using
CRISPR/Cas9.7 The CCR5Δ32 allele, which naturally
occurs in 213 human triploid zygotes, wasintroduced by injecting a CRISPR/Cas9 component
containing two types of guide RNAs. In the control
group, 72 percent of the zygotes were injected with
the CRISPR/Cas9, and 64 and 62 percent of thezygotes developed into the 8 to 16 cells. Of the total
26 embryos, four embryos were found containing
CCR5Δ32. Three of the four embryos showed amosaicism. Though 28 potential off-target sites
were investigated in three embryos containing the
CCR5Δ32 allele, no indel (DNA sequence insertionand deletion) was observed.
Third case
In March 2017, the Guangzhou University researchteam in China first tried to investigate the successrate of gene editing by applying the CRISPR/Cas9
on human normal embryos.8 Male sperms withgenetic disease were injected with CRISPR/Cas9
into the normal oocyte before division to make six
7 Kang, X., He, W., Huang, Y., Yu, Q., Chen, Y., Gao, X., et al.

(2016). Introducing precise genetic modifications into
human 3PN embryos by CRISPR/Cas-mediatedgenome editing. Journal of Assisted Reproduction andgenetics, 33(5), 581-588.
8 Tang, L., Zeng, Y., Du, H., Gong, M., Peng, J., Zhang, B., etal. (2017). CRISPR/Cas9-mediated gene editing inhuman zygotes using Cas9 protein. Molecular Genetics
and Genomics, 292(3), 525-533.

Eubios Journal of Asian and International Bioethics 29 (May 2019)
embryos. In the correction experiment of G1376T
mutated G6PD gene using two embryos, both werecorrected, but one of them showed mosaicism. In
the correction experiment of ß41-42 mutant betaThalassemia gene using four embryos, one embryo
showed mosaicism, and the other three failed. The
number of embryos used in this study was so smallthat they could not make a definite conclusion.
Fourth case
After treatment of CRISPR/Cas9, repair efficiencies
were reported as low as 2 percent in cultured
human embryonic stem cells and 14-25 percent in
human embryos.9 Shoukhrat Mitalipov and Kim JinSoo collaborated on the editing of human embryo
genes. This experiment used normal embryos andintroduced a CRISPR/Cas9 component at the timeof fertilization, and did not show any off-target
effect and mosaicism that appeared in the previous
study. The research involved eggs from 12 healthy
female donors and sperm from a male volunteer
who carried the MYBPC3 gene, which causes
hypertrophic cardiomyopathy.
The yield of corrected embryos (72.4%, 42/58)
in the M-phase-injected group was significantly
higher than in untreated controls (47.4%, 9/19),
reflecting the probability of having a normal copy
to be about 25 percent higher. The remaining 16
embryos showed indel formation in addition to
repair of MYBPC3 copies. Almost all embryos with
MYBPC3 were repaired with a maternal copy rather
than an externally introduced template. Similar tothe control embryo, 50 percent of the geneticallymodified embryos reached blastocyst stage,
confirming normal development after editing. But
the integrity of this research is now being
debated.10
Fifth case
On September 5, 2017, Zi-Jiang Chen attempted toedit the tripronuclear embryos using a single baseediting method, which is different from theconventional method of gene editing. Using the BE3base editor, the taget sites of beta-Thalassemia
gene in eight of the 19 (42 percent) embryos werereported to be modified.11 Seven embryos were

9 Ma, H., Marti-Gutierrez, N., Park, S. W., Wu, J., Lee, Y.,

Suzuki, K., et al. (2017). Correction of a pathogenic
gene mutation in human embryos. Nature, 548 (7668),
413-419.
10 Callaway, Ewen. (2018). Did CRISPR really fix a genetic
mutation in these human embryos? Nature doi:
10.1038/d41586-018-05915-2.
11 Zhou, C., Zhang, M., Wei, Y., Sun, Y., Pan, H., Yao, N., et al.
(2017). Highly efficient base editing in human
tripronuclear zygotes. Protein & Cell, doi,
10.1007/s13238-017-0459-6.

83

modified into A base with G base, and C base with
A/G base in one embryo.
Using the SaKKH-BE3 editing tool, the target
region of the FANCF gene of Fanconi anemia wasmodified in all 17 embryos. In 10 of them, the Cbase was modified to T base and the other 7 C basewas modified to A / G base. By SaKKH-BE3 baseeditor, the target site of the DNMT3B gene, a DNA
methyltransferase, was modified in 6 out of 9embryos (67 percent). Three of them weremodified into C base with T base and C base with A/ G base, respectively. This study demonstrated
that it is possible to make precise editing throughsingle base modification in human embryos.
Sixth case
On September 20, 2017, the Niakan Groupannounced their results. Through knockout of the
POU5F1 gene encoding the universal transcription
factor OCT4 during human normal embryo
development, the blastocyst was not welldeveloped.12 They lowered the expression of theuniversal ectodermal regulator such as NANOG as
well as the exogenous gene of the embryo, such as
CDX2, which is different from results previously
observed in mice. The researchers concluded thatthe technique of CRISPR/Cas9 was a powerful tool
in investigating gene function in human embryonicdevelopment. Therefore, similar studies are
expected to continue in the future.
Seventh case
On Sept. 20, 2017, Huang's group, the first humangermline gene editing researchers, of Son Yat-Sen
University edited the human embryos using baseeditor. 13 The beta Thalassemia HBV-28 (A>G)
mutation, which frequently occurs in China andSoutheast Asia, was edited by CRISPR/Cas9 and theefficiency of gene editing was measured. To model
mutated embryos, the researchers conductednuclear transfer embryos by fusing the lymphocyte
or skin fibroblast cells with enucleated in vitro
oocytes and gene correction efficiency of the baseeditor was found to be over 23%. More than 20
percent of the embryos developed into blastocysts.
The researchers acknowledge the possibility oftreating genetic disorders in embryos by baseediting. These results can be summarized as in thefollowing table.
12 Fogarty, N. M. E., McCarthy, A., Snijders, K. E., Powell, B.

E., Kubikova, N., Blakeley, P., et al. (2017). Genome
editing reveals a role for OCT4 in humanembryogenesis. Nature. doi. 10.1038/nature24033.
13 Liang, P., Ding, C., Sun, H., Xie, X., Xu, Y., Zhang, X., et al.
(2017). Correction of beta-thalassemia mutant bybase editor in human embryos. Protein & Cell 8:811–
822

84

Eubios Journal of Asian and International Bioethics 29 (May 2019)

Table 1. Summary of the cases of CRISPR/Cas9 gene editing on human germline cells.
Dategermline cell

Condition

gene

MethodReference

2015.4non-viable zygote

β-Thalassemia

HBB

HDR

Liang, P. et al. Protein Cell 6,363–372.

2016,5non-viable zygote

HIV infection

CCR5Δ32

HDR

2017.6

leftover embryo

β-Thalessemia

HBB, G6PD

HDR

2017.8produced embryo

hypertrophic cardiomyopathy

MYBPC3HDR

2017.9non-viable zygote

β-Thalassemia /.../ Fanconi
AnemiaHBB
DNMT3B
FANCF

Base
edit

2017.9leftover embryo

embryofailure

POUF1
CDX2

NHEJ

2017.9constructed nuclear
transfer embryos

HBB

Base
edit

β-Thalessemia

Developing a matrix
It may be the time to gradually transition from total
ban to partial prohibition. That is because many
researchers already have done germline gene
editing research since 2015. There is a pacing
situation where regulation is lagging behinddevelopment. The time has come that experiments
on human germ cell editing should be properly
regulated.
This matrix approach can help resolve theregulatory difficulties in formulating generalregulations for human germline gene editing.
Table 2. Possible matrix for regulating the use ofhuman germline cells and boundaries of purposes
non-viablezygote(protrinuclear)
therapeutic×basic science?

proof-ofprinciple
enhancement①②⑤

embryoproduced
for research

leftoverembryo⑥⑦③④

×

Now I want to analyze each case of humangermline editing based on the degree of
acceptability. Before doing this, I have drawn amatrix in sequence according to acceptability.
Germline cells
The tripronuclear (3PN) zygotes have one oocyte
nucleus and two sperm nuclei. Polyspermic zygotes
such as these occur naturally in ∼2%–5% of
zygotes during in vitro fertilization (IVF) clinical
trials. Crucially, these zygotes invariably fail todevelop normally in vivo, so they are notKang, X. et al. J. Assist.
Reprod. Genet. 33, 581–588.
Tang, L. et al. Mol. Genet.
Genomics, 292, 525–533.
Ma, H. et al. Nature,
DOI10.1038/nature23305
Zhou, C. et al. Protein Cell
DOI10.1007/s13238- 0170459-6
Fogarty, N. M. E., et al.
Nature, doi.
10.1038/nature24033.
Liang, P. et al. Correction of
β-Thalessemia mutant bybase editor in humanembryos.

considered to be viable for implantation. They will
never produce a live baby. The use of non-viable(protrinuclear) zygotes is the least problematic andmore acceptable than the use of normal viableembryos.
Many legislative systems, including Korea, allow
the use of leftover embryos but instead inhibit the
production of new embryos. This reflects the factthat the production of new embryos could be
ethically more problematic than the use of leftoverembryos.
Boundaries of purposesThough the boundaries of purpose are somewhat
blurred, I deliberately categorize these purposes,
such as therapeutic, basic science, proof-ofprinciple and enhancement.
Therapeutic research is a study of mitigating andeliminating inborn disorders directly by genecorrection.
Basic research is a study of developmental or
physiological products that result from gene editing.
Proof-of-principle research is a study to determine
whether CRISPR / Cas9 works well in humanembryos, whether there is any off-target effect ormosaicism, and how to improve precision andefficiency technically. Enhancement research is a
study for genetic modification used to improve
traits for purposes other than therapy.
AnalysisUsing the developed matrix, I try to categorize theexisting seven experiments based on the possibilityof ethical acceptance.
Though it caused fierce controversy, the firstexperiment (①) by Liang et al. could be judged to
be ethically the least problematic compared to theother experiments. Although the target genes aredifferent, the second experiment (②) is almostEubios Journal of Asian and International Bioethics 29 (May 2019)
similar to the first. We can improve methodology
by base editing (⑤) using non-viable tripronuclear
embryos.
So, doing the proof-of-principle experiment with
non-viable embryos or animal embryos is ethicallymore compelling than with viable embryos. The
seventh experiment (⑦) is a little unusual. Insteadof using tripronuclear zygotes or embryos,
constructed embryos from somatic cells were used.
The moral status of these embryos requires a long
discussion but for convenience it is placed between
the leftover embryo and the produced embryo.
I think the research conducted by mitallipov’s
team (④) is the most ethically problematic because
they produced embryos for research. Even
compared to the third experiment (③) it is more
problematic, because the latter used 131 embryos,
while the former used only 6 embryos.
Acknowledging this, they are trying to give theimpression that this experiment has been
conducted for therapeutic purposes to move tomore ethically compelling category.
How can we justify the experiment? Do we haveto experiment with the embryo? In case the goal iscompelling, it will be justified to use embryos forexperiment.
The use of embryos for therapeutic purpose canbe considered to be more acceptable forhumanitarian reasons. In contrast to this, the use ofembryos for enhancement purpose might be theleast acceptable. In some cases, though, it is hard totell therapy from enhancement.
In therapeutic research and enhancement studies,
it is difficult to experiment with non-viableembryos because a fully developed embryo isneeded. Basic science research can sometimes be
conducted with non-viable embryos, but if
development patterns are different from those ofother animals, experimentation with a viableembryo would be acceptable.
Proof-of-principle studies are more valid thanenhancement studies, but less valid than basic
studies.
Matrix to regulation
Firstly, the genome-editing purposes are
categorized as therapeutic, basic science, proof-ofprinciple, and enhancement. from top to bottom the
purposes may potentially increase the regulatory
relevance. Even for those who advocate germline
treatment, the other puposes such as enhancement
could be treated differently from a regulatory
viewpoint. Secondly, germline cells were
subdivided based on the possible use or disposal, inorder to map these embryos according to theirregulatory relevance.
Using leftover embryos for research is considered
to be less problematic and thus less subject to85

regulations than making new embryos for research.
Some legislative systems allow the use of surplus
embryos while inhibiting embryo production forexperimentation reflecting on this concept.
Concluding remarks
I propose that the regulation bodies should
consider introducing regulation standards drawing
the line between cells. For therapeutic purposes, we
can reconsider moving the line ahead if technicaldifficulties are sufficiently resolved and benefits
outweigh the risk.
Such a cautious approach would contribute toharmonizing countries that show a regulatory
divide on germline editing.
The recent report from an international
committee convened by the U.S. National Academyof Sciences (NAS) and the National Academy ofMedicine concludes that such a clinical trial ofediting the DNA of a human embryo to prevent
disease in a baby “might be permitted, but only
following much more research” on risks andbenefits, and “only for compelling reasons andunder strict oversight.”
In the gene editing era, the medical practices
developed by advanced genetic engineering are nothampered by technological aspects only, but by
understanding and acceptance of such technologies
in society. Researchers, the public, and regulatory
bodies should discuss the socially acceptable
integration of germline gene editing. And I hope
this kind of matrix can help resolve the regulatory
challenges.

Heritable gene editing – Whoseburden is it?
- Oana Iftime, Ştefana-Maria Petruţ
Faculty of Biology, University of Bucharest, Romania
Email: stefana.petrut@gmail.com

Abstract
In 2018 Dr. He Jiankui announced the successful
performance of gene editing on human embryos.
This paper examines Dr He’s claim beginning with
its scientific foundations, and advancing through aseries of ethical considerations to a larger
perspective, examining Jiankui He’s acts into theframe of contemporary society.

Introduction

A couple of months have already passed since theworld became aware of Dr. Jiankui He’s pretentionsof having obtained the first gene edited babies inhistory. His claim has not been independently
confirmed yet. A record pertaining to Dr. He’s
project (Chinese Clinical Trial Registry 2018b),

86

Eubios Journal of Asian and International Bioethics 29 (May 2019)

linked at the project’s page (Chinese Clinical Trial
Registry 2018a) on the website of the Chinese
Clinical Trial Registry shows genetic data of twoembryos who share some inherited gene variants,
and even one de novo variant of a gene. Are those
the records of Lulu and Nana, the supposedly geneedited twins? Has Dr. He really gene edited humanembryos? If he has, what are the implications?
Could Jiankui He have taken a major step in science,even though he did not scrupulously follow acertain approval procedure (Cohen, 2018) orshould he have refrained from [CCR5] heritablegene editing, even if approved by thousand
committees? And, if there is a burden of ethicalconsequences to bear, should Jiankui He
contemplate it alone, or should his deed be
examined into a larger context and his
responsibility at least symbolically shared byothers?
CRISPR-Cas 9 in gene editing
The theory of gene editing is pretty simple – use
molecules that can cut DNA in order to modify it.
The practice is very difficult – DNA modifying tools
are hard to deliver and control and the final process
obeys the in-built constraints of the cellularenvironment, so that ‘gene editing is an inherently
stochastic event occurring in only a fraction of thecells in which the nuclease is expressed’ (Morgan
and Gersbach, 2016).
CRISPR-Cas 9 is an RNA guided nuclease
originating from microorganisms. RNA associatedCas9 binds at complementary sequences in thetarget, guiding the enzyme to cut the DNA.
Subsequently the cells try to repair those cuts andone of the repair mechanisms might be used toinduce specific modifications in the genes. The
difficulties of employing this system are significant.
Proper packaging and distribution of the editing
tools, as well as the immunogenic potential of the‘vehicles’ carrying them represent serious
challenges. But the main problem with the Cas9
enzymes is their lack of safety, the potential toinduce ‘off-target’ effects – uncontrolled andpossibly harmful modifications of the genetic
material. Other issues are the inefficacity of thecellular repair system, poor survival of the alteredcells and the problematic in vivo translatability of
the in vitro editing protocols (Dai et al., 2016).
Sharma et al. (2017) review the use of CRISPRCas9 in animal models and after listing someapparently promising results conclude that “thesafety and efficacy of its application in gene therapy
require further improvements and extensive
validation”. The paper mentions “the prevalence ofoff-target effects” in a certain study, and thepresence of “very few off-target effects”, and “little
off-targeting” in other studies. In [clinical] practice,

the consequences of “very few/little off-targeting”
of an enzyme cutting into a patient’s DNA can range
from neutral to devastatingly pathogenic and are by
all means unpredictable. In fact, after CRISPR-Cas9
has been presented for many years as ‘reasonably
specific’ – in spite of the paucity of experimental
data – Kosicki et al. (2018) showed that not only
the off-target but also the on-target activity of Cas9
is dangerous, leading to large deletions andcomplex genomic rearrangements in various cell
populations of different origins (stem cells, mousehematopoietic progenitors and a human
differentiated cell line) both on-target and on spots
distal to the cut site. Strategies intended to reduce
the off-target effects also lower the on-target
activity and impact on delivery of the system into
the cells. Also, an increase in the efficiency of
employing Cas9 in human pluripotent stem cells –potential candidates for many therapeutic
applications – revealed that Cas9 is actually highly
toxic for the cells and tends to kill them via a
P53/TP53 dependent mechanism; therefore, thecells surviving will be those that have dangerous
mutations in the tumor suppressor p53 andconsequently cannot be safely used in patients(Ihry et al., 2018). Furthermore, the methods
aiming to detection of the off-target modifications
cannot detect their entire spectrum throughout the
genome, a problem that might be alleviated but noteradicated by combining various approaches (Goriet al., 2015).
CCR5 and its avatars
A series of problematic aspects can also be
discussed in relation to the gene that Dr. He Jiankui
and his team targeted, CCR5. The C-C chemokine
receptor type 5 (CCR5) is a protein found on thesurface of immune system cells, such as
macrophages, monocytes, T lymphocytes anddendritic cells. It is known as a co-receptor for the
M tropic R5 HIV viral strains that have affinity
mainly for macrophages and monocytes (Munjal,
2012). Individuals with 32-bp deletions in the CCR5
gene are either immune (CCR5-Δ32/Δ32) or lesssusceptible (CCR5-Δ32/wt) to invasion by the M
tropic HIV-1 strains, which account for about 95%of the infections. The CCR5-Δ32 polymorphism israre in European Caucasians (with an estimate of
1% homozygotes and 20% heterozygotes in the
population) and absent in Africans and East Asians(Marmor et al., 2006). Other effects of the CCR5Δ32 variant that are considered positive areresistance to hepatitis C virus (OMIM®, entry# 609532), and possibly a lower risk forrheumatoid arthritis (Lee et al., 2017). In certain
human populations CCR5-Δ32 seems to beprotective in multiple sclerosis, being possibly
associated with a less severe phenotype resultingEubios Journal of Asian and International Bioethics 29 (May 2019)from lower inflammation associated with the
immune response at the CNS level (Troncosoa et al.,2018), while in others might predispose to thechronic course of the disease (Pulkkinen et al.,2004) or exert no effect on the disease onset andprogress (Ristić et al., 2006; Song and Lee, 2014).
Again, in lupus erytemathosus, the deletion seems
to be a protective factor in certain populations andan aggravating factor in others (Schauren et al.,2013; Baltus et al. 2016). Also, a positive
correlation has been shown between the 32-bp
insertion/deletion and diabetes mellitus (OMIM®,
entry # 612522), and susceptibility to aggressive
symptomatic West Nile virus infection (Lim et al.,2010; OMIM® - entry # 610379). It is known as wellthat CCR5 is involved in bone metabolism by its
influence on the functional regulation of osteoclasts
via establishment of their proper architecture, on
chemotaxis, on their interactions with theosteoblasts, and on other still unidentified
mechanisms (Lee et al., 2017). It is obvious that thefunctions and interactions of CCR5 are not simple
to understand, describe and place into the general
picture of the organism’s economy and that theeffects of the naturally occurring CCR5 genedisruption vary considerably among populations
and individuals.
Burden of unnecessary risk in CCR5 editing
To sum up, a procedure like that performed by Dr.
He Jiankui confronts 1) the unpredictable effects of
the utilization of CRISPR-Cas9; 2) the unforeseeable
effects of the disruption of the CCR5 gene in general,and 3) the unknown effects of the disruption of the
CCR5 gene at the individual level. Last but not least
the burden of futility might be easily associatedwith such an experiment, as the CCR5 receptor does
not need to be disrupted permanently in HIV
therapy. It can be targeted by reversible
antagonists that block it in order to prevent viralinvasion. Maraviroc (MVC, Pfizer) is such a productthat has been approved in the USA, Canada, by theEuropean Commission, and several other countries
for the treatment of patients infected with HIV-1
and it was shown to be efficient, well tolerated(Woollard and Kanmogne, 2015; Giaquinto et al.,2018) and with potential for an advanced
treatment of HIV infections, also aiming toeliminate the latent viruses whose persistence inthe organism is a major issue in HIV therapy(Madrid-Elena et al., 2018). As for treating HIV
patients through gene editing, experimental limited
disruption of CCR5 by means of a promising
approach that could be much safer than a general
disruption of the CCR5 gene in embryos was forexample reported by Tebas et al. (2014).

87

Whose burden is it?
It can be undoubtedly concluded that we are not yet
technically competent to safely perform gene
editing in embryos, as underlined by the specialists
calling for a global moratorium on heritable gene
editing (Lander et al., 2019), quoting the
documents of the First International Summit on
Human Gene Editing held in December 2015 thatspoke about the need to solve the safety andefficacy issues in gene editing. Not only heritable
editing, but all applications should be carefully
examined in terms of safety.
Did He Jiankui ignore ethics? Yes, he did ... if he
did it! If he did edit the embryos, he ignored what is
generally considered an ethical must – not to
induce heritable modifications. He has as wellcontradicted the principles presented on hislaboratory’s website, where he stated, among
others, that “Performing gene surgery is only
permissible when the risks of the procedure areoutweighed by a serious medical need” (The Jiankui
He Lab, 2018).
Some very practical questions arise. As Dr. He
underlined himself in the above quoted EthicalPrinciples of Therapeutic Assisted Reproductive
Technology, “genetically engineered” humans are
humans and they should not be treated otherwise.
Will nations agree, or will gene edited individuals
be labeled as victims in some countries and asbiohazard in others? What if the “gene surgery”
procedure leads to unforeseen unpleasant results?
What should the society or the state do? Keep an
eye on the gene edited subjects for their entire life –with or without their consent? Which are theadequate measures in the event that theyexperience detrimental effects of the genetic
modifications? Describe them the situation andwait for their euthanasia request so that the“mistakes” be erased from the species and thehistory of science? Ban them from reproduction?
Make them use “therapeutic assisted reproduction”
in order to reverse the modifications for future
generations – of course, with no guarantee that theprocedure will not issue yet another series oftroubles? What if the undesirable consequences do
not show in the first generation, but further in the
future?
Maybe we should also wonder about the larger
picture. Communist China was indeed blamed forits ‘climate where scientists are exhorted to
produce world firsts’ (Cook, 2018c), where ‘ethicalconsiderations and the ultimate moral goals ofscience and medicine can be compromised oralienated by the unchecked pursuit of personal
ambition, financial interests, interests of the Partygovernments and institutions, economic growth, or
national glory’ (Nie and Pickering, 2018). But, in therest of the world do scientists really enjoy a milder

88

Eubios Journal of Asian and International Bioethics 29 (May 2019)

climate? Are the members of the other nations
immune to personal ambition, financial interest,
etc.? Are capitalists selfless and ascetic, as opposedto the ambitious greedy communists in China?
Which country is not subject to ‘interests of partygovernments and institutions, economic growthand national glory’? Is China competing with itself,
or with other powerful countries seeking to outride
each other in the ‘science chase’, as in every otherfield? Would Jiankui He have done the same not
only in China, but in a world less centred on pride
and achievement? Would he have done it provided
he had no worldwide public for his spectacle? It isinteresting to examine Dr. He Jiankui’s motivations,but what about the motivations of those promoting
compulsory progress in research all over the world,
either under the knightly motto “Publish or perish”
or under other – supra-individual – mottos.
Studying the factors implicated in research
misconduct, Davis et al. (2007) identified sevenclusters of personal and professional stressors –among others, the pressure to produce, being
overworked and stressed, job insecurities, factorsthat are not particular for researchers but common
to an entire world sunk into rivalry. In a world ofgeneralized fierce competition, we ask Dr. He why
he could not wait.
Last but not least, if citizen Jiankui He’s action isperceived not as a simple, surprisingly grossmistake, but as a worldwide scale social experiment,
then the results might be considered quite
interesting.
While
many
individuals
andorganizations strongly disapproved of his work,
still Dr. He – or rather the type of research he wasinvolved in –included some renowned scientists
from prestigious institutions as advocates (Cook,
2018a). Whilst ‘generally regarded as’ unethical,
heritable gene editing has its fans, dreaming of new
eugenic promises: “I don’t think the research iscontroversial, but everyone agrees it should be kept
away from patients for now… In the future, people
will go to clinics and get their genomes tested, andhave the healthiest baby they can have” (Werner
Neuhausser, Harvard’s Stem Cell Institute, apud
Cook, 2018b). Ideologies do not perish – they justtravel through ages and contemplate progress intheir potential tools.
Where there is crime, attention should also be
payed to the bad influences that might contribute toindividuals committing the crime and to accessories
that might encourage them to engage and persist inaction. If what Dr. He did – if he did it – is to beconsidered a ‘heritable gene editing crime’, thenmaybe we should wonder how the actual climate inscience and society might encourage individuals tocommit such deeds, in spite of all the talk about
ethics.

References

Baltus T. H. L. et al. (2016) CCR5Δ32 (rs333)
polymorphism is associated with the susceptibility tosystemic lupus erythematosus in female Brazilianpatients, Rheumatol Int, 36(1), 7-15;
Chinese Clinical Trial Registry (2018a), 因不能提供原始数据供审核，已驳回补注册申请 HIV 免疫基因 CCR5
胚 胎 基 因 编 辑 安 全 性 和 有 效 性 评 估 ,http://www.chictr.org.cn/
showproj.aspx?proj=32758;
Chinese Clinical Trial Registry (2018b), Calculated
Results
after
the Study Completed, http://www.chictr.org.cn/
uploads/
file/201811/65bc3ccdc7284a2fab1e1e6d12bb5d03.xl
sx;
Cohen J. (2018) ‘I feel an obligation to be balanced.’ Noted
biologist comes to defense of gene editing babies,
https://www.sciencemag.org/news/2018/11/i-feelobligation-be-balanced-noted-biologist-comesdefense-gene-editing-babies;
Cook M. (2018a) Harvard profs defend ‘rogue scientist’,https://www.bioedge.org/bioethics/harvard-profsdefend-gene-editing/12918;
Cook M. (2018b) Nothing unethical to see here, movealong,
please,https://www.bioedge.org/bioethics/nothingunethical-to-see-here-move-along-please/12925;
Cook M. (2018c) China’s first law of science: do notembarrassthegovernment,
availableathttps://www.bioedge.org/ bioethics/chinas-first-lawof-science-do-not-embarrass-the-government/12926;
Dai W. J. et al. (2016) CRISPR-Cas9 for in vivo Gene
Therapy: Promise and Hurdles, Mol Ther Nucleic Acids,
5, e349, doi:10.1038/mtna.2016.58;
Davis M. S. et al. (2007) Causal Factors Implicated in
Research Misconduct: Evidence from ORI Case Files, Sci
Eng Ethics, 13, 395–414;
Giaquinto C. et al. (2018). Pharmacokinetics, safety andefficacy of maraviroc in treatment-experienced pediatricpatients infected with CCR5-tropic HIV-1, Pediatr Infect
Dis J, 37(5), 459–465;
Gori J. L. et al. (2015) Delivery and specificity of
CRISPR/Cas9 genome editing technologies for humangene therapy, Hum Gene Ther, 26(7), 443-451;
Ihry R. J. et al. (2018) p53 inhibits CRISPR–Cas9
engineering in human pluripotent stem cells, Nat Med,
24(7), 939–946;
Kosicki M. et al. (2018) Repair of double-strand breaks
induced by CRISPR–Cas9 leads to large deletions andcomplex rearrangements, Nat Biotechnol, 36(8), 765;
Lander E.S. et al. (2019) Adopt a moratorium on heritablegenome editing, Nature, 567, 165-168;
Lee J. W. et al. (2017) The HIV co-receptor CCR5 regulates
osteoclast function. Nat Commun, 8(1), 2226, DOI:
10.1038/s41467-017-02368-5;
Lim J. K. et al. (2010) CCR5 deficiency is a risk factor forearly clinical manifestations of West Nile virus infection
but not for viral transmission, J Infect Dis, 201(2), 178185;
Madrid-Elena N. et al. (2018) Maraviroc is associatedwith latent HIV-1 reactivation through NF-κB activationin resting CD4+ T cells from HIV infected individuals onEubios Journal of Asian and International Bioethics 29 (May 2019)suppressive antiretroviral therapy, J Virol, 92(9),e01931-17;
Marmor M. et al. (2006) Resistance to HIV Infection, J
Urban Health, 83(1), 5-17;
Morgan L. M., Gersbach C. A. (2016) Genome-editing
Technologies for Gene and Cell Therapy, Mol Ther,
24(3):430-46.
Munjal Y. P., ed., API Textbook of Medicine 9th edition, API,
Mumbai, 2012, 2086 p.;
Nie J. B., Pickering N. (2018) He Jiankui’s Genetic
Misadventure, Part 2: How Different Are Chinese andWestern
Bioethics?,
https://www.thehastingscenter.org/jiankuis-geneticmisadventure-part-2-different-chinese-westernbioethics/
OMIM® - # 609532 Hepatitis C Virus, Susceptibility to,
http://www.omim.org/entry/609532;
OMIM® - # 610379 West Nile Virus, Susceptibility to,
http://omim.org/entry/610379;
OMIM® - # 612522 Diabetes Mellitus, Insulin-Dependent,
22; IDDM22, http://omim.org/entry/612522;
Pulkkinen K. et al. (2004) Increase in CCR5 Δ32/Δ32
genotype in multiple sclerosis, Acta Neurol Scand,109(5), 342-347;
Ristić S. et al. (2006) No association of CCR5D32 genemutation with multiple sclerosis in Croatian andSlovenian patients, Mult Scler J, 12(3), 360-362;
Schauren J. S. et al. (2013) CCR5 Δ32 in systemic lupus
erythematosus: implications for disease susceptibility
and outcome in a Brazilian population, Lupus, 22(8),802-809;
Sharma S. et al. (2017) CRISPR-Cas9: A New Tool for Gene
Therapy.
eLS,
1-9,
DOI:
10.1002/9780470015902.a0026629;
Song G. G., Lee Y. H. (2014) A meta-analysis of the relation
between chemokine receptor 5 Δ32 polymorphism andmultiple sclerosis susceptibility, Immunol Invest, 43(4),299-311;
Tebas P. et al. (2014) Gene editing of CCR5 in autologous
CD4 T cells of persons infected with HIV, NEJM, 370(10),901-910;The Jiankui He Lab (2018) Ethical Principles ofTherapeutic
Assisted
Reproductive
Technology,
https://web.archive.org/
web/20181126135349/http://www.sustcgenome.org.cn/ for_public.html
Troncosoa L. L. et al. (2018) CCR5Δ32 – A piece ofprotection in the inflammatory puzzle of multiple
sclerosis susceptibility, Hum Immunol, 79(8), 621–626;
Woollard S. M., Kanmogne G. D. (2015) Maraviroc: areview of its use in HIV infection and beyond, Drug Des
Dev Ther, 9, 5447–5468.

89

Revisiting the proposal of Asian
principles of bioethics- Michael Cheng-tek Tai
Medical Humanities/Bioethics Dept.,
Medical University, Taichung, Taiwan
Email: mctaicht@gmail.com

Chungshan

Abstract

There are sets of principles of medical ethics. The
ancient Hippocratic teachings of nonmalificense
and benefifence lay the ground for bioethicaldeliberation.
Georgetown’s
four
principles
published in 1973 had set the tone for the modern
discussion of medical ethics.
A European
commission of the biomed-II project for basic
ethical principles in bioethics and biolaw during
1995-1998, under the leadership of Peter Kempt
and Jacob Rendtorff, proposed autonomy, dignity,
integrity and vulnerability as basic ethicalprinciples in European bioethics. Asian scholar Prof.
Michael Tai proposed principles of bioethics with
Asian spirituality in 1999 at the second Asian
Bioethics Seminar held at Nihon University in Japan[1]. Twenty years has passed since these Asian
principles were suggested but the proposed Asian
principles have not been widely discussed since it
was not pubslihed in a well-known journal. As welook back to the last 20 years, we find that these
Asian priciples are not only still valid, they should
also be widely circulated for the bioethical world toponder, as these principles are based on Asian
cultural ethos effecting one fourth of the world
population. Principles of bioethics must include
cultural passion in order to reflect on the ways
people live and act. The set of principles suggested
by Porf. Tai are rooted in Asian culture, and include
Compassion, Ahimsa (nonmaleficence), Respect,
Righteousness and Dharma (responsibility).

Introduction

Much discussion and debate have taken place after
the publication of Principles of Biomedical Ethics,
co-authoredbyGeorgetown
University’sbioethicists, Beauchamp and Childress who impliedthat the four principles they promoted reflect not
only the common concerns of the world but also
are trans-cultural in nature [2]. In other words,
these four principles, based on common morality
theory, can be universally valid.
At first glance, one cannot but agree with thisarguement. But on a closer examination, one will
notice that these four principles are more Western
than Eastern, let alone universal, despite the factthat Asian religious and philosophical thoughtshare similar concerns.

90

Eubios Journal of Asian and International Bioethics 29 (May 2019)

Principles of medical ethics with Asianspirituality
Biomedical ethics have been guided by a few broad
principles, for instance veracity, autonomy,
beneficence,
nonmaleficence,
fidelity,
confidentiality and justice, [3] but Beauchamp andChildress listed only four and saw the other three
as derivatives. Both Hippocratic tradition andGoergetown scholars listed non-malificence andbeneficence first. Indeed, these two reflect the basic
humanistic ethical teachings yet Asians will see
compassion as the foundation of all endeavours.
1. Compassion
Compassion is not only a Buddhist teaching,
Confucian and Shinto virtues also emphasize on its
importance too. It is like beneficence stressing theimportance of doing good for others. Mencius, thesecond sage of Confucianism believes that all men
are endowed with a concern toward others. In his
own words, “all men have the mind which cannot
bear to see the suffering of others…. a man without
the feeling of commiseration is not a man. The
feeling of commiseration is the beginning of
humanity…” [4] Buddhism has taught compassion
for all living creatures, animal life as well as human.
In ancient Japanese mythology, the Records ofAncient Matters written in 712 BC told thatSusanoo, a younger brother of goddless
Ameraterasu was expelled from heavenly court due
to his mischievous act. Once he descended toearthly world, he noticed an eight headed dragon
had disturbed a poor farmer and his family; theinner nature of compassion within Susanoo sprungout right away so that he decided to assist this poor
farmer and killed the evil power represented bythis eight-headed drageon. Later he even married
farmer’s daughter and presented the sword he used
to slain the evil power to Amaterasu which became
one of the symbols of Japesnese emperor [5].
Islam has been regarded as a Western religion,but many Asian countires have adopted this faithsuch as Indonesia, Malaysia, Pakistan, Bangladesh…,
etc. Koran teaches that compassion towards the
weak and defenseless persons of the community isa reflection of the compassion of God. Widows,
orphans and females in general are of particularconcern in the words of Muhammad and believers
are exhorted to be compassionate to them.
Obviously, the main spirit of Asian cultures has
been centered upon compassion which is directed
not only toward humankind, but has an impersonal
goodwill to all living beings too. Compassion is notbased on sympathetic feeling; it is more empathy
than sympathy. And this is what bioethical ethics
should emphasize, that is to extend empathy
toward suffering patients.

According to Mencius, the feeling ofcommiseration is the beginning of humanity. Whencommiseration is felt in medical settings, both
healthcare providers and patients mutually benefit
as the relationship is brought closer together. He
further explained: “ When I say that all men havethe mind which cannot bear to see the suffering ofothers, my meaning may be illustrated thus: now
when men suddenly see a child about to fall into awell, they all have a feeling of alarm and distress,
not to gain friendship with the child’s parents, nor
to seek the praise of their neighbors and friends,
nor because they dislike the reputation of lack ofhumanity if they did not rescue the child “. [4] Fromsuch a case, we see that beneficence andnonmaleficience are expressions of the feeling ofcommiseration which Mencius asserted as the
beginning of humanity. From this, we see that
Confucian thought regards benefience andmalificence as more than principles to be promoted.
They are part of human nature reflecting on human
compassion. Without compassion, the good will
people extended to others are but external
expression lacking an inner firm motivating force.
2. Ahimsa or nonmaleficence
Asians have always upheld the idea of non-violence,
especially in the Buddhist and Hindu traditions.
Ahimsa goes beyond the concept of nonmalefience
to extend “do-no-harm” to all living creatures.
Ahimsa, from Sanskrit, is normally translated asnonviolence and reverence for life [6]. In practice, itmeans abstaining from animal food, relinquishingwar, rejecting all thought of taking life, andregarding all livings as akin. This noble thought
reflects on the idea of nonmaleficence to the pointthat we should not harm our fellow humankind oranimals. This loving care is to extend to all living
beings. This concept can be transformed into abiomedical principle to emphasize the spirit ofnonmalefience. Ahimsa is native to Asians, unlike
the Western nonmaleficence that bears a foreign
tone. Thus, adopting Ahimsa to promote the idea of
do-no-harm will be more far-reaching and effectivein the Asian cultural sphere.
In Confucian tradition, Ahimsa is expressed
through filial piety. What we have physicallyinheriated in our bodies are gifts from our parents
and we must safeguard and cherish them. Mencius
said “Body and hair are given by our parents, onemust not harm them.” It implies nonmaleficencenot only to oneself but also to others. [7]3. Respect
Respect, in Western bioethics is shown through theprinciple of autonomy affirming one’s right ofdecision-making. In Asian understanding, it refers
to respect as found in the spirit of filial piety.

Eubios Journal of Asian and International Bioethics 29 (May 2019)
According to Confucian tradition, children are
required to pay due respect to their parents andelders. Furthermore, this piety is to be extended toa larger scope of family, where brotherly love isemphasized along with mutual respect required forsocial dealings. It also implies informed consent
based on family decision-making rather than
individual determination. For instance, the family
head or father is usually the one whom thephysician consults with in a medical decisionmaking situation. Individualistic autonomy is weakin Asian tradition. Thus, informed consent is done
collectively in a family circle. Respect here
therefore refers to the rights of the individual aswell as the right of the family as a collective unit ofindividuals. Traditionally, Asians have worked as acollective unit in which the father or the eldest son,in case father is deceased, functions as the head of
the family. Respect is due to this “collective
individualistic
autonomy”.
Althoughthiscollectiveness is gradually being reduced by theprocess of modernization, it remains strong inmany parts of Asia. When we talk about informed
consent, we must not neglect this Asian “collectiveindividualism”. This respect has a two-foldmeaning: respect toward the individual’s
individuality and respect to the traditional
collective individuality. Autonomy thus has to beunderstood in a larger individualistic context.
Furthermore, this respect also pinpoints to thephysician-patient relationship. Respect implies
mutual trust. The lofty work of a physician is highly
respected in Asian society. They are not only
healers but also advisors in many instances in avillage. This kind of privilege should not be taken
for granted but rather it should reciprocate topatients in the manner of respect toward patient.
Mencius was once asked if men love theirneighbors’ children in the same way as they love
their brothers’ children; he answered: “treat theaged in your family as they should be treated andextend this treatment to the aged of other peoples’
families. Treat the young in your family as theyshould be treated and extend this treatment to theyoung of other people’s family” [8]. Here Confucian
scholars lay the ground for a proper way of treatingothers and this becomes a good ground for medical
ethics principle.
Although we can say that Asian society is verymuch paternalistic, Confucian teachings as well asother Asian ethos indicate that due respect should
be given. His concept of respect is also expressed
through the idea of righteousness.
4. Righteouness
Righteousness is an oriental way of expressing
justice with a different emphasis from the west. Itmeans the right thing to do as well as doing things

91

right. Thus, righteousness and oughtness are
standards for moral judgement.
The fundamental basis of this teaching is thatone should act according to his conscience without
having any desire to gain profit. So, righteousness
and profit are two opposing terms. When one doesthings because of the potential profit, it is not
righteous and therefore is not just. Confucius thus
said: “the superior man comprehends yi(righteousness), the small man comprehends li(profit)” [9], meaning that superior man will act
according to righteouness while the small man will
act because of profit.
Righteousness in Chinese understanding also
refers to one’s willingness to sacrifice himself forthe sake of a noble cause, such as for patriotism orfor filial piety. A person who died for such a cause isdescribed as giving up life to opt for righteousness(sur shun tsi yi) or as bravely embracing
righteousness when confronted with the situation
to make a choice (chien yi yiong wei). When one
betrays and denies his benefactor who helped or
did him good, it is described as forgetting grace to
be in debt of rightesousness (wong un hu yi). It is
obviousthatrighteousness
inChineseunderstanding has moral and religious implications.
Applying this self-giving righteousness to medical
settings, the patient-physician relationship could
greatly be enhanced. As from this understanding
we can derive that a just physician, would try hisbest to take care of the sick regardless of gain andprofit. Can we find any role model in thisrighteousness principle? Gandhi had emplified this.
In the West, Dr. Albert Schweitzer and Sister
Theresa were also good examples as they had
devoted their lives for rightesouness sake.
The Asian social habit of gift-receiving or giving
can serve as another example to explain thisprinciple. The red Envelope is a traditional Chinese
way of wishing someone good luck or expressing
gratitude. Usually the gift is money put in a redenvelope. The color “red” signifies good fortune.
Children receive red envelopes on New Year’s Dayor some special occasions, such as birthdays or
weddings. Red envelope is also given tocongratulate the recipient for any accomplishment.
Without such an envelope the physician might
either refuse to take care of the patient or simply
purposely extend no care at all in a hospital. A
principle of righteousness will warn physicians that
this demand for red envelope is bioethicallyunjustifiable and unrighteous. Givng care topatients is physicians’ undeniable duty, thus
receiving gifts is unrighteous and unjust.
In the Confucian tradition, justice is notunderstood as fairness but as righteousness andoughtness of a situation. Using filial piety as an
example, the elders deserve their rights to have the92

Eubios Journal of Asian and International Bioethics 29 (May 2019)first share in time of destitution. It is not a questionof being fair or not, but rather it is a question ofoughtness as respect toward the elderly. The
Western concept of fairness and equality are
missing in Confucian society.
Secondly, everyone in society has certain things
which he ought to do. If, however, he does them
only because of other non-moral considerations,then even though he does what he ought to do, his
action is no longer a righteous one. To use a word
often disparaged by Confucius he is then acting forprofit. Righteousness and profit are opposing terms
in Confucian teachings. Confucius sees justice notso much as fairness but as oughtness of a person to
be right. Justice thus to Confucians must be
interpreted differently. It is not justice according toneeds but justice according to what one deserves.
5. Dharma or responsibility
Dharma is a Hindu concept meaning “pattern of rightliving”. Everyone in his/her social station is endowedwith duties which must be carried out. Without
following this, disgrace descends on all who flee theirduties as illustrated in the Hindu epic the
Bhagavadgita. In one passage the Hindu diety Krshna
answered Arjuna, a warrior who was afraid to fight asa soldier in fear of acquiring karma. Krshna said that
real duties of life must not be abandoned. Performing
duties of station in life is a service to God; thus, nokarma will be created. On the contrary if a person
refuses to carry out his duties, disgrace descends uponhim [10].
Applying this dharma to medical settings, taking
care of oneself is one’s dharma just like what Mencius
said that body, skin and hair… are gifts to us from ourparents and we must safeguard them. Any negligencein caring one’s given life is irresponsible and thus isdisgraceful. This implies that each person must notabuse their health. It is our inviolable responsibility totake a good care of our body. Failing to do so isirresponsible and thus unfilial.
The principle of dharma asserts that each person
has a duty to take care of themselves not depending
on medical insurance to ensure their health, norshould they take health services for granted. Each
person must fulfill his duty of maintaining a good lifestyle and co-operate with physicians when sick to
restore their health.
This principle of duty is also expressed in
Confucianism through the concept of the
Rectification of Names. Names refer to social statusof each person. When asked what is therectification of names, the master answered: “letthe ruler be ruler, the minister minister, the father
father and the son son” [11], meaning that each
person should act according to what a person is
expected to do in his profession and station in life.
Every name contains certain implications whichconstitute the essence of that class of things towhich this name implies. Doing should agree withnames. The ruler must bring wellbeing to his
subjects, the minister be loyal to his master, thefather should care for his young and the son be filial
to his superior. Every name in a social relationship
implies certain responsibilities and duties. Ruler,
minister, father and son are all the names of suchsocial relationships and the individual bearing
these names must fulfil their responsibilities:“Between father and son, there should be affection:
between ruler and minister, there should berighteousness: between husband and wife, there
should be attention to their separate functions:
between old and young, there should be a properorder and between friends, there should befaithfulness”. [12] In other words, the person whobears names ought to make sure that his action
reflects the requirement of his names. A person
who does so, is a man of Jen. By the same token, aphysician must fulfil his responsibilities. His
dharma is to care for his patients benevolently andthe patient must cooperate with physicians besides
dutifully taking care of himself or herself

Conclusion

The four principles advocated by Beauchamp andChildress have indeed expressed some moral
concerns of the East, yet their emphases andimplications are not quite the same for Asians. A set ofprinciples based on the Asian ethos may make more
sense to Asians, and in turn facilitate theimplementation of medical ethics in Asia. These
proposed principles are in no way in competition
against the western concepts but rather help enrichthem so that bioethical globalization can becomecontextualized to suit cultures across the world.
Globalization does not mean universalism, rather it
pinpoints to the global and universal endeavour toenhance human dignity and wellbeing for humankind
in biomedical settings.
Despite the fact that Asia is not homogenous,(containing many different relgions and cultures),
Asians share a similar ethical framework, thus theprinciples proposed above are suggested forconsideration.

References
1. Tai MC: The Principles of Bioethics with Asian Spirituality

in Global Bioethics from Asian Pewrspectives II.
Comprehensive Study on East Asian Culure Project, Uni
versity Research Center, Nihon University, Tokyo,
Japan.2000: 42-51
2. Beauchamp, TC and Childress JF: Principles of Biomedical
Ethics, 4th ed New York: Oxford University Press, 1994;
100-105.
3. Raymond SE and Groves JR: The Ethics of Health Care,
Albany New York: Delmar Publishers Inc,1994;.32
4. Mencius 2A;6 (translated by James Legge. The ChineseClassics vol.2. Oxford, Clarendon Press)

Eubios Journal of Asian and International Bioethics 29 (May 2019)
5. Aston WG; trans. Nihongi, The Chronicles of Japan
from the Earliest Time to 697 A.D. Rutland, VT andTokyo: Charles E. Tutile: 1972
Also see Source of Japanese Tradition Vol I. compiled
by Ryusaku Tsunoda. Columbia University Press, New
York, 1958:29
6. Koller JM and Koller P: A Sourcebook in Asian
Philosophy. New York MacMillan Publishing,
1991:158-162
7. Tai MC: Principles of Medical Ethics and Confucius’
Philosophy of Relationship. In Religious Studies andtheology, University of Saskatchewan, Canada, Vol 16,
No. 2. Dec, 1997: 60
8. Mencius 1A:7
9. Analects 4:16 (translated by James Legge. The ChineseClassics vol 1. Oxford, Clarendon Press).
10. The Bhagavadgita, Bolle, Kees trans. Berkeley,
University of California Press 1979: 2:5-22
11.Analects 12;11
12. Mencius 3A:4

Albert Einstein in 1935 on
Electrosmog and Fake News- Hans-Martin Sass, PhD,
Professor of Philosophy Emeritus, Ruhr University,
Bochum, FRG; Senior Research Scholar Emeritus,
Georgetown University, Washington DC, USA;
Honorary Professor, Renmin University and Peking
Union Medical College, Beijing PRC
Email: sasshm@aol.com

Abstract
The biological impact of electromagnetic radiation
on humans and other living beings still is
controversial and inconclusive. In 1935 Albert
Einstein called such an impact ‘fake news’, probably
using the prestige of the Nobel Price as a powerfulplacebo. How should he and we deal with issues ofelectrosmog, placebo effects, and fake news today?
Key words: cancer, electrosmog, fake news, health,placebo, radiation.
In 1933, Albert Einstein left his professorship at
the Berlin University and the Kaiser Wilhelm
Physics Research Institute, renounced his German
citizenship because of the Nazis, and shortly
thereafter accepted a position at the Institute forAdvanced Studies in Princeton, USA. From avacation home in Lyme, Connecticut, he wrote to ayoung lady on August 29, 1935 on potential impactsof electricity on human health: “Dear Miss Davies:
Excuse that I answer your letter only today. Electricrays, which in some way can be proven to impact
human individuals remotely are not existing. The
fact that such a belief widely exists among lay
people, probably can be explained by the fact thatthey have been influenced by radio broadcasts
which they did not understand. This is especiallytrue for people who are nervously over-exited. Of

93course, there is no physicist who would fall a victim
to such speculations. With my outmost respect A.
Einstein. - On request of Mr. Rudolph Thielen sent
to his address 325 East 84. Street, New York City,
N.Y.” (1)
Einstein’s answer was a definite and very clear‘no’ and he blamed the mass media of those days the radio - for spreading ‘fake news’. But issues are
more complicated and the biological impact ofelectricity on humans and other bios had alreadybeen a hot topic since the early days of electricity inthe midst 19th century. On September 1 and 2, 1859,a huge geomagnetic solar storm caused many of the
few first electric power lines in the US and Europe
to burn; widespread utility damages and a numberof fires were also reported. (2) A similar solar storm
today would wipe out electric power grids and themicro-electric infrastructure of the 21th century
including microchips in cellphones, pacemakers,
vehicles and machines. Such an electromagnetic
pulse (EMP) could also be used by bad people, badcorporations, and bad governments to silence all or
specially selected electric and microelectronic
networks of other peoples, states and non-states. In
foggy weather we hear a sort of roaring or
mumbling under high voltage lines; mammals andbirds recognize ultraviolet light emitted from thoseoverland lines and avoid them later even whenelectricity is switched off (3). But the direct impactof low or high voltage on life forms still is notclearly documented and controversial (4).
Microwave
ovens,
cellphones
computers,
televisions and radios create electromagnetic fields(EMF) of various intensities; some appliances suchas microwaves claim to have inbuilt protection but
manufacturers nevertheless suggest to stay not too
close, when they are operating. Review of scientific
literature argues that not enough qualified research
has proven that exposure to wifi and otherradiation has no biological effects (5). The
introduction of much more powerful 5G technology
for internets of people, of things, and everything
will provide additional challenges not only to ourways of communication and cooperation with eachother and with interactive and learning things, butalso raises additional issues for our physical andpsychological health and those of other bios andbiotopes.
Nobel Price winner Einstein did not know Miss
Davies personally, but her letter and maybe also Mr.
Thielen might have given him the impression that
she was a neurotic and nervous young lady. Einstein
blamed the radio to produce fake news, butscientists also produce fake news for various
reasons such as to intimidate people or to profit
financially. The scientific medical ‘law’ that inhumans sometimes pregnancy last up to 11 months
is an example that physicians falsely and94

Eubios Journal of Asian and International Bioethics 29 (May 2019)deliberately stated a natural law to camouflage thetime of conception by 2 more months from the 7th
to the 11th week in order to protect sexual privacyof women from husbands and the public (6). Did
Einstein and Mr. Thielen deliberately initiate aplacebo effect (7) in the young woman using thehigh prestige of the Nobel Price to ‘heal’ her with‘fake’ scientific information, or should Einstein havetold her that science did not have a definite answer
yet.
In May 1935 Einstein co-published a paper,
asking whether our knowledge about physicalreality ever will be a complete one, confirming ‘thatthe description of reality as given by a wave
function is not complete. Any serious considerationof a physical theory must take into account thedistinction between the objective reality, which is
independent of any theory, and the physicalconcepts with which the theory operates. These
concepts are intended to correspond with theobjective reality, and by means of these concepts wepicture this reality to ourselves … the wave function
does not provide a complete description of thephysical reality’ (8). Much earlier, in a 1919 letter toHans Vaihinger, the editor of ‘Kantstudien’ andauthor of ‘Die Philosophie des Als Ob’, Einsteinmade a difference between ‘Anschauung’ (opinion,
view, consideration) and ‘Begriff’ (term) andargued that while terms are clear and firm they
nevertheless will be used in different contexts andmodels and that ‘true culture’ based on the sciences
and using scientific terminology may comfort us indifficult personal situations. (9)How would Einstein interpret the objective
reality of electric rays of all sorts and the impact on
biological tissue today? Do only lay people fall
‘victim to speculation’ initiated by ‘fake news’ fromradio and other mass. What is ‘scientific truth’ inour ongoing discourses and debates in physics,
medicine and other sciences? And how would or
should Einstein warn Miss Davies about
microwaves, cellphones, electro smog in general, Xrays and other rays, and about new high-frequency
electromagnetic waves and 5G radiation inparticular?
References

1. Unpublished letter, kept in my personal archives: “Old
Lyme, Conn, den 29. August 1935, White House. – Sehr
geehrte Miss Davies: Entschuldigen Sie, dass ich erst
heute Ihren Brief beantworte. Elektrische Strahlen, die
irgendwie nachweisbar in der Ferne auf menschliche
Individuen wirken, gibt es nicht. Dass sein solcher
Glaube bei manchen Laien Verbreitung findet, erklaertsich wohl dadurch, dass sie durch die von ihnen meist
nicht
verstandenen
Radio-Uebertragungenzuderartigen Gedanken angeregt wurden. Das trifft
besonders auf nervlich ueberreizte Personen zu.
Natuerlich aber gibt es keinen Physiker, der solchen

Spekulationen zum Opfer fiele. – Mit ausgezeichneter
Hochachtung [signed] A. Einstein. – Auf Anfrage desHerrn Rudolph Thielen zugesandt an seine Adresse.
325 East 84. Street, New York, N.Y.”
2. Cf the internet on ‘solar superstorm 1859’, also HM
Sass: Cultures in Bioethics, Zuerich: Lit 2016:238-257.
3. N Tyler, KA Stokkau, C. Hogg, AI Vistnes, G Jeffery:
Ultraviolet Vision and Avoidance of Power Lines in
Birds and Mammals, in: Conservation Biology 2014,
28(3)630f; https://doi.org/10.111/cobi.12262
4. International Agency for Research on Cancer: Nonionizing
Radiation(2):
Radiofrequency
Electromagnetic Fields. Lyon 2013 [IARC monographs102]. - L Kheifets, A Ahlborn, CM Crespi et al: A pooled
Analysis of extremely low frequency magnetic fields
and Childhood Cancer, in: American J Epidemiology
2010, 172(7)752-761
5. KR Foster, JE Moulder: Wi-Fi and Health. Review ofcurrent Status of Research, in: Health Physics 2013.
105(6)561-575. – K Hug, L Grize, A Seidler, P Kaatsch, J
Schuetz: Parental occupational Exposure to extremely
low frequency magnetic Fields and Childhood Cancer,
in: Am. J Epidemiology 2010. 171(1)27-35
6. AA Carranza: De patu naturalii et legitimo. Geneva
1630; cf. HM Sass: Diagnosing the 11-months
Pregnancy, in: The Ethics of Diagnosis: Dordrecht:
Kluwer 153-162.- This fake ‘natural law’ wasparticularly helpful in feudal societies when women
could not inherit property after the death of her
husband, but they could function as guardian for amale heir and his property up to his 18th birthday. Is
this ‘science’ early evidence of feminist and medical
ethics among physicians. Of course, a pregnancy ofmore than 9 months is totally impossible in humans;
however, as evidenced by Rabelais’ widely read novel,‘Gargantua’ was said to have gotten his gigantean
powers from being formed for fully 11 months in his
mother’s womb.
7. Placebo effects are well documented, cf. A
Hrobjartsson, PC Gotzsche: Is the placebo powerless?
Update of a systematic review with 52 new
randomized trials comparing placebo with notreatment, in J Intern Med 2004, 256(2):91–100; H
Wallach, WB. Jonas: Placebo Research: The Evidence
Base for harnessing self-healing Capacities, in: The
Journal of Alternative and Complementary Medicine,
2004, 10 (Suppl 1):103–112. – In European literature,
Plato was one of the first who justified lying to achieve
good therapeutic effects and speaking ‘positively’ topeople, Politeia 389b, Charmenides 155c.
8. A Einstein, B Podolsky, N Rosen: Can quantummechanical Description of physical Reality beconsidered complete?, in: Physical Review (ser. 2)
48:78 (Received March 25, 1935)
9. HM Sass: Einstein ueber ‘wahre Kultur’ und die
Stellung der Geometrie im Wissenschaftssystem, in:Zeitschrift fuer allgemeine Wissenschaftstheorie 1979,
10(2)316-319; I had discussed this very personal
letter of May 3, 1919 from Einstein to Vaihinger on therole of science in ‘true culture’ at the Einstein
Centenary on March 14, 1979, in Bern in the presenceof Andre Mercier, Stephen Hawkins and other leading
physicists.

Eubios Journal of Asian and International Bioethics 29 (May 2019)

Bargainingwithpositivism:
Science’s nexus to philosophy- Jan Gresil S. Kahambing
Leyte Normal University, Tacloban City, Philippines
Email: vince_jb7@hotmail.com

Abstract

This article pushes forward the idea that positivism,
the philosophical system in the early analytic
tradition that recognizes only those which arescientifically verifiable through logic andmathematical proof, is still embedded in anexistential impetus of philosophical reflection. The
extent to which science advances in the reflection ofhuman life is seen for instance in the current
research of transferring young mouse blood to old
mice for rejuvenation, possibly rendering cure todiseases stemming from old age and ultimately
immortality. The success of the experiment on miceis a jumpstart for its application to humans, andfrom there, one cannot but speculate whether thisset-up is an irony to the supposed antinomy ofscience to demystify immortality elixirs and ancient
cure superstitions. The set-up is open and though
positivism will find it hard to accommodate
philosophical reflection, it still needs suchdisposition to critically assess the loopholes of asternly logical and mathematically inclined
universe. Science has a social dimension and isconnected to the social influence and importance ofanalytic philosophy and philosophy in general.
Science and the tension between positivism
and meaning
Language is loose – its meaning lies in the
ambiguity residing within concepts. In this sense,
vocabulary too is context-dependent since theanalysis of a given text varies on the convention
upon which it is constructed. And this does notexempt the vocabulary of science. Scientificlanguage would claim firstly – out of observablephenomena – a hypothesis, a proposition made as aprobable guess to provide explanation. When the
hypothesis is affirmed through the experimentationof its variables, it becomes confirmed – it iselevated into a theory. When the theory is further
confirmed from its hypothetical manner of
explaining phenomena, it is universally accepted –then, it becomes a law. But Cohen (2014, p. 560)
points out that there is a discrepancy insystematizing the vocabulary of scientific language.
He points that Newton’s discovery is called law ofgravitation but Einstein’s reinvention andimprovement of it is only called ‘theory of relativity.’
Cohen then says that essentially, laws and theories

95

are hypotheses and that they cannot stand as
absolute claims of knowledge.
Positivism, which grounds its philosophical nut
on the scientific process, composes the point that“laws have meaning only in the sense that they are
abstracts from which statements can beconstructed. This is the view which is generally
entertained by Positivists of the Viennese Circle andrelated groups (Weinberg, 1936, p. 143).” It is to be
drawn however that science is separate fromlogical positivism, the former being thesystematized body of knowledge and the latterbeing the philosophical movement early in the
Analytic tradition that insists on scientificallyverifiable facts as its core. For Anchinstein andBarker (1969, p. 451) “science does not needpositivistic interpretation; but, in the spirit of thebest positivist work, it very much needs an analysis
of its methods.”
The Vienna Circle started with the Thursday
evening discussion of Moritz Schlick together with‘philosophically-mindedmathematiciansandscientists (Caldwell, 2003, p. 11).’’ On the relevanceof science to philosophy and vice-versa, the Vienna
Circle took it in an oversimplified manner to meanthat philosophy had to become ‘scientific’ (Uebel,
1992, p. 11). Logical positivism or logicalempiricism took its name when the Vienna Circle
saved empiricism and gave it a positivistic light in
the name of logic. Uebel labels this the ‘marriage’ of
empiricism and logicism (1992, p. 8). But there is aweakness that positivism poses in philosophy.
The greatest weakness of positivism, in thephilosophy of mind as elsewhere, is that it tries
to make the notion of meaning bear too heavy aburden. This is always a bad tendency inanalytic philosophy, but it is fatal in a school
which begins by scrapping the customary
notion of meaning anyway, and which hasseriously examined every science except
linguistics (Anchinstein and Barker, p. 451).
While science and positivism compose logicalstructures to clarify analytically the terms oflanguage into systematic procedures in order toverify knowledge, it dispels in the process theessential warrant for meaning. That is to say, that‘giventhecloseconnection
betweenmeaningfulness and knowledge, verificationism
after the linguistic turn meant that there simply
could be no defense of non-empirical scientific or
non-metascientific philosophical knowledge (Uebel,p.10).’The question of meaning is repressed, apart fromknowledge, and albeit science and positivism try to
clarify, they instead tend to proselytize. The
relationship of science and positivism here
endangers the crucial fact that concepts are never96

Eubios Journal of Asian and International Bioethics 29 (May 2019)

dogmatic. They are in the first place open for new
conventions and formulations. This perhaps risks
the idea of knowledge as a cold realistic assessmentof things: when meaning is transposed as a foreign
element apart from knowledge, its scrutiny islikewise questionable when the austere measures it
adapts are enacted in a manner similar to themedieval inquisitions and witch hunts.
The French philosopher and sociologist, Auguste
Comte brings to light the essential nature ofknowledge acquisition. Auguste Comte’s positivism,
although accounted as his own, is acted only inwhat for Comte as the founders of Positive
Philosophy in the time of Bacon, Descartes andGalileo (Mill, 2005, p.3). For John Stuart Mill:The fundamental doctrine of a true philosophy,
according to M. Comte, and the character bywhich he defines Positive Philosophy, is thefollowing: We have no knowledge of anything
but Phaenomena; and our knowledge ofphaenomena is relative, not absolute. We know
not the essence, nor the real mode of
production, of any fact, but only its relations toother facts in the way of succession or ofsimilitude. These relations are constant; that is,always the same in the same circumstances. The
constant resemblances which link phaenomena
together, and the constant sequences which
unite them as antecedent and consequent, aretermed their laws. The laws of phaenomena are
all we know respecting them. Their essential
nature, and their ultimate causes, either
efficient or final, are unknown and inscrutable
to us (Mill, 2005, p. 3).
Only in the sense that positivism knows its limits
as confined by phenomena, it becomes aware of its
own meaning. A scientist may project the life of anorganism as normal to the detriment of any
meaningful end, but it is narrowing the possibilityof further probabilities in the relations of things. In
order to illustrate this, one can only evaluate theexisting question or hypothesis of current scientificadvances.
Bargain:biomedical
research,
immortality, and life
The next big thing could be inclusive fitness: (inGenetics) the principle referring to the ability of anorganism to pass its genes to the next generation. It
might not be in the same cohesion as with, forinstance, the harmony of a raga placed side by sidein sync with the latest emo jam but talking about
what will be the best for the upcoming generationmust have something to deal with perfectcontinuity. The classic exitus-reditus scheme in
antiquity and the middle ages (see Aristotle’s
Physics, 261a12, cf. Aquinas’ Commentary on

Aristotle’s Metaphysics. I-I, 4.) once again has to put
in the frontline its substratum of resolution
towards a source that gets higher in degrees.
Without signifying yet whether the Prime Mover ofAristotle is God, as baptized by Aquinas, Aristotle
already acknowledges that substances that comefrom the same origin will move towards each other– hence, acknowledging that the perfect motion is acircular motion where substances return to theirunderlying similitude or ‘quintessence’. In theexitus-reditus schema, perfection is achieved
through a return.
Current biomedical researches (Scudellari, 2015;
Shytikov, et. al., 2014; Conboy, et. al., 2005; Kaiser,2016) thus adjudge it correct to look at its trail insuch a ‘return’ perspective: the genes, cells, bloodplasma, etc. of the young generation below age 25
could be medically injected to boost the vitality ofthe old ones. The wonder of our rodent friends is
initiating wishes to come true, as the pioneeringexperiments of mice prove to be applicable tohumans after all. Rejuvenation is the apt term,
where youth reclaims its essence. Up-to-date, there
are excesses and deficiencies of the process. But itwould not take long before studies advance in theprocess’ golden mean; its posology and bug fixes.
Moving forward to its incisive outcome, if thiseffect might come to mean not only reducing aging
from its normal pace but also blurring thedefinition of a running age as it might possibly
come to a stop and even move the physiologicalchanges backward, then it carries in a nutshell theplausibility of immortality – its rigors, fascination,and deflating of the entire airship of ideas humanity
has ever contemplated in its existential queries offinitude and oblivion.
It is not even a big bang. To have come up with theequation that deals with the young as the future,that is to say of ‘what is new’ to marvel the next
generation, is nothing that merits a shock. The
celebrated futurism tangled in the reveries
accorded for the young is an age-old mentality ofthe passing idealists. What makes this a paradigm
shift is the scientific breakthrough: how the wholethought process materialized into its effectivenessas a real-time apparatus.
This further sets forward the implication that toa large extent, the next decade or century is nolonger a fatalistic perspective of the universe e.g.
chaos has run down everywhere where there areglitches, inconsistencies, loopholes of all sorts,much that a widespread adikia roams through thenatural fabric of human societies and its inevitable
decay. But this reprehensively tarnishes the noveltyof the future as it stands now, because the next faceof human civilization is already verging in theglorious theft, not anymore of fire, but of eternity.
The stage following Prometheus and Heraclitus willEubios Journal of Asian and International Bioethics 29 (May 2019)
fulfill a promise that upgrades reason andinstability into the beginning of a stable end, a done
deal with Comte or a more promising version of
Fukuyama’s end of history (1992) – for the last man
is not anymore the calculable goal-driven picture
Nietzsche (1969) presents but the last man in thepresent state: a stage of time’s stoppage that signals
the paradoxical emergence of higher men, andperhaps of supermen.
That science can provide men immortality isreflective of the demon Mephistopheles in Goethe’sFaust where Dr. Faust gave up his soul for the sakeof a limitless desire for knowledge and power. The
irony here is: while science demythologized voodoo
rituals, alchemists, demonic insurgences ofmedieval influence and primeval naturalism, it will
now serve as the Mephistopheles setting up thebargain for humanity’s immortal birthright:
science’s process shall bring forth men in the
bloodline of Dr. Faust, uncovering their esotericinterests, animal impulses, in an infinite horizon
opening both extremes of puritan self-mastery or
the corruption of the whole moral order. The
bargain does not even have to work both ways: theacquisition of immortality itself is the soul’s
disappearance.
However, its quest would also denote the
Dionysian (Nietzsche, 1927) dissolution of reality:
those who have the power to gain it will have to put
hindrances for others to do the same. One science
to rule them all. For advancement was never about
success but monopoly – who gets there first, who
suppresses the rest, who stands above the statusquo. In this sense, life is not merely biological life
but also social life and from here, bargaining
becomes the social dimension that is positioned
within the constellation of complex interlinkages.
Hence, the sociality of science. Moreover, one canconnect here Babette Babich’s reservation (2017)
in the contemporary post-human era: even if
technologies will be produced through theadvancement and improvement of humanity, she
forwards the realistic claim that only the rich or
those on the top of the food chain can afford suchnew technologies.
It will not, therefore, be an easy bargain, for souls– in desperation, gamble, chancing, and so on – will
still need to be put in the line, in which theprobability of succeeding has lesser percentage
than a risky participation of Russian roulette. One
still needs to go into the system of gaining more to
get the prize and work within the systematic
possibilities offered by the social environs of reality.
Reality had to teach again the lesson that theultimate basis supervening positivism is the ideathat only in science can one find salvation, at least
for those who control the modern Archimedes at
gunpoint.

97

While the young are fed with vampirism
fantasies and the old fascinate themselves with
their long lost vivacity, the parabiosis that depicts
both as one aspiration to an immeasurable life
ahead is still in psychoanalytic standards a glaring
impossibility of desire. The bargain for immortality
remains, as it were, a formula that needs countlessresolutions. It will therefore not dissolve totally thequestions of human expiration, even as it may
philosophize on an everlasting concept of matter.
What the bargain may offer at best is an ethicalchoice, however complex it may seem – and within
this realm, all the other social dimensions –psychology, economics, politics, morality, and social
justice – are inherently constituted therein. It
would not be a problem for a person, for instance,as the case may be if he has a lifetime to read all the
books he wants to read or to write all the
manuscripts to clear his head, and to discover
everything that the old and new world opens. But –and here goes the limiting conjunction – what
would everything, minus the hyperbole, mean:
what would that differ to a lifetime lived in anauthentic dealing towards death? How would that
affect the weight of every word, every action, every
relationship that governs persons, regardless ofimmortality? What would an infinity make of two
persons who are in love to exhaust all thepossibilities of a relationship – reevaluating thelimits and maturity of monogamy and polygamy
altogether?
The next big thing could not simply be a smoothtransition to an inclusive fitness. A brave new world
could be up ahead and science will not explain for
us a theory of everything. It will then leave at best
an open bargain that will guarantee still
philosophy’s search for meaning and how living
coalesces every single sophistication along with it.
Tying
the
nexus
of
(analytic)
philosophy’s importance
Zabala and Davis (2013) opines in Aljazeera
concerning Stephen Hawking’s pronouncementthat ‘philosophy is dead,’ and further asks which
philosophy is dead. They emphasized that if there
is a specific philosophy that is dead, it is analytic
philosophy. They began reiterating the late Richard
Rorty and French theorist Alain Badiou in theirecho of Hawking that philosophy is dead. In
Badiou’s Infinite Thought (2004), particularly, one
can draw the point that analytic philosophy’sorientation and standard, beginning fromWittgenstein and Carnap in the Vienna Circle, is the
specific philosophy that does not seek truth but
polices it. The desire not to create idea but todemarcate a rigid standard for meaning andutterances is limiting. Hence, the orientation ofanalytic philosophy turns philosophy ‘into a slave

98

Eubios Journal of Asian and International Bioethics 29 (May 2019)

to the hard sciences, especially physics,’ andbecause this kind of philosophy cannot keep up
with the sciences, it is thereby dead in Hawking’seye.
For the essence of analytic philosophy focuses
on meaning at the expense of openness todifferent and surprising truth-conditions that
may appear beyond an assumed analytic
structure, stipulating what philosophy can do or
cannot do.
If a person behaved like the vast majority ofanalytic philosophy does in our time, theywould be diagnosed with having a death wish
and imposture syndrome, by enslaving itself toa scientific elitism. In this respect, the Trojan
horse of philosophy might just be analytic
philosophy snuck into the city of Troy, whichtoday has become ever-shrinking conservative
philosophy departments in universities.
Students in these universities are not only
forced to read summaries rather than the greatclassics texts from the history of philosophy, but
are trained, like scientists, to write articles
instead of books (Zabala and Davis, 2013).
This would come as unsurprising given that evenin Moore’s conception of ethics, one cannot relay
easily an ‘ought’ proposition, a prescriptive, apartfrom, a descriptive tendency of analytic language.
For him, the term ‘good’ – the coinage in ethics that
implies a force of action – is indefinable and that for
his naturalistic fallacy, any attempt whatsoever todefine ‘good’ is bound to fail (Moore, 1903, 11-16;
cf. Glock, 2008, p. 57). One can also read in G.E.
Moore’s preface in his Principia Ethica (1903): “Itappears to me that in Ethics, as in all otherphilosophical studies, the difficulties anddisagreements, of which its history is full, aremainly due to a very simple cause: namely to theattempt to answer questions, without first
discovering precisely what question it is which you
desire to answer.” This led Moore into proposing
his ideal utilitarianism: “A utilitarianism that bases
its judgments solely on pleasure and pain ishedonistic. Some theorists, such as G. E. Moore,
have suggested that there are other goods thatshould be maximized, such as knowledge,
friendship, health, aesthetic awareness; this isconsidered ideal utilitarianism (Edgar, 2003, p. 61).”
G. E. Moore, whom Tom Regan (1999, xii) called“analytic philosophy’s patron saint,” then takes theapproach that reflects a meta-ethical standpoint(Gunkel, 2012 p. x).
And yet on the other side of the spectrum, Glock(2008, p. 182ff) comprehensively analyzes that on
the question “Is Analytic Philosophy Morally
Neutral and Conservative?” analytic philosophy
cannot absolutely be said to have excluded practicalmatters. Because the moral philosophy that ‘logicalconstructionism’ and ‘conceptual analysis’ analyzes
is confined to meta-ethics, such as Moore’s accountabove, analytic philosophy is often illustrated as
neutral or conservative. But analytic philosophers
are not silent in political matters. Glock says that“no philosopher of any age has every trumped
Russell’s political engagement on the side of thedown-trodden and oppressed (p. 184).” In spite ofHorkheimer – a representative of continental
critical theorists of the Frankfurt school that is
active in the socio-political sphere – saying analytic
philosophy is apolitical, Glock notes that “theVienna Circle was the most political philosophicalgroup of note in the twentieth century (p. 184).”
Despite the complexity of political times,
philosophy insists and continuously penetrates into
the socio-political arena.
However, this is not to say that analytic
philosophy in itself is active even if the analytic
philosophers who represent it are. It is not only thecritical theorists attacking analytic philosophy whogive rise to this critique, but also ‘otherphilosophers have accepted the ethical andexistential irrelevance of analytic philosophy (Glock,p. 188).’ But if there is one thing that assuresconcerning relevance, it is that contemporary
mainstream analytic philosophers accept neither
the point that moral judgments are ‘non-cognitive’and that philosophy ‘should remain ethicallyneutral.’ This goes to show that truth of analytic
philosophy’s relevance accommodates the critiqueof non-usefulness but also the point of politicoethical involvement. In this sense, philosophy is still
not passé.
Going back to the nexus of science to philosophy
in general, David Purdie of Edinbrugh University
discovers a letter whose author is Einstein (Malik,2019). Against scientists who claim of philosophy’s
irrelevance, the letter states the importance ofDavid Hume’s A Treatise of Human Nature to
Einstein’s scientific work. Einstein was influenced
by philosophers, from Mach to Schopenhauer,
which suggests how ‘science is not simply theaccumulation of empirical data’… but also ‘thequestions we ask, the methods we employ toanswerthosequestions,theconceptual
frameworks within which we fit the facts (Malik,2019).’
On a final note, the Slovenian philosopher SlavojŽižek (2006) says that “the task of philosophy is not
to provide answers or solutions, but to submit tocritical analysis the questions themselves, to makeus see how the very way we perceive a problem isan obstacle to its solution.” Therein lies an opening
for analytic philosophy and, by extension, theanalyses offered by positivism in its verification
methods. The task is not to bargain with theEubios Journal of Asian and International Bioethics 29 (May 2019)
thought in mind of dispelling meaning and anyother philosophical venture that seeks it, but toconstantly put into questioning – that is, intobargaining – truth with its manifold philosophicalimplications.

References
Achinstein, P., and Barker, S. (eds.) The Legacy of LogicalPositivism. Baltimore: John Hopkins Press.
Aquinas, Thomas (1993). Commentary on Aristotle’s
Metaphysics, trans. John P. Rowan. USA: Dumb Ox
Books.
Babich, B. (2017). Nietzsche’s Post-Human Imperative:
On the “All-too-Human” Dream of Transhumanism. In
Tuncel, Y. (Ed.). Nietzsche and Transhumanism:
Precursor or Enemy? (pp. 101-132). UK: Cambridge
Scholars Publishing.
Badiou, A. (2004). Infinite Thought: Truth and the Returnto Philosophy. (trans. and ed. Oliver Feltham and Justin
Clemens). London and New York: Continuum.
Caldwell, B. (2003). Beyond Positivism: Economic
Methodology in the Twentieth Century. Revised Edition.
London and New York: Routledge.
Conboy, I.M., Conboy, M.J., Wagers, A.J., Girma, E.R.,
Weissman, I.L., Rando, T.A. (2005). Rejuvenation ofaged progenitor cells by exposure to a young systemic
environment. Nature 433(7027), 760-764.
Cohen, C., Copi, I. (2014). Introduction to Logic. 14th
Edition. Pearson New International Edition.
Edinburgh: Pearson Education Limited.
Edgar, S. (2003). Morality and Machines: Perspectives on
Computer
Ethics.
SecondEdition.
Sudbury,
Massachusetts: Jones and Bartlett Publishers.
Fukuyama, F. (1992). The End of History and the Last
Man. Free Press.
Gunkel, D. (2012). The Machine Question: Critical
Perspectives on AI, Robots, and Ethics. London, England:
The MIT Press.
Kaiser, J. (2016). Young Blood Antiaging trial raises
questions. doi:10.1126/science.aag0716
Malik, K. (2019). Einstein got it – philosophy and science
do go hand in hand. The Guardian. Retrieved fromhttps://www.theguardian.com/commentisfree/2019/feb/24/einstein-got-it-philosophy-and-science-do-gohand-in-handMill, J. S. (2005). Auguste Comte and Positivism. Project
Gutenberg e-book.
Moore, G. E (2005). Principia Ethica. New York: Barnes &Noble Books. Originally published 1903.
Glock, H-J. (2008). What is Analytic Philosophy?
Cambridge: Cambridge University Press.
Nietzsche, Friedrich (1927). The Birth of Tragedy, trans.
Clifton P. Fadiman. New York: Modern Library.
Nietzsche, Friedrich (1969). Thus Spoke Zarathustra, abook for Everyone and No One. trans. R.J. Hollingdale.
Penguin Books.
Regan, T. (1999). Foreword to Animal Others: On Ethics,
Ontology, and Animal Life, ed. Peter Steeves (pp. xi –xiii). Albany, NY: SUNY Press.
Scudellari, M. (2015, January). Ageing research: Blood toblood. Nature: International Journal of Science517(7535), 426-429.

99

Shytikov, D., Balva, O., Debonneuil, E., Glukhovskiy, P.,
and Pishel, I. (2014). Aged Mice Repeatedly Injectedwith Plasma from Young Mice: A Survival Study. Biores
Open Access 3(5). US National Library of Medicine,National Institutes of Health.
Uebel, T. (1992). Overcoming Logical Positivism FromWithin: The Emergence of Neurath’s Naturalism in the
Vienna Circle’s Protocol Science Debate. Atlanta, GA:
Rodopi.
Weinberg, J. R. (1936). An Examination of LogicalPositivism. London: Kegan Paul, Trench, Trubner & Co.
Ltd.
Zabala, S., and Davis, C. (2013). Which Philosophy is
Dead?
Al
Jazeera.
Retrievedfrom:https://www.aljazeera.com/indepth/opinion/2013/0
6/201361082357860647.html
Žižek, S. (2006). Philosophy, the ‘unknown knowns,’ andthe public use of reason. Topoi 25(1-2) Springer Link,
137-142.

Debunking the perceived loss of
the Committee on Publication
Ethics (COPE) moral compass:
Conspiracy theory, or a genuine
cause for concern?
- Jaime A. Teixeira da Silva
P. O. Box 7, Miki-cho Post Office, Ikenobe 3011-2,
Kagawa-ken, 761-0799, Japan
Email: jaimetex@yahoo.com

Abstract

The natural instinct for members of the Committee
on Publication Ethics (COPE), which now number
almost 12,200, as well as academia, is to assume
that this organization works under strict andclearly defined ethical parameters, with a solid
vision, and an independent mandate that is not
influenced by power, think tanks, or partisaninterests. Naturally, whistle-blowing and scienceshaming are not practices that one would usuallyassociate with an ethics organization like COPE,
because they involve ethically and morally
questionable practices. Despite this, ethical borders
have become blurred between the objectives ofRetraction Watch and PubPeer, two self-moderated
science watchdogs that rely heavily on thesequestionable practices, in their efforts to grow andsurvive, and the values espoused by COPE. A
Retraction Watch post, in which the former COPE
Chair, Virginia Barbour (2012-2017), made a claim
of apparent harassment, is the most striking
example of the dangers when collaboration may
take place between science-shaming websites, andan ethics organization, COPE. These bonds appear
to have been in development for a number of years
already, with the inclusion of Elizabeth Wager, the100

Eubios Journal of Asian and International Bioethics 29 (May 2019)

former COPE Chair (2009-2012), as a director of
The Center for Science Integrity Inc. (CSI),
Retraction Watch’s parent organization. Retraction
Watch was financed by, among other groups, theLaura and John Arnold Foundation (LJAF), whose
leader, John Arnold, an ex-Enron trader, declared a“war on bad science”, which may naturally include
the destruction of aspects of science as well.
Retraction Watch embraces several infamous
pseudonymous personas under the broad umbrellaof freedom of speech, liaising thereby with PubPeer.
There is no doubt that errors in the literature needcorrecting, but this apparent connection with COPE
raises questions about the basic ethical foundationof this relationship. Are scientists to embrace thisbond between COPE and science watchdogs andpseudonymous whistle-blowers as the new normal
in the correction of the scientific literature? This
opinion piece puts forward arguments why theauthor believes that the ethical compass of COPE
has become skewed.
Is COPE about industry lobbying or aboutpublishing ethics, or both?
The Committee on Publication Ethics (COPE) has
now become the de facto largest publishing ethics
group, primarily for the biomedical sciences, having
attained almost 12,200 paying members to date
(COPE 2019). However, as is known by well versed
academics, including Paul S. Brookes, of the
University of Rochester Medical Center, COPE has
primarily been a trade representative of for-profit
publishers that has now gained a stronger mandate,although that mandate fails to represent authors’
rights, or concerns with COPE member editors,
journals or publishers (Teixeira da Silva, 2017a).
Brookes, a well-known whistle-blower andprominent science activist whose website Sciencefraud.org was shut-down as a result of an automatic
insinuation that all papers critiqued on that blog
were fraudulent, noted that COPE is a “lobby groupfor the publishing industry”14. Brookes called forthe use of PubPeer to counter the toothless
response by COPE regarding the dismissal ofacademic concerns in the literature of several COPE
member journals and publishers, while COPE
member editors were not fulfilling their ethical andacademic obligations (Teixeira da Silva andDobránszki, 2018) in correcting the literatureaccording to COPE-established guidelines. COPE
thus represents to many academics the model of
publishing ethics and thus incorporates the
publishing industry’s moral compass andleadership. Thus, any concerns about the COPE
leadership, or its purported focus, or deviations
from its assumed or stated moral path, would affectthe entire publishing industry and academics
around the globe, because at stake would be thecore values and ethics of the publishing industry.
This opinion piece puts forward arguments why
some relationships held by COPE or its current orformer leadership that calls into question the
direction of this organization’s moral compass.
Does COPE shy away from, or cozy up to, postpublication groups?
PubPeer is primarily an anonymous whistleblowing website that works closely with Retraction
Watch, a website that is also associated withshaming science, the scientific establishment andscientists. Users of PubPeer and Retraction Watch,includingpseudonymous
entitieslike
fernandopessoa, and others, often act in a highly
coordinated approach, in what appears to be a bid
to purge academia of its errors and its ills, but withas yet unclear or unknown consequences. Public
humiliation and shaming does not drive social
progress (Stryker, 2013). Calls by Susan Fiske, theformer President of the Association for
Psychological Science, in November of 2016 to end
the culture of shaming in science (Fiske, 2016),
which was largely fortified and popularized by
Brookes, and sites like Retraction Watch and
PubPeer, were immediately shot down by
Retraction Watch’s co-founders, Ivan Oransky andAdam Marcus (Oransky and Marcus, 2016). The
defense offered for this ethically questionable
practice, at least to some, resembled a similar
attitude displayed by one of the PubPeer cofounders, Boris Barbour, at PubMed Commons15, in
response to an editorial by Michael Blatt, who
described posts at PubPeer as “negative andoccasionallymalicious”,
thelanguageas“tendentious, if not confrontational”, the discussion
as “devoid of ideas and polarized from the outset”,
and the commentators as “vigilantes” (Blatt, 2015).
In a separate blog post, Brookes came to thepassionate defense of PubPeer, referring to Blatt’s
editorial as a “piece of literary detritus”, and callingin essence for the destruction of “their outdated
business model”, referring broadly to the
traditional form of publishing as practiced by most
COPE members (Brookes, 2015). These radical anddestructive opinions were never publicly discussed
or challenged by COPE or by COPE members, whowere very obviously absent from this extremely
important discussion about the fate of traditional
peer review and the current publishing system,
which is being ravaged – some may argue as anecessary purge – by PubPeer and Retraction
Watch, and their supporters. An attempt to better
https://www.ncbi.nlm.nih.gov/pubmed/26417050(see comments section)
15

14 http://www.psblab.org/?p=410

Eubios Journal of Asian and International Bioethics 29 (May 2019)
understand this attitude and mode of functioning,
within the context of COPE-related members, bythese science watchdogs (Teixeira da Silva, 2016a)
and anonymous critics of the publishing status quo
is a key objective of this commentary. As an
academic that publishes in COPE member journals
and even having been banned from all journals of a
COPE member publisher (Taylor & Francis /Informa) for making “excessive” editorial
challenges, it is of interest to know why COPE
appears to be so distant from the conversation
involving Retraction Watch and PubPeer, or theopinions and concerns expressed by Fiske and Blatt.
The absence of COPE’s voice as an ethical arbitrator
leaves a moral vacuum within academia’s
discussion on the issue of how best to heal
wounded literature. These are issues that allacademics should be deeply concerned about, andinvolved with.
Is COPE encouraging, or threatened by,philanthrocapitalism?
A core problem of sites like PubPeer and Retraction
Watch is that they are self-moderated, thus theirown moral compass is focused on their own
perception of right and wrong. If such sites truly
represented the ethical and moral voice of global
academia, then they would be open to critique by,and suggestions from, academics, including theircritics, as well as from groups such as COPE, oreven COPE members. Most importantly, to ensurethat the discussion takes place in an accountable
and transparent manner, such dialogues should
occur in the open, not behind closed doors or at
exclusive meetings such as the 5th World Congressof Research Integrity (WCRI)16, as currently occurs.
PubPeer and Retraction Watch are receiving or
have received considerable funding from powerfulinterest groups that claim a philanthropic posture,
but that appear to have much broader long-termsocial reengineering objectives in mind. One of thegroups that has funded both PubPeer andRetraction Watch is the Laura and John Arnold
Foundation (LJAF). The leader of the LJAF, John
Arnold has retreated quietly, allowing his LJAFsponsored sentinels – including PubPeer andRetraction Watch – to begin to purge, in a sectorby-sector denigration of science’s current
structures, “bad science”, beginning with cancer
research and psychology. The central planning unitof the latter is referred to as the “Reproducibility
Project: Psychology”, and of the former as“Reproducibility Project: Cancer Biology”, which
are centralized at the Center for Open Science,
directed by Brian Nosek, and also funded by

16 http://wcri2017.org/

101

philanthropic organizations other than the LJAF17.
This carefully planned purge is toppling legends
along the way, and the fact that public shaming –even if the facts speak for themselves – is being
used primarily behind masked individuals orgroups makes the process imbalanced, or unfair,
and thus all the more destructive, a point that bothBlatt and Fiske tried to argue, albeit unsuccessfully.
John Arnold has pointedly stated that his war is a“war on bad science”18, but what is not being
discussed is that any war that is declared on science– good or bad – will involve a frontal attack onscience’s current structures, including traditional
editor boards, and traditional peer review. This in
itself is not a bad thing because the system is indesperate need of reform (Teixeira da Silva andShaughnessy, 2017). Close scrutiny of the PubPeer
and Retraction Watch data-bases will reveal that alarge proportion of the literature currently being
scrutinized, and shamed, is in fact COPE member
literature, emphasizing even more why COPE has amoral responsibility of being at the front-line of thebattle in and on science, rather than conducting
business as usual, quietly and silently, in the
background, via position-neutral lobbying andmembership recruitment.
The LJAF and related parties have failed toindicate precisely how much error in the publishedliterature is considered to be “bad”, leaving theoption of open and indiscriminate attack on
academia and on academic structures, including on
COPE member journals. By leaving the debate ofwhat constitutes “bad” wide, vague, and undefined
gives PubPeer and Retraction Watch moral leverage
to literally label any academic with an error, or
retraction, as being “bad”, if not only by mere
association with these sites. Retraction Watch has
tried, but in vain, to dilute its science-shaming
image by creating a “doing the right thing”
category19. However, this attempt at softening theshaming nature of that blog is tempered by the vast
majority of cases published on that site,
culminating with the retraction leaderboard, apunitive list of academics20, which only serves tofortify the shaming nature of that site (Teixeira da
Silva, 2018a). The LJAF-funded initiatives related to“open science” and “open data”, including open
peer review and preprints, has also becomeenmeshed in a culture of shaming. Brookes (2015)
stated “Dr. Blatt accuses the founders of PubPeer of
17 https://cos.io/about/our-sponsors/

https://www.wired.com/2017/01/john-arnoldwaging-war-on-bad-science/
19 http://retractionwatch.com/category/by-reason-forretraction/doing-the-right-thing/20
http://retractionwatch.com/the-retraction-watchleaderboard/
18

102

Eubios Journal of Asian and International Bioethics 29 (May 2019)

unmasking themselves solely for the purpose of
making money”, followed soon after by thisideological nail to Blatt’s editorial coffin: “It takes
an exquisite amount of hipocrisy, to speak from thebully pulpit of an entitled publication, part of amulti-billion dollar enterprise, punching down at a
non-profit foundation, and accusing it of beingmoney-hungry. The only possible motivation I canthink of for this Op-Ed, is an editor and an industry
witnessing the slow decentralization of theircontrol over information (for massive profit),seeking to discredit an upstart grass-roots
organization that might disrupt the status quo.” Infact, it turned out that Blatt had been perfectly
correct, with the California-based PubPeer
Foundation, with Brandon Stell as its president,
receiving US$ 412,000 from the LJAF in Novemberof 2016 for development between 2016 and 2019.
Only months after having received this funding did
PubPeer finally formally announce it publicly, on
June 15, 2017, with the launch of PubPeer 2.0, thebeta version. Yet, there was no media
announcement, and no coverage of this important
fact by leading journals such as Science and Nature,
who had previously covered the unmasking of the
PubPeer founders. Details about precisely how
PubPeer and Retraction Watch are using LJAF
funding, or about their interaction, had beenmasked from the public (Teixeira da Silva, 2017).
This secrecy, or lack of opacity (Teixeira da Silva,
2018b), decreases trust in these organizations andtheir leadership, even as they demand of scientists,
and the scientific publishing establishment,
maximum transparency. This can only be described
as a hypocritical moral and ethical stance. Even theissue of comment ownership and concerns related
to comment manipulation at PubPeer raise doubt
about the transparency of the arbitrage process inplace at this science watchdog website (Teixeira da
Silva, 2018c). Once again, COPE remains noticeably
silent, and thus displaying opacity, when it should
be demanding of PubPeer and Retraction Watch,maximum transparency, especially since many of
its members are being shamed by these blogs.
Perhaps the silence is a subtle recognition that peer
review has failed in COPE member journals, even as
some of them achieve record profits throughsubscriptions and open access fees. Are there
financial conflicts of interest (COIs) that prevent
COPE from being more vocally critical of its
members and its allies?
Does COPE support the notion of retractions as
trophies?
Retractions are treated as trophies by Retraction
Watch. One such case of a trophy for the LJAF-

funded axis of science activists is Carlo M. Croce21, aclose and long-term research partner in cancer
research to Alfredo Fusco, and chair of the
Department of Cancer Biology and Genetics at The
Ohio State University (OSU), who has been shamed,
possibly even hounded, for years – withundoubtedly much more to come until Croce loses
all of his prizes, having already lost his position as
department chair at OSU. Croce still undoubtedly
faces a long road of shaming and a public lashing at
PubPeer 22 andRetraction
Watch,
withpseudonymous fernandopessoa leading this charge.
The LJAF and its science-shaming sentinels are now
beginning to place their trophies proudly on the“destroyed science/scientist” shelf, including
Haruko Obokata, Olivier Voinnet, Paolo Macchiarini,and many others, as the pile of bodies of “boom-tobust” legends (Teixeira da Silva et al., 2016) begins
to stack up. This is not a hyperbolic image, it is areality. It may be reasonably argued that thelegendary status of an academic is self-created, andthat the responsibility with academic records lie
with academics themselves, but the path to that
destruction or staining of the legendary status isbeing speeded up by the existence of sites like
PubPeer and Retraction Watch. What about thesilent victims of the LJAF-funded war, like Yoshiki
Sasai23? What role, and responsibility, does the LJAF
and its funded organizations like PubPeer andRetraction Watch that heavily and negatively
profiled Sasai and his work, play and have, in thecollateral damage suffered by co-authors ofretracted papers that have been subjected to
PubPeer- and Retraction Watch-induced public
humiliation? The picture that began to be painted inabout 2010-2014, when PubPeer and Retraction
Watch were still in their establishment phases,
prior to receiving funding from the LJAF and others,
and apparently free of financial or other visible
COIs, was that academia was dealing with groups
who appeared to genuinely care about science’s
integrity and that dearly wanted to see theliterature corrected. However, only after thesegroups received LJAF (and other) funding, didacademia begin to appreciate the true dark natureof this apparent conspiracy against science, heavily
profiling COPE member journals and publishers,
but curiously also in collaboration with COPE
and/or its leadership, which embodies the
publishing establishment, as was noted by Brookes.
The LJAF-COS plot and the PubPeer andRetraction Watch plan have now been partiallydebunked. From 2015-2019, it has become clearer
21http://retractionwatch.com/?s=carlo+croce

22https://www.pubpeer.com/search?q=+Carlo+M+Croce23

http://retractionwatch.com/2014/08/04/stap-stemcell-co-author-commits-suicide-reports/

Eubios Journal of Asian and International Bioethics 29 (May 2019)that PubPeer and Retraction Watch are now part ofa highly coordinated attack on science, including on
bad science, using errors and flaws as excuses toadvance the political and social agenda that John
Arnold has clearly mapped out, not only for the USA,but also for the UK, and possibly even at a wider
global scale, as evidenced by LJAF sponsorship of
the 5th WCRI. The problem with making the moral
and/or ethical waters murky, by mixing bad science
with unintentional errors, is that many innocent
academics may be defamed, or even psychologicallydamaged. Yet these tales are not being told, andthese issues are not being openly or properly
discussed, and it is here that COPE could play adecisive moral voice for the academic communityand publishing industry, by serving as a moderator
between these feuding parties, imposing a justethical stance that is critical of both ethicsinfracting COPE members, and also public shaming
PubPeer and Retraction Watch. Valid arguments
aside, reputations of individuals, institutions,editors, journals and publishers, including of COPE
members, are being destroyed, and an industry that
had perceived itself to be academically rock-solid –except for the threat offered by the “predatory”
open access and fake science movements (Al-Khatib
and Teixeira da Silva, 2017a; Teixeira da Silva,
2017c) – may be in a potential state of collapse. As
the retractions begin to pile up, and when it
becomes evident that a critical mass of flawed
papers that are now either retracted or corrected,
had been sold either as subscriptions, or as
packages to research and academic institutions
worldwide, resulting in sometimes billion dollar
profits (Larivière et al. 2015), what moral argument
can COPE put forward in defense of its paying
members?
RePAIR Consensus Guidelines: publishing’s“destroy and replace” policy
What might be one the game plans of the LJAFfunded “war on bad science” and of COPEsupported and LJAF-funded PubPeer andRetraction Watch? By betting on science’s collapse,
including the powerful institutions that are
currently holding this fragile support structure inplace, John Arnold has, as indicated in his interview
published by a student, Sam Apple, ample time towait for science to implode, which would allow
Arnold-envisioned measures to be gradually, but
aggressively, introduced, to replace the current
structures. This might include the replacement oftraditional peer review, as practiced by many COPE
members, with LJAF-funded open peer review,
open data and open access projects, spearheaded
by COS. With contacts deep within the NIH, such as
Hilda Bastian who heads an equally opaque andnow defunct PubMed Commons (Teixeira da Silva,

103

2018d), and other academic and government
institutions, primarily in the USA and the UK, as
well as with COPE, a powerful “destroy and replace”
policy is already in the implementation phase. Thiscan be clearly observed by a new set of “ethicalguidelines”, the RePAIR Consensus Guidelines24,
that began to be crafted in Fort Collins in June of
2016, and that have reached a statutory level. Fearhas successfully spread, using powerful media like
Retraction Watch and others, anger has been
stoked, tension is high among academics who see
their literature in unsafe repositories, and there
may be a sentiment that science is under imminentcollapse. This current negative sentiment withinpublishing is being projected as an “opportunity”
only by those who are benefitting from science’s
collapse, namely the LJAF and its funded groups, by
COS and its philanthrocapitalist partners, and by
for-profit publishing entities that craft theirbusiness models and their ethics policies, to suit theflavor of the day. Retraction Watch serves as the
LJAF public voice and media portal, transmitting
weekly primarily negative criticism of science andits foundations, in “Weekend reads”25.
COPE: playing devil’s advocate while sleepingwith the enemy
The relatively unknown marriage between the LJAF
and COPE has been a strategic one, including in the
new RePAIR Consensus Guidelines, graduallyachieved silently behind closed doors and inmeetings dotted with industry “ethicists”, but not aunion that has been made too obvious in the publicdomain, nor in consultation with ground-level
academics and scholars. The COPE-led ethics
industry has assumed a morally superior position,
similar to the for-profit publishing industry, withlittle regard for grass-roots academics’ opinions.
Like many of the LJAF-funded anti-science or antibad science groups currently operating to degrade
science’s image and integrity, but masqueraded as apro-integrity movement, the union with COPE hascome through the smart association between COPE
and Retraction Watch. However, has thatassociation been established under stress, threat, or
duress, for example the threat of collapse of the
COPE member establishment, as was suggested by
Brookes? The LJAF and COS, and their allies will
obviously, and expectedly, push back and defend
their plan, labeling these views as a nonsense
conspiracy theory, a typical psychological strategy
to attempt to derail criticism and avoid scrutiny.
24 https://publicationethics.org/files/RePAIR%20Consen

sus%20Guidelines.pdf (dateless document that has notchanged between 2017 and March, 2019)25
http://retractionwatch.com/category/weekendreads/

104

Eubios Journal of Asian and International Bioethics 29 (May 2019)

There is evidence that critics will be smeared on
PubPeer and Retraction Watch, and thus theircriticism will be aggressively silenced. The
President of The Center for Science Integrity Inc.
(CSI), Retraction Watch’s parent organization, Ivan
Oransky, has been associated with and/or dealing
with COPE for years, having first recruited
Elizabeth Wager, the former COPE Chair (20092012), as a director of the board of directors of the
CSI26, a carefully timed maneuver, coincidentally
just prior to receiving funding from the LJAF andother philanthropic organizations. One can also
observe, with no publicly stated COIs, that FerricFang, a director of the CSI, is also one of the authorsof the RePAIR Consensus Guidelines. There aredozens of hidden professional and personal
relationships and COIs – which COPE considers aserious ethical infraction27 – among the groups
being discussed in this paper that are influencing
ethics policies, but that are – surprisingly – not yet
being openly debated and scrutinized by any
member of the global academia. This serves as
direct evidence that the LJAF has infiltrated theglobal ethics platform, through Retraction Watch, ina carefully crafted alignment of allies. A Google
search for “ethics” meetings and symposia willquickly reveal how close the relationships havebecome between the LJAF-funded groups and COPE,
and also with key entities within the US
Government and/or academic institutes, including
Shara Kabak (DHHS Office of Research Integrity(ORI)) and James Kroll (National Science
Foundation (NSF), Office of the Inspector General(OIG)), who are, as astute readers of this opinion
piece may already have guessed, co-authors of the
RePAIR Consensus Guidelines. The LJAF play is infull swing, the props have been carefully placed, thecompany has been selected, new recruits are beingsought, and the first two acts (cancer andpsychology research) are currently on display. But
who is applauding? Only those within this tight,
closely controlled net of individuals and interest
groups that are putting in place a set of ethicalguidelines like the world has never before seen,
deeply impregnated with clauses, rules andrestrictions that will turn research and sciencepublishing into a veritable battle ground, andfurther restrict authors’ rights freedoms (Al-Khatib
and Teixeira da Silva, 2017b). Will these powerful,well-connectedindividuals
withpolitical
aspirations, be seeking to introduce criminal
penalties, incarceration, and other US-influenced
principles of justice into science and sciencepublishing? Kenneth D. Pimple, who is one of the
http://retractionwatch.com/the-center-for-scientificintegrity/board-of-directors/
27 https://publicationethics.org/competinginterests

RePAIR Consensus Guidelines co-authors, and aclose Retraction Watch supporter, has been one of
the most hawkish members advocating forincreased legal and criminal intervention in science
fraud,
referring
euphemisticallytothismilitarization and criminalization of science(Teixeira da Silva, 2016) as “reform”. The
criminalization of scientists was a key focus of the
5th WCRI.
In mid-2017, academia suddenly woke up to areality where only a tiny number of non-LJAFassociated academics have begun to understandthat science and science ethics have gradually
become somewhat hijacked by LJAF-funded groups,
on both sides of the Atlantic, for example AllTrials
by Sense About Science28 in the UK, whose US
branch is funded by the LJAF 29 (“A note on
funding: Sense About Science USA is being
established with a grant from the Laura and John
Arnold Foundation. We would like to achieve
similar funding to Sense About Science in the UK,
where 95 percent of donations are from membersof the public and scientists.”). Like mostphilanthropic groups seeking to influence public
policy and ultimately score political points andrewards, such initiatives, groups and sites arebrilliantly worded, with carefully crafted marketing
punch-lines that give the impression of a savior-likemission. Take, for example, the mission statementof this organization, which appears prominently on
its UK top page: “Sense about Science is anindependent campaigning charity that challenges
the misrepresentation of science and evidence inpublic life. We advocate openness and honesty
about research findings, and work to ensure thepublic interest in sound science and evidence isrecognised in public discussion and policymaking.”
What that marketing blurb fails to state is that partsof this objective, most likely as part of the “Ask for
Evidence” campaign, is being achieved throughscience and scientist shaming using primarily
PubPeer and Retraction Watch, failing also to notethe network of LJAF-funded groups that arecolluding to achieve this objective, i.e., hidden COIs,
and giving the misleading impression, to academia
and the public, that this is some random
independent socially conscientious group that is
operating in the UK with a branch in the USA. Does
the public and academia not deserve to know, in aprominent public notice, that the funder of Sense
About Science USA is the LJAF, and that the LJAF is
also funding (or have funded) PubPeer andRetraction Watch, which are using less-thandesirable techniques to exploit science’s
weaknesses? Once again, COPE, which is based in

26

28 http://senseaboutscience.org/

29 http://www.senseaboutscienceusa.org/about/Eubios Journal of Asian and International Bioethics 29 (May 2019)
the UK, is visibly absent from the public discussion.
Curiously, Ben Goldacre30, the founder of AllTrials,
is on the editor board of a COPE member BioMed
Central journal, Research Integrity and Peer Review(RIPR), in which Elizabeth Wager, the former COPE
Chair, serves as the editor-in-chief, and whose
editor board is riddled with individuals with deep
professional COIs, none of whom have any COI
statements31. As one example, the recently retired
COPE Chair (2013-2017), Virginia Barbour, is also
on the editor board, as is Miguel Roig, a staunch
defenderthat
self-plagiarism
constitutes
misconduct, and a CSI co-director. These unstated,hidden COIs and relationships between the global“ethics” establishment, that extend between COPE
and LJAF-funded Retraction Watch place academia
in a very serious ethical bind: how can global
academia trust any of these individuals or groups,
including COPE, when they are all colluding toadvance their own financial and political agendas?
COPE collusion with groups: fact, myth orconspiracy theory?
How did global academia suddenly wake up to thissickening reality that the barrage of rules andregulations that have hit them has been a carefully
crafted experiment behind closed doors, without
their consultation? When will global academia
demand that the same parties that appear to becolluding – for what appears to be some years now– to craft rules and regulations for millions ofacademics, primarily in the biomedical sciences,involve an odd and uncomfortable mix of a giant
ethics lobbyist (COPE), US Government regulatory
bodies (ORI, NSF, OIG, NIH), and whistle-blowing,
science-shaming websites like PubPeer andRetraction Watch, the latter two funded byphilanthropic organizations like the LJAF withinitial morally dubious sources of funding (i.e.,
Enron)?
Striking evidence of this apparent take-over ofthe ethical establishment, and the potential
collusion with COPE, with the objective of creating
an indestructible globalist front, is theaccumulation of LJAF-funded or -associated groups
who united to celebrate their successes, andexpanded their future plots, in the 5th WCRI32. It is
unclear who paid for the attendees’ expenses nor
were COIs – ethical, financial, professional andother – indicated on the 5th WCRI website. John
Arnold’s “destroy and replace” marketing campaign
campaign has been carefully planned, advertised
30 https://en.wikipedia.org/wiki/Ben_Goldacre

31 https://researchintegrityjournal.biomedcentral.com/about/editorial-board

32 http://www.wcri2017.org/images/Program_at_a_glan

ce_5th_WCRI_2017.pdf

105with morally perceptive catch phrases such as“greatertransparency”
or“increased
reproducibility”, masquerading thereby the
anonymous and pseudonymous backgroundcampaign of shaming, i.e., including of COPE
members. Another high-profile successful “capture”
was of Nature, whose solutions to science wereusurped by LJAF-funded COS33.
This apparent usurpation of ethical values by the
LJAF, epitomized by the literal dominance of the 5th
WCRI, in a bid to replace the current research andpublishing systems with an Arnold vision of scienceand society – clearly with political ambitions on thehorizon, and ultimately lucrative returns in theform of science-based laws and criminalization –places COPE in a very ethically uncomfortablepredicament.
Byoffering
anonymousor
pseudonymous critics legal protection – in the formof powerful legal “civil liberties” groups such as the
ACLU (American Civil Liberties Union), as occurredin the Fazlul Sarkar case 34 (Teixeira da Silva,
2018e) – academics, academic institutes andpublishers will feel pressured by LJAF’s objectives.
The need to correct errors or retract highly
erroneous or fraudulent papers is reasonable, but
the sugar-coating with marketing-laced visions forbetter science, greater reproducibility and a morerobust research infrastructure that is spear-headedby philanthropic organizations and science
watchdogs that operate with opacity, seems to be
counter to the core COPE ethical principles oftransparency35.
It is under this climate of LJAF increasing
expansion into ethical territory that a to-beexpected, yet somewhat incredible, event took
place on March 23, 2017. Virginia Barbour used,while still COPE Chair in her second term,
Retraction Watch36 to publicly lament claims ofharassment, anonymously attacking Klaas van Wijk,
a Dutch ornithologist. van Wijk, who later admitted
by email to be the target of the Barbour shaming
campaign, has been passionately rallying against
the validity of the findings of a paper published in a
COPE member (Taylor & Francis / Informa) journalthat he and other ornithologists claim is fraught
with errors, and possibly fraudulent data (Teixeirada Silva, 2017d), in an almost tragic-comic displayof total lack of professionalism. Why did Barbour
not use her own private blog or the COPE website
http://www.nature.com/news/announcementtransparency-upgrade-for-nature-journals-1.21627
34
http://retractionwatch.com/category/byauthor/fazlul-sarkar/
35 https://publicationethics.org/files/Principles_of_Trans
parency_and_Best_Practice_in_Scholarly_Publishingv2.
pdf
36
http://retractionwatch.com/2017/03/23/agreedlisten-complaint-paper-harassment-began/
33

106

Eubios Journal of Asian and International Bioethics 29 (May 2019)

to vent her personal frustrations? Why was
Retraction Watch used as her bully pulpit? In aclear sign to the scientific community by the LJAF
that the reigns of science and ethics are being taken
over, by force and if necessary by embarrassment
and shaming, COPE has now officially succumbed tothe pressure of the hooded masses and theRetraction Watch – PubPeer – LJAF form of science
responsibility through social justice, i.e., science’s
kangaroo courts37. Has the ethics movement been
kidnapped or hijacked? Curiously, even ironically,in her public rant, Barbour stated: “COPE, bycontrast, aims collectively and individually topractically address the problems that occur inpublication and research integrity in a rigorous andprofessional way. Yet we are increasingly
witnessing that an acknowledgement by authors orjournals of a mistake and a subsequent correction is
not seen to be enough. Vilifying authors or editorswith public humiliation – driven often by a crowd
mentality — seems to be what some in this arena
want. As one tweeter said (hopefully ironically)– a“public lashing” may even be expected. We strongly
refute this way of thinking. With such a climate it ishard to see how we could ever develop a culture ofno blame correction, which is a prerequisite for areliable published record.”In brief, Barbour’s personal lament using aperceived – at least by some – anti-science whistleblowing blog, Retraction Watch, to express herviews to a monthly audience of several hundred
thousands of viewers, shows how COPE and theprimarily for-profit publishing industry’s ethics
movement, has now been usurped. It isinconceivable – morally or ethically – that COPE
could be working with, or alongside, Retraction
Watch and PubPeer, in any capacity. Even more sosince Oransky and Marcus, with their own
retraction, have not listed themselves into theirown retraction database, displaying a clear case of
double standards (Teixeira da Silva, 2017e). Such
relationships would not only reflect deeply
concerning COIs, but pose deeply troubling ethicalchallenges. By allowing Barbour to shame herself inpublic, COPE has now been placed in a deeply
embarrassing situation of promoting – or at leastaccommodating – LJAF-based ideals andmethodologies, and by succumbing to potentiallyanti-science LJAF ideologies. Most importantly,
COPE has now conceded to the shady scienceshaming practices employed by LJAF-fundedgroups like PubPeer and Retraction Watch. Thisalignment with groups that use ethicallyquestionable methods to “correct the literature”, inessence usurping the post-publication peer review
movement, has clearly placed COPE in a very
37 https://en.wikipedia.org/wiki/Kangaroo_court

complex and perhaps unretractable ethical bind.
COPE’s flopped reform policy amid hidden
conflicts of interest
Fearful of the massive fall-out of the ravages to beinflicted by the LJAF-funded groups on the COPE
membership establishment, Barbour and selectallies published a badly envisioned reform policy tocurrent retractions, as a preprint (Barbour et al.,2017a), which was then republished almost
without any improvements in F1000Research(Barbour et al., 2017b), proposing that retractions
be replaced by amendments, with the hope of
buffering the negative damage caused by Arnold’s
deeply destructive war on “bad science”. In doing so,
COPE exposed itself again as a weak and toothless
proponent of the for-profit publishing industry thatis now suffering severe reputational damage at thehands of PubPeer and Retraction Watch, but is now
left in a highly uncomfortable position of having todeal with the hooded and masked whistle-blowers,
in all of their gloriously innovative pseudonymous
forms, who have the power of erroneous literature,as their weapon to take down the industry andreplace it with Arnold’s vision. Almost
apologetically, and once again dealing a significant
psychological and reputational blow to COPE,
Barbour and colleagues – curiously referred to as“publishing experts” and not as “ethical experts” –once again found themselves having to explain,very ironically, their positions to the public on theshaming platform, Retraction Watch38. Not only was
this preprint signed as “on behalf of COPE working
group”, a group whose constituency is as enigmaticas the content of this preprint, the COI statement
was incomplete and thus highly misleading, andtherefore unethical. The COI (competing interests)
statement states: “Virginia Barbour and Theodora
Bloom are both on the Eighth International
Congress on Peer Review and Scientific Publication
Advisory Board. Virginia Barbour is the Chair of
COPE. Elizabeth Moylan is on the COPE council.” Itis well known that Barbour also serves on the
Ethics and Policy Committee of WAME (World
Association of Medical Editors)39, while Barbour
and Moylan served on the editor board of RIPR.
Why were these incredibly important COIs allowed
to be hidden by this ethical elite and why was thisreprint not retracted on the basis of clearly false
COI declarations and hidden COIs 40 ? Elizabeth
38 http://retractionwatch.com/2017/04/04/problematic-papers-dont-retract-correct-say-publishing-expertsamend/
39 http://www.wame.org/about/wame-executive-boardand-committees
40 http://retractionwatch.com/category/by-reason-forretraction/failure-to-disclose-coi/Eubios Journal of Asian and International Bioethics 29 (May 2019)
Moylan, the last/senior author of this preprint, isalso an editor of RIPR. Requests to the authors to
explain these hidden COIs were not responded to.
And, not surprisingly, the RIPR editor board is
riddled with COI-impregnated individuals, such as
an LJAF-funded protégés, Ben Goldacre, a COPE
trustee, Chris Graf, the Director of ResearchIntegrity and Publishing Ethics of Wiley Blackwell
and the current COPE Vice Chair41, Ana Marusić,
who was the President of the European Associationof Science Editors42, Elizabeth Wager and MiguelRoig, who are two among 10 directors of Retraction
Watch’s parent organization, the CSI, and several
others. It is thus very and plainly evident that
Barbour et al. have not accidentally forgotten to
declare these COIs, they have purposefully omitted
them. It therefore comes as no surprise thatcomments indicating these hidden COIs are notpublished on the LJAF-funded PubPeer page for thispublication43. If COPE and others consider hidden
COIs to be unethical, then why are the links (i.e.,
COIs) between these anti-science groups, COPE,
other ethics organizations and the main for-profit
publishing establishment being hidden from thepublic?
COPE: crumbling credibility and selling out
ethics
COPE has the responsibility, representing some of
the most powerful and richest for-profit publishers,
to publicly state, in no uncertain terms, what its
precise association with the LJAF and/or LJAFfunded groups is. Questions and concerns about
this alliance between Retraction Watch and COPE,
and thus between the LJAF and COPE, have notbeen answered by all parties, in direct violation ofadvice offered by Bourne and Barbour (2011):“Rule 2: Do Not Ignore Criticism; Rule 3: Do Not
Ignore People”. Issues that have become the core
topic at the heart of the “trust” crisis in sciencepublishing are being deeply compromised by theopacity displayed by, among others, these parties:
the LJAF, PubPeer, Retraction Watch and COPE. It ishighly ironic, if not blatantly hypocritical, that theseorganizations are trying to hold, as part of theiranti-“bad science” campaign, scientists’ and editors’
feet to the fire, demanding openness, honesty,transparency and accountability. COPE has ahistory of opacity related to its operations andaddress (Teixeira da Silva, 2017f).
COPE has been – since its inception in 2007 as a
UK charity and charitable company – an41https://publicationethics.org/about/council/chris-graf

42 http://www.ease.org.uk/about-us/organisation/ease-council-2018-2021/

43 https://www.pubpeer.com/publications/4F308D8E8B

CC398C4106F4F482C297

107

organization that offers a service for payment, theservice being providing “ethical” rules, or
guidelines, several of which its members areunaware of, or do not follow. So as not to
exclusively appear to be an ethics-providing service
and brand for the publishing industry, COPE has
diversified its services, such as workshops. Without
creating new rules, COPE would become irrelevant.
So, to promote its relevance, it has formed allianceswith even questionable groups, like Retraction
Watch and PubPeer, and tried to evolve and change
the rules and guidelines annually, to justify its
existence. Even as COPE sees an unprecedented
increase in membership – owing in large part to themarketing prowess of some of its most powerful
publishing members – it is now faced with a real
dilemma: should it seen to be working with, andalongside, actual or perceived anti-science groups
like the LJAF-funded Retraction Watch and PubPeer,or should it distance itself, physically andideologically, from these groups, and evolve its own
distinct working and ethical framework? The
answer to what should in essence be a simple
rhetorical question, seems to generate an almost
ironic second question: is COPE being forced orpressurized into conforming to the LJAF’s vision ofscience and society, through its direct links andinfiltration in Retraction Watch, and as evidenced
by the RePAIR Consensus Guidelines? Academics’eyes should thus be carefully fixed on this COPE
alliance with LJAF-funded groups in their globalist
effort to dominate, control and implement ethics
and science “integrity” and to control a potentially
profitable “ethics” market and its associatedservices (editing services, etc.).
In my view, COPE has to some extent, as a resultof its business-like model, association with forprofit publishers and links to “radical” science
watchdogs, lost its moral compass and standing.
COPE sold out some core ethical values, firstly tothe for-profit publishers, serving merely as amarketing agent or service provider selling COPE
membership and services (i.e., ethics and ethics
guidelines), and now to the anti-(bad) science LJAF
establishment, and its financed allies such as
PubPeer and Retraction Watch. Is it time for global
academia to rebel against this usurpation ofresearch and publishing ethics?
The issues underlying science publishing arecomplex and no easy or quick solutions are in sight,
although many influential and powerful individuals,
groups and vested interests are all vying to makechange, enact reform, and thus proudly announce
their part in science’s Renaissance, or lay a claim of
victory in its collapse. Yet, the issue of transparency,
openness and accountability are grossly
disproportional, and many inconsistent or evenhypocritical stances by the very same entities

108

Eubios Journal of Asian and International Bioethics 29 (May 2019)attempting to impose these ethical norms uponacademia are themselves violating some of thenorms that they are preaching. COPE is a large andpowerful ethics organization, maybe the largest
globally, with much influence and sway among
many of the entities discussed in this commentary,and yet its distinct silence and absence from thepublic arena of debate of so many critical issues
suggests that COPE has lost it moral compass, ordoes not have a robust enough one to guideacademia through these troubled times.
A final cautionary note to readersThis commentary represents the perspective of asingle individual. While concerns about specificindividuals and/or their relationships with specificorganizations or groups may have been criticallyexamined, the ultimate objective is to provide analternative perspective on these relationships since
they affect the background ethical framework of
STEM publishing for the vast majority of academics
around the world. While the author can in no way
assess the good or bad intentions of those who are
critiqued in this paper, knowing full well that theunderlying intentions of such individuals andorganizations is hopefully for the greater good ofscience, academics deserve to be able to have apoint of departure related to alternative, andpossibly controversial, views on the publishingethics “market”.
Conflicts of interest
The author and his work have been profiled by
PubPeer and by Retraction Watch. The author has
used PubPeer and Retraction Watch, both as asigned, registered commentator, and anonymously.
The author has been banned from commenting at
the PubPeer, Retraction Watch and Leonid
Schneider blogs. The author declares no otherconflicts of interest.

References

Al-Khatib, A., Teixeira da Silva, J.A. (2017a) Threats tothe survival of the author-pays-journal to publish
model. Publishing Research Quarterly 33(1): 64-70.
DOI: 10.1007/s12109-016-9486-z
Al-Khatib, A., Teixeira da Silva, J.A. (2017b) What rights
do authors have? Science and Engineering Ethics 23(3):947-949. DOI: 10.1007/s11948-016-9808-8
Barbour, V., Bloom, T., Lin, J., Moylan, E. (2017a).
Amending published articles: time to rethink
retractions and corrections? bioRxiv 118356. doi:
10.1101/118356
Barbour, V., Bloom, T., Lin, J., Moylan, E. (2017b).
Amending published articles: time to rethink
retractions and corrections? [version 1; referees:
awaiting peer review]. F1000Research 6:1960. doi:
10.12688/f1000research.13060.1
Blatt, M.R. (2015). Vigilante science. Plant Physiology
169: 907-909. Doi: 10.1104/pp.15.01443
Bourne, P.E., & Barbour, V. (2011). Ten simple rules forbuilding and maintaining a scientific reputation. PLoS
Computational
Biology7(6):e1002108.
doi:10.1371/journal.pcbi.1002108
Brookes, P.S. (2015). Punching down; In defense of
PubPeer.
http://www.psblab.org/?p=445(lastaccessed: March 6, 2019)
COPE (Committee on Publication Ethics) (2019).
Members.
https://publicationethics.org/Members(last accessed: March 6, 2019)
Fiske, S.T. (2016). A call to change science’s culture of
shaming.
http://www.psychologicalscience.org/observer/acall-to-change-sciences-culture-of-shaming(lastaccessed: March 6, 2019)
Larivière, V., Haustein, S., Mongeon, P. (2015) The
oligopoly of academic publishers in the digital era.
PLoS
ONE
10(6):
e0127502.
Doi:
10.1371/journal.pone.0127502
Oransky, I., & Marcus, A. (2016). Too much public
shaming is bad, but that’s not the real problem inscience.
https://www.statnews.com/2016/11/04/publicshaming-science/ (last accessed: March 6, 2019)
Stryker, C. (2013). The problem with public shaming.
https://www.thenation.com/article/problem-publicshaming/ (last accessed: March 6, 2019)
Teixeira da Silva, J.A. (2016a). Science watchdogs.
Academic Journal of Interdisciplinary Studies 5(3): 1315. DOI: 10.5901/ajis.2016.v5n3p13
Teixeira da Silva, J.A. (2016b). The militarization ofscience, and subsequent criminalization of scientists.
Journal of Interdisciplinary Medicine 1(2): 214-215.
DOI: 10.1515/jim-2016-0031
Teixeira da Silva, J.A. (2017a). COPE requires greater
consistency and accountability. Mediterranean JournalofSocialSciences8(1):11-13.
DOI:
10.5901/mjss.2017.v8n1p
Teixeira da Silva, J.A. (2017b). Why does PubPeer not
acknowledge Retraction Watch as a media source?
Journal of Advocacy, Research and Education 4(1): 5-8.
Teixeira da Silva, J.A. (2017c). Fake peer reviews, fake
identities, fake accounts, fake data: beware! AME
Medical Journal 2: 28. DOI: 10.21037/amj.2017.02.10
Teixeira da Silva, J.A. (2017d). The Basra Reed Warbler
saga: where is the original data? Sandgrouse 39(1): 89.
Teixeira da Silva, J.A. (2017e). The Retraction Watch
retraction: how bad advice became worse advice forscientists and academics. Eubios Journal of Asian andInternational Bioethics 27(4): 136-140.
Teixeira da Silva, J.A. (2017f). Opacity about COPE
(Committee on Publications Ethics) physical address
and operations. Journal of Advocacy, Research and
Education 4(2): 45-53.
Teixeira da Silva, J.A. (2018a). Freedom of speech andpublic shaming by the science watchdogs. Journal of
Advocacy, Research and Education 5(1): 11-22.
Teixeira da Silva, J.A. (2018b). The opacity of The
PubPeer Foundation: what PubPeer’s “About” pagetells us. Online Information Review 42(2): 282-287.
DOI: 10.1108/OIR-06-2017-0191
Teixeira da Silva, J.A. (2018c). The issue of comment
ownership and copyright at PubPeer. Journal of
Educational Media & Library Sciences 55(2): 181-191.
DOI: 10.6120/JoEMLS.201807_55(2).e001.BC.BE

Eubios Journal of Asian and International Bioethics 29 (May 2019)
Teixeira da Silva, J.A. (2018d). PubMed Commons
closure: a step back in post-publication peer review.
AME
MedicalJournal3:
30.
DOI:
10.21037/amj.2018.02.07
Teixeira da Silva, J.A. (2018e). Reflection on the Fazlul
Sarkar vs. PubPeer (“John Doe”) case. Science andEngineering
Ethics24(1):
323-325.
DOI:
10.1007/s11948-016-9863-1
Teixeira da Silva, J.A., Dobránszki, J. (2018) Editors
moving forward: stick to academic basics, maximize
transparency and respect, and enforce the rules.
Recenti Progressi in Medicina 109(5): 263-266. DOI:
10.1701/2902.29244
Teixeira da Silva, J.A., Dobránszki, J., Al-Khatib, A. (2016)
Legends in science: from boom to bust. Publishing
Research
Quarterly
32(4):
313-318.
DOI:
10.1007/s12109-016-9476-1
Teixeira da Silva, J.A., Shaughnessy, M.F. (2017) Aninterview with Jaime A. Teixeira da Silva: insight into
improving the efficiency of the publication process.
North American Journal of Psychology 19(2): 325-338.

Silence in Violence: A curse or a
Goodwill?
- Afsheen Amir Ali Hirani
The Aga Khan University Hospital
Email: afsheen.hirani@aku.edu- Nasreen Rafiq; Shyrose Sultan; Zainish Hajani;
Samreen Siraj
The Aga Khan University Hospital

Abstract

Healthcare professionals face dilemmas regarding
maintaining and breaching confidentiality while
dealing with victims of sexual violence. The
sensitivity of the cases of violence and the aim toprevent harm generates ambiguity for soundethical and legal decision making. In Pakistan,maintaining silence is often preferred overbreaking the silence. Thus, it is essential to view therisks and benefits of the conflicting positions
keeping in mind the diverse perspectives and thebigger picture. Organizations, community andgovernment can plan different strategies to put an
end to this obscene game of “silence in violence”.
Description of the issue“Ssshhh… Don’t talk about it! It is better to remainsilent!” Sexual violence and intimate partner
violence are always tagged as hush-hushphenomena in Pakistan (Ali & Khan, 2007). A
survey by Human Rights identified thatapproximately 90% of females in Pakistan have
faced some sort of abuse, among which 60% is
related to physical abuse and almost 30% isreported as sexual abuse. However, due to theconservative and patriarchal societal system andlack of proper ethical-legal policies, the victims

109

tend to keep the sexual violence confidential;
therefore, it remains under-reported (Abugideiri,
2010; Pakeeza, 2015). Victims try to mask theoccurrence of sexual violence through other vague
reasons, and if a healthcare professional (HCP)
identifies the case, patients force them to keep it
confidential because of the fear of stigmatizationand lack of socio-legal support (Andersson et al.,2010). However, few of the policies and laws like‘domestic violence bill and prevention of antiwomen practices’ encourage the citizens to reportsuch events (Weiss, 2012). HCPs face dilemma
regardingmaintainingandbreachingconfidentiality of such sensitive events asreasonable ethical decision making is quite
ambiguous in these situations. One of the clinicalscenarios is described below.
A 20 year old female patient was admitted to a
general surgery ward with rectal perforation.
Further examination revealed multiple lacerations
and cuts on her whole body especially on the breast
and abdomen. Her husband said that few days ago
patient fell down in the bathroom so these marks
were due to the traumatic fall. However, on detailed
interaction with the patient, the nurse identified
that it was a case of intimate partner violence
portraying physical as well as sexual abuse. Patient
asked the nurse to keep this information
confidential. The nurse was concerned about thepatient so she shared this with higher authorities.
The management paid no heed and insisted her tofocus on nursing care. The nurse then tried to
advocate for patient’s right by talking with patient’s
mother about it. However, this created a chaos
when patient’s husband came to know about thissituation. He filled the LAMA (Leave Against
Medical Advice) form and discontinued his wife’s
treatment. Moreover, an observation was filled
against that nurse by the management.
The ethical questions that arise from the abovementioned scenario are: Does the duty to warn
supersede the duty to maintain confidentiality ofthe victims? Does patient’s safety override theprinciple of fidelity towards patient? Does
breaching confidentiality rationalize beneficence orinfringe on the principle of non-maleficence? Does
one’s job security outweigh one’s responsibility ofpatient’s advocacy? This paper will reflect on the
scenario from diverse paradigms and findjustifications based on ethical principles andtheories.
Our position
We believe that in the aforementioned scenario andother similar circumstances remaining silent andmaintaining confidentiality is ethically unjustified.
The HCPs should breach the confidentiality in orderto protect the patient from foreseeable preventable

110

Eubios Journal of Asian and International Bioethics 29 (May 2019)

harms and to put an end to this vicious cycle of“maintaining silence and promoting recurrent
violence”.
1) Confidentiality versus duty to warn
Privacy is the basic right of every individual thatallows them to control their personal information,
whereas confidentiality is a branch of informational
privacy that highly demands non-disclosure ofprivate information of patients by the HCPs
(Burkhardt & Nathaniel, 2013). Liberalism theory
also highlights that an individual is unique and is
free to make decisions. Thus, the victims of violence
can unrestrictedly make decisions and take choices
regarding their privacy based on their values andbeliefs, and it would be unethical to disclosepatient’s sensitive information without theirconsent. On the other hand, HCPs are obliged towarn individuals at risk. Thus, for the beneficenceof vulnerable population, it is necessary to breachconfidentiality (Burkhardt & Nathaniel, 2013). For
instance, in this scenario, not warning the family
members and the victims about the future risks
could lead to more incidences of sexual violence,
unstoppable harm and even the incidences of incestby the abuser. Duty to warn is based on two factors:(i) Potential threat (ii) Potential victims. In the
scenario, both factors are foreseeable; therefore,
breaching confidentiality is also justified.
The consequence of our position: Universal
Declaration of Human Rights (1948) and theconstitution of Pakistan (1973) clearly affirm thatevery individual’s decision should be respected andthey should be protected from undignified actions.
Patient’s ability to maintain privacy is anexpression of autonomy, which safeguards theirdignity (Beauchamp & Childress, 2013); breach inconfidentiality of these victims may question thecorresponding virtue of respectfulness. It may leadto stigmatization and loss of social relationships
due to the taboo attached to sexual violence.
Counter argument for justification: In Pakistaniculture, people live in extended families; thus theincidences of intimate partner violence not only
affects the primary victim but also threatens thephysical, social, emotional and mental state of otherpeople in the family including children and elderly
people (Ali, Asad, Mogren & Krantz, 2011; Widom &Wilson, 2015). Hence, dignities of all other family
members’ precious lives are under control of asingle perpetrator. Utilitarianism theory assertsthat maximum benefit (happiness) for maximum
people is always at an upper hand than an
individual’s priority. It clearly justifies breaching
confidentiality of a sexual violence case in order towarn a larger group of people at risk to prevent
recurrent harm (Beauchamp & Childress, 2013).

2) Fidelity versus patients’ safety
Confidentiality is one of the key aspects of patients’care mentioned in both the Hippocratic Oath andthe Nightingale’s pledge (Beauchamp & Childress,2013). Thus, obligations of fidelity arise once an
HCP builds a therapeutic relationship with a patient.
Victims of violence are highly distressed; therefore,
the role of HCPs is very crucial to rebuild their trust
and to provide psychosocial support to them. Thiscan be accomplished when the HCPs show
trustworthiness by maintaining confidentiality. In
contrary, HCPs are obliged to ensure patients’safety for patients’ beneficence. The argument ofmaintaining strict confidentiality could bequestioned based upon the probability andmagnitude of a preventable harm. According to risk
assessment criteria cited in Beauchamp andChildress (2013), if the probability of harm is highand the magnitude is major, then confidentiality
could be breached (refer to appendix 1). In the casescenario, there was a high probability that patient
could get abused physically and sexually aftergetting discharged from the hospital which could
result in recurrent major psychological, physicaland emotional harms, hence, confidentiality should
be breached.
Consequence of our position: Breaching
confidentiality could break the fiduciary
relationship between HCP and a patient (Burkhardt& Nathaniel, 2013). Thus, the overall system of
medical confidentiality and fidelity could geteroded. Hence, victims of sexual violence would
never disclose sensitive information and would
never opt for treatment despite the medical
emergencies caused by violence (Ali & Khan, 2007).
Furthermore, defying fidelity could also infringe on
the principle of non-maleficence by creating an
additional threat to the already compromised
emotional and psychological well-being of thevictim.
Counter argument for justification: Overriding
fidelity may serve as a short-term source ofmaleficence for the patient; however, taking actions
for beneficence may prevent harm and promote
good for a long run. Females in Pakistan are
financially and physically dependent on theirhusbands; therefore, the probability of recurrent
violence is very high (Chatha, Ahmad & Sheikh,2014). Islam also refers to sexual violence andintimate partner violence as “Zina and infliction ofharm” respectively, and guides us to take actions tosave one’s life (Abugideiri, 2010). Hence, breaching
confidentiality for the victim’s beneficence may
prevent the victim from life-long recurrent physical,
psycho-social and emotional harms caused byEubios Journal of Asian and International Bioethics 29 (May 2019)
intimate partner violence, and it could also reducethe burden of hospital re-admissions. Thus, theprinciple of beneficence outweighs the duty to keeppromises in this situation.

111

treatment. Likewise, the abuser may threaten the
HCP who reported the incidence of sexual abuse.
Therefore, safety of the HCP is equally important asof the patient.
Aaaaa3) Job security versus patient’s advocacy
Moral standards are of two types. Ordinary moral
standards are the obligations of common moralitythat pertain to every HCP working in an
organization, whereas extraordinary moral
standards are the supererogatory acts that are
performed by the HCPs who aspire to achievemoral ideals altruistically (Beauchamp & Childress,2013). Unfortunately, the institutes and thehealthcare systems in Pakistan are not flourishedenough to demarcate the fine line between
obligations, ordinary moral standards and moral
ideals (Syed,2012). The hospital-based policies andtop management force HCPs to just stick to their
obligations and criticize them to perform
supererogatory acts at times and vice versa. In ourhealthcare system, job description confines nurses
to routine care activities and prohibits them fromindulging in legal and personal matters like sexual
violence. In the case scenario, although the nurse
was criticized by the management, she altruisticallyadvocated for the patient by going against thepolicies of the organization. Consequently, anobservation was filled against her. Thus, thesetypes of repercussions compel HCP to think about
their job security and associated personalconsequences
ratherthan
performing
supererogatory tasks for patients’ benefit.
In contrast, Kantianism theory emphasizes onrationales and reasons of an act rather than relying
purely on consequences. Kant believes that an
HCP’s actions depend on his/her maxims that canbe justified through categorical imperatives(Beauchamp & Childress, 2013). If HCPs do not
advocate for their patient in order to save their job,then, do those HCPs believe that someone would
advocate or care for them when they are in need?
Will those HCPs presume that somebody would act
to prevent them from foreseeable harm? Obviously
not! Hence, advocacy should be given priority overpersonal means.
Aaaaa
Consequence of our position: There is a threat tojob security of HCPs because of unclear job
descriptions and obligations. Due to therepercussions faced by the nurse in the scenario,
nobody would take charge to talk about such issues
in healthcare when faced with similar situations.
Moreover, due to lack of ethical and medico-legal
policies in an institution as in the mentioned casescenario, the abuser may deny the truth and may
show his/her dominancy over the victim. As in this
scenario, the husband discontinued his wife’s

Counterargument for justification: It can be
deduced that HCPs prefer to remain silent due toorganizational constraints and lack of policies.
Hence, it is an organizational issue rather than
HCP’s fault. However, advocacy for the victims ofsexual violence is one of the fundamental duties
which lie within the holistic care model of nursepatient therapeutic relationship and it is an act thatcan easily become a universal imperative as per
Kant (Burkhardt & Nathaniel, 2013). Thus, in thiscase advocating for the patient is justified as it isembedded in nursing and medical ethics. Hence, theapplication of Kantian ethics vindicates that it isunethical to remain silent over preventable harmful
conditions for patients.
Recommendations for implementation
According to WHO’s world report on sexual
violence (n.d.), the following interventions could be
strategized at organizational, community andgovernmental levels. Organizations must work in a
coherent way so that patients and HCPs both cantrust the system; therefore, hospitals must develop
an ethics committee that should solve medico-legal
and ethical issues. All HCPs should be trained to
identify the potential cases of violence, to assess thevictims and to handle these situations in a sensitive
yet effective manner. This should be included in thenursing and medical curriculum as well. Besides,
hospitals should have “sexual violence evidence kits”
that include instructions for collecting medico-legal
evidence and legal forms for proper documentation.
Furthermore, a trio approach should be consideredwhen dealing with victims. This includes
emergency care nurse/doctor, hospital ethics
committee and psychologist. Victims must be
counseled regarding potential harm and the ways
to deal with a situation. Moreover, hospitals must
collaborate with legal authorities so that legal
proceedings could be done against the perpetrator.
Additionally, rather than criticizing, the institution
must appreciate the HCPs who advocate for victimsof abuse and organizations should provide job
security and safety to its employees too.
At the community level, community-based
projects should be run to empower victims. Lifeskills and other educational programmes should beinitiated and men should be involved in suchactivities to support women. The stigma attached to
the victims can be erased via community-based
theatres, debates, public meetings and media.
Community health nurses could propose psychosocial support programs and referrals for the112

Eubios Journal of Asian and International Bioethics 29 (May 2019)

patients. Additionally, centers for providing
comprehensive care to the victims could beestablished. Also, a helpline number could beinitiated, where a victim can anonymously ask forhelp and opt for further guidance. Besides,
exploratory researches should be done to dig out
culturally sensitive solutions and to planinterventions accordingly.
Government must make strict laws and reforms
for reporting abuse and must provide assistanceand support to the victims. The sensitivity andspeed of processing of sexual violence cases shouldbe improved in the courts. Moreover, government
based legal authorities should be linked with eachand every hospital and it should consist of men andwomen both, so that victims could approach themaccording to their comfort and feasibility.
Additionally, media should be discouraged todisclose the confidentiality of the victims for thesake of generating breaking news; however,perpetrators should be exposed. Furthermore,
media should raise awareness regarding existing
policies formed by the government such as “law forprotection of women and a domestic violence bill”.
Last but not the least, the government should
ensure the rigorous implementation of thesepolicies and programs.

Conclusion

Variousethical,legal,
andsociocultural
perspectives create a dilemma for HCPs dealing
with victims of sexual violence. The sensitivity of
the cases of violence and the aim to prevent harm
generates ambiguity for sound ethical and legal
decision making. Thus, it is essential to view therisks and benefits of conflicting situations keeping
in mind the diverse perspectives and the bigger
picture. Organizations, community and government
play an important role in providing social, financial,
psychological and legal support to the victims,
erasing the stigma of being a victim and providing
job security to the HCPs in order to put an end to
this obscene game of “silence in violence”.

References

Abugideiri, S. (2014). A perspective on domestic violencein the Muslim community. Faith Trust Institute, 6(11),2014.
Ali, T. S., Asad, N., Mogren, I., & Krantz, G. (2011).
Intimate partner violence in urban Pakistan:prevalence, frequency, and risk factors. International
Journal of Women's Health, 3(1), 105.
Ali, T. S., & Khan, N. (2007). Strategies andrecommendations for prevention and control ofdomestic violence against women in Pakistan. Journalof Pakistan Medical Association, 57(1), 27-32.
Andersson, N., Cockcroft, A., Ansari, U., Omer, K., Ansari,
N. M., Khan, A., & Chaudhry, U. U. (2010). Barriers todisclosing and reporting violence among women in

Pakistan: findings from a national household survey
and focus group discussions. Journal of Interpersonal
Violence, 25(11), 1965-1985.
Aumir, Z. (2016). Domestic violence In Pakistan: Is
legislation available? The Law, 1(1), 347-349.
Beauchamp, T., & Childress, J. (2013). Principles ofbiomedical ethics, (7th ed.). New York, NY: Oxford
University Press.
Burkhardt, M. A., & Nathaniel, A. (2013). Ethics and issues
in contemporary nursing, (4th ed.). Delmar, Austrailia:
Nelson Education.
Chatha, S. A., Ahmad, K., & Sheikh, K. S. (2014). Socioeconomic status and domestic violence: A Study on
Married Women in Urban Lahore, Pakistan. South
Asian Studies, 29(1), 229.
Pakeeza, S. (2015). Domestic violence laws and practices
in Pakistan. Transactions on Education and Social
Sciences, 6(1), 17-20.
Syed, A. (2012). Decline of moral values. Daily Times.
Retrievedfromhttps://dailytimes.com.pk/109500/decline-of-moralvalues/
UnitedNations(1948).
Universal
https://dailytimes.com.pk/109500/decline-of-moralvalues/declaration of human rights (pp.1-4). UnitedStates: UN General Assembly.
Weiss, A. M. (2012). Moving forward with the legal
empowerment of women in Pakistan (pp. 1-12). UnitedStates: US Institute of Peace.
WHO. (n.d.). World report on violence and health: Sexual
violence (pp. 149-173). Geneva, Switzerland: World
Health Organization.
Widom, C. S., & Wilson, H. W. (2015). Intergenerationaltransmission of violence. In J. Lindert & I. Levav,
Violence and mental health (2nd ed., pp. 27-45).
Switzerland, Dordrecht: Springer Link.

EJAIB Editor:
Darryl Macer (Chair,
Sovereign Nations)

Accredited

Universities

of

Associate Editor:
Nader Ghotb (Ritsumeikan Asia Pacific University(APU))

Editorial Board: Akira Akabayashi (Japan), Sahin Aksoy(Turkey), Martha Marcela Rodriguez-Alanis (Mexico),Angeles Tan Alora (Philippines), Atsushi Asai (Japan),
Alireza Bagheri (Iran), Gerhold Becker (Germany), Rhyddhi
Chakraborty (India/UK), Shamima Lasker (Bangladesh),
Minakshi Bhardwaj (UK), Christian Byk (IALES; France), Ken
Daniels (New Zealand), Ole Doering (Germany),
Amarbayasgalan Dorjderem (Mongolia), Hasan Erbay(Turkey), Soraj Hongladarom (Thailand), Dena Hsin
(Taiwan), Rihito Kimura (Japan), Abby Lippman (Canada),
Umar Jenie (Indonesia), Nobuko Yasuhara Macer (Japan),
Masahiro Morioka (Japan), Anwar Nasim (Pakistan), JingBao Nie (China, New Zealand), Pinit Ratanakul (Thailand),Qiu Ren Zong (China), Hyakudai Sakamoto (Japan), Sangyong Song (Republic of Korea), Takao Takahashi (Japan),
Noritoshi Tanida (Japan), Ananya Tritipthumrongchok(Thailand), Yanguang Wang (China), Daniel Wikler (USA),
Jeong Ro Yoon (Republic of Korea).

Eubios Journal of Asian and International Bioethics 29 (May 2019)

Istanbul Communiqué on Looking
Beyond Disaster 2019
1. We, citizens of all creeds, races and disciplines
from disaster-affected nations in Europe, Asia, theAmericas, Africa and the Pacific, gathered on 12-16
April 2019 in Istanbul, Turkey, at the Tenth Youth
Looking Beyond Disaster Workshop (LBD10):
Ethical Disaster Resilience for our Global
Community, organised by Beşikçizade Center for
Medical Humanities (BETİM), Eubios Ethics
Institute, American University of Sovereign Nations,
Youth Looking Beyond Disaster; Youth Peace
Ambassadors International and other partners.
2. Recognizing the increasing impact of natural andhuman-caused disasters, and their complexity inmany parts of the world, we declare ourdetermination to enhance our efforts to strengthen
disaster risk reduction to reduce losses fromdisasters worldwide.
3. We express our solidarity with the people ofChristchurch, New Zealand and all across the world
who lost their lives and loved ones on 15 March
2019, and were affected by the terrorist attack on
persons praying in mosques. Senseless terrorist
attacks against persons of all faiths, religions, andideologies, are human-made disasters that
contradict the love of life. We need to ensure
education and social maturity that embraces all
persons in love and peace as members of local
communities and the global community. We
applaud the swift responses by government andcitizens in New Zealand to overcome the hatred,
and we support the project of Legacies of Love,
Peace and Hope.44 We choose the politics of loveover the politics of hate.
4. The inhumane terrorist attack on the Al Noor
Mosque and Linwood Mosque communities inChristchurch, New Zealand, caused 50 people to be
killed. This unfortunate event deeply saddened theconscientious people all over the world. We believethat in the face of such an event, everyone who hasa share of human dignity, regardless of their faith,nationality and ethnicity, should take a standagainst terrorism, racism and social discrimination.
5. Calling the perpetrator of this appalling attack as
simply “a lone wolf” or ”psychopath” does not only
lead to ignore the context in which action takes
place, but also neglects the fascist, racist and113

Islamophobic discourses and attitudes, which are
increasing day by day all over the world, West andEast, South and North. Also, this attitude causes theattacker to be freed from his responsibility or to
moralize his action on an individual basis. However,
it is not possible to solve the problem without
taking a stand on the rhetoric and social dynamics
that terrorism and racism feed on. In this respect,
we must raise our voices against the growing
fascism and anti-Islamic rhetoric by focusing ourattention on the ground where the issue isnourished, and we should come out against and put
an end to all these subversive ideologies andactions.
6. The participants of the workshop express theirsolidarity with the victims of ongoing disasters at
the time of this workshop, such as the devastating
floods in Iran, and all other disasters that afflict
every nation of the world. We reinforce thestatement in the Sendai communique on the
responsibility of the media to accurately and openly
report disasters in all parts of the world.
7. When faced with disasters, youth are proactive
agents of change for rebuilding their communities
worldwide. After exclusion as a stakeholder fromthe Hyogo Framework for Action 2005-2015:
Building the Resilience of Nations and Communities
to Disasters45 during the past 10 years, we highlightthat youth have since 2011:a. shared their disaster experiences as part of
Looking Beyond Disaster (LBD) 46 , a series ofinternational youth fora held at various locations in
the Pacific, Asia, America and Europe, including:§ LBD1 Christchurch 2011
§ LBD2 Sendai 2012
§ LBD Auckland 2012
§ LBD3 Kobe 2013
§ LBD Padang 2013
§ LBD4 Manila 2014
§ LBD5 Yogyakarta 2014
§ LBD6 Arizona 2015
§ LBD Vanuatu 2015
§ LBD7. Kathmandu, 2015
§ LBD8. Bangkok, 2016
§ LBD9. Kumamoto, 2017
§ LBD10. Istanbul, 2019;b. declared their commitment to disaster risk
reduction in the Christchurch Communique 2011
and Sendai Communique 2012 produced at LBD
fora*, which were used in the Sendai Framework
45

44

http://www.eubios.info/legacies_of_love_peace_and_hopehttp://www.unisdr.org/2005/wcdr/intergover/officialdoc/L-docs/Hyogo-framework-for-action-english.pdf
46 http://www.eubios.info/looking_beyond_disaster114

Eubios Journal of Asian and International Bioethics 29 (May 2019)for Disaster Risk Reduction 2015-2030 preparatory
process from July 2014 to March 201547; andc. created international, interdisciplinary, andintercultural action plans at LBD fora*.
8. Taking into account the heavy disaster losses
suffered within that same 10 year period*, we value
the inclusion of youth in the Sendai Framework for
Disaster Risk Reduction 2015-2030 (Sendai
Framework). Youth and all people are committed tothe implementation of the Sendai Framework toenhance all efforts for the future. Specifically, we
agree that:a. Governments should engage with youth indesigning and the implementation of policies, plans
and standards, in accordance with section 7 (of the
Sendai Framework).
b. An age perspective should be integrated in allpolicies and practices and youth leadership should
be promoted, in accordance with section 19d.
c. Youth are agents of change and should be given
the space and modalities to contribute to disasterrisk reduction, in accordance with section 36aii.
9. We are aware that implementation of the Sendai
Framework depends on our unceasing and tirelesscollective efforts to strengthen resilience to hazards
for the benefit of the present and future
generations. To this end, we believe that
implementation of the Christchurch Communique
2011, Sendai Communique 2012, and the Sendai
Framework for Disaster Risk Reduction 2015-2030
can only be achieved with the full and meaningful
engagement of young people.
10. We consider that LBD needs a continuingcommitment from all stakeholders, working
together, to provide visible ongoing mentoring,financial and monitoring support for action plans
related to policy-making, practical action in disasterprevention and recovery, and sustaining andincreasing
innovative
youth
engagement
in reducing disaster losses. We welcome allpartners and stakeholders to achieve this full andmeaningful engagement of young people throughthe ethos of LBD, including all LBD alumni and LBD
Ambassadors.
11. Community resources and educational degrees
and programs for ethical disaster risk reduction,
can provide a safe ‘space’ for people to share theirdisaster experiences and LBD action plans provide‘modalities’ for meaningful contributions to
disaster risk reduction, in accordance with section
36 a ii of the Sendai Framework.

47 http://www.wcdrr.org/preparatory/prepcom1

12. We call upon all stakeholders to make a lifetime commitment to support the role of youth ascontributors to DRR, through annual budget
allowances which will:i. enable youth experiences of disaster to be shared
at regular LBD fora held at various locations
globally;ii. ensure work-to-date on LBD action plans are
documented,
madeaccessible
toyouthinternationally and online, and advanced further.
3b. Support the inclusive global LBD governancestructure:48
i. empower any party wishing to use the LBD,AUSN 49 and other resources at any locationworldwide;ii. provide on-going mentoring, financial supportand monitoring for implementation of LBD actionplans;
iii. catalyse a coherent global movement of young
people in DRR through a community of practice.
13. We thank all individuals and organizations
involved in all LBD fora from the first in
Christchurch to the tenth in Istanbul for theircommitment to youth and advancing disaster risk
reduction in the global development agenda.
14. All persons of every specialty have animperative to be engaged in disaster response andcollective action responses.
a. Recognizing the commitment of youth, andcontinued call for recognition at the highest
Governmental and International level, forcollective action responses on disaster,b. Recognizing the imperative to engage youth,
to avoid their disenfranchisement in a
warming, and more disaster prone world,c. Recognizing the need to train, develop andnurture the development of leaders in
disaster response and risk management,
15. Humanitarian relief from disasters should
never be subject to restrictions because of
sanctions that impede the ability of a community,
and those from outside the community who areinvited to offer humanitarian assistance. Politics
should not sacrifice the lives of persons living withdisasters, and wars that lead to loss of lives are
disasters and crimes against humanity.
16. We make the following recommendations tothat effect:a. Support nascent youth engagement andinterest in disaster risk recovery.

48 http://www.eubios.info/youth_ambassadors

49 http://www.ausn.info and http://www.eubios.info

Eubios Journal of Asian and International Bioethics 29 (May 2019)b. Build capacity for youth, including training
programs, mentoring opportunities to ensure youth
engages in a responsible and sustainable way.
c. Involve such trained youth in all policy
making and evaluation of its implementation.
d. Work together to develop and implement
global educational degrees and courses to build up
the capacity and resilience of societies to prevent
disasters, and to recover from them.
e. We, as BETİM based in İstanbul and Eubios
Ethics Institute based in Christchurch, condemn theabomination cited above that coincides with our
joint organization of the LBD10 forum. We also notethe recent signing of a Memorandum of Agreement
between the Turkish Red Crescent Association and
New Zealand Red Cross. We hope that thismeaningful workshop organized by institutes fromboth countries, and attended by persons from all
inhabited continents of the world, will promote thedeep understanding of how we need to construct a
global society based on love and coexistence of all
people in the world in harmony with human dignity.
For further information please contact: Email:darryl@eubios.info; tayyibe.b@gmail.com

115

For forthcoming conferences see: www.eubios.info
Email to Darryl@eubios.info.

We are all shocked and heart broken by theterrorist attack against worshippers in Mosques in
our hometown, Christchurch, New Zealand. We
invite contributions for a new book from Eubios
Ethics Institute: Legacies of Love, Peace andHope: How Education can overcome Hatred andDivide. The number of contributors will equal thedeathtoll of the hateful senseless massacre that
occured on 15 March 2019. This is counter to thedecades of work for intercultural dialogue all
around the world and reflection on a good life forall - the very reasons we were founded to achieve.
For contributions in writing please submit yourwriting, up to 5,000 words in English. Anyone cancontribute, no matter what your age, gender or
nationality. For those who would like to submit avideo presentation or other memorial, the Legacies
project will also have a playlist on the website of
the American University of Sovereign Nations(AUSN) youtube channel.
Please email to Prof. Darryl Macer,
Email: darryl@eubios.info

https://www.eubios.info/legacies_of_love_peace_and_hope

ASIAN BIOETHICS ASSOCIATIONMEMBERSHIP 2019and 2019 subscription to Eubios Journal of
Asian and International Bioethics (EJAIB)____ I wish to pay my annual membership fees of Asian Bioethics Association (ABA), and receive the 2019
issues of Eubios Journal of Asian and International Bioethics (EJAIB) (The Official Journal).
____ Regular Price: US$80 Euro 60 ¥9000 (=Credit card price NZ$100)____ I wish to make a reduced contribution of____ I wish to register as a member of Asian Bioethics Association, but am not in the position to pay a fee. I
understand that I should be satisfied with Internet access to Eubios Journal of Asian and International
Bioethics (EJAIB) <http://eubios.info/EJAIB.htm>.
____ I wish to make a donation to Eubios Ethics Institute of ________ Exchange subscription with journal, newsletter, etc. (Name____________________ )____ I agree / ____ do not agree to my name being listed on the ABA www site
List Research Interests to be included:
Post or send an E-mail with your address* (or include current address label)
To: E-mail: asianbioethics@yahoo.co.nz
Please charge my VISA / MASTERCARD card (circle) for NZ$________
Account #Expiry Date

Signature

Name:*Mailing address:
E-mail:Web site: <http://eubios.info/ABA.htm>

116

Eubios Journal of Asian and International Bioethics 29 (May 2019)

Eubios Ethics Institute Publications (Books sent by SAL post, Journal by Airmail - Price included)
Eubios Journal of Asian and International Bioethics (Annual subscription)
NZ$100
Shaping Genes: Ethics, Law and Science of Using Genetic Technology in Medicine and Agriculture
by Darryl Macer, Oct. 1990, 421pp.
NZ$50
Equitable Patent Protection in the Developing World
by William Lesser, May 1991, 150pp.
NZ$40
Attitudes to Genetic Engineering: Japanese and International Comparisons (Bilingual)by Darryl Macer, May 1992 330pp.
NZ$40
Human Genome Research & Society
Eds: Norio Fujiki & Darryl R.J. Macer July 1992
ISBN 0-908897-03-0 (English), 230pp. ISBN 0-908897-04-9 (Japanese), 240pp.
NZ$40
Intractable Neurological Disorders, Human Genome Research and Society Eds: N. Fujiki & D. Macer
Feb. 1994 ISBN 0-908897-06-5 (English), 320pp. ISBN 0-908897-07-3 (Japanese), 340pp.
NZ$40
Bioethics for the People by the People by Darryl Macer,... May 1994 ISBN 0-908897-05-7, 460pp.
NZ$50
Bioethics in High Schools in Australia, Japan and New Zealand, by D.Macer, Y.Asada,
M.Tsuzuki, S.Akiyama, & N.Y.Macer March 1996, ISBN 0-908897-08-1, 200pp.(A4)
NZ$50
Protection of the Human Genome and Scientific Responsibility (English and Japanese Bilingual)
Editors: Michio Okamoto, Norio Fujiki & D.R.J. Macer, April 1996, ISBN 0-908897-09-X, 210pp.
NZ$40
Bioethics in India Eds: Jayapaul Azariah, Hilda Azariah & Darryl R.J. Macer
June 1998 ISBN 0-908897-10-3, (includes 115 papers) 403 pp. (Printed in India)
NZ$60
Bioethics is Love of Life: An alternative textbook by Darryl Macer, July 1998 ISBN 0-908897-13-8,
152pp. (Note 2nd edition published on iTunes Store as an iBook in 2015)
NZ$40
Bioethics in Asia Eds: Norio Fujiki & Darryl R.J. Macer, (includes 118 papers from Nov.1997
conferences, ABC’97 Kobe and Fukui Satellite) June 1998 ISBN 0-908897-12-X, 478 pp.
October 1999 ISBN 0-908897-14-6 (Japanese), 320pp.
NZ$50
Ethical Challenges as we approach the end of the Human Genome Project
Editor: Darryl Macer, April 2000 ISBN 0-908897-15-4, 124pp.
NZ$40
Bioethics Education in Japanese High Schools (in Japanese only)
Editor: Darryl MacerApril 2000 ISBN 0-908897-16-2, 112pp.
NZ$40
Bioethics and the Impact of Human Genome Research in the 21st Century
Eds: Norio Fujiki, Masakatsu Sudo, & D.R.J. Macer March 2001 (English and Japanese bilingual, 350pp).NZ$50
Bioethics in Asia in the 21st Century
Eds: Song Sang-yong, Koo Young-Mo & Darryl R.J. Macer
August 2003 ISBN 0-908897-19-7, 450pp.
NZ$50
Challenges for Bioethics from Asia Ed: Darryl R.J. Macer
November 2004 ISBN 0-908897-22-7 656 pp.
NZ$70
A Cross Cultural Introduction to Bioethics, Editor: Darryl Macer 2006, 300pp. (A4)
NZ$50
(Note 2nd edition published on iTunes Store as an iBook in 2015)
Bioethics in Iran, Editor: Alireza Bagheri, 2014. ISBN 978-0-908897-25-4 262 pp.
NZ$50
Bioscience Ethics Education Curriculum for Pre-Schoolers to Elementary Age Children,
Irina Pollard and Amara Zintgraff,. 2017 ISBN 978-0-908897-28-5, 60pp. (A4)
NZ$50
Getting Along: The Wild, Wacky World of Human Relationship, Laura R. Ramnarace 2017
ISBN 978-0-908897-29-2, 73pp. (A4)
NZ$50
Most Books can be downloaded for free online at www.eubios.info
Please charge my VISA / MASTERCARD card for NZ$
Account #Expiry Date
Signature
Name:
Date (D/M/Y)
Mailing address:
Email:
Research Interests (for Network)
Email this order page/details to asianbioethics@yahoo.co.nz

Education for All People – We offer the best of every tradition! You can start any week, with atailor-made and flexible residential or combination hybrid mixture of in-person classes and workshops held all around theworld, and/or on-line group skype classes and/or video. Share perspectives of over a hundred students with a hundredfaculty from over 40 countries, and study in different countries. We celebrate learning from every culture and every discipline!
Students proceed at their own pace to suit their own life!

American University of Sovereign Nations
•
•
•
•
•
•
•
•
•
•

(https://ausovereignnations.org)
Ph.D. in Bioethics, Sustainability and Global Public President: Professor Darryl Macer
Health• Ph.D. from University of Cambridge, UK• Former UNESCO Regional Adviser
Masters in Public Health (MPH)• From Aotearoa / New Zealand
Masters in Bioethics and Global Public Health (MBGPH)• Professor of Bioethics and Biochemistry since
Masters in Business Administration (MBA)1990, University of Tsukuba and University of
Kumamoto, Japan.
Masters in Healthcare Administration• Authored and edited 50 books and 300
Masters of Science and Technology for Sustainability
papers(MS)
Master of Science in Sustainability, Peace & Join us! We are looking forpartnerships to decolonize education!
Development
Master of Arts in Leadership, Wisdom and Resilience AUSN has students/alumni from Australia,
Belgium, Bangladesh, Cambodia, Cameroon,(MA)
Canada, Chile, China, Congo, Egypt, Ethiopia,
Postgraduate Certificate in Community & Peace [and Germany, India, Indonesia, Iraq, Iran, Japan,
Laos, Malawi, Malaysia, Mexico, Mozambique,others]Myanmar, Nepal, New Zealand, Nigeria,
Tailor-made educational and exchange programs
Pakistan, theOur faculty include leaders from academia, the business world, policy makers andIndigenous leaders. Free subscription to our youtube channel where you can see hundredsof lectures. All our one hundred alumni have a job!
AUSN has over 30 cooperation agreements with Universities and Academic Centers of
Excellence around the world, and provides educational and consulting services.

Email: provost@ausn.info

Philippines, Rwanda,
Singapore, South
Africa, Spain,
Tanzania, Thailand,
Turkey, Uganda,
USA, Vietnam,
Yemen, Zimbabwe...