Eubios Journal of Asian andInternational Bioethics
EJAIB Vol. 24 (6) November 2014www.eubios.info ISSN 1173-2571
Official Journal of the Asian Bioethics Association (ABA)
Copyright ©2014 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

Abstract Bookth
15 Asian Bioethics
Conference (ABC 15)
1-9 November 2014
Venue: Ritsumeikan Asia Pacific University (APU),
Beppu; and Kumamoto University, Japan. Organized by1
the Asian Bioethics Association (ABA) , Ritsumeikan Asia
Pacific University (APU), Kumamoto University, Eubios Ethics
Institute & American University of Sovereign Nations (AUSN).

Saturday, 1 November2
12th Asia-Pacific Conference: Ethics,
Human Security and Sustainability:
Knowledge & Practices in Asia PacificstVenue from 1 – 3rd: Building FⅡ (Classrooms), 1-1
Jumonjibaru, Beppu, Oita 874-8577 Japan

Session 1: Bioethics Beyond Borders
Words of Welcome
Prof. Nader Ghotbi, Director, Ritsumeikan Center for Asia
Pacific Studies (RCAPS); Professor, Ritsumeikan Asia Pacific
University (APU), Japan

Ethics, Human Security and Sustainability:
Knowledge & Practices in Asia PacificProf. Francisco Jr. Fellizar, APU Vice-President of Research

Fifteen Asian Bioethics Conferences and theEmergence of the AUSN Masters in Bioethics andGlobal Public HealthProf. Darryl Macer, Provost, American University of Sovereign
Nations, Scottsdale, AZ, USA; Director, Eubios Ethics
Institute; Secretary, Asian Bioethics Association (ABA)
Email: dmacer@au-sn.com
The first Asian Bioethics Association Conference was heldin 1995 in Beijing, and in the past two decades bioethics has
rapidly developed in Asia. The previous conferences have12

http://www.eubios.info/asian_bioethics_assn

1-3 November in Ritsumeikan Asia Pacific University (APU), Beppu
th(concurrent with the 12 Asia-Pacific Conference: Ethics, Human
Security and Sustainability: Knowledge and Practices in Asia
Pacific organized by Ritsumeikan Center for Asia Pacific Studies(RCAPS), Ritsumeikan Asia Pacific University (APU))

been held in China, Japan, Korea, Turkey, Thailand,
Malaysia, Indonesia, India, Iran and Taiwan. The conference
brings together scholars and policy makers from many
disciplines all around the world (beyond just Asia and thePacific) to discuss and deliberate on the latest issues facing
humanity. What is the future of the ABA? In the ABAConstitution:‘Article 2’ (Definitions)In interpreting this Constitution thefollowing definitions shall be used: Bioethics is theinterdisciplinary study of philosophical, ethical, social, legal,
economic, medical, therapeutic, ethnological, religious,
environmental, and other related issues arising from biologicalsciences and technologies, and their applications in humansociety and the biosphere. Asia is the regions, peoples, andcultures which constitute the geographically largest continentof the world.”‘Article 3’ (Objectives)The basic objective of the Association
is to promote scientific research in bioethics in Asia throughopen and international exchanges of ideas among thoseworking in bioethics in various fields of study and different
regions of the world. In order to achieve this end the
Association will encourage the following work and projects:(1) to organize and support international conferences inbioethics in Asia; (2) to assist the development and linkage ofregional organizations for bioethics; (3) to encourage otheracademic and educational work or projects to accomplish
their goals consistent with the objectives of the Association.”

Asian Bioethics Association (ABA) Presidential
Address: Bioethics Beyond Borders: Responding
to Challenges of a Globalized World
Prof. Aamir Jafarey, Asian Bioethics Association (ABA)
President, CBEC, SUIT, Karachi, Pakistan
E-mail: aamirjafarey@gmail.com
Despite obvious differences and divisions on geographic,
religious, ethnic, economic and numerous other grounds, weare all citizens of one world. Ease of travel and inexpensive
communication have shrunk distances and we remaininterconnected in numerous ways. We cannot remain
dissociated with happenings even in the remotest corners of
the globe since they may affect us in ways beyond the limitsof our present vision, making it imperative to embrace thechallenges of this rapidly globalized world.
Bioethics empowers us in many ways to do just that. It
bridges divides and creates a space where the commonalityof issues can be discussed and debated. This is importantsince seemingly regional problems have a global impact.
Poverty, lack of healthcare and illiteracy, although ostensibly
someone else’s problems, can morph into global threats andshould be regarded as global responsibilities.

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

This presentation will use the example of two apparently
local problems, which were neglected for long and now
threaten the world, in their own different ways. Just a few
years ago Polio and Ebola seem to have nothing in common
except that they were infectious diseases that struck the poor,
in remote areas of the world. And now they are headline news
across the world.
The presentation examines ethical issues that haveemerged in the wake of these threats, and the responsibilitiesof the world community towards tackling them.
In a globalized world, burdens need to be shared. Our
efforts to mitigate suffering should not surface only whenthings spiral out of control, but much before that, to mitigate
their occurrence in the first place.

Session 2: Public Health & Medical Ethics
Public responsibility in healthcareProf. Shamina Lasker, Dhaka, Bangladesh, ABA VicePresident for South Asia; General Secretary, Bangladesh
Bioethics Society
E-mail: splasker04@yahoo.com
Health is a basic human right. It is the moral obligation of
the society to ensure the access of everyone to some level ofhealth care services necessary for living, functioning normallyand pursuing life activities. Traditionally, patients are usually
not held responsible for having a role in causation of theirillness. When a person becomes ill, medical treatment implies
that patients cannot be blamed for their condition. But if theindividual choices have been unhealthy, if an individual
remains uninfluenced by health education, and suffers ahealth problem due to his unhealthy life style or risky
behavior, some legal and financial repercussions may apply
and be justified. Examples include a drunk driver causing an
accident, a smoker getting lung cancer, or suffering heart
attack because of serious over weight, liver disease causedby alcohol consumption, AIDS because of unsafe sexual
activity, etc. Since the person plays a major role in in thecausation of the medical problem, he/she may be held
legally/financially responsible for the consequence of
unhealthy and risky behavior to the public. This is especiallytrue because of the use of advanced technology incontemporary health care which offers sophisticated andexpensive therapeutic options. A political dialogue may beneeded over the moral and ethical issues.

Bioethics of pharmaceutical services in Indonesia
Prof. Umar Anggara Jenie, Indonesia’s National Bioethics
Commission (KBN); Indonesia; ABA Vice President forIndonesia
E-mail: umar.anggara.jenie@mail.lipi.go.id
Public pharmacists are health services professional, andsince 1975, pharmacists are required by the Indonesian
Government to provide information to patients regardingprescriptive as well as over the counter (OTC) medicines.
Before 1975, only the doctors could provide drug- information
to the patients and the pharmacists’ duty was only to prepareand dispense the doctors’ prescriptions. After nearly 40 year,
the relation between pharmacists and patients has become
more and more complex. Patients have been eager to know
about drugs/medicines they get from their doctors, asking
questions about pharmacological effects, adverse reactions,the cost of the medicines, possible less expensive substitutes
for medicines, etc. The relationship between pharmacists andpatients could be built up using ethical principles similar to therelation between doctors and patients. Beauchamp andChildress (1994) have proposed four principles of medical
bioethics, known as prima facie. The principles include (1)Autonomy (respect to patient autonomy), (2) Beneficence(effect cure), (3) Non-maleficence (cause no harm), and (4)Justice. These four bioethical principles (prima facie) could
also be adopted by pharmacal professionals in relation withpatients. Moreover, some ethical principles in the Universal
Declaration on Bioethics and Human Rights (2005), such as
principles of human dignity and human rights, benefit andharm, autonomy and individual responsibility, nondiscrimination and non-stigmatization, etc. could be adopted
in building up ethical principles in the pharmacist-patient
relationship.

Spirituality and science; is there a conflict?
Prof. Nader Ghotbi,
Graduate School of Asia Pacific Studies, Ritsumeikan
Asia Pacific University (APU), Beppu city, Oita, Japan
E-mail: nader@apu.ac.jp
Bioethics is a discipline that connects science withhuman values; it emphasizes on the benefits of scienceand pushes for their applications that are acceptablewithin the values of people. People get their values
from their cultures and traditions, and religious
traditions play a large role in the formation of humanvalues, though there are other sources for traditions
besides formalized religions. A common andunfortunately
growing
misunderstandingincontemporary societies is that a belief in religion and
God is contrary to science and/or rational thinking. In
this presentation, I shall use a number of arguments to
explain why science and religion/spirituality are notcontradictory. I will also explain how a belief in any of anumber of religions provides the basis for ‘spiritual
health’ among the majority of humans, and trying totake the spirituality away can be the most un-scientificthing to do. The definition of ‘health’ includes spiritual
health as an important dimension of human health. In
this paper there are references to the Big Bang theory
in relation with the origin of the universe, as well as thetheory of evolution through natural selection andresearch on the probability of spontaneous generationof life in its simplest form. But more importantly thefields of science and spirituality are examined,
particularly in areas they may overlap and areas they
are completely separate; and the benefits of spirituality
on individual health, social culture and traditions aredescribed.

Cross-cultural bioethics: Western and Hindu
philosophical traditions
Prof. Sivanandam Panneerselvam
Department of Philosophy, University of Madras, India
E-mail: sipasel@rediffmail.com
Respect to life is emphasized by cross-cultural bioethicaltheorists. For example in the West, Leopold argues in favor ofa land ethic, which includes soil, water, plants and animals orcollectively, the land. Leopold thus demonstrates a shift fromhuman to nature. The contemporary approach is an extensionof environmental aesthetics to plants, animals and nature.
Animal rights philosophers like Peter Singer and ‘deep
ecologists’ like Arne Naess and Warwick Fox represent sucha concept. Philosophy teaches us how to live with ourenvironment with peace and free from conflict. But sufficient
care has not been taken to understand the traditional
methods of preserving nature. This has led to innumerable
environmental problems. In the current scientific andtechnological civilization, there is a need for protecting

Eubios Journal of Asian and International Bioethics 24 (November 2014)
mankind as well as the environment. Every individual andevery creature has intrinsic dignity and inalienable rights andeach one has an inescapable responsibility for what he does.
The role of bioethics, bio-safety and the ethical implications ofgenetic engineering are important in the contemporarysociety. In Indian tradition animals and plants are importantas sentient beings, and even inanimate parts of nature likemountains and rivers, the sun and the moon, all are endowedwith life. The Vedic deities are personification of natural
phenomena, fire, wind, the sun, the moon, rivers, mountains,the day and the night. This is not just a poetic personification.
The mystic seers of the Vedic hymns believe in divinepresence in every phenomena of nature with the same reality
appearing in different ways. This tendency is found even inlater classical Sanskrit literature. In the Kumarasambhava,
Kalidasa describes the Himalayas as Devatatma, the heroine
Parvati is the daughter of Himavan. Ganga and Sarasvati arerivers as well as deities. In the context of contemporary
problems of environmental destruction and pollution, we must
consider the harmony which existed between man and naturein ancient India. The theory of Samsara emphasizing karma
and rebirth apply not just to human beings. The ten
incarnations of Visnu as fish, tortoise, boar etc. are wellknown. The Ramayana refers to the story of Ahalya being
cursed to become a stone for a long time until Lord Rama
resurrected her by the touch of his foot. The unsophisticatedvillage men and women treated nature as part of theirhousehold. Sri Aurobindo believed that evolution is not always
straightforward and that it often entailed involution too.

Session 3: Environmental
World Views of Nature

EthicsandKeynote lecture: Fukushima nuclear accident and
the Post-Fukushima energy issues
Mr. Hitoshi Mizuta, Executive Officer, Nuclear Fuel, Nuclear
Division, Kansai Electric Power Co., Inc., Japan
In the TEPCO’s Fukushima Daiichi accident in March
2011, the loss of off-site power supply caused by theearthquake and the loss of on-site power supply caused by
the ensuing tsunami resulted in a ‘Station Blackout”. This
resulted in the failure of safety systems and thus developed
into a severe accident (SA) with core melting.
We, nuclear licensees, learned the following three big
lessons from the accident:
1) Countermeasures toward SA of low probability may
have been inadequate,
2) The attitude to enhance safety and to stay ahead of theregulatory requirements may have not been strong enough,and3) Voluntary measures to improve safety through learning
world best practices may have not been enough.
Therefore, we have been enhancing safety throughimplementing emergency safety measures since the accident,such as diversifying emergency power supplies, diversifying
cooling functions, and improving anti-flooding systems. We
are also implementing measures to conform to the new
regulations established after the accident. The Nuclear
Regulation Authority is currently reviewing the conformity of
nuclear power plants (NPPs) to new regulations, but as yet nopower plant has passed their review.
Given the circumstances, the supply from NPPs which
had been 30% of the total demand until the earthquake wassubstituted with that from thermal power plants. As a result,dependency on imported fossil fuels, fuel prices and CO2
emissions have increased. Namely, energy security,
economy, and environmental conservation –“3Es”- have beendamaged.

171

There has been an emphasis on supply from renewableenergy sources such as solar and wind since the accident
and the utilities are actively developing the renewables.
However, they cannot be sufficient alternatives for nuclear
energy associated with their low availability and low energy
density. From this viewpoint, nuclear power generation isimperative for Japan to restore the “3Es”, with securing safety
as its essential premise. We continue to make every effort torestart NPPs timely through a verification of compliance to the
new regulations.

From a Repository of World Views of Nature to
Conventions on Environmental Ethics
Prof. Jasdev Rai, Sikh Human Rights Group, UK; ABA Vice
President for Asian Ethnic and Religious Minorities
E-mail: jasdevrai@yahoo.com
The project of “Repository of Worldviews of Nature” hasencouraged at least one region of the world to discoverindigenous perspectives on nature that have preceded thecolonial era and modernity. Academics from South Africa areproudly digging deeper into the diversity of philosophicalconcepts on the relationship of humans to nature that exist indifferent parts of Africa. They have been joined by academics
and practitioners from other African countries such as Nigeria,
Zimbabwe, Botswana, Tanzania, Sudan, and Togo among
others. During a series of workshops they noticed that theconsiderably distinctive aspects of different African views
warranted an African Convention on Ethics of Environment. A
similar process is taking shape in India where academics andenvironmental activists are considering a similar exercise.
This paper will review some of the different perspectives andconsider whether different conventions will lead to a better
protection of the environment.

Bioethics for Environmental Security andIndigenous Peoples
Prof. Darryl Macer, AUSN, USA (New Zealand)
Email: darryl@eubios.info
One sixth of the world’s population lacks access toelectricity, struggling to meet basic and essential needs
fundamental to health and wellbeing such as heating, lighting,cooking and hygiene, let alone have time to reflect on social
science policy. How can we respond to ethical dilemmas thatare global in scale? Although there are a number of ethicalprinciples agreed in international normative texts, theadoption of these principles by most communities is difficult
because people in much of the world have different
paradigms than the universalist rhetoric of United Nations
texts. However, some ethical concept of justice andresponsibility to future generations can be found in every
society. In addressing the problems such as right to water, or
ensuring ample access to essential energy services to allliving human beings, the issue can be viewed through theperspective of human rights. The risks to human security fromdangerous climate change are not the product of ecologicalrisk alone, but are caused by existing global inequalities in the
distribution of power, opportunities and resources between
and within countries. Indigenous Peoples are often among thepersons with lowest environmental footprint, but living inplaces that are most vulnerable to the impacts of climatechange, and environmental pollution, that other Peoples havecaused. Environmental security takes an ecocentric ethicalapproach towards the value of the living and non-living
environment, which implicates a minimization of the damages
done to nature by energy production and use. The
anthropocentric approach of human security underestimateshuman integration into various ecosystems. Ecosystem
functioning is crucial for human survival. Individual lifestyles

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

and attitudes have to be changed towards more austerity andfrugality through questioning of the consumerist myths ofmarket economies. If we want to allow every human being tohave equal access to energy, we have to understand that
there are limits to sustainable energy provision.
Intergenerational equity requires us to secure the energy
needs of future generations, as well as consider the injustices
to those alive in our own generation. There is a lot of work to
be done by social sciences and humanities in every tradition
to challenge all the assumptions of what is a good life, andour reliance on energy to achieve this.

Humanizing ethics: the synergy between
environmental ethics and human security
Prof. Ravichandran Moorthy, ABA Vice President for SouthEast Asia; School of History, Politics and Strategy, Faculty ofSocial Sciences & Humanities, Universiti Kebangsaan
Malaysia, Malaysia; President, Asia Pacific Forum on Ethics& Social JusticeE-mail: drravi5774@gmail.com
Environmental ethics primarily concerns the ‘ethicalrelationship’ between human beings and the naturalenvironment. Even though many scholars have addressed
this relationship throughout history, it was only in the 1970s
that environmental ethics began to develop into a specificphilosophical discipline. The environmental ethics discoursebegan to take center stage with the increasing awareness,
globally, of the disastrous effects that rapid industrialization,
depletion of natural resources, population overgrowth andeconomic expansion have had on the environment and thesurvivability of mother Earth. The fundamental question
answered by environmental ethics is basically: what moral
obligations do we have concerning the natural environment?
Although the question appears simple, it may lead to several
other more probing questions. What are our environmental
obligations for the sake of human beings living in the world
today, for humans living in the future, or for the sake ofentities within the environment itself, irrespective of any
human benefits? Discourse on environmental ethics is also
often politicized, because it demands for change in life styleand consumption patterns, and the way we conduct our usualbusiness. Environmental degradation due to human activities
has placed enormous pressure on livable habitats andecosystems, resulting in a decline in the quality of life. In linewith this, the paper will examine the relevance andimplications of environmental ethics to human security.

Ethical issues: Energy sector in Union of Myanmar
Ms. Yamin Thu, Graduate School of Technology
Management, Ritsumeikan University, Shiga, Japan;
MyanmarE-mail: yaminnthu@gmail.com
Myanmar energy consumption mainly depends on
traditional energy such as fuel wood, charcoal and biomass.
Domestic conventional energy sources such as oil and natural
gas have recently been increased a bit though new
discoveries and improved technological developments,
though they may not fully satisfy the demand of the country of
Myanmar. Myanmar’s government has been setting up theenergy policy guidelines and emphasized on renewableenergy sources which have less environmental impacts incomparison to traditional energy types. This paper will
discuss the current energy situation in Union of Myanmar, andthe environmental impact and ethical issues related to energy
sector. Finally, the future plan for energy conservation ishighlighted.

Thoughts
on
Improving
Education in High School

Ecological

EthicsLiu Xiaoyan, The High School Affiliated to Beijing Normal
University
E-mail: liuxiaoyan@bjsdfz.com
Ecological ethics education is carried out in various forms inmany schools, but we also found some common problems in
the process of practice. This paper is on how to solve these
problems in the secondary education level perspective, andsummarizes several measures to enhance the effect of
ecological ethics education, including clarifying the ecologicalethics theory, applying "positive energy" case and pay
attention to practical activities. Try to find the practice
opportunity, and strive to implement long-term planning of
ecological ethic education.

Teaching plan on understanding of wetland andwetland protection
Liu Xin, The High School Affiliated to Beijing Normal
University, Beijing, China
For lack understanding the ecological value of the wetland,
the phenomenon of damaging wetland is very serious in
China. It is necessary to popularize ecological ethics
education on wetland for students. In the process of teaching,first of all to lead the students to study what are the value of
wetland and the concept of wetland, discuss the reasons for
Chinese wetland destruction and wetland development case.
Then analyze and discuss some controversial cases. Finallysummarize how to reasonably use and protect the wetland,
and achieve the teaching objective of understanding of
wetland and wetland protection.

Teaching the Islamic worldview of environmental
ethics to students of science in Malaysia
Maisarah Hasbullah, Siti Nurani Mohd Noor, Mohd Hazim
Shah, Suzana Ariff Azizan, Rosnah Sadri
Department of Science & Technology Studies, Faculty of
Science, University of Malaya, Kuala Lumpur, Malaysia
E-mail: maisara@um.edu.my
Religion is an important cultural resource in Malaysia
particularly for environmentalists who are engaged in creating
new paradigms of thinking about managing the current
ecological or environmental crisis. This paper presents thecourse content of an undergraduate course for science
students entitled ‘Philosophy of Islamic Science andTechnology’ of which a component on the ‘Islamic Philosophy
of Environment’ is emphasized. The course is designed toparticularly groom students who recognize the importance ofenvironmental conservation and hence would act ethicallytowards nature. The Islamic view of nature perceives theenvironment in a rather different way from the modern view ofnature. While the modern view of earth systems and humans
may be divided into human-centric views or anthropocentrism,
and nature-oriented ones, or eco-centrism, Islamic
environmental ethics encourages humans to see theinterconnection and interdependence of all elements in theuniverse. It emphasizes and expounds the harmonious
relationship between humankind and nature in concordancewith Islamic teachings. This course also highlights an Islamic
epistemology of the environment as practiced in Malaysia thathas been translated in many institutions, as presented by theterm “Islam Hadhari’. Islam Hadhari calls for Muslims to be
progressive, modern and dynamic, and yet moderate inbehavior and attitude.

Eubios Journal of Asian and International Bioethics 24 (November 2014)
A critical comparison of scientific misconduct instem-cell research between the two infamous
cases in Japan and in South Korea
1

2

Young-Joon Ryu and Young-Mo KOO
1Department of Pathology, Kangwon National University
College of Medicine, Chuncheon, Korea
2
Department of Medical Humanities and Social Sciences,
University of Ulsan College of Medicine, Seoul, Korea
E-mail: ymkoo@amc.seoul.kr
In 2014, the RIKEN Center for Developmental Biology(CDB) in Kobe, Japan found misconducts in the work ofstimulus-triggered activation of pluripotency (STAP), a
method allegedly able to turn ordinary mature mouse cells
into cells that share embryonic stem cells’ capacity to turn into
any type of body’s cells. Two papers published in Naturepresenting the technology were retracted from publication
after all. This case of scientific misconduct has various
aspects in common with the case of embryonic stem-cellresearch fraud in South Korea, or the Hwang Woo-suk
scandal that took place in 2005. By presenting the striking
similarities and the significant differences between thoseconspicuous cases, we analyze them with respect to thecourse of events, players on the stage, triggering causes, andthe society’s responses as well as the professional measuresof handling the matter.

Sunday, 2 November
Session 4: Ethics and Conflict
The true cost of conflict and its implications for
future generations
ABA Vice President for the Pacific, Department of Biological
Sciences, Faculty of Science, Macquarie University, Sydney,
NSW 2109, Australia
E-mail: irina.pollard@mq.edu.au
Issues such as equity, peaceful conflict resolution within
and between nations, environmental protection andsustainable development, are matters of ethical concern andcollective responsibility. Increasingly insights gained from the
Human Genome Project are highlighting mechanisms
whereby social trauma can influence health parametersacross the generations. Yet despite our inferred ethicalobligation to leave a healthy and fruitful planet for generations
to come, the world’s military are responsible for 8% of global
air pollution, 6% of raw energy use and almost all high-low
nuclear energy waste. Essentially, the Global costs of conflictare multifaceted and far-reaching and cannot be quantified bymeans of financial, injury or casualty burdens. For instance,
epigenetic influences (that is, all the external environmental
variables which regulate gene activity) modulate normal
developmental processes; and normal development maybe
disrupted by harmful epigenetic variables that (1) disrupt DNA
forming deleterious mutations; (2) change gene imprinting
processes and their consequent expressions; and (3) activate‘fetal programming’ strategies that trigger changed endocrine
indices that modulate normal growth and personal
development. A major concern has thus been to understandthe unique long-term physiological configurations of stressresponses as experienced by traumatized children in nations
caught up in institutionalized violence – whether declared or
undeclared war-zones. This presentation develops from a3
bioscience ethical standpoint and focuses on how exposure
to traumatic events; such as experienced at times of conflict,
impact upon the health of future generations and futuresocieties which, in turn, have bearings upon economic status,

3

Bioscience Ethics by I. Pollard. Cambridge University Press, 2009.

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political activities and cultural conditions as created bycircumstanceandchoice.
Bioscience
ethics(http://www.bioscience-bioethics.org/) facilitates free andaccurate information transfer from applied science to appliedbioethics which, in turn, provides unique educational
opportunities for advancing biological understanding within
the scaffolding of ethics.

Visiting the principle of “vulnerability” in thecontext of bioethics education
Prof. Sr. Daphne Viveka Furtado, Department ofBiochemistry, Sophia college, Mumbai University, India;
Department of Bioethics, St. John’s National Academy ofHealth Sciences, Bangalore, India; Visiting Professor, Kurji
Holy Family College of Nursing, Patna, North India
Email: dvivekarscj@gmail.com
Historically, Bioethics has steadily evolved over the past
four decades, since the early 1970s, from theology tophilosophy, the secular and the rational, at times verging on a
discourse between “moral strangers”. However, from theearliest time when the principles were accepted, there was amove to integrate experience (“narrative ethics”) and also
“virtue ethics” (McIntyre and Pellegrino). Van Potter extended
the term to include “global ethics” and “ethics of theenvironment”. At the start of the new millennium, Warren
Reich (editor of the Encyclopedia of Bioethics) said: “One cansee that there is a new understanding opening up in the 21st
century where rationality alone is not the basis forphilosophical and ethical dialogue, but where the individual,
especially the one with no voice is given importance”. In
contrast to the four American principles of biomedical ethics,
the four principles of European bioethics include vulnerability
along with autonomy, dignity, and integrity. Quoted fromRendtorff and Kemp, “Basic Ethical Principles of Bioethics
and Biolaw” (Vol. I, 2000), “The principle of vulnerability is
ontologically prior to the other [European] principles, as it
expresses better than all of the other ethical principles thefinitude of the human condition and therefore it might be thereal bridging idea between moral strangers in a pluralistic
society”. This paper reflects on the importance of inculcatingin students today the importance and appreciation of theprinciple of ‘Vulnerability’, linking it with the response of the“Ethics of Care”, the principle of “Justice” and the concept of“Global Ethics” in the context of vulnerable populations aswell as of the environment.

Session 5: Bioethics Education
Implementation and evaluation of a ‘seven-stepmethod’ for ethical case discussion
1,2

1,2

Amalia Muhaimin , Miko Ferine , and Diyah Woro Dwi
1Lestari
1
2
Department of Bioethics, Medical Education Unit, School of
Medicine, Faculty of Medicine and Health Sciences,
Universitas Jenderal Soedirman, Indonesia
E-mail: amalia.muhaimin@gmail.com
Case discussion is often used in bioethics teaching topractice both knowledge and skills. The ‘seven-step method’has been developed as a teaching method to discuss ethicalthcases with students. It was introduced in 2012 during the 11
World Congress of Bioethics in Rotterdam. Previously othermethods were used in clinical ethics to discuss clinical caseswith ethical issues; they were developed especially for
problem solving and to find the best solution for the case.
However, ethical issues do not occur in only clinical casesthat involve interaction between doctor and patient, but they
may also occur in any other cases such as education,
environment, public health, etc. Therefore, in bioethics
teaching, cases might also include ethical issues in a broader

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Eubios Journal of Asian and International Bioethics 24 (November 2014)sense. Furthermore, emphasis should be put more on thelearning process rather than on the output or solution. This
paper introduces a simple structured approach or method in
ethical case discussion for students. The method is intended
to be used for ethical cases in general, not necessarily clinicalcases. Furthermore, it focuses more on the learning process
and is not necessarily intended to find one single solution as
in clinical ethics consultation or deliberation. The ‘seven-stepmethod’ has been tested (pilot study) for undergraduate
students in the School of Medicine, Universitas Jenderal
Soedirman. The piloting was then evaluated through focus
group discussions with both students and tutors (facilitators).
This paper first explains the background in developing thismethod from a particular context, and then will briefly
elaborate on each step and provide reasons for constructingthat particular step. At the end, it will describe the piloting
process and the results of the evaluation.

Bioethics curriculum development using the ‘six
step approach’ in medical education
Bioethics curriculum development using the ‘six step
approach’ in medical education
1,2
1,2
Miko Ferine , Amalia Muhaimin , and Diyah Woro Dwi
1Lestari
1
2
Department of Bioethics, Medical Education Unit, School of
Medicine, Faculty of Medicine and Health Sciences,
Universitas Jenderal Soedirman, Indonesia
E-mail: mikoferine@gmail.com
Bioethics has become a quite popular subject among
medical students and practitioners in Indonesia during thepast decade. “Ethics and professionalism” have been
included as one of the core competencies according to thefirst (2006) and second version (2012) of the Standards ofCompetencies for Indonesian Physicians, or the so called“SKDI” (Standar Kompetensi Dokter Indonesia). Since 2007,
Indonesia has also started a national standardized exam forall medical doctors to obtain a certificate of competence fromthe Indonesian Medical Council (Konsil KedokteranIndonesia). The exam, called the Indonesian Physicians’
Competence Exam or Uji Kompetensi Dokter Indonesia(UKDI) includes questions on bioethics and ethical issues.
Since then, medical schools have started to include bioethics
into their curriculum. Despite the high enthusiasm inpromoting bioethics in the field of medicine, there has not yet
been any proposed or standardized bioethics curriculum inIndonesia, especially for medical schools. For this reason, theSchool of Medicine, Universitas Jenderal Soedirman, hasstarted a project to develop a structured bioethics curriculum
for the undergraduate. The curriculum will adapt various
materials and methods to the local setting. The ongoingproject uses the ‘six step approach’ to curriculum
development from Kern et al, which is well known in medical
education. The approach starts with problem identificationand general needs assessment, and ends with evaluation andfeedback. This paper wishes to share experience indeveloping a bioethics curriculum in an undergraduate
medical school. The paper includes discussions on the
problems and obstacles encountered in each step, andpossible solutions or problem solving strategies that havebeen implemented.

Session 7: Ethics of Public Security
Keynote Lecture: Opportunities for Asian Scienceto Address Ethics and Human Security
Prof. Lukman Hakim, Director, Indonesian Institute for
Sciences (LIPI), Jakarta, Indonesia [1 hour]Sinking of ethics with MV Sewol
Prof. JUN Bang-Ook, President, Gangneung_Wonju National
University, Korea; ABA Vice President for Korea
E-mail: bojun@gwnu.ac.kr
The sinking of the Korean ferry MV Sewol on April 16th
resulted in the reported death of 293 passengers, with 11 still
missing, most of whom were high school students on a field
trip. It turned out to be a man-made tragedy, resulting in
ethical debates on each actor’s behavior. Chunghaejin Marine
and Korea Resister of Shipping breached business ethics intrying to make more (illegal) money at the sacrifice ofpassengers’ safety. The Korean media failed to follow the setof ethical guidelines on reporting disasters and major
accidents provided by the Journalist Association of Korea.
Above all, the ship crew, especially the captain, should beblamed for not meeting the desired ethical codes andstandards. First of all, they abandoned the sinking shipleaving many passengers on board without giving any proper
information for evacuation. The standard for a captain’s
ethical responsibility can be simply understood from the
popular phrase: “the captain goes down with the ship.”
However, the captain of MV Sewol did not make any efforts to
rescue passengers under the condition of minimal risk.
Currently there is no specific international regulation on
captains’ violations of professional ethics, but some legal
punishment for not obeying the rule of beneficence may bejustifiable. In fact, Korean Seafarer Act Article 10 says thecaptain must check for the passengers’ safety and should
remain on the ship during disaster. The captain and the othercrew members have been indicted on charges of negligent
homicide and abandoning the ship.

Breaking the Vicious Cycle of Hate and Revenge:
The True-Life Story of 'Wounded Tiger’. A Lesson
From History
Dr. Timothy D. Boyle, Economics Department, Kwansei
Gakuin University, Nishinomiya, Hyogo, Japan
E-mail:boyle@kwansei.ac.jp
Achieving peace between warring factions is almost always
an exceedingly difficult task, and unless there is a way ofenemies becoming reconciled through mutual forgivenessand acceptance, the vicious cycle of hate and revenge willcontinue to rear its ugly head. "Wounded Tiger" is a recently
released historical novel, soon to be made into a movie, thatis based on the true story of two soldiers from opposite sides
who thoroughly hated the other side, but who later becameclose friends and associates. Mitsuo Fuchida was thecommander and lead pilot of the Japanese bombing of Pearl
Harbor, while Jake DeShazer was a bombardier on the
Doolittle Raid that was the initial American response.
DeShazer was captured and spent over three years as a
prisoner of war, enduring torture and deprivation. The
kindness of a young American girl who had been raised inJapan and whose parents had been executed by theJapanese military was instrumental in bringing these two
together. It is a fascinating, real-life story that makes apowerful plea to our world today to become peacemakers andto bring reconciliation where there is hatred.

Eubios Journal of Asian and International Bioethics 24 (November 2014)
Session6:
Cross-cultural
Ethics,Indigenous Peoples & Asia-Pacific Studies
The importance of culture and gender sensitivity indisaster research ethics
Vincent Shieh, Ed.D., Graduate Institute of Gender Education,
National Kaohsiung Normal University; Center for Teachingand Learning Development; Executive Director, Pacific Rim
Park in Taiwan; Past President, World Council for Curriculum
and Instruction (WCCI)
E-mail: vshieh@nknucc.nknu.edu.tw
Taiwan is a county at risk of various natural disasters suchas wind damages, floods and earthquakes may happen
because it is located on the monsoon belt and a seismic zone
(Eurasian plate in collision with the Philippine Sea plate).
Disasters not only destroy the natural ecological order, butalso reshape the structure and context of individual and social
culture. In the process of reconstruction and rehabilitation, thedisruption and reconstruction of the social relationship impact
the collective memory of Taiwan residents and its social
culture. Disasters have an impact on the original social
structure and order. Groups with few social resources areprone to be overlooked and isolated or even ignored in therelief and reconstruction process of disaster; mishandling byhumans will expand the disaster impact on victims and pose athreat to their life and property. The unjust distribution ofsocial resources may lead to violence and increase the gap ofgroups with fewer social resources and lower social class.
Taiwan used to be a colonial (colonized) society, governed bydifferent groups and regimes, and has a complex, rich anddiverse content. Thus, in the earthquake disaster andreconstruction, we must be aware of their similarities anddifferences on different cultures, ethnic groups, classes,
gender, age and other factors. Multicultural thinking may allow
us to help victims in overcoming fear and plight with justice,bring a relief system into full play, and achieve the goals ofcommunities in the future. Bankoff (2001) presented different
interpretations about the Western society and theirvulnerability to disasters. He said that there are different
experiences and perceptions among ethnic groups withdifferent cultural backgrounds, and class. Interpretation alone
cannot meet the expectation of groups with diverse
backgrounds. If we overlook the importance of unique cultural
meanings and ethnic emotions, disasters may expand andendanger the human society order, and its inherent culturalawareness. Gender-sensitive issues should also be included
in disaster relief and prevention system, by understanding theexperience of women, their needs and role. But there is no indepth analysis and interpretation for women’s experiences,feelings and cognition; gender has become a researchvariable only used in econometric analysis. Disaster-related
research must place cognitions, contributions, experiences
and feelings of women in the social, cultural and historicalcontext to eliminate the blind spot of knowledge dominated bymen. Ethical considerations of disaster-related research arealways challenging our wisdom.

Assessment of implementation of Free, Prior andInformed Consent (FPIC) between bio-prospectors
and indigenous peoples in Taiwan
12

3

Ding-Zhang Chen , Jui-Chu Lin and Shih-Chang Chen
1
Graduate Institute of Applied Science and Technology,
NTUST, Taiwan
2
IP College, NTUST, Taiwan
3
Graduate Institute of Patent, NTUST, Taiwan
Email: 3721@mail.ntust.edu.tw
This study assesses the meaning, origins and uses ofFree, Prior and Informed Consent (FPIC) and theassumptions underlying its application to traditional

175

knowledge (TK) and biological resource transactions. It also
deals with the complexities that need to be overcome before
this can become a workable policy tool. Using a case study
approach, the immense challenges of applying FPIC indiverse and different cultural settings in a tense politicalcontext are demonstrated. Even with the best intentions andthe most carefully drawn up plans, things may go wrong. The
concept may in many cases be inapplicable because a great
deal of knowledge and resources are already in circulationand can no longer be attributed to a single community or
country of origin. This, however, does not mean that there canbe no moral obligations even in the absence of legal ones. A
review of the various policies, programs and mechanisms of
the Taiwan government in relation to indigenous peoples andnature resource management reveals that several laws andpolicies touch on TK of the indigenous peoples. One is the
Basic Law of Indigenous Peoples’ Rights (BLIPR), which
provides for the recognition of indigenous culture including
TK, the consultation of indigenous peoples towards obtaining
FPIC for any project in indigenous territories, the participationof indigenous peoples in the formulation of development
plans, and the recognition of ancestral land rights. However,
the implementation of BLIPR in practice and its impact on
indigenous peoples need deeper study and analysis, before
its effectiveness as a law recognizing indigenous peoples’
rights can be established. Other problems identified included
conflicting laws, overlap of policies and unclear jurisdiction
among various government agencies concerned withindigenous peoples. The assessment also revealed a lack ofawareness among government personnel of their international
commitments, coupled with a lack of funding for the
implementation of government programs and commitments.
There is a lack of awareness and sensitivity among
government personnel and decision-makers on indigenous
peoples’ rights. Not many are able to appreciate the valuableknowledge and contribution that indigenous peoples havemade to the cause of sustainable development. However, thisis not to suggest that it is a useless concept. Indigenous
peoples have the right to be formally asked for consent by
bio-prospectors. Still, obtaining FPIC is not a substitute forrespect to basic human rights. FPIC should be seen as anecessary but not a sufficient requirement for theestablishmentof
more
equitable
bio-prospecting
arrangements; it must be acquired according to proceduresthat are effective, culturally appropriate, transparent
and flexible.

A comparative examination of the concept ofcompassion between Western and Buddhist
medical ethics
1

1

2

Damdinjav Kh, Shagdarsuren D, and Gerelmaa B
Health Sciences University of Mongolia, Ulaanbaatar,
Mongolia
2
Newly Coded Medical University, Ulaanbaatar, Mongolia
E-mail: shagdarsuren_11@yahoo.com
Compassion is commonly mentioned in both Western andEastern medical ethics. However, there are some differencesin the understanding of compassion in these two approaches.
Briefly, compassion can be defined as prioritizing others’interests and welfare before your own ones. In modern
medicine, principles of compassion can serve to find solutions
for highly debatable issues such as euthanasia or testing on
animals. In traditional medicine in Mongolia, all actions of a
medical professional such as treatment and diagnosis are
conducted based on clearly defined Buddhist ethics.
According to the famous script “Four Tantras of Traditional
Medicine,” ethics is based on the compassionate conscienceof “love for all beings”. This paper analyzes compassion in1

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

medical ethics as stated in “Four Tantras of Traditional
Medicine” with a comparative perspective to Western medical
science.

Macro-bioethics: a “Bioethics Community without
National Borders
Prof. Tsuyoshi Awaya, Department of Bioethics, Graduate
School of Medicine, Dentistry and Pharmaceutical Sciences,
Okayama University, Okayama, Japan
E-mail: t-awaya@nifty.ne.jp
Bioethics may be assumed to include three main areas.
The first is in medical practice and medical research. The
second one is in life sciences, including medical engineering andrelated technologies. The third area is embedded in theinconvenient reality of structural injustice that threatens thelife of humans and their rights. I call the area of bioethics thatcovers such issues as ‘life-protecting bioethics.’ War,terrorism, disaster, etc. are included in this area to the extent
that they perpetuate such injustice. Therefore, it is not enoughthat bioethicists simply discuss ethical dilemmas in the firstand second areas. Bioethicists should also target structural
injustice; macro-bioethics is needed. Although there arevarious structural injustices which threaten human life andrights in the world, the reality is that the existing academic
societies hardly treat these problems as bioethical. For
example, no one in the academic bioethics community
adequately addresses the issues of human life and rights in
Asian autocratic dictatorships. In order to address this third
area directly and effectively, we urgently need to establish anorganization such as a “Bioethics Community without National
Borders”. However, how can bioethicists deal with structural
injustice concretely? It is contemplated that bioethicists canestablish an “International Citizens’ Tribunal” that will behosted by the “Bioethics Community without National Borders”
and publish its “judgments” on the Internet. For example, thetribunal will return verdicts of guilty for the leaders of Asianand other autocratic dictatorships and post them together
along with the process of deliberation on the Internet. It will be
one of the means to indirectly realize conclusions. Such a
proposal makes me appear as a character like Don Quixote!
Will some bioethicists approve my idea? This is the upversioned talk of my speech which I had at the 11th
conference of International Society for Clinical Bioethics(Oct. 10th-11th, 2014 at Kazan State Medical University,
Russia).

Peace and Conflict resolution
Prof. Chutatip Umavijani, Department of Philosophy andReligion, Faculty of Liberal Arts, Thammasat University,
ThailandE-mail: chujid2@gmail.com
Since ancient time the world has seen many wars andconflicts, and after the last major wars World War II there has
been attempts to keep peace and a balance of power toprevent from another major war. However, internal and outer
turmoil still exist in many parts of the world. There is a saying:“if we cannot find peace within, how can we create outerpeace”. It is important then to make peace from within andthen spread it out. The purpose of this paper is to underline
certain concepts in order to keep peace around the world.
First, how can we spread the idea that ‘all is one’ and we area part of the whole? Whatever we do always has effects uponothers. Second, how can we perceive the reality of self? How
can we see ourselves in relation to others, the society and theworld? Third, learn to have sympathy and compassion to all,no matter if there are differences in the outlook, race,
nationality, occupation or social status. If we can follow thethree points above, we all can exit together in peace andharmony, and we can overcome being self-centered anddeceived by the material world around us. No matter what
nationality, religion, and social statue one belongs to, one cango beyond all the differences to attain peace, and canovercome any conflicts that may happen. A sense of justicecan be created for all people.

Can Bioethics in Thailand Make a Secure Society
Ms. Ananya Tritipthumrongchok, General Manager, Eubios
Ethics Institute, Thailand
Senior Research Fellow, American University of Sovereign
Nations, USA
E-mail: ananya@eubios.info
Bioethics is a way of thinking that embraces the humanfactor as the core value. Bioethics is a system of refection
based on guides that promote ability of human beings toreach their full potential. Both culture and religion influence
decision making on contentious issues in the realm of medical
ethics and bioethics, including responses to emerging
infections, integration of Western and Eastern medicines,
medical tourism, stem cell research, organ transplantation,
informed consent, malnutrition, abortion, public health,genetic testing and reproductive medicine.
Thailand is perhaps the only country in the world where
His Majesty the King is constitutionally stipulated to be a
Buddhist and the upholder of the Faith. For centuries
Buddhism has established itself in Thailand and had enriched
the lives of the Thais in all their aspects indeed, without
Buddhism, Thailand would not be what it is today.
Buddhism's holistic understanding of human natureencourages a mental approach to the pathology of disease,something to which Western medicine is now increasingly
attuned. It may also be suggested that the Buddhist
philosophy of origination in dependence is both a fruitfuldiagnostic model and a philosophy, which encourages a
preventive approach to the risks of life, including promoting
spiritual and physical health. However, anxiety has been
voiced recently about how "natural" certain forms of traditional
Buddhist medicine that included in Traditional Thai herbal
medicine actually are, including coconut, banana, garlic,ginger, pepper, jackfruit, mango, mint, pineapple, pumpkin,sugar cane, tamarind, Thai Basil, Thai eggplant etc. Most
people who live in rural areas are familiar to use all traditional
Thai herb medicine, and in popular belief they have a longer
life than those who live in urban areas, which is often
attributed to “Alternative medicine.” We will also consider
other factors such as lifestyle stress, and statistics, to assess
how this actually enhances the human security of people.
Human security includes respect for human rights andpeace. One of the most difficult bioethical issues is abortion.
Buddhism does consider abortion to be the taking of a human
life. At the same time, Buddhists generally are averse tointervene in a woman's personal decision to terminate apregnancy. Buddhism may discourage abortion, but it also
discourages rigid moral absolutes. This may seem a conflict.
In our culture, many think that if something is morally wrong it
ought to be banned. However, the Buddhist view is that therigid following of rules is not what makes us moral. A further,“magnificent authoritative rule” often creates a new set of
moral wrongs.
Buddhism does not approach morality by handing out
absolute rules to be followed in all circumstances. Instead, it
provides guidance to help us see how what we do affects
ourselves and others. The karma we create with our thoughts,
words and actions keeps us subject to cause and effect.
Thus, we assume responsibility for our actions and the resultsof our actions. Even the percepts are not commandments, but
principles, and it is up to us to decide how to apply thoseprinciples for our lives.
The struggle to find balance between development andEubios Journal of Asian and International Bioethics 24 (November 2014)
conservation occurs in many arenas, including culture andreligious. Various actors for pre-development schemes andconservation projects use cultural and religious beliefs,
practices and attitudes toward nature to promote theirpositions. Religious beliefs themselves are not essentiallyeither ecologically or developmentally oriented, but they canbe interpreted in ways to support either conservation ordevelopment. The Thai government, for example, has used
Buddhism to promote rapid national economic development,on the other hand, a handful of Buddhist monks and nongovernment activists incorporate both indigenous spirit beliefs
and Buddhist practices to foster and environmental ethic on a
local level. Both approaches claim to be based on afundamentally “Thai” understanding of the world as well asbasic Buddhist teachings.

The comparison of ‘role stress’ between Indian andmultinational company employees in India

to empirically investigate whether HIV/AIDS actuallyendangers state security in an appropriate way. Keeping thisproblem in mind, this article will focus two issues: Firstly, it will
investigate the various approaches to securitization of
infectious diseases. Specially, this is a critical approach to
Selgelid and Enemark (2008) securitization model of
infectious diseases. Secondly, this research work will focus
on the justification of obligations with regard to precautions
against HIV/AIDS, the world’s most deadly Sexual
Transmittable Disease (STD). The question in this context iswhich ethical theories or moral principles form the basis ofobligatory precautions against HIV/AIDS. This research workat hand will focus on utilitarianism and contractualism asimportant theories. Hereafter, I will argue that the question ofover-demandingness
presents
uswithdifferent
considerations when it concerns precautions against
HIV/AIDS as compared to other infectious diseases.

A. Sebastian Mahimai Raj, Arul Anandar College,
Karumathur, India
M. A. Jothi Rajan, Arul Anandar College (Autonomous),
Karumathur, India
E-mail: asmrajaocd2002@gmail.com
Today, Indian companies are unable to compete withmultinational companies in India such as Korean andJapanese companies. It was theorized that the style ofmanagement had to be revamped in order to compete withmultinational companies. The role of human resources wasconsidered of paramount importance and the management
started to focus on the employees. One such important
aspect is the concept of ‘role stress’. The researchers
selected two organizations (one from a multinational company
and another from an Indian company) for the present study.
Both the multinational company and the Indian company
manufacture automobile parts. The objective of the study was
to compare the level of organizational role stress of theemployees between the multinational company and the Indiancompany. All permanent employees of both companies were
included for data collection, and the census method was
adopted to recruit the respondents for this study. Data
collected from 450 employees in an Indian company alongwith data from 450 permanent employees of a multinational
company were included for the analyses, The researchers
identified ten dimensions of ‘role stress’ as the major
variables, and T-tests were employed. The researchers could
establish who was having more stress in the minds of theboth company employees. Findings of our study will be
discussed in this presentation.

Enhancing professional obstetric care withcompetence in clinical bioethics

Securitization of Infectious Diseases andObligatory Precautions against HIV/AIDS

Monday, 3 November
Session 7: Applied Bioethics

Dr. A S M Anwarullah Bhuiyan, Professor, Department of
Philosophy, Jahangirnagar University, Bangladesh
E-mail: bhuiyan_phil@yahoo.com
The HIV/AIDS pandemic across the globe has been
declared as an international security issue, because it
threatens economic and social security of many countries of
the world. The theory of securitization of infectious diseaseargues that it is appropriate to respond to HIV/AIDS and someother infectious diseases with various resources normallyused only for military and state security issues. Some
research works claim that stating an infectious disease as asecurity risk is lending it a sense of urgency. It is also a wayof seeking for extra resources and investments that areassociated with traditional (military) concepts of security. In
this regard, the question may rise “how could we materialize
securitization?” To frame an infectious disease as a security
issue, it is necessary to define the semantic issues, and then177

Nasrudin A.M. and Shulhana Mokhtar, Faculty of Medicine,
Muslim University of Indonesia, Indonesia
E-mail: shulmd@gmail.com
The rapid development of medical science and technology
without attention to ethical values has raised moral issues in
the field of obstetrics. Medical professions have foundthemselves in a dilemma because they all geared for the
mastery of knowledge and skills in diagnosis and scientificdecision-making, but lack the skills needed for ethicalassessment. Formal education and training in ethicalassessment is needed to help make medical decisions thatcan be justified. This paper intends to describe a new
approach in improving the quality of medical practice inobstetric care based on competence in bioethics and clinical
Ethics in accordance with the demand of society indeveloping countries. Ethics should be observed by every
physician as indicated in the “Preamble of Indonesian Code of
Medical Ethics”. It includes values such as purity of intention,
generosity, humility, sincerity in work, scientific and social
integrity, and amity among physicians. Ethics is related tolegal aspects, and the two are complementary for achieving
good practice in medicine. Obstetric care decisions cannot
rely on a single approach; several alternative approaches
including feminist ethics and bioethical principles should
always be considered in medical decision-making.
Consultation with experts in the field or a hospital ethics
committee can also be helpful. Therefore no good ethicaldecision can be made without ethical guidance.

Personal identity and moral responsibility: A
Confucian response to neuro-ethics
Prof. Shui Chuen Lee, ABA Vice President for Taiwan;
Graduate Institute of Philosophy, National Central University,
Taiwan, R.O.C.
E-mail: shuiclee@cc.ncu.edu.tw
One of the bioethical problems raised by the advance ofneural science is that we have the technology to change
one’s memory which could disturb our common
understanding of one’s personal identity. However, personal
identity is in a broad sense usually based upon one’s
memories and it is this base that accounts for the moral
responsibility of what one has done before. A radical changeof one’s memory thus may lead to difficulty in identifying withthe self, and if they have committed something wrong, with
their wrongdoings. This may provide a loophole for criminals
trying to escape the charge of their previously committed

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

crime. Derek Parfit has pointed out the defects of traditional
theory or conceptions of personal identity and has tried toreplace it with his ‘Relation R’. However, ‘Relation R’ could
not cope with such disturbance of memory, and moral
responsibility could not be maintained under suchcircumstances. In this paper, I shall argue how Parfit’s
thoughtful analysis could not tackle this new challenge andwhat are the key factors for the solution of this new moral
problem. I then argue that the Confucian concept of ‘a person’
could provide us with another criterion of personal identity that
could meet this challenge and could provide strong reasoning
to assure that the culprits of a crime shall meet their moral
responsibilities.

Perceptions of medical students regarding the useof cadavers for medical education in Turkey
Hasan Erbay and Abdulkadir Bilir
Faculty of Medicine, Afyon Kocatepe University, Turkey
E-mail: hasanerbay@yahoo.com
The use of human cadavers is one of the most common
practices in medical education in Turkey. However, there
have been many ethical conflicts and debates about thispractice. This study is aimed at evaluating the students’perspective on the use of human cadavers in medical
education and its ethical dimension. A questionnaire wasdesigned and administered to 382 students in eight different
medical schools in the western part of Turkey, from May toJune 2014. The questionnaire asked about twenty phrases
which included in both educational and ethical perspectives,
and the items were scored on a five-point Likert Scale. The
study had received ethical approval from the Ethics Committeof Afyon Kocatepe University. Most of the participants were
women (n=227, 59,4%) and 155 were men. The majority ofthe students were concerned with the (human) dignity of the
cadavers, and the ethical conflicts of dissecting a dead body.
The findings of this study addressed and highlighted that
medical students were aware of the ethical dimension of the
cadavers. The main ethical conflict was about the status of
cadavers as educational material and the dignity of the deadbodies of humans.

The influence of mass media on medical decisionmaking: the case of extracorporeal membrane
oxygenation
1

2

3

Yen-Yuan Chen , Yen-Hsuan Ni , Tzong-Shinn Chu
1
Department of Social Meicine, National Taiwan University
College of Medicine, Department of Medical Education,
National Taiwan University Hospital
E-mail: chen.yenyuan@gmail.com
2
Department of Pediatrics, National Taiwan University Collegeof Medicine, Department of Medical Genetics, National
Taiwan University Hospital3
Department of Primary Care Meicine, National Taiwan
University College of Medicine, Department of Medical
Education, National Taiwan University Hospital
Several studies have demonstrated how medical
information may be portrayed incorrectly in media. For
example, depiction of an over-optimistic survival rate forpatients receiving cardiopulmonary resuscitation, presenting
the positive outcomes of a new drug rather than the negative
ones in newspapers, and so on. This is to highlight that theincorrect information presented on media can mislead thereaders into believing that medical decision-making ofpatients/family members should be based on the presented
information. Nevertheless, few studies have ever examined
the influence of incorrect medical information on decisions
made by patients and their families. Our presentation will
focus on how the media influence patients’/family members’

medical decision-making in critical care medicine, based on
two articles we have already published to examine this issue
on the subject of extracorporeal membrane oxygenation.
Extracorporeal membrane oxygenation was introduced toclinical practice aeveral decades ago and is now the most
famous and important life-support intervention in Taiwan. This
presentation concludes that incorrect medical information
presented on media may significantly influence medical
decision-making by patients and their family members.

The Islamic and Iranian view on bioethical issues ofusing transgenic animals
1

2

3

Mobina Ostadi Asrami, Farzaneh Zahedi and Fateme
Yousefi Lalimi
1Islamic Azad University of Tonekabon, IranE-mail: mn.ostadi@yahoo.com
2
Endocrinology
andMetabolism
ResearchCenter,
Endocrinology and Metabolism Clinical Sciences Institute ,Tehran University of Medical Sciences, Tehran, Iran3
Medical University of Mazandaran, IranThe rapid growth of biotechnology in recent decades andits great potential in various fields of science such as
agriculture and medicine has attracted the attention ofscientists and politicians around the world. The application of
biotechnology on animals is not new but one of the greatest
successes of modern technology is to produce transgenic
animals. Transgenic technology consists of inserting new
genes into the animal genome for eugenic purposes to
produce certain attributes in them. These animals transfer the
new genes to the next generations. Although the responsible
production of transgenic animals is very useful, we should
always be aware of the possible hazards of this technology.
Also, the ethical aspect of this issue has to be considered
carefully. In this paper, we review the ethical aspects of usingtransgenic animals and present the Islam’s view briefly. We
have also surveyed the ethical guidelines for research on
animals in Iran in the context of transgenic animals. There arevarious perspectives on production and the use of theseanimals around the world. Some of them are essentiallyagainst the application of animals for welfare of humanbeings, but some others support any kind of application even
if it involves hurting the animals for various benefits. Issues
such as profit seeking and inhumane abuse, annoyance andsuffering of animals and also biological hazards, make itessential to assess the benefit-to-risk ratio for ethical approvalof this technology. Islam has a very unique point of view
regarding the treatment of animals. Considering the ethicalaspects of the issue, there seems to be some precautions for
production and application of transgenic animals inbiotechnology. The ethical guidelines for research on animals
in Iran need updating to cover this issue.

Ethical regulation of Homoeopathy, Dr. Mihaela
Serbulea, Romania; Japan

Session 8: Integrated Human Systems
No Charity, but a Chance! The challenge of JapanSun Industries in realization of a society which
preserves the dignity of human beings
Dr. Taro Nakamura
President of Japan Sun Industries, Beppu, JapanAt the closing ceremony of the 1964 Tokyo Paralympics,
Dr. Yutaka Nakamura, the founder of Japan Sun Industries(JSI), was determined that “the days of giving charity wereover” and, from that moment, “independence and active
participation in society through employment were key”. JapanSun industries was established one year later at the 1964

Eubios Journal of Asian and International Bioethics 24 (November 2014)
Tokyo Paralympics and, since then, has continued to provide
opportunities to people with disabilities. Dr. Yutaka Nakamura
dedicated his passion to hold the Paralympics in Tokyo 1964
to the spreading and promotion of ‘sports of the disabled’. The
event succeeded but he was not satisfied and was rather
depressed. He noticed a difference between disabled‘participants’ from other countries and Japanese participant
who appeared like ‘patients’. Participants from other countries
had jobs and were independent, and thus filled withconfidence, while the Japanese participants were dependent
on caregivers. JSI was started with 16 people with disabilities,
with the purpose to create jobs for people with disabilities andhelp them gain their true independence. JSI believed that“even if they have disabilities, it does not mean that they do
not have the ability to work”. JSI has supported them to create
an environment conducive to working and living by
themselves. JSI is now a place where people with disabilities
work, live and enjoy life. They participate in the local
community as other local citizens. Since 1964, the rights fordisabled people has come a long way and now, 50 years
later, Tokyo has been chosen again to hold the
Olympic/Paralympics in 2020. The JSI group which started
with 16 people with disabilities now has over 1,200 people
with disabilities and over 600 supporting staff in Oita
prefecture, Aichi prefecture and Kyoto, Japan.

Keynote lecture: Leading Edge of HAL: Fusion of
Human, Robot and Information Systems
Prof. Yoshiyuki Sankai, Director, Center for Cybernics
Research, University of Tsukuba / CEO CYBERDYNE, Japan

Session 9: Ethical Medicine, Science andTechnology Across Asia
Bioethics in science and technology in Kazakhstan,
Dr. Bakhyt Sarymsakova, Astana, Kazakstan, ABA Vice
President for West Asia; Central Asian Bioethics Association(CABA), Regional Training Center, Astana Medical University,
Astana, Kazakhstan
E-mail: bakhyts@yandex.ru
Bioethics has become one of the growing areas in thefield of science, technology and education in Kazakhstan. The
development of bioethics was initiated and driven by the
public medical organizations, physicians and healthresearchers in the last decade; however, the recent bioethicalissues go beyond medical and research ethics. There is awide national policy for the development of science and newtechnologies in the field of biomedicine, biotechnology,
nanotechnology, green energy, and the environment andnatural resources in Kazakhstan, with an understanding thatthe new policies should include ethical considerations. The
Central Asian Bioethics Association (CABA) has been
involved in the project of the Ministry of Science and
Education, “System analysis and prognosis in the field of
science and technologies in Kazakhstan – 2030”, also called
as “Foresight”. Developing the future research agenda should
follow the legal and ethical frameworks, and CABA is
responsible for this part of the project. For this purpose it isnecessary to establish cross-sectoral cooperation ofinterested parties in the various fields of science, educationand new technologies development. It is necessary to raiseawareness and widely involve the various communities in thediscussion of bioethical issues, to implement an educational
program in bioethics in school and university curricula, and todevelop international cooperation. During the Second Central
Asian Symposium on Bioethics last December in Almaty(Kazakhstan), there was a special section on bioethics
education at the university level with participation of the
Ministry of Health, Ministry of Science and Education. This

179

event has been considered as significant for further practicalsteps for promotion of bioethical principles through educationand public awareness. The Foresight project allows CABA totake the leading role and, more importantly, it provides anopportunity to include bioethics in the current agenda ofscience and technology development in Kazakhstan.

A disability conscious universal bioethics
curriculum for an inclusive society
M.A. Jothi Rajan, Arul Anandar College, Karumathur, India
E-mail: anjellojothi@yahoo.co.in
Arockiam Thaddeus, Jayaraj Annapackiam College for
Women, Periyakulam, India
M.P. Richard, Loyola College, Chennai, India
E-mail: anjellojothi@yahoo.co.in
Disability is one of the inherent disparities beyond humancontrol. Though biomedical engineering has advanced
significantly, the number of persons born with disabilities has
not come down. A disabled person may be considered a
liability to the family as well as the society, and hundreds ofmillions of families in developing countries are affected.
Currently around 10 per cent of the total world population, orroughly 650 million people, live with a disability. Eighty
percent of persons with disabilities live in developing
countries, according to the UN Development Program(UNDP). The World Bank estimates that 20 percent of theworld's poorest people have some kind of disability, and tend
to be the most disadvantaged in their own communities.
Statistics show a steady increase in these numbers. The
reasons include: a) Emergence of new diseases and othercauses of impairment, such as HIV/AIDS, stress and alcoholand drug abuse; b) Increasing life span and numbers ofelderly persons, many of whom have impairments; c)
Projected increases in the number of disabled children overthe next 30 years, particularly in developing countries, due tomalnutrition, diseases, child labor and other causes; d) Armed
conflict and violence. For every child killed in warfare, three
are injured and acquire a permanent form of disability. In
some countries, up to a quarter of disabilities result frominjuries and violence, according to WHO. The two-way link
between poverty and disability creates a vicious circle. Poor
people are more at risk of acquiring a disability because of alack of access to good nutrition, healthcare, sanitation, as well
as safe living and working conditions. Once this occurs,
people face barriers to education, employment, and public
services that can help them escape poverty. A study in the
United Kingdom found that the poverty rate for disabled
people was 23.1 percent compared to 17.9 percent for nondisabled people, but when extra expenses associated withbeing disabled were considered, the poverty rate for people
with disabilities shot up to 47.4 percent. In this grave situationan ‘Inclusive Society’ should emerge so that the rights of thedisabled persons can be protected and they can enjoy theirlives like able-bodied persons. In this context Bioethics
Curriculum in schools can include topics on disabilities andteach the concept of ‘Justice’ in bioethics by interesting
methods and help them realize that disability can affectanyone at any time however disability can be challenged bytherapies and a life full of joy is still possible. Here we share amodel curriculum designed for the slum dwelling children in
Chennai, India on ‘Disability Management’.

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

The ethical aspects of halal certification of medical
devices in Malaysia
1

1

Nur Farhani Zarmani , Mohd Anuar Ramli , and Shaikh Mohd
2
Saifuddeen Shaikh Mohd Salleh
1
Department of Fiqh and Usul, Academy of Islamic Studies,
University of Malaya, Kuala Lumpur, Malaysia
E-mail: farhani40@ymail.com
2
Consultant, Programme of Applied Sciences with Islamic
Studies
The medical devices industry is one of the fastest growing
sectors of healthcare industry with a large market, a wide
variety of products and growing applications. In Malaysia, thisindustry is a major contributor to the economy andgovernment initiatives support its growth to position Malaysia
as a medical device manufacturing hub in the Asia-Pacificregion. There are more than 180 manufacturers of medical
devices in Malaysia involved in the production ofsophisticated devices such as orthopedic products, surgicalinstruments and dialysis machines. Local companies are
moving towards complying with internationally recognized
quality standards such as ISO 13485 as an attempt topenetrate the global market. However, there is a religious
need to provide medical devices that are certified halal inorder to cater to the needs of Muslim consumers who makeup 64.3% of the Malaysian population. It is an advantage that
Malaysia halal certification industry is well-developed andrecognized as a model all around the world. Malaysia showsa strong industrial manufacturing potential for a wide range of
halal products. The availability of supporting industries thus
provides Malaysia with the ideal conditions to develop into a
medical device hub in Asia as well as to establish a global
acceptance model for halal medical devices. This paper will
discuss the ethical aspects of developing halal medical
devices for the needs of Muslims in Malaysia and other
Islamic nations.

The Need and Ethical Handling of Promoting EastWest-Native Integrated Global Medicine
Neoh Choo-Aun M.D., EMHA, PhD. Director, Research
Department of Pingtung Christian Hospital, Taiwan
E-mail: neohca@gmail.com
The financial burden of medical care expenses isincreasing for families globally. Much of the rise in healthcare
costs can be attributed to advances in medical technology.
63% of all deaths worldwide currently stem from noncommunicable diseases (NCDs) chiefly cardiovasculardiseases, cancers, chronic respiratory diseases and diabetes.
The risk factors stem from a combination of modifiable andnon-modifiable risk factors; non-modifiable risk factors cannot
be changed by an individual or the environment and include
age, sex, and genetic make-up. Non-Western traditional
medicines should step in to provide local treatment modalities
that have been proved suitable because of genetic and local
sociocultural and environmental factors and the history of
their usage for over thousands of years. Complementary
medicine can provide safe and affordable medical care to
local residents. Modifiable risk factors are those that societies
or individuals can change to improve health outcomes.
Traditional Chinese medicine can be of great help. The gap in
health and life expectancy between aboriginal and Torres
Strait Islander Australians continues to be significant. Western
medicine specialists think that the gap in life expectancy will
not be closed until aboriginal peoples and Torres Strait
Islanders have better access to high quality primary
healthcare. Traditional Chinese medicine offers great benefit
in health promotion for a unique local social economic
environment. There are often major inequalities in access toWestern healthcare that may be improved by promoting East-

West-Native integrated medicine. However, one may facewith ethics, human security and sustainability issues. We thus
need to accumulate more knowledge and experience in thisnew field to provide safe care with scientific evidence to ourpatients. We need to empower the public in their healthcare
choices. The physicians may face role stress in providing
Western medicine along with Eastern or native traditional
medicine. The principle of autonomy governs decision-making
in the healthcare system of local and Native residents.
Personal identity and moral responsibility also play animportant role in selection of the type of treatment. Many
issues such as genetics and ethics, biotechnology,
environmental ethics, medical ethics, bioethics education inschools and universities, and public health ethics need to be
discussed and debated for promoting East-West-Native
integrated global medicine.

Session 10: Ethics and Biobanks
New ELSI challenges in the management of“Taiwan Biobank” based on a comparative study ofinternational biobank consortiums
1

2

3

Fan Chien-Te , Lin Jui-Chu and Hung Tzu-Hsun
1
Institute of Law for Science & Technology, National Tsing
Hua University, Taiwan
2College of Intellectual Property Studies, National Taiwan
University of Science & Technology, Taiwan
1
Corresponding author, Institute of Law for Science &Technology, National Tsing Hua University, Taiwan
E-mail: starfever1211@gmail.com
Due to the unique island and immigrant culture in Taiwan,
biobanking has raised serious and complex “ethical, legal andsocial implications” (ELSIs), e.g. the issue of aboriginal
protection. To deal with these complex ELSIs, thegovernment of Taiwan in 2010 enacted the “Human Biobank
Management Act”, specific legislation focusing on biobank
activities. But this single-act government regulation is now
insufficient to deal with issues emerging from the integrationof domestic biobanks in Taiwan, or future needs ininternational research cooperation. International researchcommunities have already developed several cross-borderbiobanking consortiums. We have reviewed the governancestructure of two of the most sophisticated consortiums among
them, P3G and BBMRI. We found the governance strategiesof the two consortiums to be different. P3G takes a bottom-up
governance strategy involving ethical self-regulation by its
own members and NGO members of the international
research community; this is useful for the establishment of adomestic network of biobanks in Taiwan. On the other hand,
BBMRI takes a top-down governance strategy involving acentral node to integrate national biobank infrastructures in its
member states; this is valuable for future legislation in
Taiwan. Through a comparison of the international biobanking
consortiums and current situation in Taiwan, we also
identified major barriers including ethical, logistical and legal
issues in either international and domestic cooperation orcollaboration between biobanks. In conclusion, we suggest
solutions including legal and ethical strategies to Taiwan
government and its national biobank to overcome thesebarriers.

Protection of genetic resources in Taiwan in
retrospect and prospect
Prof. Chung-His Lee, Graduate Institute of Health andBiotechnology Law, Taipei Medical University, Taiwan
Email: lee2013@tmu.edu.tw
Since the “Nagoya Protocol on Access to Genetic
Resources and the Fair and Equitable Sharing of Benefits
arising from their Utilization (ABS)” to the “Convention onEubios Journal of Asian and International Bioethics 24 (November 2014)
Biological Diversity (CBD)” was adopted in October 2010, theinternational community is forecasting new and effective rules
for regulating genetic resources through prospective methods.
Although Taiwan will not be able to join the Nagoya Protocol’s
contracting parties, nonetheless legislative plans have been
initiated since 2004, far earlier than this Protocol. Following
the principles set in Bonn Guidelines (2002), the drafted lawsin Taiwan for protecting genetic resources and indigenous
peoples’ traditional knowledge conform with most principles in
the Nagoya Protocol. Unfortunately, the legislative progress ofthese two drafted laws in Taiwan has been left in a limbo formany years, due to political and legal concerns. This paper
looks into some of the work that has been done over the pastten years in Taiwan, to try and bring national legislation in linewith the international community on biological diversity issues,
and more importantly regulations over access and benefit
sharing. It goes without saying that Taiwan occupies a rather
unique position when it comes to participation in international
treaties, bodies, protocols etc. as it is not permitted to join
most multilateral environmental agreements (MEAs) thatgenerally require statehood as a qualification for membership.
However, Taiwan’s non-contracting party status to the CBDcannot diminish the nation’s capacity to engage in the buildingof a relevant ABS legal system. This paper shows that the
recently developing Nagoya Protocol can bring some new
momentum for legislative progress in Taiwan.

Tuesday, 4 November
Session11:
Geothermal
activity;
Disability; and Monkeys in Beppu
Wednesday, 5 November
Session 12: Mount Aso, biodiversity andethicsThursday, 6 November
Session 13: Nagasaki and nuclear ethics
Friday, 7 November4
Session 14: Oversight of Medical Research
Teaching ethics to professional scientists
Prof. Ann Boyd, Hood College, Frederick, MD, USA
E-mail: boyd@hood.edu
Supporting the view that ethics can be taught, this paper
will explore the frequent lack of a philosophical foundation inscientific training and its impact on a course on ‘Science andEthics’. The incidence of cases of misconduct by scientists
engaged in basic research led the United States to establish
the Office of Research Integrity. Their publication covers the
ethical conduct of research and defines misconduct asfabrication, falsification and plagiarism. Concern for breach of
public trust with dubious repercussions in scientific funding
has led to mandated courses in ethics for students training forscientific research careers. Having concentrated their course
work in laboratory-based science, they have less familiarity
with philosophy and consequently struggle with the ethicalreasoning aspects of a course in science and ethics.
Discovery of a therapeutic drug or device opens a complex
web of regulations by Food and Drug Administration for the
ethical use of human subjects. Again the ethical system is
one of rules and conduct based norms without foundational
4

Concurrent with the Ninth Kumamoto International Bioethics
Roundtable (KBRT9) organized by the Interdisciplinary and Glocal
Oriented (HIGO) Program, Kumamoto University, Japan

181

philosophical support for the ethical principles used in theguidelines. Rules of law reflect corrective action. Engaging
students in case studies helps alert them to potential ethicaldilemmas and invites them to explore why one action is right,
good, or better than an alternative. Narrative ethics provides
a human presence to competing and compelling claims, theintersection of which is the ethical issue and concept.
Dissecting narratives helps students explore how ethics canbe taught and learned in a pluralistic society and remain
relevant to the field of expertise they have chosen. The
challenge is determining the best methods in teaching ethics
in a particular discipline. Is there a code of ethics that applies
cross culturally and cross disciplinarily? Early and often
should be the mantra of teaching ethics throughout thedevelopment of the individual and emergent professional.

Ethical issues in biomedical research on humansubjects in developing countries
Dr. Md. Abdus Shakoor
Physical Medicine and Rehabilitation, BSM Medical
University, Dhaka, Bangladesh
Email: dmashakoor04@yahoo.com‘Research ethics’ is the discipline for evaluation of merits,
demerits, risks, benefits, and social concerns over research
activities. Maximum benefit should be derived from researchand no harm should be employed to the participants. In adeveloping country, there are many vulnerable subjects likepeople of slum areas, patients of low socioeconomic
condition, females, low income groups, etc. Protection of
persons with diminished autonomy, i.e. vulnerable subjects,
should be ensured. Informed consent (IC) is an essential
prerequisite for starting a biomedical research involving
human subjects. For all biomedical research involving humansubjects, the investigator must obtain voluntary IC of theprospective subject. Some important ethical issues likevoluntary IC, inducement, confidentiality, autonomy andassessment of risk-benefit should be kept in mind during
research and all ethical norms should be maintained withjustification. A total of 214 doctors of a postgraduate medical
institute in a developed country were included in a study toassess their knowledge of research ethics. A structured
questionnaire was supplied to them to answer questions
regarding research ethics. It was found that many participants
had poor knowledge about research ethics guidelines like theNuremberg Code, Helsinki declaration, etc. (p=0). Regarding
the knowledge of informed consent (IC), most participants
were more or less knowledgeable about it, and the attitude of
the respondents was also in favor of taking IC. In practice,most of them had taken IC in verbal (39.3%, P = 0.001) andwritten forms (47.6%, p = 0.001). But some of the researchers
had not taken any IC (13.1%. p = 0.001). It can be concluded
that the knowledge of most of the researchers of theconcerned institute was poor about guidelines of research
ethics, but they were aware of informed consent.

Ethical awareness on reproductive genetic
technology (RGT) in Pakistan in the context ofpoverty, lack of education, gender discrimination
and absence of regulation
Ayesha Irshad, Division of Biological Chemistry, Medical
University of Innsbruck, Innsbruck, Austria
Email: Ayesha.irshad@mci.edu
Assisted
reproductive
technologies
(ART)
and
reproductive genetic technologies (RGT) are intertwined andco-evolving. The latter comprise pre-implantation genetic
diagnosis (PGD), sex selection (either through PGD or sperm
sorting) and hypothetical genetic modification, all based on
concepts of optimizing the ‘outcome’. RGT are used to182

Eubios Journal of Asian and International Bioethics 24 (November 2014)

overcome certain forms of inherited diseases and may serve
the quest for a ‘perfect baby’ (or ‘designer baby’) and ‘humanenhancement’. These technologies are increasingly used tofulfill socially and culturally framed requests, e.g. for familybalancing or to enable post-menopausal women or
homosexual couples to have genetically linked children. The
realm of ART and RGT is loaded with countless ethicalissues, particularly as different social practices and legal
regulations as well as economic inequalities within andamong countries create numerous vulnerable groups andchances for exploitation. ART and RGT are being offered to
citizens in Pakistan. This research provides an overview of
the ART and RGT landscape in Pakistan and analyzes theavailable online content related to the field for Pakistani
citizens. I explore the topic in the context of deep rooted
poverty, lack of education, gender discrimination and absenceof regulation. More information about applicability oftechniques and their use is continuously emerging; however,social, ethical and legal debates in this field are unfortunately
lagging behind in Pakistan. This research provides an insighton how ART & RGT industry is developing in Pakistan andwhat are the potential threats associated with their provisionin an unregulated market.

Incorporating higher learning skills into bioethics
education of multicultural students of science in
Malaysia
Dr. Siti Nurani Mohd Nor, Mohd Salim Bin Mohamed,
Mathana Amaris Fiona Sivaraman and See Hooi Yan
Department of Science & Technology Studies, Faculty of
Science, University of Malaya, Kuala Lumpur,
Malaysia
E-mail: sitinuraninor@um.edu.my
An overview of bioethics courses offered to pure science
undergraduates from the University of Malaya is presented.
Students come from three ethnic groups affiliated with threemajor religions with diverse values and belief systems. It wastherefore important to incorporate a bioethics curriculum
where the youths could identify with and relate to theirintrinsic beliefs and moral discernment. For example, theconcept of non-violence is an important ethical rule for the
Hindus and Buddhists affecting their stand related toembryonic stem cell research. Likewise the concept of charity
in Islam and Christianity would be important virtues toconsider in regards to organ transplant issues. Two overriding
concerns when designing the bioethics curriculum are
therefore discussed in this paper: (1) the rationale for acourse structure that accommodates varying ethical values on
issues of scientific research and innovation, and (2) a suitablecourse design should incorporate and induce critical thinking
and problem-solving skills. Positive feedback was received
from students through a course evaluation survey and most
students reported having fun while tackling ethical problems
collectively in a peer group.

Experience during the gestational period of acouple selecting fertilization treatment receiving
egg donation
1

2

2

Harumi Hayashi , Mitsuko Sayama and Michio Miyasaka
1
Gender Equality Office, Niigata University, Niigata, Japan
2
Graduate School of Health Sciences, Niigata University,
Niigata, Japan
E-mail: miyasaka@clg.niigata-u.ac.jp
This study presents the results of an interview with acouple, analyzed qualitatively and inductively, to understandthe experience and struggles they experienced during
pregnancy and following the delivery of a baby following
infertility treatment with a donated egg. The married couple,

who were the same age, was interviewed when the baby was
six months old. The husband cared about the feelings of hiswife and continued the stance of “leaving all decision-making
on the baby to her” and “talking nothing about the baby”. Healso continued having “the anxiety whether she would
recognize the baby without genetic relation as her own baby”
and spent days “with great caution so that she would feel likedelivering a baby”. Moreover, he continued “struggling andbrooding over the righteousness to receive egg donation”.
Meanwhile, the wife, already 40 years old, had started
designing her life without a child. She said that she received
egg donation as “the decision of her husband’s parents togive up on having a blood-related grandchild”. When
pregnancy was confirmed, she was confused anddisappointed at “whether she could take good care of thebaby without genetic relation.” Furthermore, since thepregnancy was costly, she felt the pressure that “miscarriage
would be unforgivable” and consulted her parents that knew
about the secret of egg donation. Starting to feel fetal
movement, she felt “a joy and love along with the
helplessness of having no genetic relation.” However, as the
fetus grew, she felt a miraculous connection and started tofeel like “raising the baby with love as her own child”.
However, she continued struggling because “she was
uncertain about the ethics of delivering a baby by receiving
egg donation”. Both of them had decided not to declare “theplace of origin” to their child, but were aware of the necessityof announcement under certain circumstances.

Session 14: Public Health Ethics
A study on the truth telling of Yemeni doctors toterminally ill patients
Dr. Gamil Abdul-Rahim Ali Saleh, Faculty of Medicine &Health Sciences, University of Aden, Yemen
Email: Jameel5200@yahoo.com
This work was conducted with the objective of exploring
the attitude of Yemeni graduated doctors in regard to ethicalissues in terminally ill patients. A cross-sectional descriptive
study was applied. A total number of 130 doctors representing
all graduated doctors from the Faculty of Medicine, Aden
University, Yemen participated in the study. The opinions ofdoctors were obtained by means of self- administrated
questionnaires that included different criteria regarding
terminally ill patients. The results show that the majority of
doctors answered ‘always’ or ‘often’ to the questions asking
about truth telling to patients and relatives, informing patient
relatives that patient would die, whether there was a lie used
when asked by patient about the truth, informing the relatives
that the disease was cancer, and telling the truth when asked
by relatives with mean percentage scores of 99%, 97%, 94%,
93%, 93% & 91%, respectively. Ninety seven percent ofdoctors responded that they would involve the patients andtheir family when making decision on using artificial life
support for a deteriorating patient while 80% of doctors would
not like to be told about the truth if they were patients. The
main reason identified by doctors for not telling the truth toterminally ill patients was that the patient would not like toknow the truth, and the main reason for not telling the truth tothe patient family was to protect the family from emotional
stress. The study concluded that truth telling to terminally illpatients was a common dilemma in that ‘to tell’ or ‘not to tell’was the main question which was evaluated differently by
doctors.

Eubios Journal of Asian and International Bioethics 24 (November 2014)
Ethical considerations of restrictive public healthmeasures for the control of Hand, Foot and Mouth
disease in Malaysia
111

Safiya Amaran , Halim Salleh , Nor Azwany Yaacob ,2
3
Suhaiza Sulaiman , Wan Nor Ariffin Wan Mansur
1
Department of Community Medicine, School of Medical
Sciences, Universiti Sains Malaysia
E-mail (Nor Azwany Yaacob): azwanyusm@gmail.com
2
Surveillance Unit, State Health office, Kota Bharu, Kelantan
3
Research Methodology & Biostatistics Unit, School of
Medical Sciences, Universiti Sains Malaysia
Hand, Foot and Mouth disease (HFMD) is known to beendemic in Malaysia. The most recent outbreak was in theyear 2012. Public health prevention and control measures for
HFMD include active and passive case detection, restrictive
measures and health education. Restrictive measures include
case isolation and institutional closure accompanied bymeasures in hygiene and sanitation. The effectiveness ofthese measures thus relies much on the compliance of thechild parents to willingly isolate the sick child. In Malaysia, themost common institutional closure is the child care center,kindergarten and schools. However, in the era of working
parents nowadays, not all working parents can cope withprolonged closure of care centers or schools. This study
explored the perception of this restrictive measure enforced
during the 2012 outbreak among the healthcare workers andthe parents of the children in care centers in Kota Bharu,
Kelantan. Four child care centers were closed during the2012 outbreak. An in depth interview was carried out among
healthcare workers involved in the 2012 HFMD outbreakmanagement, parents of children and the managers ofrespective child care centers. Six public health ethics themes
were discovered namely moral justification, burden to parents,
support to parents, proportionality of closure, communication
gaps and compliance. The restrictive measures wereperceived as morally justified but the implementation process
had issues in term of reciprocity, transparency andproportionality resulting in an undue burden to parents
especially to those who had limited support or access tosocial support. In conclusion, restrictive measures for thecontrol of HFMD were considered as justified but would be
more receptive by the public when accompanied by social
support.

From bioethical definitions to the setting of public
policy by the court of law in the Philippines
Marlon Patrick P. Lofredo
St. Paul University, Quezon City, the Philippines
E-mail: mlofredo@yahoo.com

Population control, abortion and contraception are themost divisive bioethical topics in the Philippines. For years,
the Philippine Congress has been embroiled in heateddebates and political squabbles between conservative andliberals, hardline constitutionalists and postmodernists. The
enactment of the Responsible Parenthood and Reproductive
Health Act of 2012 (RH Law) aggravated the already tenseand polarized social, religious and political atmosphere in the
country and led to the submission of petitions to the Philippine
Supreme Court to declare the law unconstitutional. Led byreligious groups, the cases revolved around the constitutional
provision in respect to freedom of religion and the sanctity ofhuman life from the time of conception. The Supreme Court
eventually decided to partially grant the petitions on March 19,
2013 and declared Republic Act. No. 10354 as notunconstitutional except with respect to some provisions which
are declared unconstitutional, like those related to freedom of
religion, consent, freedom of conscience, and contraceptives
as primary medicines. But the most striking part of thedecision is the definition of the beginning of life, which has

183

now become the basis of all public policies related to the useof contraceptives, abortion, population control, and possibly,
even future policies related to stem cell research and therapy,
genetic engineering, therapeutic cloning, etc. For bioethics in
the Philippines, this is a defining decision, putting a final sealon the debate on the beginning of life and personhood of theindividual. In this paper, we shall discuss the implications of
the decision in Philippine bioethics as well as public policies
related to current bioethical issues in the country.

Session 15: Global Bioethics
Official Opening of Kumamoto Bioethics
RoundtableVice-President, Kumamoto University

Welcome to Kumamoto
Prof. Takao Takahashi, Emeritus/Visiting Professor, Priority
Organization for Innovation and Excellence, Kumamoto
University, Kumamoto, Japan

Welcome to Kumamoto
Prof. Darryl Macer, Provost, American University of Sovereign
Nations, Scottsdale, AZ, USA; Director, Eubios Ethics
Institute; Secretary, Asian Bioethics Association; Visiting
Professor, Kumamoto University, Japan

Triage and the medicine in disasters
Prof. Takao Takahashi, Emeritus/Visiting Professor, Priority
Organization for Innovation and Excellence, Kumamoto
University, Kumamoto, Japan
E-mail: ttaka@kumamoto-u.ac.jp
Triage is the medical assessment of patients to determine
the priority for treatment and transportation based on theseverity of their medical conditions, in situations where
medical resources are limited and answering the needs of all
the patients is impossible. Triage takes place in urgent
circumstances, such as battlefronts, disasters and emergency
hospitals. When medical professionals perform triage indisasters or emergency hospitals, they prioritize the severely
wounded patients who are likely to survive. The ethicalprinciple working here is a utilitarian principle, i.e. the greatest
happiness (survival) for the greatest number. However, in
triage in military medicine, less severely wounded soldiers areoften treated in preference to more severely woundedbecause a military setting may require soldiers to return to thefront as quickly as possible. In this presentation, I concentrateon the triage in disasters, and consider it from an ethical pointthof view. According to Encyclopedia of Bioethics 4 edition,
decisions in triage are controlled by a mixture of utilitarian andegalitarian considerations. Generally, utilitarianism treats a
person as one person; therefore, it is not incomprehensiblethat both utilitarian and egalitarian considerations appear in
the judgments of triage. The most important point to examine
is why utilitarianism is justified in those situations, and more,whether more basic principles such as ‘restoration of theorder’ are the basis of justification for utilitarianism. The
consideration of triage in disasters seems to lead to a morecomprehensive consideration of ‘ethics in disaster’.

Gandhi’s talisman, a challenge to modern day
youth
1*

2

3

S. Vincent, Arockiam Thaddeus, & M.A. Jothi Rajan,
Loyola Institute of Frontier Energy, Loyola College, Chennai,
India Email: svincentloyola@gmail.com
2
Department of Zoology, Jayaraj Annapackiam College for
Women, Periyakulam, India
1*

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Eubios Journal of Asian and International Bioethics 24 (November 2014)3

Department of Foundation Courses, Arul Anandar College,
Karumathur, India
In this presentation we will address how Gandhiji was apracticing bioethicist by narrating some of the incidents in hislife so that the modern day youth can research over it andpublish the findings. This presentation, for instance, discuses
one of the last notes left behind by Gandhi in 1948,
expressing his deepest social thought: “I will give you atalisman. Whenever you are in doubt, or when the self
becomes too much with you, apply the following test. Recall
the face of the poorest and the weakest man whom you may
have seen, and ask yourself if the step you contemplate isgoing to be of any use to him. Will he gain anything by it? Will
it restore him to a control over his own life and destiny? Inother words, will it lead to SWARAJ (freedom) for the hungry
and spiritually starving millions? Then you will find yourdoubts and your SELF melts away.” The presentation will
explain concepts such as Swaraj, Satyagraha (non-violent
resistance), justice, and human dignity in this perspective.

Bioethics: From a scandalous past to a perilous
futureProf. Aamir Jafarey; ABA President; Sindh Institute of Urology &Transplantation (SIUT), Karachi, Pakistan

E-mail: aamirjafarey@gmail.com
Contemporary bioethics is a phenomenon of the last 4
decades and largely owes its existence to research scandals
in the earlier part of the twentieth century. This paper will
examine some of the stimuli that created a need for a
discipline with the overarching objectives of bringing thediscourse of morality into the life sciences. The discipline hasa great deal of achievements to its credit in its relatively shortlifespan and is now recognized as a distinct and necessary
field in its own right. However, bioethics now also faces
diverse yet interlinked threats from within itself and fromoutside. This paper aims to highlight some of them so thatthey can be recognized for the danger they present. A
worrying trend faced by bioethics is its reduction to four easily
memorizable principles bereft of context and devoid of social,
cultural and religious influences. A bioethics stripped ofcontext simply does not work when called upon in analyzing
real life dilemmas. The paper will describe this trend and how
it has created a divide between what is taught and what canactually be put in practice. Bioethics has gradually also been
institutionalized, and proceduralized. Rather than focusing on
the moral agent and doing what is right, bioethics is now often
perceived to be limited to rules and regulations that need to
be followed in order to secure funding, get research proposals
approved or acquire and maintain accreditation which
threatens the very ethos of bioethics. Another threat to thefield is its decline into irrelevance. The academic discipline ofbioethics has so far not made a market for itself in most of theworld, a qualification hardly ever leading to a career in thefield. Bioethics may therefore not attract fresh blood, and risks
stagnation. The most alarming trend in bioethics is thegradual encroachment of the pharmaceutical industry into
bioethics, which is now providing funding for education,
research and even supporting bioethics centers. The conflictof interest here is obvious and the future agenda of bioethics
may soon be set by the industry rather than the academia andpublic concerns. This paper discusses these disturbing trends
and suggests countermeasures to stem this erosion.

A method for the development of an international
bioethical management system
Dr. Kayo Uejima, Coordinator, Free Think tank, Japan
E-mail: Kayo@lablink.jp
Amarytya Sen (Why Human security? presentation at“International Symposium on Human Security” in Tokyo, 28
July, 2000) emphasized on human security for survival, daily
life, and dignity of human beings, and the significance of
health, peace and tolerance for survival and thus humansecurity. However, Sen did not suggest a management
system to help achieve human security. There are two ethicalaspects to human security: one is on the moral choice of
behavior by individuals and the social choice by the generalpublic, and the other is a need for an ethical standard for
management of social organizations for cooperation. Sen
focuses on the moral aspect and democracy for humansecurity. Meanwhile, he focuses on the management of socialorganizations that can contribute to human-security in daily
business affairs. Social organizations need social
responsibility to be able to contribute to human-security indaily business activities. For the achievement of social
responsibility in daily business, not only a rule verification of
all members inside the social organization but also a systemand structure for the governance of social organization, likecooperative governance, are needed. ISO (International
Organization for Standardization) has utilized the cycle ofmanagement for achievement of industrial and commercial
standards by social organization in daily business affairs.
Advanced management systems like ISO focus on theachievement of social responsibility. But, there is nointernational bioethical management system for theachievement of social responsibility that can contribute tohuman-security. In this age of rapid globalization, cooperative
work is needed for the development of an international bioethical management system. The author shows theapplication of the management cycle to the development of abioethical management system. The bioethical management
system should be a universal manual for business underinternational bioethical standards. For the creation of auniversal manual through international cooperative work, aframework and basic system need to be developed on a website. The framework of management cycle may be composed
by “Plan” (ethical standards, ethical codes), “Action”(guidelines), “Monitoring” (standards and norms forevaluation) and “Conclusion” (remediation of daily business inthe future). It is possible to develop a system for international
cooperative work on a web-site about the management cycle.
In this paper, the author concentrates on the actual method
for the development of an international bioethicalmanagement system through international cooperative work
as a tool that may contribute to the realization of humansecurity. The author has already founded a Free Think Tank
system on the web-site for cooperative work.

Session 16: Biocosmology and Bioethics
The Concept of Identity and Otherness,
Prof. Sivanandam Panneerselvam, Chennai, India
Department of Philosophy, University of Madras, Chennai,
India
E-mail: sps@md4.vsnl.net.in‘Identity’ has been the central theme of cultural studies
since 1990s. Driven by the cultural politics of feminism,
human rights and multiculturalism, as well by philosophicaland linguistic concerns, there has been a new mode of
thinking. The concept of ‘identity’ has also been subject tocriticism. Identities are not universal, fixed or essential
entities, but contingent on historically and culturally special
construction of language. This means that identities areEubios Journal of Asian and International Bioethics 24 (November 2014)
wholly cultural and cannot exist outside of representations.
Identities are discursive constructions, i.e. descriptions ofourselves with which we identify and in which we haveemotionally invested. While identities are matters of culture
rather than nature, this does not mean that one can easily
replace those ethnic or sexual identities into which one has
been acculturalized. While identities are social constructions,they constitute us through the impositions of power and theidentifications of the psyche. Stuart Hall identified threedifferent ways of talking about identity: the ‘enlightenment
subject’, the ‘sociological subject’, and the fractured (decentred) or ‘postmodern subject’. There are different
perspectives to the concept of ‘otherness’: Philosophicalperspective (Indian Philosophy, especially Buddhism andJainism, Foucault, Levinas, Habermas, Rorty), ReligiousSocial Perspective (social stratification in Hinduism, Karma,
Moksa), ecological perspective (human being and nature),
feminist perspective and Hermeneutical perspective. Levinas(Totality and Infinity: An Essay on Exteriority) talks about the
responsibility for the other. Responsibility is the proximity ofthe other. In Levinas, the radical responsibility is an infinite
responsibility proper to human psyche. Radical responsibility
develops interpersonal relationship, i.e. to take care of theneighbour, his suffering and pain. Responsibility is a bond,response and recognition. Habermasian notion of “inclusion of
the other” and the “symmetrical understanding” are useful inthis context. This paper will discuss these concepts in detail.

Triadologic
bioethics:
rehabilitating
foundations of Aristotle’s biocosmology
intermediate holistic ‘integralism’

the
and

Prof. Konstantin Khroutski, Novgorod State University after
Yaroslav-the-Wise, Veliky Novgorod, Russia
E-mail: knstntnkh@gmail.com
Aristotle is considered to be the father (founder) of ethics
as a scholarly discipline. Therefore, naturally, we cannot
develop modern ethics or bioethics, in relation to all forms oflife, without a clear understanding of Aristotle’s system ofknowledge. Moreover, Aristotle is commonly known as thefather of modern science in general, i.e. his rational scholarly
knowledge forms the foundation and matrix of the edifice ofmodern science. However, paradoxically, Aristotle’s
supersystem of scholarly knowledge and his scientific‘organicism’ – ‘biocosmology’ – as a comprehensive form ofrationality in scholarly endeavors has been forgotten during its
long history and eventually removed from the agenda ofmodern scientific activity. Following Aristotle, ethics examines
the good of the individual, emphasizing the importance ofdeveloping excellence or virtue of character and aiming at theindividual’s wholesome activity, thus achieving eudaimonia(happiness). Essentially, Aristotle regards excellent activity as
pleasurable for a man of virtue, i.e. when it has an immanent(intrinsic) origin. Another cornerstone concept is that asAristotle emphasizes, virtue is practical. The roots of virtue
ethics in Chinese philosophy are even more ancient, however,the philosopher from Stagira stresses the unity of knowing
and acting, i.e. the unity of mind, body and the environment(i.e. places or topos of activity). Indeed, this is a true‘organicist’ approach based on the organic universality of theworld (Kosmos), and in respect to bioethical studies, it isrationally reducible to the individual’s ontogenesis of
its/her/his inherent virtual (functionalist) potentials. A crucial
concept, therefore, is that Aristotle’s bioethics has an intrinsic(inherent, inborn, endogenous) etiology and essence.
Substantially, all this is fully opposite to the currently
dominating forms of modern bioethics which mainly have adeontological – i.e. extrinsic (outward, separated from theman’s endogenous potentials) origin and essence. In general,
as expressed in Pitirim Sorokin’s “Social and Cultural185

Dynamics”, 1937–1941, we have three types of sociocultural
supersystems: two polar and one intermediate (integral) one.
Each and all of the three types are permanently active andautonomic (independent from each other), and eachembraces all the forms of social and cultural life, including thebioethical one as well. Therefore, we need to rehabilitate thestudies of etiology and methodology (anthropology, physics
and metaphysics, evolutionary theory, etc.) of contemporary
cosmologies (comprehensive supersystems of knowledge),
including the Aristotelian (‘organicist’, biocosmological) andintegralist (intermediate, holistic) types. It is exactly in thisTriadologic perspective that we have a good chance to getcloser to the true effective forms of bioethics.

Recovering Indigenous Knowledge in the Wake ofEnvironmental Ethics. Concern: A Case from
Taiwan’s Tayal People
Dr. Yih-Ren Lin, Taiwan
Lessons for environmental ethics in the indigenous
knowledge of Tayal people in Taiwan
Yih-Ren Lin
Institute of Humanities in Medicine, Taipei Medical
University, Taiwan
E-mail: oyrlin@tmu.edu.tw
This study explores the significance of indigenous
knowledge among Tayal people in the context of nature
conservation efforts in Taiwan, particularly the ethical aspectsof the human-nature relationship. Based on a participatory
research for over 10 years in the Tayal communities, theauthor argues for the indigenous viewpoint in facing thecurrent ecological crisis. The major study focus is on Tayal
people, the third largest indigenous tribe in Taiwan, and theirworldview of nature. First, a general outlook of indigenous
peoples in Taiwan is presented in terms of their relationshipwith nature; secondly, some controversies like the conflict
between indigenous hunting and wildlife protection are
analyzed to reveal the neglect of the ethical dimension of theindigenous worldview of nature; thirdly, “Llyung” (literally
meaning watershed), the Tayal people’s cultural core concept
to understand nature is explained along with its possible
contribution to environmental ethics. This paper concludes
with an emphasis that the worldview and knowledge ofindigenous people in Taiwan can help with the healing ofongoing worldwide ecological crisis.

Ethical, legal and social implications (ELSI) of theuse of communication robots in care settings
Dr. Yutaka Kato, Ishikawa Prefectural Nursing University,
Ishikawa, Japan
E-mail: utnapishtim@kib.biglobe.ne.jp
Among the major trends of healthcare today is anincreasing integration of knowledge in engineering and use oftechnology. Advanced robotics has been introduced in the
medical field since around the turn of the century. As is wellknown, robots transporting medical records and robotassisted surgery are already in practical use. Robot-assisted
therapy, primarily intended for psychological healing of elderly
people’s minds, is currently being developed. Japan has been
an international hub of robotics with several examples ofJapanese robotic products in this field including AIBO by
Sony Corporation (production discontinued in 1999), Paro by
the National Institute of Advanced Industrial Science andTechnology, OriHime by Ory Laboratory, Palro by Fujisoft andHugvie by Vstone Corporation. While the disputes related torobots both in Japan and in the Western countries havecentered on the military use or ‘cyborgization’ (partial
robotization of human bodies), the ethical, legal and social

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

implications (ELSI) of the communication robots used in caresettings have apparently received less attention. In this paper,
I present the result of a systematic review of the literature.
After summarizing the arguments made so far in literature, toclarify the research trends of the field, I provide the results of
keyword searches of databases provided by patent offices inJapan, the United States and the EU. In doing so, I will point
to the ELSI of emerging applications of care robots that has
scarcely been discussed so far. In addition, special focus isplaced on robots resembling human beings or animals, as it
may entail deception of elderly users.

Saturday, 8 November
Session 17: End of Life Care
The moral status of euthanasia in Bangladesh
Dr. ASM Anwarullah Bhuiyan, Bangladesh, Department of
Philosophy, Jahangirnagar University, Dhaka, Bangladesh
Email: bhuiyan_phil@yahoo.com
The intention of euthanasia is to dispose of the life of apatient affected with unbearable pain and suffering caused byan incurable disease/injury. This article focuses on its pros
and cons and the controversy related to the moral
permissibility of euthanasia as a means of death. In addition,
the article provides an assessment of the scenario of
euthanasia in Bangladesh, after firstly clarifying the idea froma Western perspective. Secondly, the common normative
approach is used to see whether there is any compatibility
between the Western approach and the normative one. Mostof the inhabitants of Bangladesh are Muslims (80%); there
are also Hindus (12%), ethnic communities (5%), and others(3%). Each of these has got its own religious and culturalvalues. The government of Bangladesh does not favor any
specific form of religious or cultural value reformulating its
policy or ethical framework. However, people are prone tocome to their conclusions on the basis of existing sociocultural-religious norms. While adapting a moral course ofaction, it is essential to resolute the moral conflicts that arise
between the concerned parties. The article does two theses:
First it presents philosophical arguments with an aim to reachto the conclusion as to whether it is permissible to adopt theideal of killing a patient. Second, it presents a report on a fieldsurvey which was conducted over the country’s different
hospitals and medical colleges in urban and non-urban areas.
Finally, it is concluded that (1) most decisions regarding one’s
ending his/her life or the withdrawal of life-support systems
are not according to the procedure of ethics committee, (2)believers of either Islam or Hindu or other religions are notprepared to take a decision on euthanasia because of a lackof religious or cultural permissibility. However, in extreme
cases we need to find an alternative solution for not ending apatient’s life.

Clinical ethics consultation to withdraw life
sustaining treatment from terminal patients in
TaiwanJeng-Yuan Hsu M.D., PhD. Clinical Ethics and Law Center,
Taichung Veterans General Hospital, Taiwan
E-mail: hsujy@vghtc.gov.tw
Taiwan was the first Asian country to have a ‘Natural
Death Act’. The act was enacted in 2000 to provide themedical personnel with a legal basis to respect patients’autonomy in refusing to perform CPR on a patient in theterminal stage. To achieve a ‘good death’ in terminal illness,
the act has been continuously revised. The latest version
allows the family to decide not only to withhold but also to
withdraw CPR as a life sustaining treatment from a terminalpatient. In fact, the act is not only a claim to clarify the right ofa terminal patient to refuse medical futile treatment but a

response to the great strides made by medical technology
and national insurance of Taiwan over the last decade in
prolonging the life of the severely ill. Although the latest
version has been enacted for more than one year in Taiwan,
health care providers encounter difficulties in practicing theact. First, the patient must have been diagnosed as being in aterminal stage by two physicians. However, the judgment ofterminal stage is difficult for some patients. Second, thesurrogate decision maker (usually the closest family) who acts
on behalf of the incompetent patient may feel a lot of tension
in deciding what the patient’s best interest is. Third, without
the assurance from the hospital ethics committee that thedeclaration has become effective, health care providers would
not feel comfortable to comply with the declaration, e.g. thewithdrawal of life support treatments. Taichung VGH(Veterans General Hospital-Taichung) began to provide ethics
consultation services in May 2011. Seventy two ethics
stconsultation cases have been proposed until 31 May, 2014.
In 89% (64 cases) of the cases, the main reason of
consultation was end-of-life issues, and 74% (53 cases) of
the consultations included a request for withdrawing life
sustaining treatment. Our experience seems to indicate that
ethics consultation before withdrawing life sustaining
treatment is important for both the family of the patient andhealth care providers to understand the ethical justificationand eliminate the doubts in their mind.

Wider implications of the right to die debate in theUK
Dr. Jasdev Singh Rai, Division of Biomedical Sciences,
American University of Sovereign Nations, USA; UK
E-mail: jasdevrai@yahoo.com
The United Kingdom House of Lords has conducted apassionate debate on the right of some individuals to end
their lives when suffering extreme discomfort and pain in
terminal diseases. This is one of the most challenging
dilemmas facing human beings as medicine continues toadvance unrelentingly without considering the ethicalconsequences of medical breakthroughs on human relations,human suffering and traditional human approaches to end oflife suffering. It is time that humans come to terms with thefacts of terminal or untreatable illnesses regarding the optionof ending their life through a cocktail of pain relief and othermedications to avoid suffering. However as medicine
advances, hope rises for new breakthroughs. While medicine
cannot relieve suffering it can prolong life through newtreatment modalities, though the quality of life is not always
good in some of these circumstances. Fear of patients taking
their own lives to relieve their relatives of the burden oflooking after them, or fear of relatives and others pushingsuch patients to take their own lives remain strong arguments
against relaxing of the laws against assisted dying. This
paper will examine some of the issues and the difficult
choices that society has to make.

Session 18: Bioethics teaching for cultural
diversity and medical humanities
Challenging learning across generations with reference
to bioethics education
Dr. Irina Pollard, Department of Biological Sciences, Facultyof Science, Macquarie University, Sydney, Australia
E-mail: irina.pollard@mq.edu.au
There is an urgent need to reduce the gap in translating
newly acquired knowledge from the bench to the classroom.
With no secure, long-term solutions towards protecting our‘global’ natural and cultural heritages, we must empower
future generations to become sufficiently knowledgeable tobest provide them with a safety net for survival. This proposal

Eubios Journal of Asian and International Bioethics 24 (November 2014)
depicts a workable framework incorporating more ethicalelements into existing educational programs as taught inscience, medicine, law and economics. To facilitate reform, acommitment to update education and to expand the pool ofindividuals concerned about ‘Global’ ethics would, ofnecessity, facilitate path-breaking discoveries and creative
opportunities for social advancement. I am convinced that
newly created Education Departments will enhance thepleasure of learning whilst increasing community accessibility
to much needed ethics education. By working together toimprove the available resources for learning, we will promote
understanding and further endorse relevant themes crucial tomodern bioethics. UNESCO can be a powerful and neutral
platform where stakeholders with diverse backgrounds fromall over the world get together to incorporate updated
education materials and create adaptive change.

A situational and relational learning paradigm forcommunity mental health in Taiwan with pragmaticchallenges to the contemporary visions ofprofessionalism
Prof. Duujian Tsai, M.D., Taipei Medical University, Taiwan
E-mail: dj.tsai@msa.hinet.net
This research uses community mental health fordeveloping a learning paradigm that encompasses asituational
andrelational
approachtomedicalprofessionalism, and hoping that it would contribute toexchanges among regional professionals as well asprotection of human rights. Major mental hospitals in Taiwan
have established models for therapeutic communities thatincorporate
pragmaticallyadoptedpatient-centeredapproaches, while successfully integrating biomedical
knowledge with social support networking skills. Thesemodels were developed in Taiwan not only to address theissue of humanizing psychiatric treatment, but also to create
an opportunity for Taiwan to earn a good international
reputation. Based upon Taiwan’s established international
collaborations with Southeast Asian countries, this project
adopted a participatory narrative approach towards a learning
paradigm that is situational and relational. Using Jonsen’sfour-topic approach as a directing concept, we designed
learning environments and service learning curricula incollaboration with mental health workers and appropriate
patient groups. In conclusion, Taiwan’s experiences canserve as evidence for a patient-centered professional modeland open new horizons by addressing gaps in contemporary
theories about professionalism.

Bioethical Reflections on Spiritual and Terminal
Care for Cancer Patient: lessons from recent
curriculum designs in Taiwan
1

2

Wenyu Hu and Duujian Tsai
1National Taiwan University Nursing School, Taiwan
E-mail: weyuhu@ntu.edu.tw
2
Taipei Medical University, Taiwan
Training in basic and clinical sciences gets medical
scientists and doctors so much indulged in the study ofpathology or therapeutics that they may lose competence inhumanistic matters. Death then can act as an informal‘curriculum’ for clinicians to reflect on the meaning of life andto reconsider the humanistic value of medicine. We havedesigned courses with a comprehensive approach that
includes thinking reflections, care capacities and academic
practices so that the learner’s holistic competence can be
insured. This includes the care of dying cancer patients, with
an emphasis on empowering their families and close friends
with body-mind/spirituality approaches, and mastering theknowledge, skills, and attitude of hospice care. Accordingly, a187

narrative method with four-topic approach has been
introduced for students to help them explore the challenges of
hospice in the Taiwanese context, to reflect ethically on
medical care, and to conduct participatory research withcompassion. By critically reviewing the related curriculum
designs and policy reform in the last five years, this paper
proposes a bioethics oriented medical humanity education
program for early clinical exposure in hospice contexts. In
conclusion, the prospective of this medical education programon professionalism and cultural competence will be
addressed.

Students as facilitators for development of ICT
methods at ‘Living Labs’ in an indigenous tribe in
TaiwanYu-Chia Chen (National Central University), Richard TerngRen Hsu (Chung Hua University, Taiwan), Shyh-dye Lee(National National Taipei University of Nursing & Health
Sciences), Yuga Chen (Jin-Yue Community Development
Association), Estela Lu (Social Empowerment Alliance),
Hsing-yi Lu (National Taiwan University), Duujian Tsai (Taipei
Medical University)
E-mail: dj.tsai@msa.hinet.net
ICT can help overcome cultural barriers that inhibit theaccess of elderly people to medical and social services.
‘Living Labs’ use a participatory approach to the design ofproducts and services that can effectively be used in rural
areas and among the elderly, tailored to the needs of these
populations. This paper reports on project to overcome
cultural and technological gaps between an indigenous tribe
and the mainstream society in Taiwan. The success of efforts
to improve health literacy depends on the capacity ofhealthcare professionals to overcome cultural barriers, andthus promoting cultural competence is an important issue intraining medical students and health professionals. In ‘Living
Labs’, we designed an IT platform to manage and share
information in a user-friendly approach with a feedback
mechanism to improve knowledge management. The ‘LivingLab’ provides for a systemic innovation approach in which all
stakeholders in the service can participate in the development
process. First, a workshop was conducted to empower the
medical device users in the tribe. Medical students and IT
masters students worked in interdisciplinary teams. Oral
history taking enabled them to learn about the lifestyle ofdevice users, and to collect users’ health-related narratives.
Students then continued working in their groups to design
prototype ICT projects for the tribe. Their designs madesignificant contributions to the development and deploymentof healthcare devices, to cultural preservation efforts, and to
the establishment of an innovative user-based platform. The
contributions were not limited to the cultural domain or healthissues, but created bridges between the two. Students’
feedback showed they were fully aware of the cultural barriers
inhibiting
tribalpeople’sunderstandingof
students/professionals/mainstream
society,andtheinformation disparity between the students and the tribal
people.

Nurturing global care and competence to medical
students through professional training in social
medicine and cross-cultural studies
1

1

2

Kwong-leung Yu , Choo-aun Neoh and Duujian Tsai
1
Pingtung Christian Hospital
E-mail: kwongleung.yu@gmail.com
2
Taipei Medical University
With globalization, the barrier between countries has
decreased and cross-country activities have increased.
Pingtung Christian Hospital (PTCH) has followed the footstep

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Eubios Journal of Asian and International Bioethics 24 (November 2014)of medical missionaries in international cooperation andservice. During cross-cultural learning programs, we realizedthat Taiwanese students had inadequate knowledge andparticipation in international cooperation. Therefore, PTCH
facilitated overseas missions for Taiwanese students, andworked closely with several universities in Taiwan for medicalor health clerkship and internship in order to enhance
Taiwanese students’ delivery of humanities and interest ininternational cooperation. With support from a cloudcomputing platform for service learning, designed by our
project team members, and collaboration between the PTCH
tele-care and mobile care project and governments in South
Africa, Malawi, Lao and the northern part of Thailand, we
extended the know-how of an integrated information
technology with community medicine and regional healthplanning to international spheres. The action plan was based
upon our design of integrated delivery systems to serve tribal
communities, and has been demonstrated in recent annual
Southeast Asian Professional Collaboration Workshops and isfurther helping with training professionals in international
programs. Regarding regional hospitals as the core hub tofacilitate the development of health promotion and health caredelivery resources in communities, the action plan has beenarranged into 3 phases including community care, aboriginal
mental health services and international cooperation andeducation. Comparing the differences of cross-culturallearning and training can be helpful in the facilitation of
professionalism and global involvement to Taiwanese
students. Such projects enrich collective learning
opportunities for professionals and help cultivate capable
leaders with cross-cultural competence for shaping thefoundation of a regional civil society beyond national borders.

Session 19: Bioethics Education
Implications of AUSN MBGPH for Future of
Bioethics Education
Prof. Darryl Macer, Eubios Ethics Institute, New Zealand;
Provost, American University of Sovereign Nations,
Scottsdale, AZ, USA
Email: darryl@eubios.info
The American University of Sovereign Nations (AUSN)
Masters in Bioethics and Global Public Health (MBGPH)
program has emerged in 2014 as a full master’s course inbioethics education. This paper will describe the courses andneeds. The development of the value of love of life is quiteconsistent with a holistic view of life. The word ‘Eu-bios’means good-life, and such a life must be sustainable. The
pursuit of a bioethical life, a good life for all, is something we
can see across the world, and is a core of the bioethicalimperative. The task of a teacher includes empowering theirstudents to develop their maturity as individuals as well as
being able to be cooperative members of changing societies.
Students need to be prepared so they are able to apply
knowledge to make good decisions during their life. This begs
the question of “what is knowledge?” Knowledge is much
more than the latest trends in science and technology, or thelatest political ideals. The wisdom from traditions of one’s
own, and many other communities are essential to theresources that our minds call ‘wisdom’. How can we trainteachers and sustain their motivation to take upon thisvocation of sharing wisdom? How can we create communities
that support these goals? There are various roles andchallenges for teachers and educational institutions, andthose who develop curriculum. Depending on the goals of theeducational systems a variety of training strategies andmethods will be used. This paper will bring together the ideasof the bioethics education sessions to assess future research
directions and teaching strategies.

Design of Bioethical cases spanning over generaland professional education
Prof. Dena Hsin-Chen Hsin, Center of Faculty Development,
China Medical University, Taiwan
E-mail: hchsin@hotmail.com
Bioethics helps with the handling of the difficulties anddilemmas in life-related issues through its multidisciplinary
studies of population, behavior and life sciences. Bioethics
education may be more successful if high quality trigger
cases can be presented to integrate these three aspects oflearning. In China Medical University of Taiwan, a revised
curriculum with a three-level ethical course was proposed tosupport the graded learning objectives of bioethics and tomeet the need for general and professional education. The
diverse aims in each level imply the need for multiplicity incase scenarios that can represent a wide spectrum of ethicalissues. For example cases of animal rights, GM food, geneprivacy, human experiments, etc. were designed to achieve
the first level’s aim to cultivate an attitude to respect life,
consider risk vs. benefit and understand the value of diversity.
For the second level, cases on truth-telling about terminal
cancer, patients’ right to self-determination, doctors’ rights
and duties, reports of medical malpractice have been
designed to cultivate the ability of moral reasoning and torealize values in medical profession. Narratives about thepatients and their families in several real clinical cases weredeveloped mainly to encourage students to introduce ethicalconsiderations in their clinical learning. In general, the cases
have been designed along a path that moves from moregeneral to more specialized and professional. To create
effective cases for bioethics learning, the case scenarios
should not only lead students to a particular area of study toachieve those diverse learning objects, but also it must
contain cues to stimulate discussion and encourage students
to seek information from various learning resources. In
general, cases of ethical enquiry are commonly derived from
dilemmas in everyday life, which are then grown into more
specific issues relevant to the context in professional practice.

Nurses as facilitators of clinical ethics: Aninterview survey of their experienced incongruities
in teamwork
Dr. Megumi Taguchi and Dr. Michio Miyasaka, Graduate
School of Health Sciences, Niigata University, Niigata, Japan
E-mail: miyasaka@clg.niigata-u.ac.jp
While teamwork is essential for the delivery of high-quality
nursing, it has been reported that nurses face certain
difficulties in communication and collaboration with colleagues
who have a different sense of values. Since nurses are
expected to facilitate ethical conflicts or seeds of conflict thatcan occur between stakeholders in clinical settings, they often
experience incongruities and dilemmas when working withpatients, families, physicians, and other healthcare providers,
including colleague nurses. Therefore, the objective of thisstudy was to examine the incongruities experienced bynurses in their teamwork, as well as to clarify their common
structures. A semi-structured interview survey was conductedwith 10 nurses (with clinical experience ranging from 3 to 10
years), and a narrative analysis was performed in regard to
the structure of the nurses’ stories of incongruities. As aresult, 31 episodes were extracted from the stories told by the
10 participants. The reported causes for such incongruities
were categorized into three themes: (A) related to differencesin the conventional codes of conduct in their nursing teams,(B) related to a difference in the length of clinical experience,and (C) related to nurse–doctor relationships. In addition, thefindings of the structural narrative analysis suggested threeEubios Journal of Asian and International Bioethics 24 (November 2014)
structural patterns in the reported episodes: (1) the nurse did
not take any action (19 episodes); (2) the nurse took someactions, but they had no effect (10 episodes); and (3) the
nurse took some actions and they had some effect (twoepisodes). Regarding the latter two episodes, one nurse
noted that her colleagues were a “good model” while anotherreferred to her previous successful experiences when dealing
with the current incongruity. These results are informative as
to the role of teamwork and group dynamics in clinical ethics,
especially in the Japanese healthcare context.

Comparison of the effects of lectures vs. narratives
for teaching ethics on the moral sensitivity andlearning satisfactionof Iranian nurses 1
5
2
Nasrin Imanifar , Abolfazle Vaghar Seyedin , Leila Afshar
and Gholam Reza Sharif-Zadeh3
1
Nursing School, Birjand University of Medical Sciences,
Birjand, Iran
2
Assistant Professor of medical Ethics, Shahid Beheshti
University of Medical Sciences, Tehran, IranE-mail: lafshar@gmail.com
3
Assistant Professor, Birjand University of Medical Sciences
Ethics education has a crucial role in the development of
moral sensitivity in nurses. Meanwhile, curriculum instructors
constantly look for new and effective ways for ethics
education. The aim of this study was to compare two methodsof teaching: narrative ethics and lecturing, on moral sensitivity
and learning satisfaction of nurses. Fifty-six nurses from two
educational hospitals in Birjand city participated in thisrandomized field trial research. Data were collected by using
Lutzen’s Moral Sensitivity Questionnaire before and after
intervention. The participants were divided into two groups
and four sessions of classes (each 3 hours) with a one week
interval for each. A learning satisfaction questionnaire wasalso completed after the intervention. Both methods, narrationand lectures, significantly increased the nurses’ moral
sensitivity in each group (p<0.001 and p=0.01, respectively).
Despite the higher mean score of moral sensitivity in narrationgroup than in the lecture group, moral sensitivity did not show
a significant difference (p=0.70) and also there was not a
statistically significant difference between learning satisfactionin the two groups (p=0.09), despite the higher mean score ofnarration group. Concerning the results of this study, since
there was no significant difference between two methods, it
was concluded that a combination of narration and lecture indevelopment of moral sensitivity can lead to better outcomes.

Professionalism and Citizenship: Cultivating CrossCultural Sensitivity through Writing Local History an Interdisciplinary Service-learning Project forCommunity Development
Serena Ching-I Wang (Hung Kuang University), Li-Chuan
Kuo (Tzu Chi University), Estela Lu (Social Empowerment
Alliance), and Duujian Tsai (Taipei Medical University)
E-mail: dj.tsai@msa.hinet.net
We report a community-building project that enabled thedevelopment of a university-community partnership with aparticipatory and multilayered approach. The project used oral
history as a rich and sustainable methodology for producing
local records. It has potential applications and future
implications for liberal and professional education. The project
employed oral history as a tool for community building bystrengthening community ties and collective memory, andintegrated it with a service-learning curriculum designed tonurture the responsibilities of citizens. The curriculum thus
served as a bridge linking cultural sensitivity, desirable in

189

liberal education, with the required competencies in
professional problem-based learning in the field of community
development. By guiding students to take part in local history
projects, they could appreciate the maritime influence ofChinese Empires
andthe distribution
range of
Austronesian/Malay-Polynesian nations. Such understanding
provided incentives for learning cultural competence, enrichedtheir professional competence within the field of community
development, and ultimately helped students realize Taiwan’s
potential as a crucial international hub for professional andcultural exchange. Such projects can help prepare premedical
students in developing competence as professionals andcitizens, before going deeper into their professional
education.

The Medicalization of Suffering
Prof. Tomoaki Tsuchida, Faculty of Human Sciences,
Waseda University, Tokyo, Japan
E-mail: ttsuchida@waseda.jp
Concerning especially with the end-of-life stage care ofpeople in today’s developed countries, most people have thebenefit of professional medical care. Therefore, people may
assume that they can most of the time get pain management
and that they should somehow manage their disease orillness on their own with medical help. WHO sets a guideline
for managing pain in “physical, mental, social and spiritual”
aspects. Medical professionals are preparing for theirpatients’ good death, laying out its components, such as: 1)
Management of pain and other symptoms, 2) Clear decision
making, 3) Preparation for death, 3) Completion, 4)
Contribution to others, and 5) Affirmation of the whole person(Steinhauser et al. 2000). Here in Japan, where more than
80% of people die at hospitals and clinics, it is considerednecessary for the medical staff to look after their patient’s
process of dying. Ordinary people, too, are now encouragedby the media and by commercialism to plan and arrange foreach one’s own death and dying. Thus, there is a grave issue
from a humanistic point of view; that is, along with otheraspects of ageing and illnesses, the contemporary society
tends to ‘privatize’ human suffering: namely, each one has
to deal with suffering and dying as private matters with thehelp of institutional medical assistance. Thus, suffering isshunted off as an individual affair. I argue that this poses afundamental obstacle to our personal, interdependent
understanding and living out of our humanity.

Sunday, 9 November
Session 20: Bioethics in the Clinic
Remembrance : The 4th 'R' of Animal Experiments
1, 3

1, 3

1, 3

Masako Shimamoto,Uzzal Kumar Acharjee,
Akane
2, 3
2, 3
Anai, Ayumu Ohyama,
Tatsunori Hirotsu,
1
Graduate School of Medical Sciences, Kumamoto University
2
Graduate School of Pharmaceutical Sciences, Kumamoto
University
3
Program for Leading Graduate Schools HIGO (Health life
science: Interdisciplinary and Glocal Oriented) program,
Kumamoto University
Animal experimentation or in vivo experiments use nonhuman animals, such as mice, rats, monkeys, dogs, cats, etc.
in research. Although the sacrifices of these experimental
animals have helped researchers to follow with the successful
development of medicine and technology, there have been
growing debates and bioethical concerns regarding animal
experiments. When experimental animals are used in the lab,scientists have a moral and ethical responsibility to provide
high quality care. In 1959, British scientists, Russell andBurch described the principles of working with and caring forthese animals, which can be represented with 3Rs:

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

Replacement, Reduction and Refinement. In the last few
thdecades, the 4 R, ‘Remembrance,’ has been proposed as a
new idea to acknowledge and show appreciation to sacrificed
experimental animals. This proposal is not yet popularworldwide; however, in Japan almost all universities andresearch institutes have annual memorial services andceremonies to comfort their souls. Bioethical issues of
performing animal experiments have been raised and willthcontinue, but the 4 R may be able to help the society reach acompromise between agreement and disagreement over theuse of animals in research field. In this presentation, we will
focus on the ‘Remembrance’ of those sacrificed animals, andwill introduce the situations of memorial services and rituals
not only in Japan but also in other countries. We would also
like to discuss some viewpoints of remembering experimental
animals based on religious views, and provide information of
the origin and historical backgrounds about remembering theanimals in Japan. We hope this presentation would stimulate
researchers to reconsider animal welfare in research fields allover the world.

Nurturing medical ethics and professionalism
through experience of ‘A day in a doctor’s life’1

Nor Azwany Yaacob , Siti Rahmah Hashim Isa Merican, Wan
Nazirah Wan Yusuf
Students Personal and Professional Development Program,
School of Medical Sciences, Health Campus, Universiti Sains
Malaysia
1
E-mail : azwanyusm@gmail.com
The teaching and learning of medical ethics and related
professionalism have been discussed as a process beyond
the boundaries of lecture halls. This component of medical
education should not be focused on theory alone but be
inculcated as a work culture in future career of medical
graduates. In Universiti Sains Malaysia (USM), the basic
theory and principles have been well scheduled as part of thecurriculum activities, but additional non-lecture activities arealso arranged to emphasize the application of it. ‘A day in adoctor’s life’ program is a program where a group of first year
medical students were assigned to a volunteer medical
lecturer. They follow all the lecturer’s clinical duties such as
ward round, clinic, operations and patient education session.
This paper describes the qualitative findings from thestudents’ reflection diaries. The students wrote theirobservations on how the doctors communicate differently in
different situations and with different types of patients, how
they realize that a doctor may not always cure but provide the
comfort that the patients need, and how a doctor’s job must
be carried out with caring, determination and dedication to
overcome the challenges in medical profession. Theseobservations were more meaningful for them in pursuing their
medical profession dream.

Organ donation and family relations in Bangladesh
Md. Sanwar Siraj, Department of Public Policy, City Universityof Hong Kong
E-mail: mssiraj2-c@my.cityu.edu.hk
This paper presents a cross-cultural and comparative
review of the situation of organ donation and transplantation
policies between Bangladesh and the UK. The focus of thispaper is on how the human organ donation andtransplantation policy of Bangladesh is different from thesecular Western perspective such as in the UK. Structurally,organ donation and transplantation policies in Bangladesh arefamily oriented in comparison with the secular Western notionof self-reliance. The biomedical practice in Bangladesh is in a
way that organ donation and transplantation are only
acknowledged for family members. However, family members

can donate their organs to any stranger in most Western
societies. This family oriented donation of organs is very
typical and unique in the traditional and Muslim majority
society of Bangladesh. I also address the normative questionof why organ donation and transplantation policy ofBangladesh is family oriented. Based on the Islamic religious
laws and accounts, cultural and ethical perspectives, I argue
that saving a family member’s life is the prime duty andresponsibility of the religious Muslim majority of the society in
Bangladesh. Each account offers a comprehensive
framework in relation to the family oriented approach of organ
donation and transplantation policy in Bangladesh. I also
argue that organ donation and transplantation policies in
Bangladesh are family oriented because the families are more
vulnerable and the issue may be critical in the sense thatfamily relationships may be lost, and organ trafficking may
increase. This bioethics study presents a new research
aspect and is based on widespread practices in the society.
This cross-cultural study may help policy makers,
researchers, transplant practitioners as well as patients in
Bangladesh.

Shortage of organ donation resulting fromdifficulties in the diagnosis of brain death by
medical practitioners in Malaysia,
1

1

Nor Aina Mhd Khotib ,Noor Naemah Abdul Rahman , Shaikh2
Mohd Saifuddeen Shaikh Mohd Salleh
1
Department of Fiqh and Usul, Academy of Islamic Studies,
University of Malaya, Kuala Lumpur, Malaysia
E-mail: nor_ina@siswa.um.edu.my2
Consultant, Programme for Applied Sciences with Islamic
Studies, Academy of Islamic Studies, University of Malaya,
Kuala Lumpur, Malaysia
The issues of brain death and organ donation are closely
related. Brain death is the irreversible loss of brain function,and from the medical perspective, a person who is brain deadcannot be recovered. The shortage of organs fortransplantation is a worldwide problem. One of the reasons
contributing to the shortage of organs is the refusal of medical
practitioners to diagnose brain death. This paper will highlightfour factors why medical practitioners in Malaysia may refuse
to diagnose brain death. These factors include: 1) medical
practitioners may not accept brain death as true death, 2) a
misconception of the concept of brain death, 3) a lack ofknowledge about brain death, 4) a lack of responsibility incarrying out professional duties. These four factors will be
discussed on the backdrop of ethics as the ethicalimplications pertaining to brain death diagnosis in Malaysia.

Newly Elected ABA Presidential Address: The
influence of gender on living donor kidneytransplantation in Japan: a questionnaire survey of
spousal kidney donors
Prof. Miyako Takagi, University Research Center, Nihon
University, Japan; President, Asian Bioethics Association
E-mail: takagi.miyako@nihon-u.ac.jp
Living donor nephrectomy for renal transplantation has
become widespread as surgical techniques and outcomes
have improved. However, living donor transplantation
presents an ethical dilemma because physicians must risk thelife of a healthy person to improve or save the life of thepatient. Between January 2012 and March 2013, aquestionnaire survey was conducted on living transplantation
donors who had donated a kidney to their spouse todetermine their perceptions of living donor kidneytransplantation. The survey included 41 husbands and 99
wives as donors, i.e., over 70% of kidneys were donated by
wives. Thus, there may be a gender bias with regard to theEubios Journal of Asian and International Bioethics 24 (November 2014)
number of donations from wife vs. husband living donors. In
Japanese society, men are commonly the breadwinners in thefamily and women may be more often expected to act as
donors. For the question “How much the decision to becomea donor was yours?” 85.4% of husband-donors and 79.8% of
wife-donors answered that the donation was only theirintention. Surprisingly, however, 1 wife-donor answered it was
not her intention to donate (under 10% her decision) and her
decision was influenced by others. Apparently, wife-donors
were under pressure from their husbands, children, parents,
parents-in-law, or close relatives. Another finding was that
92.7% of husband-donors compared with 86.9% of wifedonors perceived living donor transplantation as ongoing
medical care. Donors were also asked about their opinions
regarding transplantation of surgically restored cancerous
kidneys. This is currently not allowed in Japan because of thelack of necessary evidence. The issue of cancer recurrence isa concern in restored kidney transplantation, and weestimated the 5-year recurrence rate to be 6%. In total, 78.0%
of husband-donors compared with 82.8% of wife-donors
recognized restored kidney transplantation as ongoing
medical care. These results thus show that husband-donors
preferred living donor transplantation, while wife-donors
preferred transplantation using a restored kidney.
Transplantation using a previously cancerous donor kidney
may offer some relief from the pressure on family members,
particularly wives, to donate.

Session 21: Seminar on Conflict
Resolution
Can a community restorative justice model intransitional justice contexts be applicable totransforming community conflicts after
environmental disasters?
Prof. Akiko Ishihara, Kumamoto University, Japan
E-mail: aishihar@hotmail.com
In this presentation, I will discuss the applicability ofcommunity restorative justice model after civil wars to aprocess of conflict transformation and justice building after
mass environmental disasters such as Minamata andFukushima cases. Divisions and conflicts among community
members tend to happen after mass environmental disasters.
For example, Minamata and Fukushima experienced and arestill experiencing them. In both cases of civil wars andenvironmental disasters, 1) all community members aretraumatized, 2) some level of victim-offender relationships
exist in the community. The restorative justice model seems
to be useful for building justice and re-building community.
However, there exist differences also. In this presentation, I
will compare the Rwandan genocide case, the Minamata
environmental pollution case, and the TEPCO Fukushimaenvironmental disaster case. In the Rwandan genocide
cases, violence was usually direct, physical, and visible; it
was easy to identify who was an offender and who was a
victim about one incident. Both the victim and the offender are
individuals. In the environmental disaster case, violence isstructural, but is not direct. The victim-offender relationship is
not visible and scientific proof for the victim-offender
relationship is needed. I would like to discuss at what stagesof community transformation process we can use therestorative justice model and what practical form of restorative
justice is appropriate in each case.

191

Avoiding ethnic religious hatred; concept of ‘Kita’
Prof. Ho Young Lee, Chung-Ang University, Seoul, Korea
E-mail: wesyuzna@gmail.com
She said: Don’t make others suffer for your hatred – Neon
Generation Evangelion
Even in this century, Asians are still living withunreasonable superstitions. In this essay, I would like tocriticize such ill-affected concepts. I can use the example of
my mother’s experience during the World War II, when Korea
was occupied by Japan. She was born and raised in a far-off
island but to avoid being captured by the military as a sexual
slave she had to fake being married and get asylum to an
inland city. But there were many Japanese living there, andwhen she went to use the public bath, she was told off byJapanese women who yelled at her: “Josenjin Kitanai”, “getoff from my eyes”. Another example is my colleague who lives
in Canada. He studied Japanese religions for two years andlived in a Japanese home. When he moved in, the landlord
mentioned that a ‘Kitanai’ person was in the town; here,‘Kitanai’ is a religious and racial term. But ‘kita’ is a medical
notion of ‘health’. There are two levels of the concept of ‘kita’(‘sanity’ or ‘clean’). The two dimensions of the concept mean
good and healthy at the same time, which is the root ofhygiene as well as racial discrimination. The former meaning
is health and hygiene, the latter refers to religious emotions. It
is neither a philosophical concept nor an ethical norm.
Religious and ethnic studies demonstrate that the sense ofclean and dirty is critical for the survival of indigenous
societies. The holiness comes from such thinking, but thenthe discrimination follows. For example, delivering a baby is
not ordinary but a holy affair, so they have to be separate
from the public for a while. In the ethnic religious sense, amenstruating woman is not clean therefore she may beisolated for a while. This may only be justified when we live ina small and segregated village. But when we live in large
cities, separation by racial discrimination is not valid and does
not suit a globalized life style. In this environment, a religious
approach is helpless. When AIDS struck in 1980’s, it resulted
in a panic approach which was not a solution. There was only
a witch hunt with the blame of immorality on sexual minority
people. They accused sexual minorities under the name ofGod. It led to a huge wave of political conservatism, claimingthat AIDS patients were sinful, dammed, cursed, anduntouchable. In a logical point of view, this was a categoricalfallacy. The religious beliefs were mixed with medical
concepts. It was mere superstition. However, now we knowthat it was not a suitable treatment for patients and families.
In Africa and worldwide, there are many people suffering due
to hatred. They suffer more pain from the disgust of neighbors
rather than the disease. This is a negative aspect of religious
hatred. In old times, leprosy was known as a highly infective
and cursed disease. So they were separated from the public
to prevent from an outbreak. Nowadays, we know that it is nottrue. Still, they may suffer from the hatred of others. Animosity
is the other face of ‘kita’, a religious idea of ‘clean’ that is not
any longer used. The Japanese, Chinese, Korean, Indian andothers have their own criteria of cleanliness. Each notion has
the religious sense of immunity. Shunning is a significant
function of each religion. But, it is not suitable for medical
ethics or moral philosophy. Now we are facing the Ebola virus
with a worldwide panic. Discrimination against African people
may become more severe than before. Sanity is a great idea
when applied to hygiene and medical ethics. However, by
judging others by the name of ethnic religion, it can change
into a nightmare.

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

Dialogue Project for the Affected People by the
Fukushima Nuclear Disaster using Deep
Democracy Model
Mr. Norio Hiromizu, PhD Candidate, Kumamoto University,
Japan
In this presentation, I will discuss the possibility of the
Deep Democracy Model as a philosophy for a dialogue
project for Fukushima people affected by the Nuclear
Disaster. We have had the dialogue project for the people
from Iitate village, which is severely affected by the Nuclear
Disaster in Fukushima. We used the Deep Democracy Model
there. ‘Deep Democracy’ is a psychological, social andpolitical paradigm and methodology for decision making that
Arnold Mindell, the founder of Process Work, proposed. I
define it as “a philosophy, attitude, a viewpoint, and techniqueto make much of every person, every event, and every
dimension (dimensions of reality, dreamland and essence)equally”.
We can rarely improve the tangle situations
in our society because we focus on the factors that we needto consider. Then I believe that we could expect new
possibilities for the approach of Deep Democracy to solve thetangle situations by adding the other parts that look unrelated
without separating the problem that we face from the whole.
‘The Kasukadari society’ is a dialogue project to support a
revival of the broken hearts of the refugees from Iitate village
and to contribute to community rebuilding. The participants
are various stakeholders and basically they listen to eachother. The potential of ‘Deep Democracy’ to empower people
and to start community rebuilding will be shown.

Role of conflict resolution in Global Business,
Ms.Keiko Suzuki, President, Footsteps, Tokyo, Japan
How and who would deal with conflicts in the globalorganizations where many work virtually? Today, the global
firms face more complex and demanding work situations
which often create stress and internal conflicts. Global teamleaders are challenged to handle more diverse teammembers with a different nationality, cultural background andset of values. Exercising the idea of inclusion and diversity
becomes critical to create a high performance team. The
World Bank defines social inclusion as the process ofimproving the terms for individuals and groups to take part insociety. Inclusion ensures that people have a voice indecisions which affect their lives and that they enjoy equal
access to markets, services, and political, social and physicalspaces. It is about recognizing and valuing diversity; it isabout engendering feelings of belonging by increasing social
equality and the participation of diverse and disadvantaged
populations. Let’s look at how the organization leadersmanage conflicts using meta-skills and the concept of “DeepDemocracy” for inclusion and diversity, which foster trust,
flexibility and collaboration instead of confusion and conflicts
at the work place.

Challenges and opportunities of deliberative
democracy approach on complex public issues

advancement of science and technology, these institutions
have undergone marked changes in maintaining their socialand cultural values. This paper examines the bioethical issues
that are emerging in the institution of marriage, family andparenting, as a result of changes in social and cultural values.
Marriage from time immemorial has been a public event. The
earliest report is found in the Old Testament when Labanmade his daughter’s wedding a ‘public event’ by “gathering
together all the men of the place and making a feast” (Gen.
29:22). There are three options in defining the partners ofmarriage: (i) marriage is between a man and a woman (ii)between two persons and (iii) between two creatures. The
legal definition of marriage is changing. Which is the rightdefinition? Changing the phases/faces of marriage is abioethical challenge. Similarly the number of parents a childcan have is changing. Traditionally a child can have twoparents, a father and a mother. Currently this number ischanging. With the onset of one parent families, a child may
be basically denied of the benefit and/or luxury of having twoparents. However, in some countries, the number of parents achild can legally have is more than two. The main issue is thatof secular thinkers who have made a vow to radically change
the institution of marriage. Which position is right? This paper
discusses the bioethical implications of marriage and family inmodern times.

Devising Disaster Ethics: Paradigm, Challenges
and Dilemmas
Dr. Mohammad Azharul Islam, Department of Law, Universityof Dhaka, Bangladesh
E-mail: azharhabib_03@yahoo.com
Disasters are frequently characterized by an abrupt onset,
with overwhelming needs in the face of scarce resources.
Therefore they pose different types of critical challenges
including especially ethical challenges that may be different
from those in a normal situation. Since disasters assume
diversified characters depending on the time, place, andextent of the event, the ethical questions that are raisedcannot naturally be answered based on a “one-size-fits-all”.
Moreover, apart from this inherent impossibility of having aunique paradigm, there are other challenges and dilemmas
that may surround the basic issue, including ethical norms,
ethical processes and elements, and ethical principles andtheories. Thus, although for each and every disaster, we may
successfully respond based on experience from diverse forms
of previous disasters affecting different parts of the globe indifferent phases of history, one must inevitably contextualize
the disaster being confronted, appreciate its unique nuances
and thereby facilitate the construction of its specific legal,
ethical as well as medical framework. This paper endeavors
to focus on the basics of jurisprudence crucial to devise adisaster ethics which eventually entails an arduous job of
meticulous analysis of components related to the constructionof apposite paradigms as well as the challenges anddilemmas affecting their viability and efficacy.

Dr. Satoshi Ishida, Kumamoto University

16:00 – 17:00 Session 22: Medical Ethics

Time to think about the changing faces of family,
marriage and parenting

Consideration of the Production of Human Skeleton
Models from Autopsied Patients with Hansen’s
Disease in Pre-War Japan

Prof. Jayapaul Azariah, Founding President, AIBA andformer President, Asian Bioethics Association; Former
Professor & Director, School of Biological Sciences,
University of Madras, Chennai, India
E-mail: jazariah1@hotmail.com
The stability of any human society is rooted in its
institutions, which include education, health care, humanrights and marriage, to name a few. Due to the rapid

Atsushi Asai , Hiroko Ishimoto , and Sakiko Masaki
1
Department of Medical Ethics, Tohoku University Graduate
School of Medicine, Sendai, Japan
E-mail: aasai@med.tohoku.ac.jp
2
Gastroenterology and Hepatology, Kumamoto University
Hospital, Kumamoto, Japan3
Department of Bioethics, Kumamoto University Graduate
School of Medical Science, Kumamoto, Japan

1

2

3

Eubios Journal of Asian and International Bioethics 24 (November 2014)
On May 9, 2013, a local newspaper in Kumamoto (locatedin Kyushu Island, Japan) reported that pathology researchersat Kumamoto Medical School had produced dozens of humanskeleton models (hereafter, models) from autopsied patients
who had died of Hansen’s disease (HD) in the 1920s. A
general meeting of the “Hansen’s Disease Citizen’s
Association” was held in Kumamoto City immediately after the
release of this news, aiming to eliminate prejudice against
individuals with the disease and to address the historicallessons learned about discrimination. The Association madean emergent appeal, demanding investigation over the
production of these models and the ethics of medical
professionals and researchers at both Kumamoto University
School of Medicine (originally Kumamoto Medical School),and the National Sanatorium Kikuchi Keifuen where all
autopsied patients had been admitted. Both former patientswith HD and commentators specialized in the history of HD in
Japan argued that medical professionals involved in the
production of these models had been discriminatory toward
patients with HD in carrying out unethical practices. The
authors believe it is important to examine, from the humane
perspective, the factors that allowed medical professionals toparticipate in those activities without any condemnation fromeither the medical community or the lay population. The paper
discusses the long history of discrimination against patientswith HD and the ethical fragility of medical professionals as
the two main factors that contributed to the production of themodels. We also consider circumstances of the era in which
this occurred, including the national atmosphere and theethical immaturity of the medical community at the time. In
conclusion, the authors stress the importance of preventing
discrimination and ensuring robust ethical guidelines for
medical professionals in order to keep history from repeating
itself. An endless battle against discrimination is necessary,and serious reflection upon the past and learning from it are
essential.

The clinical application of the new-type ofpreimplantation genetic diagnosis (PGD) on
embryos in Japan
Dr. Masayuki Kodama, National Institute of Fitness andSports in Kanoya, Kanoya City, Kagoshima, Japan
E-mail: kodama@nifs-k.ac.jp
In a recent symposium held by Japan Society of
Fertilization and Implantation (JSFI) in Oita on August 8-9,
2013, many of participants were of the opinion that in theprevention of recurrent miscarriage associated with abalanced chromosomal translocation it was remarkably
effective to apply the new-type of preimplantation genetic
diagnosis (the new-type PGD) using comparative genome
hybridization (CGH) for only the carriers of balanced
chromosomal translocations. Although the Japan Society of
Obstetrics and Gynecology (JSOG) endorses the new-type
PGD using CGH for only the carriers of balanced
chromosomal translocations, it is against the ethicalguidelines of the JSOG to decide whether or not embryos
should be implanted when aneuploidy is found in the embryoswith the new-type PGD. In my opinion, it is at the discretion of
the JSOG’s own randomized controlled studies which involve
multiple facilities whether or not a scientific basis can befound for the value of the new-type PGD in cases of recurrent
miscarriage, implantation failure, and in women of advancedage.

Closing Words for ABC15

Poster and Podcast Presentations
Anticipatory governance of social robotics

193

1

2

1

Lucy Diep , John-John Cabibihan , Gregor Wolbring1
Department of Community Health Sciences, Faculty of
Medicine, University of Calgary, Calgary, Alberta
E-mail: lucy.diep@shaw.ca; gwolbrin@ucalgary.ca
2
Department of Mechanical and Industrial Engineering, Qatar
University
Social Robotics is an emerging field, with many
applications envisioned. Scientific and technologicaladvancements constantly impact humans on the individual
and societal level, therefore, one question increasingly
debated is how to anticipate the impact of a given envisioned,
emerging or new scientific or technological development andhow to govern the emergence of scientific and technologicaladvancements? Anticipatory governance has as a goal todiscuss potential issues arising at the ground level of theemergence of a given scientific and technological product.
Our study investigated: a) the visibility of the anticipatory
governance concept within the social robotic discourse and,b) the implication of anticipatory governance for the social
robotics field and people impacted by how the social robotic
field advances.

Social work, technology governance and people
with disabilities
1

1

Gregor Wolbring , Lucy Diep
1
Department of Community Health Sciences, Faculty of
Medicine, University of Calgary, Calgary, Alberta
E-mail: gwolbrin@ucalgary.ca; lucy.diep@shaw.ca;
podcasthttp://www.crds.org/research/faculty/socialworkasiabi
oethics.mp3
This paper engages with the topic of science andtechnology governance including anticipatory governance andthe questions it raises by looking at the purpose of social workin various places ranging from North America to Asia. We
provide answers to the following questions: a) is social work
as an academic field engaged in the governance oftechnology as a means to influence how technologies areused; and b) is the field of social work visible in the area of
three concrete emerging technologies (social robotics, brain
machine/brain computer interfaces, neuroenhancement/
cognitive enhancement) and one general area of technology
application (human enhancement)? We found no engagementof social work with technology governance and no mention ofsocial work within the emerging academic literature of thetechnologies covered. We discuss these findings in light ofthe purpose of social work as mentioned in academic articles
and the 2012-2016 global social agenda generated by theInternational Association of Schools of Social Work, and theInternational Council on Social Welfare highlighting inparticular, the impact on people with disabilities.
Podcast:http://www.crds.org/research/faculty/socialworkasiabi
oethics.mp3

Anticipatory governance of scientific andtechnological advancement: what does this mean
for ability-diverse groups of the Global South
1

1

Lucy Diep , Gregor Wolbring1
Department of Community Health Sciences, Faculty of
Medicine, University of Calgary, Calgary, Alberta
E-mail: lucy.diep@shaw.ca; gwolbrin@ucalgary.ca
podcasthttp://www.crds.org/research/faculty/Podcast%20%20Social%20robotics%20through%20an%20anticipatory%20governance%20lens%20(Diep,%20Cabibihan,%20Wolbring).mp3
Scientific and technological advancements have throughout
history impacted humans on individual and societal levels.
Recently, debates of how scientific and technologicaladvancements should be governed have intensified. The

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

purpose of this paper is to contribute to the ethics of scienceand technology discourse, an analysis of anticipatory
governance anticipatory advocacy and ability expectation
governance. Anticipatory governance is a recent addition to
the governance of science and technology discourse with thegoal to discuss potential issues arising from the ground levelof emerging product. We outline in this paper, the challenges
anticipatory governance pose for disabled people in the
Global North and in particular, in the Global South. We
propose that anticipatory governance generates the need for
anticipatory advocacy by disability (ability expectation
oppressed) rights groups and we present barriers for that tohappen. Finally, using ability expectation and ableism as alens we discuss that moving from governance to anticipatory
governance of science and technology alone is not solving
the problem; it has to be accompanied, if not preceded, by asolid ability expectation and ableism governance discoursethat includes engaging in questions of which ethical theory
can contribute to how we decide which ability expectations
are accepted and which are not.

Parental perceptions of media portrayals andpublic perceptions of autism
Kalie Mosig, Gregor WolbringE-mail: mosigkd@gmail.com
Faculty of Medicine, Dept. Community Health Sciences,
stream of Community Rehabilitation and Disability Studies,
University of Calgary, Calgary, Alberta, Canada; E-Mail:
gwolbrin@ucalgary.ca(podcast) http://www.crds.org/research/faculty/Parental%20P
eceptions,%20Mosig%20and%20Wolbring.wav
Media plays an important role in distributing information to arange of audiences and also influences the opinion of various
audiences regarding various topics, one of which is autism.
Studies have been completed that have looked at autism
portrayals in media and have concluded overall that media
portrayals are one-sided, medicalized and framed in negative
ways, using terms with negative connotations such as“difficult”. How autism and autistic individuals are portrayed inmedia influences the social atmosphere surrounding autism,
and the utility of the information for the audience. Given thatpeople are impacted by media portrayals, among them
parents, this here presented study aims to ascertain theviews of parents of children with autism in regards to media
portrayals of autism and public awareness of autism. Key
findings related to media portrayals were that participants
thought: There are many inaccuracies in the media; The
inaccuracies in the media impact the parents, their children
and their families; The public perception of autism is
inaccurate The inaccuracies in the public perception of autism
has impacted the parents, their children and their families;
There are resultant social barriers the participants face due toinaccuracies in the media portrayals and public perception ofautism. The results of this study help to illuminate theopinions of those within the autism community many of whom
consider media portrayals and public perception of autism to
be inaccurate resulting in various negative impacts on thefamilies. Ethics regarding autism and its portrayal in media
should be stressed given the wide and frequent negative
effects experienced by the parents of children with autism.
This data can be used not only by academics to further
current or existing research goals particularly those in the
disability studies field, as well as advocacy groups, especiallyself-advocacy groups in regards to ethics.

“Winning is everything” as the basis of academic
misconduct among Indonesian students

Yeremias Jena, Atma Jaya School of Medicine, Atma Jaya
Catholic University of Indonesia, Jakarta, Indonesia
Email: yeremias.jena@gmail.com
Recent researches conclude that unethical behavior
among university students, such as cheating and plagiarism
has led to quasi-civilized behaviour. These findings arealarming if the acculturation process is taken as a holistic
process of internalizing values and norms that may form thestudents’ moral principles in life. Educators are concerned
whether or not the students have properly internalized themoral values and norms. A study of 360 students of thesecond semester who took “personal development” course at
Atma Jaya Catholic University in Indonesia in 2013 showedthat unethical behavior such as cheating and plagiarism wererarely done. However, the inquiry about why students commit
academic dishonesty produced alarming results. This study
shows that academic integrity among university students whoshould demonstrate high ethical behavior is worrisome,
especially considering that in the period of study they werestudying a course on “personal development”. Looking at thestrong desire of students to change the academic misconduct
culture we argue that an educational model is needed which
does not emphasize excessively on performance. This
position has to be practiced hand in hand with the
involvement of ‘clean’ students who can be role models in
influencing the formation of student awareness and ethicalbehavior.

Ethical concerns over the use of restrictive
measures for tuberculosis control in the UK
Minakshi Bhardwaj, Ph.D.
Faculty of Medicine, University of Southampton, UK
E-mail: bminakshi@hotmail.com=Tuberculosis (TB) is second only to the HIV-AIDS as thegreatest killer worldwide due to a single infectious agent.
Approximately 1.3 million died from TB in 2012. The UK has
one of the highest incidences of Tuberculosis in Western
Europe and TB remains a serious public health concern withrising trends in the incidence over the last two decades. The
TB from abroad is a leading factor in the rise of TB in the UK.
Given that TB is a notifiable infection, the UK has adopted
different methods for controlling TB including random
screening at the point of entry to the UK (ceased in April2014) and compulsory medical checks prior to permission toenter the UK and immediate referrals upon entry of individuals
coming from high prevalence regions of the world such as
Africa and Asia. Similar systems are seen in US and otherparts of the Europe where TB is not endemic. However, theserestrictive measures also raise significant ethical concerns interms of privacy, exclusion and identity. In this paper, I wish
to explore the ways in which tuberculosis implies underlying
ethical issues of globalisation and human rights within thecontext of communicable diseases.
The Homo sapiens’ place in nature from an objective‘biocentric’ point of view
Michael J. Vandeman, USA
E-mail: mjvande@pacbell.net
Are humans part of nature? Clearly we are, or we wouldn't beable to interact with it. The real question is what part are we?
Most texts define an exotic species as one translocated byhumans to an area where it had not previously existed; thiswould seem to make us, throughout most of our range, an
exotic species, although this fact is never mentioned. But theeffect the species has on its new surroundings has little to dowith how it got there, and more to do with its being a
newcomer. What is a native species? It is basically one thathas been around a long time, i.e., not a newcomer. The
question is, how long? A length of time that makes sense isEubios Journal of Asian and International Bioethics 24 (November 2014)
the length of time that it takes for the other species in the area
to evolve to adapt to the newcomer – on the order of a million
years. That would make humans native only to Africa, andeverywhere else a rank newcomer (exotic species). This is
not a value judgment, just biological fact, but maybe also agood indication of how we should behave: with restraint: withthe manners of a guest.

Olympic Truce Youth Network
Dibakar Babu Bhattarai, Tribhuvan University RR Campus,
Kathmandu, Nepal
E-mail: rimesh909@gmail.com
The Olympics games was traditionally used as a means ofpreventing conflict and creating peace between nations atwar, and the International Olympic Committee (IOC) andUnited Nations (UN) have transposed this ancient peace ethic
to the modern Games. And in order to emphasize theimportance of the Olympics tradition, a dozen youths from allover the world were trained by the UNESCO team in London
during the Olympics (2012) in several approaches tocommunity peace building and means of promoting the
Olympics peace history and process. Thus in order topromote youth participation, initiate inter-agency cooperation,
development and increased youth involvement, organizing a
2-day workshop in Nepal is essential in inspiring, coachingand supporting youths in enhancing peace and stability. To
this end, the Youth Empowerment Workshop (YEW) is aimed
at encouraging more youth participation in relation to crosscultural aspects of peace education, human security, postconflict reconstruction and socio-ethical aspects ofdevelopment in crisis prone, war-torn and peace building
communities in Nepal and the world at large. Intensive
trainings and inter-cultural measures for peace-building
activities, approaches to sustainable development andprojects will be discussed, taught and encouraged during the2-day workshop. Thus the overall aim of this workshop is to:
inform about several youths focus programs in the world,
facilitate decision-making and approaches to reinforce andsupport the leadership of the country in sustainable
development, also encourage participation of more Nepal
Youths at international forums thereby increasing network ofcontacts, and mobilize Youths for future Olympic Truce
Youths programs in Turkey, Asia, Rio (2016) etc. It isenvisaged that by creating awareness about the international
Youths programs, this workshop will echo the mission whichis “to provide development opportunities that empower young
people to create positive change” of which these opportunities
will have no boundaries or barriers.

The ethics of translating genomics research into
public health practice
Minakshi Bhardwaj, Faculty of Medicine, University ofSouthampton, UK
E-mail: bminakshi@hotmail.com
With the end of the Human Genome Project in 2003 andthe decoding of a final draft of human genome, advances inmolecular medicine and genomic technologies have brought aparadigm shift in the ways in which genomic technologies
may shape the practice of medicine in the future. The
completion of the HapMap project and ENCODE have laid thescientific and technical foundations for the use of Genome
Wide Association Studies (GWAS) that make use of genetic
maps of populations rather than individuals and are currently
routinely utilised in health research applications at populationlevel. GWAS are particularly useful in identifying and finding
genetic variations that contribute to common but complex
diseases such as diabetes, cardiovascular diseases, asthma
and cancers, for example. Although there have been rapid

195

developments in genomics research, translating them toclinical practice has had a moderate pace. However, strategic
efforts are made in the UK to integrate these developments
into mainstream clinical medicine. The aim of this paper is tohighlight some of these developments in genomics and how
they are expected to shape the future of public health practicein the UK, whilst an attempt is made to raise some pertinentand valid issues around readiness, skills and competencies
required of public health practitioners to utilise thesetechnologies in their work and decision-making.

Ethical issues in genetic engineering: are therelines we shouldn’t cross?
Carolus Dibakar and B. Kusmaryanto, Graduate School of
Sanata Dharma University, Yogyakarta, Indonesia
Member of Indonesian National Bioethics Commission &Indonesian National Commission of Health Research Ethics,
Center for Bioethics and Medical Humanities, Faculty of
Medicine, Gadjah Mada University, Yogyakarta, Indonesia
E-mail: kusmaryanto@gmail.com
One of the most fascinating rapid developments inbiological sciences is genetics. Genetics opens many
possibilities to modify an organism’s genetic makeup throughgenetic engineering. The twenty-first century is the DNA age
due to the abundant benefits that have resulted from genetic
engineering in the field of medicine, manufacturing, andagriculture. In this paper, we will discuss the application ofgenetic engineering in humans. Human genetic engineering
has to be guided by ethics so that it will not degrade humandignity but place human beings in the center of development.
There are two groups of ethical problems: general ethicalproblem and special ethical problem. The first refers to ethicalproblems that arise in all kinds of genetic engineering while
the second refers to ethical problems that emerge according
to the purposes of genetic engineering: therapy, alteration,enhancement, and perfection. The general problems include
the safety of the product for the subject and his/her
environment. This problem emerges due to the inability ofhumans to control all side effects and unpredicted reactions.
The next is about ‘playing God’; with modification, deletion,
combination and insertion of genes, people may create newlife or interference with nature as the prerogative rights ofGod. As for special ethical problems related to the purpose ofgenetic engineering, there is no serious ethical problem if theprocedure is for curing the diseases since living healthily is ahuman right. There may be no serious problem either if the
purpose is for perfection since it is the natural laws thateverything moves in the direction of perfection. The mostproblematic is the alteration of human being. With genetic
engineering, humans can be altered into a different form, both
physically and mentally. Behavioral genetics prove that genes
have big influences on human behavior. Certainly, it is nottrue that all human behaviors are determined by genes but it
is true that some genes have large influences on humanbehavior. Finally, the basic question is on human freedom:“Do humans have the freedom to do what they can, and if so,in what sense?”

Commercializing oocytes as an extension of prolife vs pro-choice debates in the era of therapeuticcloning
Dr. Teguh Haryo Sasongko, Human Genome Center, Schoolof Medical Sciences, Universiti Sains Malaysia HealthCampus, Kubang Kerian, Kelantan, Malaysia
Email: tghsasongko@gmail.com, teguhhs@usm.my
Imagine an era where therapeutic cloning has becomeroutine clinical practice; a considerable number of oocytes
should be supplied in order to meet market demands of tissue

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

manufacturing. Oocyte donation on voluntary basis would nolonger be able to cope with the demand. With this, comes the
ethical question of whether it is morally acceptable tocommercialize human oocytes in order to keep up with thedemands for oocytes. This presentation includes the different
views and moral deliberations of the two opponents, extended
from abortion debates of Pro-Life versus Pro-Choice. Pro-life
proponents would see oocytes, to a certain extent, as seedsof life, though they may not be life itself in its fullest meaning.
Selling oocytes would be seen as disrespect to the sanctity oflife because it would mean selling seeds of life, if not life itself.
Pro-choice proponents would see oocytes as part of awoman’s body, and thus in women’s possession, over which
women should have full autonomy. Selling oocytes would beseen as completely an exercise of woman’s autonomy over
her own body. In a situation where therapeutic cloning
becomes the norm in medicine, just like antibiotics are used
today, prevention of oocytes commercialization might
potentially harm the practice of medicine. It would also beinjustice to the oocytes donors who have undergone medical
interventions in order to obtain their oocytes, while thecells/organs manufacturers enjoy lucrative profits. Concernswith regards to respect over the sanctity of life could be taken
into account, in the form of regulation of non-inducementcompensation. However, this approach will be confined withinstate jurisdiction, because the amount of compensation
offered by more developed states could be more attractive towomen coming from less developed states. Therefore, transcommercialization of oocytes, which may happen duringoocyte shortages in particular countries, may be ethicallyproblematic whether in allowing or prohibiting it.

The impact of selected Yoga sana and meditation
on psychological variables of Yoga teachers
1

A. Sebastian Mahimai Ra and M. A. Jothi Rajan
Arul Anandar College, Karumathur, India
E-mail: asmrajaocd2002@gmail.com
Yoga is a systematic practice for the realization of higher
perceptions, and a method for transformation of the humansystem which influences all levels of being, including thebody, mind, personality, emotions, and their interactions.
Yoga recognizes that a pure consciousness exists withineach individual which is influenced by all levels of being. The
teachings of yoga emerged with the Vedas, other classicaltexts and a rich oral tradition. Yoga is a living tradition, and its
practices are relevant in the modern world. These practices
include asana (sitting still), pranayama (breathing exercise),
meditation, mantra chants, mudra rituals, and a disciplined
lifestyle. The researchers selected two educational
institutions, the Arul Anandar College and Madurai Kamaraj
University, for the present study, where forty male teachers
were recruited for the study at random by lot samplingtechnique. From the 40 participants, 20 male teachers wereassigned as the experimental group and 20 male teachers as
the control group. The objective of the study was tounderstand how Yoga teachers particularly embrace the idealof truthfulness in dealing with students and others. All
permanent teachers of both Arul Anandar College andMadurai Kamaraj University were included for data collection.
Findings of our study will be discussed in detail, and after
presentation of the research paper, some Mudra ritual
gestures will be demonstrated by the researcher.

The principle of autonomy and decision making
differences between the American and Chinese
cultureThe ethical imperative associated with publichealth disparities across neglected populations of
the world

Prof. Yanguang Wang, Institute of Philosophy, Chinese
Academy of Social Sciences, Beijing, China
E-mail: ameliaw2002@hotmail.com
In the United States, it seems that a surrogate from family
members makes decision for a patient who has lostdecisional capacity. But the important point is that in somestates the law would like to find the evidence of the patient’
past wishes and ‘advance directive’. So finally, this is not afamily decision or family autonomy. This ‘advance directive’ ofa patient’s wishes is so important for practicing individualautonomy, and individual autonomy is not only protected byAmerican law but also is realized by the American culture ofmaking an ‘advance directives’. The family, in Chinese
culture, functions as a whole to provide consent for significant
medical and surgical interventions when a patient has lostdecision-making capacity. And older people, including thecurrent generation do not think it is necessary to give a wishor ‘advance directives’ before they lose decisional capacity. I
think one important reason is that in Chinese culture, death isa bad thing, and especially the faith of the older generation.
Most Chinese don’t believe human will have next life and go
to Heaven after death as said in the Bible of Christians; sothey are afraid of death so they can hardly make an ‘advancedirective’ before death. However, the Chinese do make the‘advance directive’ for their property left for their family. Does
this difference cause the loss of patient autonomy in China
and the family autonomy has to be substituted for it in China?
It is true that the principle of Autonomy could not simply be
imported into ‘already existing’ Chinese cultural systems; inChina this can better be done by formulating more individualoriented laws and policies, such as those that empower thepatient to establish a written ‘advance directive’ for the family
members and physicians to follow regarding surrogate
decision making.

Prof. Thomas Gionis, President, American University ofSovereign Nations (AUSN), USA
The Fulbright Academy of Law, Peace and Public Health(www.FulbrightAcademyLaw.org,
Washington,
D.C.)
conducted critical research and analysis with respect to global
public health, the ideals of the Fulbright Program, and thecovenants of the Preamble to the Constitution of the World
Health Organization. That research was of fundamental
importance in furthering the development of AUSN,
elucidating further its overwhelming call to be formed, andhelped guide the creation of its educational programs. For
instance, striking global public health data concerning theburden of disease and global death rates related tocommunicable and infectious diseases, cardiovasculardiseases, cancer, and diabetes, the health of populations andthe increasing of international epidemics, the increasing
incidence of natural disasters, complex humanitarian
emergencies, refugees and internally displaced persons, thedevastating persistence of enormous disparity in healthcare
outcomes with respect to global health indicators and basic
provisions of and access to medical care between Native
American indigenous peoples and non-Native Americans, andthe growing disparity in healthcare access and health care,both nationally and internationally, were identified, both overthe course of the past 5-10 years and as currently exist. The
identification and understanding of this global health data
formed the foundation of our moral imperative to act andformulate what we believe is a necessary remedy. Second,
important fundamental ideals of the Fulbright Program
including promoting international mutual understanding,international tolerance, global cooperation, promotion ofrespect, human dignity, and peace, were identified as being
guiding principles which ought to be called upon to guide theEubios Journal of Asian and International Bioethics 24 (November 2014)
remedy for the devastating existing global public healthoutcome data identified from the Fulbright Academy of Law’s
research. And, third, important covenants of the Preamble to
the Constitution of the World Health Organization (WHO)were also found to serve as guiding principles for thedevelopment of AUSN, which were important in guiding theformation of the AUSN Mission, Vision, and Philosophy, which
are discussed here. Health and public health are undisputedly
foundational pillars of any sustainable community, society or
nation and serve as positive attributes of peace. In order for
us to sustain communities and nations, peace, well-being,
and maintain respect and understanding for tradition andculture of Native Americans as well as all Indigenous
Populations, we must have a sustainable educational system
which promotes graduate education in both medicine andpublic health. We believe the best way to directly address andimprove the delivery and accountability of healthcare for
Native Americans and Indigenous Populations so as todirectly address the healthcare issues of disparity is to have acenter of education dedicated to Native American andIndigenous Population healthcare on the Sovereign Land of
Native Americans.

Attitudes of Sri Lankan university students towards
animal ethics
1

2

P. H. G. J. De Silva and D. C. A. Kalubowila
1
Department of Animal Science, Faculty of Agriculture,
University of Peradeniya, Peradeniya
E-mail: desilvajayamini@gmail.com
2
Sri Lanka Council for Agricultural Research Policy, Colombo,
Sri Lanka
The use of animals by humans is morally complicatedregarding the raised ethical issues. Universities have an
obligation to ensure that students, as a vital segment of thesociety, are made aware of animal ethics. The attitude of anindividual about animal bioethical issues is governed by arange of factors. This study attempts to determine theattitudes of Sri Lankan undergraduates toward the use ofanimals for human purposes which may be affected by theirfield of studies. The views of 450 undergraduates in the fieldsof medicine (M), agriculture (A), veterinary (V), management(MG), engineering (E), and art (AR) were collected using a
structured type questionnaire. The respondents from majorsof V (98%), A (82%), M (95%) and AR (60%) held utilitarianviews on the use of animals for human activities but nobody
believed that humans have full liberty to use animals. The
most accepted use of animals by M, MG, AR and E was aspets while that of A, V undergraduates were for livestock
farming. Killing of unproductive farm animals including cattle
was accepted only by V undergraduates. Many MG (88%), E(75%) and AR (81%) students opposed any animal
experiments that would disable the animals whereas V (95%),
M (69%) and A (61 %) said that their decision depends on theoutcome of the experiment. More than 90% in any discipline
were similar in their strong agreement with treating all animals
kindly, preventing pain and providing space for animals tomove normally; A and V were more in agreement than otherswith farm animals’ interests being considered as important ascompanion animals’ interests. The highest percentages ofstating “disagreement” were in the category of animal use fortransporting, fighting, hunting (of native wildlife), andinhumane treatment (castration, intensive housing). It was
concluded that the undergraduate students’ attitudes about
the use of animals for research and other purposes varydepending on the field of study they follow.

Bioethical issues in food animal production: publicconcerns about animal welfare in Sri Lanka

1

197
2

P. H. G. J. De Silva and D. C. A. Kalubowila
1
Department of Animal Science, Faculty of Agriculture,
University of Peradeniya, Peradeniya, Sri Lanka
E-mail: desilvajayamini@gmail.com
2
Sri Lanka Council for Agricultural Research Policy, Colombo,
Sri Lanka
Food animal production systems that supply food tosociety have been directly affected by societal demands.
Ethical issues are a crucial factor for the livestock industry
today. There are significant ethical questions associated withfood animal production that the society demands to beanswered. Ethical questions and concerns focus on all
aspects of animal uses in our food production system,
including humane handling, housing, feeding, watering,
castrating, tail docking, teeth clipping, beak trimming, dehorning, breeding, transporting, slaughtering, and preventing
illness. Consequently, society has turned to science for
guidance and animal welfare has been identified as the key
attention point for future livestock production. This paper
analyzes the public concerns about farm animal welfare
issues especially in the advent of ethical basis of current
commercial livestock production and processing of foodanimals. Survey information indicates that the public
expresses great concern for issues related to conventional
animal production systems in Sri Lanka. The public is
unwilling to accept food which embodies poor animal welfare,but also willing to pay a premium for ethical (higher farmanimal welfare) products. Also Sri Lankans are perhaps
philosophically ready to accept and support the urgent
changes needed to improve animal welfare standards in theircountry. This study does not wish to push for an end to eating
meat by the public but strongly believes that animals should
receive appropriate treatment during their lives. The study
proposes that the establishment of food animal production
practices that are viewed as ethically defensible is not only
the right thing to do but also the pragmatic action to be taken
as a business tool.

Injustice in the healthcare
Americans in the US

system to Native

Giang Han Tran (Hana Tran)
American University of Sovereign Nations, USA
E-mail: hana.tran75@yahoo.com
Native Americans (American Indians and Alaska Natives)
include approximately 2.5 million individuals who self-identify
as AI/AN and an additional 1.6 million individuals who in
addition to AI/AN self-identify with one or more other races(U.S. Census 2002). Currently, there are 566 federally
recognized AI/AN tribes in the United States representing
numerous distinct languages and cultures. Approximately 50
percent of AI/ANs reside in rural areas, some on reservations,and others in organized communities; these are underserved
isolated rural areas with overburdened physicians, limited
clinical space and resources, and burdensome travel
distances. American Indians and Alaska Natives have thehighest rates of poverty in America, accompanied by lower
education levels, poor housing, and transportation problems.
The health disparities between AI/ANs and the majority
population in the United States are substantial and persistent.
Suicide and other violent deaths remain a paramount concern
for tribal communities. Youth suicide and violent deaths havereached epidemic proportions. Losing land, culture, and lives
through systematic government attempts to assimilate
indigenous populations through changed diet, culture, andforced relocation can be linked to today’s tribal healthchallenges. These combined experiences continue to result in
escalating rates of depression, alcoholism, suicide, andviolence in tribal communities. Currently, the federal
government oversees a system of hospitals and clinics

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Eubios Journal of Asian and International Bioethics 24 (November 2014)

managed by the Indian Health Service (IHS), tribes, andurban Indian programs. Historic and persistent underfundingof the Indian health care system has resulted in problems withaccess to care, including primary health care, specialty
medical care, long-term care, and emergency services. The
funding has been limited to 40 to 60 percent of need andinsufficient to maintain health status. This severe
underfunding has also resulted in concerns not only overaccess of care, but also over the quality of health caredelivered to this population. This presentation voices ademand for justice for Native Americans.

Stakeholder’s Attitudes to Embryonic and Adult
Stem Cells In Malaysia
Latifah Amin and Hasrizul Hashim, Pusat Citra Universiti,
National University of Malaysia (UKM), 43600 UKM Bangi,
Selangor Darul Ehsan, Malaysia
E-mail: nilam@ukm.edu.my
Modern biotechnology has been identified as one of the fivecore
technologies
that
will
accelerate
Malaysia’stransformation into a highly industrialized country by 2020.
However at same time, it has been classified as a complex
emerging issue which exhibits high salience combined withlimited knowledge on part of the public. In medical
biotechnology, several promising applications have beendeveloped for decades including drug production,
pharmacogenomics, gene therapy and tissue transplant. Oneof the sources of tissue for transplantation to treat humandisease is stem cells which could be retrieved either fromembryo or from various adult tissues in human. However, due
to the rapid advancement in medical biotechnology in the past
fifteen years, it has been the object of an intense and divisive
debate worldwide. Earlier studies have shown that public
understanding, perception and acceptance of new technology
can both promote and hamper its adoption. The objectives ofthis paper are to assess the Malaysian stakeholders’ general
attitudes that can shape their specific attitude to medical
biotechnology and to determine their specific attitude toembryonic and adult stem cells. A survey was carried out on
513 respondents from various stakeholder groups in the
Klang Valley region. Overall the stakeholders in Klang Valley
have moderate level of engagement with modern
biotechnology, moderate level of trust on key actors(industries, scientists and biotechnology regulators) in
Malaysia, perceived technology as having moderate negative
impact on society and the environment, and claimed to havehigh level of religiosity. They perceived both embryonic andadult stem cells as having moderate benefits, risks, moral
concerns and religious acceptance which translated tomoderate encouragement. However, embryonic stem cells
was perceived as having higher moral concerns compared toadult stem cells and in turn, adult stem cells was found to be
more acceptable from the stakeholders’ religious perspective
and was more encouraged. Factors influencing theiracceptance of stem cells will also be discussed.

Editorial address (and all correspondence to:Prof. Darryl Macer, Ph.D., Hon.D.
Provost, American University of Sovereign Nations(AUSN), 8800 East Chaparral Road, Suite 250,
Scottsdale, Arizona, 85250 USA
Email: dmacer@au-sn.com
darryl@eubios.info
http://au-sn.com
http://www.eubios.info
Registered address of EJAIB: P.O. Box 16 329,
Hornby, Christchurch 8441, New Zealand

American University ofSovereign Nations(au-sn.com)
You can enroll in the first Masters in Public Health(M.P.H.) Degree to ever be offered on Native
American Indian Sovereign Land in the USA. The
first cohort started in May 2014. We start students
every month. We have also started the first ever
Masters in Bioethics and Global Public Health(M.B.G.P.H.) Degree in the world. We welcome
students of all ages, gender, ethnicities, abilities, gifts
and backgrounds!
Among our senior management are Prof. Darryl Macer,
former UNESCO Regional Adviser for Asia and the Pacific,
Prof. Govindan Parayil, former Vice-Rector of United
Nations University (UNU), and Prof. Thomas Gionis, theyoungest person in the USA to ever complete a M.D. degree,
who is chair of the Fulbright Academy of Law, Peace andPublic Health. Our faculty are global thought leaders who
have joined this unique endeavor, from around the world!
We have several options depending on where you live!

1) MPH and MBGPH Onsite in AUSN Arizona:
Students can take the MPH and the MBGPH as either fully
onsite residential master’s degree programs (if you have valid
US residency). If you can be onsite at AUSN at least two fulldays a week for one year then you can enjoy all theadvantages of the residential program with more facultystudent contact time! (AUSN does not yet offer assistance forstudent visas).

2) MPH and MBGPH Combination programs using
onsite and online hybrid combination (open to anyone
around the world). We ask all enrolled students to join at least
three 3-day on-site intensive training programs during theirstudies…and we also offer some of these intensive training
programs at overseas venues as well. We will provide
specific details of the courses for online and onsite tostudents who apply and are accepted.
Onsite intensive
trainings are regular arranged at AUSN, Arizona, USA andalso overseas, including through the AUSN Liaison Office in
UNSOED, Purwokerto, Indonesia, as well as in some of the
15 other countries we have AUSN associated Centers
located.

We welcome applications and the MPH and programis intended to provide academically qualified individuals
who are dedicated to enhancing the status and qualityof life of all global communities, the basic competentknowledge and creative and critical-thinking ability to
improve public health all over the world. The Director of
the MPH Program is Professor Thomas Gionis,
President of AUSN.
The MBGPH program is intended to provide
academically qualified individuals who are dedicated toenhancing the status and quality of life of all global
communities, the basic competent knowledge andcreative and critical-thinking ability to improve thehealth of all the world, and to live holistically in our
precious environment. The Director of the MBGPH
Program is Professor Darryl Macer, Provost of AUSN.

Eubios Journal of Asian and International Bioethics 24 (November 2014)
Curriculum for MBGPH
Residential program(All courses are mandatory):
Ability Studies (3 credit hours)
Applied Bioethics Research Seminar (2 credit
hours)
Core Concepts in Bioethics and Cultural
Frameworks (3 credit hours)
Environmental Ethics (3 credit hours)
Essentials of Public Health (3 credit hours)
Ethics of Science and Technology (3 credit
hours)
Global Public Health and Peace (2 credit hours)
Human Research Subject Protection (3 credit
hours)MBGPH Thesis and Public Defense (2 credit
hours)
Public Health Law, Ethics and Policy Analysis(3 credit hours)(All courses are mandatory):
Bioethics and Genetics (3 credit hours)

199

Combination hybrid program(Mandatory courses):
Ability Studies (3 credit hours)
Applied Bioethics Research Seminar (2 credit
hours)
Core Concepts in Bioethics and Cultural
Frameworks (3 credit hours)
Environmental Ethics (3 credit hours)
Essentials of Public Health (3 credit hours)
Ethics of Science and Technology (3 credit
hours)
Global Public Health and Peace (2 credit hours)
Human Research Subject Protection (3 credit
hours)MBGPH Thesis and Public Defense (2 credit
hours)
Public Health Law, Ethics and Policy Analysis(3 credit hours)
Complete three of the following four Courses (3are Mandatory):
Bioethics and Genetics (3 credit hours)
Molecular Biology and Bioethics (3 credit hours)
Biosystematics and Biosphere (3 credit hours)
Biological Structures and Functions/Life Studies(3 credit hours)

Hope you will Enroll with us today!
The fulltime onsite or combination Masters degree studies with AUSN can becompleted in one year. Apply by November 2014 and we will waive theapplication fee! Some applications for full scholarships will also be
granted…preference given to earlier applications, please refer to the au-sn.com
website.
We are also conducting innovative research at the Institute of Indigenous Peoples
and Global Studies, and the Institute of Sustainability Science and Knowledge
Traditions. Research Fellows and Faculty may also join the discussions in theclasses to make for a stimulating environment.
Welcome to this unique endeavor in international and indigenous education at theAmerican University of Sovereign Nations (AUSN) in Scottsdale, Arizona, USA. We
have Memorandums of Understanding with over 20 foreign universities andinstitutions, providing unique opportunities for becoming a global citizen in yourstudies and future life.
Email to Professor Darryl Macer, dmacer@au-sn.com
http://www.facebook.com/pages/AUSN-American-University-of-Sovereign-Nations/313344592147668

Let’s meet the world and our own identities and histories in AUSN
Let’s mold the future for equity, sustainability and justice together!

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