Eubios Journal of Asian andInternational Bioethics
EJAIB Vol. 27 (5) September 2017www.eubios.info
ISSN 1173-2571 (Print) ISSN 2350-3106 (Online)
Official Journal of the Asian Bioethics Association (ABA)

Copyright ©2017 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

Special Issue:

ABC18 Abstract Book
18th Asian
Bioethics Conference:
Future of Bioethics and
Healthcare
Seoul, Republic of Korea,
25-27 October 2017
Organized by the Asian Bioethics Association(ABA) in Yonsei University, Seoul, Republic ofKorea in conjunction with the Korean Bioethics
Association; the National Bioethics Commissionof Korea, AUSN, Eubios Ethics Institute.
http://www.eubios.info/asian_bioethics_assn
http://abc2017seoul.org/
EJAIB Editorial address:
Prof. Darryl Macer, Ph.D., Hon.D.
President, American University of Sovereign Nations(AUSN), Arizona, USA
Email: darryl@eubios.info

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Registered address of EJAIB: P.O. Box 16 329,
Hornby, Christchurch 8441, New Zealand

Editorial: ABC Returns to Korea
We are honored that the Asian Bioethics Association(ABA) celebrates the Eighteenth Asian Bioethics
Conference (ABC18) in Korea. ABC4 was held in Korea in
2003, and the proceedings were published as Song Sangyong, Koo Young-Mo, and Macer, Darryl R.J., eds.,
Bioethics in Asia in the 21st Century (Christchurch:
Eubios Ethics Institute, 2003). Looking through thepapers from 2003, with the pleasant knowledge that thethree editors of the 2003 conference are all present 14
years later in 2017, we can see that there has been
progress in research development since the foundationof the ABA in 1997 in Kobe, Japan, out of the East Asian
Association of Bioethics launched in Beijing in 1995.
EJAIB is pleased to publish the available abstracts of
those who can attend ABC18. Authors are welcome tosubmit their full papers to EJAIB for publication. We
express our regrets that at the beginning of the year welost two long serving former ABA officers, Jayapaul
Azariah from India and Umar Jenie from Indonesia.
ABA wishes to thank all those involved in the holdingof ABC18, and all those who made their efforts to join us.
Bioethics is just as relevant today as it was thirty years
ago as some of us got together to develop the culture ofbioethics, with many joining us along the way. We
celebrate young scholars in the ABA tradition that all
sessions are held in plenary, and all voices are welcome.
This year has seen the 50th Masters in Bioethics andGlobal Public Health graduate of American University ofSovereign Nations (AUSN), a decolonized global
bioethics degree program built on the work developed in
Asia through numerous roundtables in Tsukuba,
Kumamoto, and the ABCs, to educate professionals. We
applaud the development of national bioethics
associations for open and free discussion of bioethics,
and it is 20 years since I organised the global forum ofnational bioethics committees in Tokyo in 1998.
For the past three years the attendance of ABC are
available as postgraduate credit towards Masters and
PhD degrees of AUSN, and many colleagues active in ABAserve as AUSN Visiting Professors. It is the stated goal of
AUSN to materialize the dream of having a dedicatedpostgraduate bioethics degree program in every country
in the world, and we must not give up in that necessary
ambition and target. Let us celebrate bioethics together.
- Darryl Macer, Secretary, ABA

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

Overview of southern cooperation from Kaohsiung
Municipal Kai- Syuan Psychiatric Hospital- Yu Shi Lu, Kaohsiung Municipal Kai-Syuan Psychiatric
Hospital, Kaohsiung, Taiwan
Email: kawaza@gmail.com
Kaohsiung Municipal Kai-Syuan Psychiatric Hospital (KSPH) is
one of the teaching hospitals in southern Taiwan and plays adominant role in the regional psychiatric network. Four years
ago, KSPH started southern Asia project along with Taipei
Medical University and formed a professional team to attend
some international meetings as well as visiting different
countries annually. KSPH also exchanged staff training annuallyfrom Vietnam and Indonesia. The last is Thailand we visited on
2016 and made a deal to sign memorandum of understanding
later.
Afterwards, the Taiwan government began to realize theimportance of mental health issues, recognizing the need forkind foreign assistance and to take aggressive actions insearching for international collaboration opportunities. 2017 isa very crucial year for us; we are able to earn support from the
New Southbound Policy of Taiwan Government as well as fromexperienced international institutes, such as Social
Empowerment Alliance, Bjorgaas Social Welfare Foundation
and Pingtung Christian Hospital (Taiwan).
True to our vision of improving the mental health of citizens,
our most important mission is to promote the Kai-Syuanservice models with southern partners and create the global
engagement of Taiwan with supports from Southeast countries.
This area is for mutual exchanges as well as learning
excellence. In conclusion, we would like to use thecollaboration as a platform creating the global engagement of
Taiwan with supports from Southeast countries, to build aholistic, 360-degree framework for how we combine ourexpertise to improve mental health of human beings.
Ethics and politics of mental health: As the pioneer toestablish Mental Health Act among East Asia, we discussedwith staff members of psychiatric service about the progress,
sameness and differences of policies on mental health between
countries. We presented the intervention of involuntarycommunity therapy and involuntary admission in our Metal
Health Acts. We shared the advantages and difficulties during
clinical practice under the current policies.
Community psychiatry and Kai-Syuan model: We had
worked hard to strengthen our psychiatric service into thecommunities. The Kai-Syuan model of community therapy
includes preparation before discharged from acute or chronic
ward, day-care wards, halfway house and community
rehabilitation center. The Qualified Community Service
Program was built on 2016 to serve patient missing the follow
up after discharged form our hospital. We aimed to help
psychiatric patients go back to society gradually with basicallysocial-economical functions
To sum up, we hope to extend and deepen the collaboration
with other psychiatric service/hospital at Southeast Asia. The
current project could also promote cultural and religious
communication between countries.

The global experience of Kaohsiung Municipal KaiSyuan Psychiatric Hospital: Asian culture ethic ofIndonesian experience - Huan Ying Hsieh, Kaohsiung
Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung,Taiwan and Kuan-Ying Hsieh, M.D.,1,2; Ming-Chou Li1;
Shu-Hui Wang1; Cheng-Chung Chen, M.D., Ph.D.1,2
1Kaohsiung Municipal Kai-Syuan Psychiatric Hospital,
Kaohsiung, Taiwan 2Graduate Institute of Medicine,College of Medicine, Kaohsiung Medical University,
Kaohsiung, Taiwan
The Kaisyuan psychiatric hospital integrated the resources
and strengths of the public and private sectors to forge a new

mutually beneficial model of cooperation and a sense of mental
health community with Indonesia since 2014, which is two
years earlier than the New Southbound Policy by President
Tsai Ing-Wen of Taiwan.
We’ve signed a memorandum of cooperation with Rumah
Sakit Khusus Daerah Provinsi Maluku (RSKD), arranged staff
training, onsite visits and communicated social and culture
issues. There are culture-bounded issues in Indonesia such as
human right problem, which is just like Taiwan 20 years ago.
The Taiwan mental health act law is established in 1997, whichis specifically formulated to protect the right of psychiatricpatients. However, there are always debates about the patient’s
right and harm. Taiwan is the first country in Asia withlegitimate mandatory hospitalization and community
treatment due to mental illness, which shall be reviewed by the
Mental Illness Mandatory Assessment, and Community
Treatment Review Committee for objections about the right ofpatients.
We are now cooperating with the Indonesian government forworkshop and society rehabilitation center program, whichhelps the patients to take treatments without limitation of
freedom. Taiwan and Indonesia government will go hands inhands to beat psychiatric diseases and promote the mental
health of the population, prevent and treat mental illnesses,
protect patients’ rights and interests, support and assist
patients living in community.

The Prevalence and Risk Factors of Psychiatric
Disorders and Quality of Life among Kaohsiung Gas
Explosion Survivors 12 Months - Frank Chou,
Kaohsiung Municipal Kaisyuan Psychiatric Hospital,
Taiwan and Huang, Joh-Jong, Department of Family
Medicine, Kaohsiung Medical University Hospital and
Wu, Tsyr-En, Chang Jung Christian University
Email: f50911.tw@yahoo.com.tw
Objective: To investigate the prevalence and related risk
factors of probable disaster-related psychiatric disorders, suchas major depressive episodes (MDE) and post-traumatic stressdisorder (PTSD), and quality of life in survivors of a fossil gas
explosion in Taiwan twelve months after the event.
Methods: A community-based screening survey with crosssectional assessments was conducted. Victims of apetrochemical gas explosion were surveyed six months after
the event. We used two screening tools, including the DisasterRelated Psychological Screening Test (DRPST) and Short Form
12 (SF-12), to survey a representative sample of 486
participants (average age: 42.89 ± 16.05 years; M: 255, averageage: 40.68 ± 15.92 years; F: 231; average age: 45.32 ±16.20
years). The Chinese version of SPSS 17.0 software was used toobtain statistics and perform data analysis.
Results: Probable PTSD, probable MDE, probable PTSD & MDE,
and non-PTSD or non-MDE (non-P or M) were present in 50(10.3%), 14 (2.9%), 34 (7.0%), and 388 (79.8%) participants,
respectively. There was a slight but insignificant negative trend
in quality of life in terms of the physical and mental aspects of
the SF-12 among survivors in the following groups: probable
PTSD combined with MDE, probable PTSD or MDE alone, andnon-P or M. The significant risk factors of probable PTSD or
MDE in survivors were female gender, severe physical injury
and financial loss. The risk factors of different quality of life
subscales were older age, physical injury, occupation,
educational level, financial problems, probable PTSD andprobable MDE.
Conclusion: One year after the gas explosion, survivors still
had a high prevalence of psychiatric impairment, and their
quality of life was affected, especially those with probable
PTSD combined with MDE. Mental rehabilitation requires not
only short-term intervention but also long-term follow-up andregular psychiatric management.

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
The global experience of Kaohsiung Municipal KaiSyuan Psychiatric Hospital: The gradual regional
collaboration with Southeast Asia - Cheng-Chung Chen,
Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan, and
Shu-Hui Wang, Ming-Chou Li, and Su-Ting Hsu,
Kaohsiung Municipal Kai-Syuan Psychiatric Hospital
Email: ccchen@kcg.gov.tw

The Taiwan President Tsai Inn-Wen announced that Taiwan
will cooperate with Southern Asian countries as one of the newpolicies for future international strategies. Kaohsiung
Municipal Kai-Syuan Psychiatric Hospital have extended thewhole psychiatric treatment programs to Vietnam, Indonesia,
and Thailand in the past 4 years included signed the MOU, staff
training, on site visits, and learned social & culture from eachothers. Also these programs can offer new ideas or methods
learning from each other’s. During these few years we alllearned a lot from new and creative methods that using in
improving quality of care. We will present these four different
Asian countries respectively and a perspective ideas &programs. Vietnam, Indonesia, Thailand and Taiwan are very
different in backgrounds in religious, societies, ethnics, politics,
and regulations. From the economic views they seem to quite
the same in new developing countries except for Taiwan.
Vietnam formed their mental hospital in every province as
their final goal. Now still developing and progressing. They alsolack of occupational therapists & psychologists. Ourinterchanges include staff training for 27 persons in two
hospitals & also onsite visiting for discussion & renewing for
four times. The most progressing facts shows thatrehabilitation programs can come truth in both our sister
hospitals. One of the psychiatric hospitals also start to set up
psychiatric social worker as well as hospital management. They
also cooperate with local university.
Thailand & our hospital are still on learning from each other &at the initial stage that we visit each other for 3 times. Future
plan include to sign MOU & more exchange programs. Also weshould learn from Thailand in the fields of mental healthpromotions.
Indonesia had one sister hospital & being onsite visit once.
Indonesia occupational therapy in psychiatric hospitalpresented in quite well. Also cooperation’s medical school had
started and we together started a new community
rehabilitation center were ongoing. Also Indonesia government
is looking formed to cooperate with social welfare to do more
for psychiatric patients. We also try to set up a training center
cooperating with medical school for setting their style & fit
their culture. In conclusion Kaohsiung Kai-Syuan psychiatricmodel can extent some to apply locally with modification underthese different backgrounds treating minorities are the same
ethic in these. Detailed sameness & differences among us will
present and discuss in this presentation. We also will share no
health without mental health for all.

12 Years’ Experience of National Bioethics Committee
in Korea- Sang Eun Park, Chair person, Korea National Bioethics
Committee
Email: sangpark90@hanmail.net
Among the KNBC activities, I would like to introduce how the
KNBC acted on major bioethics events. In the early days of thecommittee, the KNBC, in relation to Dr. Hwang Woo-suk's
research, investigated bioethical issues and published thereport as follow-up. Since then, the KNBC has been playing arole of improving specific bioethics issues and suggesting
specific directions. When there was a need to discuss about
Life-sustaining Treatment Decision process, the KNBC
organized a specialized committee and suggested theenactment. Currently, the law is enacted and related policies
such as designation of the responsible organization are being
implemented. Last year, in order to create a social atmosphere143

for the culture of respecting bioethics, the KNBC announced thedeclaration on respect for life and has been promoting it athome and abroad.
The National Bioethics Committee of Republic of Korea(KNBC) under the direct jurisdiction of the Presidentialcommission established in 2005 according to
BIOETHICS
AND SAFETY ACT . The KNBC deliberates on the following
matters according to Act and mainly discusses or reviews ofbasic national policies on bioethics and biosafety and social
issues and agenda related to bioethics. The KNBC shall becomprised of at least 16 and not more than 20 members
including one chairperson and one vice chairperson. The 4thcommittee is run now. The 4th members are composed 6
Ministers, 7 persons from among persons who have abundant
expertise and experience in research on bioscience, biomedical
science, or social science and 7 persons from among
representatives of religions, ethics circles, judicial circles, nongovernmental organizations or women.
Also the KNBC organizes 5 specialized committees for its
efficient operation. Those are Specialized committees for
Bioethics and Safety Policy, Specialized committees for Embryo
Production and Research, Specialized committees for Researchon Human materials and Biobanks, Specialized committees for
Genetic test and Gene therapy, Specialized committees for
Human subjects Protection and Ad hoc committees forSpecialized Issues (If necessary).
Since the committee was established in 2005, each committee
has carried out various activities during 12 years as follows:
1st (2005-2008): Discussion of Institutional Review Board(IRB)/ Institutional Bioethics Committee (IBC) Improvement;
Review of somatic cell cloning embryo research
2nd (2008-2011): Discussion of stem cell lines registration
system; Discussion of
The Bioethics and Safety Act
revision
3rd(2011-2014): Review of regulation of genetic testing;
Recommendation of Life-sustaining Treatment Decision
process
4th(2014-2017): Announcement of Declaration on Respect forLife ('16.5.12); Review of somatic cell cloning embryo researchand regulation of genetic testing; Host the Asia-Pacific Regional
Meeting for National Ethics/Bioethics Committees (AP-NEC)('17.10.23~25), The Westin Chosun Hotel, Seoul)

Exploring with whom humans will live in atranshuman society?
- Seongwon Park, Science and Technology Policy
Institute/ Korea Advanced Institute of Science andTechnology
Exploring With Whom Humans will Live in a
Transhuman Society?
The article forecasts the condition of humanity in 2050 byconsidering how current breakthrough technologies will drive
the future. The technologies that the article considers are onesby which humans are radically changed into transhumans. The
definition of transhumans includes being able to eliminate theaging process and greatly enhance intellectual, physical, andpsychological capacities by developing technologies. At thesame time, we have to forecast others types of beings besides
humans and transhumans in 2050, namely, humanoids.
Furthermore, we can also conjecture on the existence of future
generations that the humanoids will bring forth. The second
generation of humanoids can be called machine-sapiens. So,
there will be four different beings coexisting in the future: pure
humans, transhumans, humanoids, machine-sapiens. The fourtypes of beings are typified based on two axes: the area of
human desires divided into naturing and denaturing, andtechnology application approach divided into bio-centered andmachine-centered approaches. If one wants to denature
humanity by the bio-centered approach, then he or she can be atranshuman. This radical imagination is not merely science144

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

fiction. It is based on real possibilities. The article attempts toaddress political issues, which focus on membership in atranshuman society. Who will be members and strangers inthis transhuman society? How will the four different beings coexist in peace and harmony? What human wisdom can bebrought to bear in a transhuman society? We will explore
various aspects of discussions that have been conducted in
Korea on the topic of transhumans. Finally, the article discusses
alternative ideas on pluralism and equality in relation to atranshuman society.

ELSI Issues in Precision Medicine: Focusing on Korean
Perspective
Hannah Kim, Yonsei University, College of Medicine,
Division of Medical Humanities and Society, Departmentof Medical Law and Ethics;
Soo Jin Hong, Yonsei University, Asian Institute for
Bioethics and Health Law; Sumin Kim, Yonsei University,
Asian Institute for Bioethics and Health Law;
So Yoon Kim, Yonsei University, College of Medicine,
Division of Medical Humanities and Society, Departmentof Medical Law and Ethics
Email: hannakim83@yuhs.ac
South Korea society is known as a country for one of thelowest in birth rate and since 2017 the productive population
begins to decline. With one of the highest in life expectancy
among OECD countries, Korea performs below average in
employment, income and wealth, and has a considerable gap
between the richest and the poorest, according to Better Life
Index of OECD statistics in 2016. Meanwhile, as National Health
Insurance (NHI) program covers 95% population, it iscontinuously burden to manage the NHI program in our society
due to major diseases as well as rare diseases. To overcome
inevitable social changes and problems, precision medicine andbig data (as a part of) policies become core agendas for healthcare sector in the new economic and political wave, so called
the fourth industrial revolution in Korea. However, there are
newly arising ethical, legal and social issues (ELSI) regarding
the precision medicine (PM) and big-data. Therefore, in thisarticle, we would like to analyze the challenges and to insist theneed of international framework for health-related data nondiscrimination.
The first challenge is about privacy. These are the lists ofthe database in the field of public and private. Currently, it is all
segmented but they start the basic research to integrate someof the data sets. However, Korea’s experts start to agree that
we might need different concept of privacy since there aresome research already shows that even the anonymized
personal data can be identifiable when the data are combined
together. Considering the efficiency and minimizing the risk toinfringe privacy, our concern is whether we really need to
combine all those databases. In addition, perception of privacy
is changing rapidly in our society. Whereas the public is very
sensitive to share their own information to general companies
and the government, they have low awareness to disclose andshare their own data as well as others’ through Social
Networking Service (SNS).
The second issue is the discrimination on genetic and other
health-related data. The Nation-wide Survey on Public
Awareness for Human Genome Research (participants: 1000,
method: computer assisted telephone interview, duration:
March 7-12, 2012) was conducted to identify Korea’s
recognition regarding genetic information. As a result, 21.9%
answered that they would accept person who has a cancersusceptibility genes as a spouse, whereas 78.6% answered thatthey would accept person who has a cancer-susceptibility
genes as a friend.
From the results, we found that we need to investigatesocial and cultural hurdles of genetic (and data) discriminationin the national level. Especially, from the big-data of PM cohort,research would show the different level of importance in datatypes (gene data, lifestyle data, etc.) from disease to disease. Itmeans such data can affect individuals and society in many
ways, including insurance as well as employment, personalcredit rating, education, and even career path, etc. Therefore, itneeds to be discussed on a further framework for the genetic
and healthcare data non-discrimination to prevent social
discrimination and to protect individual autonomy while wewill be utilizing the data for a rational reason.
Next is data sharing and commercialization. There is a big
concern of data monetization from private companies, such as
mobile carriers, wearable devices, web-portal service and SNS
companies internationally. Data monetization means to makeprofit strategies using genomic and health-related information.
However, what kind of data do the companies have now, andhow do they plan to generate the secondary and tertiary dataas commercial resource? Regarding the problem, the Bioethics
and Safety Act (BSA) does not have provision to regulate it. BSA
only regulates when genome data is shared at no cost to
researchers and biobankers.
The last issue is public trust and transparency in PM cohortand its application track to the field of healthcare. The ultimate
goal of precision medicine would be to make higher
accessibility in medicine (medical service for anytime, andanywhere) and to improve quality in long-term perspective
and it would be able to affect to increase healthy-life years andlife expectancies in Korean population. However, there areremaining questions for attaining public trust andtransparency in PM cohort and its application track: How can
we obtain the informed consent from participants in PM
cohort, and which type/contents of informed consent are
affordable in further R&D in health care sector using the cohort
data?; How can we compensate the participants of precision
medicine cohort who provide his/her personal information
giving up their own privacy?; How can the new medical
technology/products
relating
to
PM,
such
as
algorithm/application services through mobile, be included to
payment items covered by NHI from the non-payment items?
How
can
we
compensate
theerrorsofthealgorithm/application services which would be covered by
NHI? Therefore, before initiating the project, Korean
government, should make a public deliberating process
responding to the challenges.
So far, this article investigated some issues, such as privacy,
data sharing, commercialization, public trust and transparency
regarding precision medicine and big-data. To enroll PM cohortand to use some service of private companies would mean not
only to give up individual’s own privacy but also to provide
personal information for R&D in the part of the 4th industrial
revolution. Within this circumstances, it will reveal that theimportance of data is varied from disease to disease or moregenerally case by case, and such data can affect individuals andsociety in many ways, including health, employment, insurance,and etc. Therefore, as a conclusion, it would be needed to
discuss on a further framework for ‘the healthcare data nondiscrimination’ to prevent social discrimination and protect
individual autonomy while we are utilizing the data as areasonable reason.
This study was supported by a grant of the Korean HealthTechnology R&D Project, Ministry of Health & Welfare,
Republic of Korea. (HI16C2397)

Review of discussions of the ELSI committee for 15
years in the BioBank Japan- Hyunsoo Hong, The University of Tokyo, Tokyo, Japanand Yoko Kambara, Akiko Nagai and Yusuke Inoue, The
Institute of Medical Science, The University of Tokyo
Email: kumahyun@ims.u-tokyo.ac.jp
In large patient biobanks, which are based on participants’collaboration, efforts to address the related ethical, legal, andEubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
social implications (ELSI) have been recognized as a part ofgenome research. Accompanied by changes in the research
environments, including new genomic technologies and new
regulations regarding privacy and human subject protection,
discussions of ELSI have been modified to protect theparticipants.
With the government’s support, Japan initiated a patient
biobank known as “BioBank Japan” (BBJ), in 2003, to promotepersonalized medicine. This project has two aims: first to
establish BBJ by collecting DNA samples, and clinicalinformation from patients with target conditions, and second
to promote research to identify genes for common diseases,
adverse reactions to drugs, and to conduct evidence-based
genetic testing and drug development. By 2017, BBJ hascollected DNA samples and lifestyle and medical records from
260,000 patients suffering from 51 diseases. Concomitantly, inorder to adequately promote the project, BBJ established an
ELSI committee as an independent external organization withexternal members who advise and make recommendations.
In the present study, we chronologically analyzed the pointsof ELSI from a total of 112 records of ELSI committee activities
to discuss the changes in issues of ELSI and research
environments by the ELSI committee of BBJ. In the analysis of
the agenda, we organized the levels separately for policy,
scientific, regulatory, ethical, and technical aspects.
The following periodical features were observed as changes
in the ELSI considerations:(1) During the first phase (2003.4–2008.3) of the initiation of
the project, there were concerns regarding the collection of alarge number of DNA samples and clinical information frompeople on a nationwide scale and collecting them in one place.
In addition, the project was required to attain its goals, and themembers of the ELSI Committee also monitored whether
informed consent was appropriately obtained at medical
institutions. (2) During the second phase (2008.4–2013.3), a
major ELSI issue involved changes in research design frominitial case control studies to cohort studies; participants were
not informed regarding possible changes in research design at
the informed consent. Because BBJ had assured that theparticipants would not be contacted again, we consideredfollowing the new procedure instead of procuring individual
consent. Therefore, ethical procedures to conduct follow-up
surveys were examined. (3) During the third phase (2013.4–
2018.3), the discussion of issues for ending the research
project as well as maintenance and continuation of biobank
functions are being emphasized. Specifically, urgent issues
being addressed include data sharing which, based oninternational trend, entails the return of research results(incidental and secondary findings from genomic analysis) as
the research progresses, and deadlines for withdrawal becauseof the completion of contract with cooperating hospitals.
As described above, ELSI have been changing withmodifications in research designs and environments. Such as
deadlines for withdrawal of consent and follow-up surveys, BBJ
is influenced by basic Japanese government policies andsubsidies, leading to contradictions between best practices andpractices that can be implemented.

Shall we "pause" PGS?
- Shizuko Takahashi, The University of Tokyo, Center for
Biomedical Ethics and Law, Japan; Josephine Johnston,Director of Research, Research Scholar, The Hastings
Center, Garrison, NY, USA; Pasquale Patrizio, Yale
University, School of Medicine, New Haven, CT, USA
Email: shizukotakahashi1205@gmail.com
Many IVF patients, vulnerable from past failed experiences,
strive to improve their chance at live birth and often with all
costs. Preimplantation genetic screening (PGS) of embryos forchromosomal aneuploidy is offered at an additional cost to IVF.
In the US, approximately 22-33% of all cycles utilize PGS.

145

Marketed for several decades, PGS advocates are pressuring
and criticizing institutions, even countries that restrict PGS as
unethical, violating the right of patients to have a viableembryo and a healthy baby. Japan, such a country, justapproved PGS this year since there seems to be increasing
evidence and performed in the US and Europe. However, while
PGS is increasingly performed worldwide, some institutions in
the US are beginning to put PGS on “pause.” Two major factors
contribute to this “pause”: the ongoing absence of a convincing
randomized control trials (RCT) using appropriate populations
and outcome measures, and human failure to presume thattechnology can accurately predict an embryo’s intrinsic nature
to err and self-repair during its development. For patients todiscard or transfer what has been diagnosed “abnormal” of adeveloping embryo can be harmful due to the loss of potential
viable embryos, burden pregnancy and health concerns for achild from an “abnormal embryo”, and the financial burden of
100 fold to repeat IVF cycles with PGS in order to attain that
“normal” embryo. For providers, distress of ethically providing
a test that has limited evidence, and explaining what abnormal
truly means without inflicting a patient is challenging. In mypresentation, I will argue that countries and institutions should
always consider sufficient evidence prior to incorporating
testing, even if it has been marked over decades and seem lesscontroversial with rapid technological advancements. I also
argue that despite demands from patients and pressures fromsociety, institutions and countries should boldly put a testingon “pause” that is found to have insufficient evidence or may
harm patients. This act may inspire and support otherinstitutions and countries considering putting a testing on“pause.”Ethical aspects of genome editing- Firuza Nasyrova, Tajikistan Academy of Sciences
Email: firuza_nasyrova@mail.ru
A detailed study of the genomes of plants, animals andhumans opens up the widest possibilities for applying theacquired knowledge in biotechnology and medicine. In the
postgenomic era, methods are actively developed that allow
manipulating DNA in genomes, as well as visualize and control
gene expression and the work of regulatory elements.
Nevertheless, by no means all methods meet the highrequirements for their effectiveness, safety and accessibility fora wide range of researchers.
Directly change the structure of DNA in a target place is thetechnology of the genome editing. Technologies of genomic
editing have revolutionized both the fundamental life sciences
and their practical application. Targeted modification of the
genome of any organisms - from bacteria to humans - suddenly
became available to virtually every biological laboratory.
This has given rise to a whole range of challenges for theworld as a whole. Many experts hope that new technologies
will allow treating many diseases. At the same time, genomic
editing is still a contentious issue, including ethical issues. Evensome supporters of the method recognize that people are notyet sufficiently prepared to safely manipulate DNA. For 4 years
since the discovery, CRISPR has been used to edit human cells,
cereals, insects (e.g. butterflies), yeast and many others. The
branch, which can be changed almost immediately by CRISPR
and editing in principle, is agrotechnology.
Genomic editing based on CRISPR can be used tosimultaneously edit each gene in the genome of plants (or eachgene of a particular type - for example, R genes that are
responsible for resistance to diseases) thus creating a wealth of
information and potentially opening useful alleles that can beinserted back in already applied plant varieties. Genomic
editing is another form of mutagenesis. An importantdifference here is that old methods rely on random events,
while genomic editing is accurate and focused, which leads to a
sharp decrease in the time costs from mutation to sowing ofexperimental plants. Once a breeder or scientist has found a

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

useful allele, with the help of genomic editing, they can transfer
it to another variety or even a plant kind of practical
immediately, without the need to obtain a series ofgenerations.

CRISPR-Cas9 - mediated Human Germline Editing
through the Lens of Shariah- Noor Munirah Isa, University of Malaya, Malaysia andMan, Saadan, University of Malaya; Zulkifli, Nurul Atiqah,
University of Malaya
Email: noormunirah@um.edu.my
The recently developed CRISPR-Cas9 technology heralds a
brave new revolution in genome editing and genetics as awhole. It offers a wide range of potential uses in research andtherapeutic applications including prevention of genetic
diseases as it provides an efficient yet inexpensive way to edit
human gene. Research on the use of this technology inmodifying human embryo, however, has revived the longdebate about whether it is ethical to alter human germline.
This paper reviews Muslim scholars’ writings on humangermline gene therapy to identify ethical principles in Islamthat should be considered in dealing with related ethical issues.
Producing healthy progeny is highly encouraged in Islam. Thiscan be seen through its encouragement for Muslims to marry ahealthy spouse. Nevertheless human germline gene therapy
would not be considered permissible unless it has met several
conditions. Among them are; a) it should be used only toachieve benefits that are compliant with shariah. Human
genetic enhancement is not allowed; b) the procedure should
be declared as safe and efficient; c) no harm or greater harm
would be inflicted upon the resulting child and his lineage. The
main principles to be abide by in this context are ‘preventing
harm takes precedence over securing benefit’ as well as
maqasid al-shariah’s principles of preservation of human’s life,
intellect and lineage.

Bioethics and Reproductive Health Care: Biological
Mechanisms – Bioethical Challenges- Irina Pollard, Science and Engineering, Macquarie
University, Australia
Email: irina.pollard@mq.edu.au
The foundation of adult health is set during the differentiationof the gametes when normal maturational processes may be
disrupted by harmful genetic and epigenetic variables.
Consequently, the health and living conditions of both parents
from the time of gamete formation to the conception of theoffspring are just as crucial as the mother’s situation during
pregnancy and lactation. While genetics focuses on howorganisms retain traits by inheriting genes from their parents,
epigenetics refers to additional methods of biologicalinheritance that do not directly relate to the inheritance ofcollections of genes. Thus, under certain conditions a gene canbe switched on or off. If it’s switched off, then it will not spellout the message to give instructions to make the protein forwhich it is responsible. Characteristically, modulated gene
expression represents a response to environmental dynamics
and is the result of genetic-environmental interactions overtime For example; the most common behaviours in any
particular environment are typically more successful, in
evolutionary terms, compared to available alternatives.
However, there are certain epigenetic variables if operative
during critical periods in development that may permanently
impose an adverse change in the offspring’s genetic program,which, in turn, may also affect subsequent generations.
Epigenetic influences may collectively be referred to as social
determinants which include the kind of housing andenvironments we live in, the health and education services wehave access to, the income we generate and the nature of work
we do all influencing health and lifestyle decision making.
Consequently, the major responsibility of the modern ethicist is

to integrate current scientific understanding of practical andcultural significance with traditional wisdom. The major
responsibility of the scientist is to ensure that scientificinformation is not omitted or corrupted in the process.
Bioscience ethics can assist in this process of integration.
Bioscience ethics facilitates free and accurate informationtransfer from applied science to applied bioethics(http://www.bioscience-bioethics.org/). By integrating the life
sciences with bioscience-ethics it becomes possible to highlightissues that relate directly to our lives and bring to thebioethical discussion a better awareness of the socio-ethicalimplications of the current biological dimension on which
ethical tradition and technological applications function.

Humanoids and the Shrinking Society
Tsuyoshi Away, Ph.D., Professor of Bioethics and Medical Law;
Dean, Faculty of Law, Okayama Shoka University, Okayama,
Japan Website (Private): http://t-awaya.o.oo7.jp/top.htm
Email: t-awaya@nifty.ne.jp
Though, nowadays, the development of humanoids is flourishing inmany developed countries, including Japan, I have been raising manyquestions about it (See Tsuyoshi Awaya, "Humanoids in Human
Desires", in Ethics of Life and Technologies, Naoki Morishita (ed.),Maruzen, Japan, 2016, pp. 160-182; Tsuyoshi Awaya, Singularity andbioethics, 12th International Scientific Conference of theInternational Society for Clinical Bioethics, "Bioethics in the Future:
Technicization of Man or Humanization of Science?", Bol, Croatia,
Sep. 21-22(22), 2015, etc.).
This time I would like to present some doubts from a totallydifferent viewpoint. There is a group which advocates, "the shrinkingof society" in Japan. This group proposes to reduce the size of oursociety in preparation for the coming depletion of fossil fuels.
According to Dr. Hiroshi Matsuhisa (Professor Emeritus, Kyoto
University, Japan) who is the representative of this group, robots ingeneral including humanoids have limitations in terms of energy
efficiency. He says as follows. "Humans act by consuming energy ofabout 100 watts. However, factory robots need over 1,000 watts. In
addition, humans use 21 watts when thinking, but the artificial
intelligence of ‘Go’, or 'Alpha Go', the board game played bycomputers, consumes 250,000 watts."
When fossil fuels run out, it will be impossible to maintainhumanoids equipped with artificial intelligence. Professor
Matsuhisa's opinion reinforces my skepticism about humanoids. The
development of humanoids seems to be an example of humanfoolishness.

The fourth industrial revolution and robot tax: Do
firms have a natural duty to employ humans?
-Cheol Kang, Yonsei University, Korea
The Fourth Industrial Revolution represented by big data,
artificial intelligence (AI) and Internet of Things (IoT) is
prompting the advent of an age of ultra connectivity and ultra
intelligence. There are both optimistic and pessimistic views on
the kind of future that those technologies will bring. We have akeen interest in technological innovation and societal changes
in the age of digital revolution. However, we don’t seem to be
as much interested in how to control and manage businesses –the agents that develop, advance and socialize innovativetechnologies.
One of the biggest concerns caused by the Fourth Industrial
Revolution is the issue of AI and robots replacing human jobs.
This replacement has been taking place on two fronts technology and economy. On the technological front, the World
Economic Forum 2016 predicted that the progress of the
Fourth Industrial Revolution would make more than fivemillion out of seven million jobs disappear across the globe. A
2015 report by the consulting firm McKinsey says that evenwith current technologies robots can replace 45% of humanjobs. However, there has been debate over whether AI androbots replace human occupations themselves. Some argueEubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
that those technologies replace human tasks not occupations,which means the net impact of AI or robots on human job
replacement would be minimal. Time will ultimately resolve
this debate but it is certain that striking advances in scienceand technology are set to diminish the number of areas
previously thought to be reserved for human intelligence.
On the economy front, a new threat to human employment is
growing with the emergence of digital platforms in the virtual
space of ultra connectivity. Now we can look for jobs by logging
on to a digital platform wherever and whenever we please.
This allows businesses to operate without hiring regular
workers. They can avoid costs and uncertainties involved infull-time employment. With the Fourth Industrial Revolution,
new employment practices will spread rapidly as the-so called
gig economy or online economy dominates the world.
From the perspective of both technology and economy, thereplacement of humans by AI or machines will eventually leadto a condition where productivity increasingly decouples from
employment. As is well-known, technology-driven productivity
gains in the First, Second and Third Industrial Revolutions
created new jobs and expanded employment. With the Fourth
Industrial Revolution, however, productivity improvement
through digital automation rapidly diminishes, not creates, jobs
- which make the issue even more serious. We must now ask
again “Does a firm have a natural duty if any to employ
humans?” “Where does the meaning of life come from?” We
need to reunion of economics and ethics.
This paper shifts the focus from the question “What is asolution to the issue of human jobs being replaced by digitaltechnology?” to “How should businesses be managed,
controlled and supported as they drive the Fourth Industrial
Revolution?” I will address this question mainly by discussing
the recently emerging issue of robot tax.
The issue has sparked debates after Bill Gates mentioned it ina recent media interview that took place on February 17, 2017.
He claims robot tax needs to be introduced to resolve massive
unemployment triggered by robotic automation. He says
governments should impose taxes on human-replacing robots
at a similar rate that would be levied on incomes if humans are
employed. Advocating for taxing robot users, Gates emphasizes
that robot tax can be used to re-educate those who have losttheir jobs due to the expansion of robot use so they can work
again and get paid. He also believes robot tax could slow down
automation that has been accelerated across the economy.
However, the rationale of the opponents sounds reasonable aswell. One of their main points is that robot tax will undermine
technological innovation. There is also the epistemologicaldifficulty of how to distinguish taxable robots from exempt
ones. Moreover, given the inherent task of businesses tomaintain their competitive advantage in order to survive in themarket, replacing human labor with automation is desirable, orat least unavoidable, and thus robot tax is detrimental to thenature of business entities.
This paper contends that addressing the rapid decline ofhuman employment in the age of Fourth Industrial Revolution
should start with two fundamental questions: “What are firms?”
and “Why do they exist?” Answering these questions is criticalto finding the right direction and policies to address the issue
of unemployment in this new environment.
In identifying the nature and mandate of businesses, thispaper will try to answer the question “Do firms have a natural
duty to hire humans?” In order to deal with this question, I will
critically review the existing theories of firm including theneoclassical economic theory, the transaction cost theory andthe firm as a nexus of contracts. Then I will use the review as abasis to present a new perspective on businesses.
The Fourth Industrial Revolution necessitates deep
introspection on the value and meaning of human labor in life
and it also requires a new approach to the nature and mandateof businesses. Humans used to give orders to machines in orderto get their job done more effectively. In the age of the Fourth

147

Industrial Revolution, however, they may be reduced tofollowing orders for the purpose of meeting the needs of AI andmachines. In order to respond as active agents to newtechnologies, we should look deeply into how to control andmanage businesses that develop, advance and socialize digitaltechnologies.

Forge New Asian Intellectual and Medical Horizons
with Service Learning - a bioethical reflection- Duujian Tsai, Pingtung Christian Hospital, Pingtung,TaiwanEmail: duujiantsai@gmail.com

There are three aims in this paper. The first is to bridge
community psychiatric rehabilitation, health promotion with
LTC, as well as the concept of living lab in shaping a learning
environment across national borders for just regional planningoriented comparative action research. The second is todevelop a Work-Based-Learning-oriented education model for
nurturing professional competence and teamwork spirit. Suchdevelopment will begin with education program forprofessional training in medicine, health and LTC. Social
education for the general public will be arranged later as well.
The core value should be ubiquitous learning for life. The third
aim is to provide a total solution on regional planning for smart
living in collaborative manners, wherein Taiwan could serve asa facilitator as well as model case for nurturing regional
bioethical practices. While exploring medical professionalism
and national cultural identities with collaborative partners in
different counties, we attempt to propose an international
bioethical horizon wherein Taiwan could serve as a role modelin shaping Asian civil society by mutual learning andunderstanding.

The Future Perspective of Research Ethics concerning
the Japanese New Regulations and Ethical
Frameworks for Medical and Health Research
Involving Human Subjects- Naoto Kawahara, Kyushu University Hospital, Fukuoka,
Japan
Email: n-kawaha@med.kyushu-u.ac.jp
We stand at crossroads of research ethics related tointernational harmonization of various regulations and ethicalframeworks. Recently, Japanese regulations and ethicalframeworks for medical and health research involving humansubjects have become more complicated. In 2014, the MEXT
(Ministry of Education, Culture, Sports, Science andTechnology) and MHLW (Ministry of Health, Labour andWelfare) of Japanese government integrated previous two
guidelines; ‘the Ethical Guidelines for Epidemiological Study’and ‘the Ethical Guidelines for Clinical Study’ into the current
guidelines. The guidelines were revised again with theamendment of ‘The Act on the Protection of Personal
Information’ in 2017.
On the other hand, the Bill of ‘the Clinical Study Law’ has been
established in 2017. Some serious incidents of research
misconduct led to the establishment of the new law in Japan. In
this new law, the following in particular was emphasized:
1) Regulation for clinical study receiving funds bypharmaceutical industry, 2) Imposing duties to obey thepractice standards which are equivalent to the GCP, 3) Making
notification for study plan which shall be reviewed by thecertified IRB, 4) Improvement order / Stay order of clinicalstudy by MHLW of Japanese government, 5) Obligation applied
to pharmaceutical industry to publish the fact of funding toclinical study.
Moreover, the Pharmaceutical and Medical Devices Act,
Ministerial Ordinance on GCP and other complicatedregulations have existed in Japan.
Methods: I extract important issues from the Japanese ethicalguidelines and regulations systematically. We also put the new148

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

Japanese ‘Clinical Study Law (2017)’ in range. I analyze theabove issues from the following points of view particularly: 1)
Informed consent according to risk levels, 2) Responsibilities ofinvestigator, principal investigator and director of research
institute, 3) Archiving / Management of biological samples andmedical information, 4) Functional enhancement of IRB
including central IRB frameworks, 5) Informed assent for nonautonomous person, 6) Criteria of research ethics according to“invasion / minor-invasion / non-invasion” and “intervention /non-intervention”, 7) Management of conflict of interest, and 8)
Monitoring / Audit requirements related to Quality Control /Quality Assurance, and so on.
I also discuss the perspective of Japanese regulations andethical frameworks for Medical and Health Research Involving
Human Subjects. And we also consider research ethics related
to international harmonization of various regulations andethical frameworks.
Conclusion: Will we never be daunted or push on toward
successful research and development of medicine? It is
required to continue to accumulate and scrutinize cases ofsolution in order to ensure consistency of value judgments
concerning research ethics. In addition, we should examine
how to manage regulations and ethical frameworks based on
unified or systematized criteria of research ethics, for example,
IC (and assent), RCR (Responsibility of conduct of Research),Protection of human rights,
IRB administration, COI
management, QC / QA, and so on.
Reflections on Global Justice and International Partnership Lessons for professionalism at different contexts- Simon Fan, Pingtung Christian Hospital, Pingtung, Taiwan andDuujian Tsai
Quest for global justice have been predominate atinternational sphere; however, health inequality are still mostdifficult barriers to be overcome across national boundaries.
International partnership is therefore proposed between thedeveloped and the developing to this end. Professional gaps in
all aspects still put such effort into questions. We propose asynergic way of international collaborations with professional
empathetic understanding for fulfilling these challenges. Ourparticipatory collaborative efforts in Malawi, Vietnam andTaiwan has been compared and evident the valuable part ofsuch efforts. Contextualized patient-center approaches with a
special emphasis on professional competences as well as
training are presented. Financial sustainability is the most
crucial in the maintenance of international partnership.
Reflections on the contextual features of these endeavors, we
argue that financial accountability should be essential indeveloping professionalism for global justice. Such lessons are
crucial for all professional practices in either developing ordeveloped countries, especially questing for partnershipovercoming economic barriers.

Reflections on Tuberculosis control strategies in
Taiwan Medical History —implications for Just Heath
theory- Yu-Chia Chen, National Central University, Taiwan andDuujian Tsai, Pingtung Christian Hospital
Email: yuchia@sea2003.org.tw
We review the “National Mobilization Plan to Halve TB in 10
Years,” which has been implemented during 2005 and 2015.
Accordingly, the annual TB incidence rate in Taiwan has
lowered by about 6%. The number of MDR-TB cases decreased
from 440 cases in 2007 to 184 cases in 2015. Analyzing thisproject through the lens of just health theory, this paper aims
to: 1) take a utility approach to clarify the effective outcomes of
the control programmes in Taiwan; 2) use an institutional
approach to analyze the organizational role play in TB control;
3) apply principle of justice as fairness to analyzing theprocedures leading to Just Health; and finally, 4) summarize

bioethical reflections on the ethical issues of TB control for
supporting or questioning just health theory. We conclude thejust health theory as desirable. Further suggestions fordeveloping and developed countries are proposed.
Health care is the important social goods for healthy living.
The objective of health care is to maintain people’s dailyfunctions for ensuring equal opportunities. However, thehealth disparity is not easy to overcome. Hence, the just healthcare becomes major concerns in all societies from time to time,
especially for the task in control tuberculosis. At present, it isstill the world’s top infectious disease killer, claims 5 000 lives
each day. The heaviest burden is evident in communities
suffering from socio-economic disadvantages. Taking ahistorical approach, we will use the just health theory ofNorman Daniels, the follower on Rawlsian theory of justice as
fairness.

On Nanotechnology: Overcoming the Limitations offMRI Research- Tyler Jaynes, Utah Valley University, Utah, United Statesof America
Email: tyler.l.jaynes@gmail.com
Functional neuroimaging techniques are highly limited intoday’s world in terms of capability and breadth of function. As
such, they must necessarily exclude certain groups of patients
due to potential medical risks that could arise from their use.
Taking from a fictitious device found in various media formats,
we can determine what qualities it may have and therefore
make it a device that does more than allow the user toentertain themselves. While this device cannot effectively bemade with current (or foreseeable) technologies, it is possible
to make a facsimile that relies upon nanotechnology as
opposed to electromagnetic radiation as envisioned by thedevice’s creator. Other advances will need to be made to allow
this device to penetrate the blood-brain barrier in a medicallysafe manner; however, this device will have the potential toreshape functional neuroimaging and conventional medicine aspracticed today. As such, a viable concept needs to begenerated to display the potential benefits, harms, and moral
concerns that surround the development of such a device.

Overview of Korean Bioethics and Safety Act- Soo Hun Park, Sookmyung Women's University
The practice of central IRB in Korea-Byung-in Choe, The Catholic University of Korea
Email: bichoe@catholic.ac.kr
Besides clinical trial regulations, Korean Bioethics Law
designates one IRB functioning as a central IRB for individual
researchers and small institutions. The amendment of the
Korean Bioethics Law in 2013 has changed the horizon of IRB
in Korea because all research involving human participants
must be reviewed by an IRB The demand for IRB review has
dramatically increased and the IRB review service is in short
not to mention quality review. Diversified areas of professional
demand and limited resources calls for a central IRB review
service. Analysis of this new demand and the opportunities
should be followed by societal discourse.
The history of IRB practice in Korea has been initiated byacademic medical institutions since 1990s. The agents targeted
to use in patients were mainly pharmaceutical products in theearlier times. The efficiency in time management of IRB review
was the first goal when initial attempts to reduce theredundancy and inconsistency of each IRB’s decisions. The
demands were positive but the legal mandate of establishing an
IRB at each institution was the first step to overcome. The
author has first initiated “IRB mutual recognition program(MRP)” and five institutions have participated in the programin 2003.IRB MRP is to use one IRB of participating institution
and recognize its review decision by the rest of participatingEubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
institutions for multi-center trial studies. The second trial was
initiated in 2010 by the Korean Association of IRBs withparticipation of five academic medical institutions. Both MRP
trials concluded with lessons and new opportunities. The
Catholic Medical Center has been in operation of a central IRB
since 2009 providing services for eight general hospitals, a
medical college and a nursing college.

The challenges of patient’s informed consent in
multilingual and multicultural countries- Vera Lúcia Raposo, University of Macau
Email: vraposo@umac.mo
Regarding the cultural issue, it should be noted that although
the majority of the medical community and the patient
population have Chinese values, the existing law is stillbasically the one inherited from Portuguese administration.
Thus, it is recurrent that day-to-day medical practice violates
what is established by law regarding informed consent.
Patient’s informed consent - that is, the communication of all
relevant information to the patient and the subsequent recall of
his consent - is the corner stone of modern medical law.
However, informed consent becomes a challenge when theparties do not share the same idiom and/or the same culturalvalues. To demonstrate our thesis we will present the case of
the Special Administrative Region of Macao (SARM), which,even though it is a part of China, retains some western tracesfrom the centuries in which the territory was subject toPortuguese administration.
In effect, by constitutional imposition SARM has two official
languages, Chinese-Putonghua and Portuguese, and in addition
two predominant languages de facto, Chinese-Cantonese andEnglish. On the other hand, although the large majority of the
population has Chinese routes, many Portuguese citizens still
live in the territory and a part of the Macanese community
actually shares Portuguese (i.e., western) values.
These disparities become evident in what regards informed
consent in medical practice.
In what concerns the language issue several solutions areapplied: the use of a language understood by all the involved
parties, even if poorly; the disclosure of written information in
the patient’s language, though sometimes the translation is notaccurate; the use of a relative as translator, disregarding
patient’s privacy and the specificities of technical medical
language.

To examine the necessity for the volunteer activities inorder to enhance the QOL of the senior through the
belly dance care - Hitomi Irizawa, Hyogo College ofMedicine and Juntendo University, Hyogo, Japan and
Gotoh Akinobu
Email: babette6018@gmail.com

Japan is a super aged society that is unprecedented in theworld, so it is necessary to reform the welfare system for the
purpose of justifying social security expenses toward 2025
when the baby-boomer generation becomes the late elderly. As
the aging of society is accelerating, the long-term careinsurance system is revised every three years and someexperts propose that we should reduce the payment for the
low-level care recipients to ensure a budget for the recipients
who need severe care. Therefore, the facilities for the aged
should try to prevent the decline of physical functions of themto extend the healthy life expectancy of them. We examine theinfluence of volunteer activities on facility users from theviewpoint of changes in physical functions and subjective QOL.

149

Bioethics Teaching for Medical Postgraduate- Anoja Fernando, Emeritus Professor of Pharmacology,
University of Ruhuna, Sri Lanka
Email: anojaf@yahoo.com
Ethics teaching to medical undergraduates in the medical
faculties of Sri Lanka is well established. While the specificsubject of Research Ethics has been included in the researchmethodology modules of postgraduate medical courses forseveral years, bioethics teaching in its wider aspects is
relatively new. I will briefly describe two such programmesthat take place at the Postgraduate Institute of Medicine(PGIM), University of Colombo.
Ethics in Health Care module for MD trainees in Medical
Administration This is a 15 hour module included in the
Postgraduate Course conducted by the Board of Study in
Medical Administration for the degree of MD (Medical
Administration) of the PGIM, University of Colombo. This wasstarted in 2011 as part of the revised syllabus, and has
continued each year for all the postgraduate trainees in
Medical Administration, since then.
Ethics teaching in the Professionalism and Ethics in Medical
Practice strand This strand was introduced for all MD Trainees
at the PGIM, University of Colombo, starting in July 2014. The
24 hour Introductory Module is spread over four days, andincludes an ethics component of 6 hours.

We Can and Must Rebuild the Bridges ofInterdisciplinary Bioethics- Darryl Macer, Director, Eubios Ethics Institute;
President, American University of Sovereign Nations(AUSN), USA;New Zealand
Email: provost@ausn.info
Although we can argue that bioethics is holistic and found inevery culture, and still alive among people of many indigenous
communities as well as the post modern ones, the academic
discipline of bioethics as interpreted by many scholars has
attempted to burn bridges to both different views as well as
persons with different life trajectories and training. The
bridges between different cultural and epistemologicalfoundations of bioethics have also been strained by thedominance of Western paradigms of principlism and theemergence of an academic profession of medical bioethics.
I challenge us all to reconsider the manner in which weconceive of bioethics, as well as the range of literature andscholars that are considered to as legitimate sources of
wisdom. Such a new approach will breath fresh light into not
only the important work of all scholars, students and teachers,
but also offer some fresh references for contemporary policychanges that face us. We should go beyond the usual
boundaries of time and space – look through history andglobally and understand bioethics as the love of life can beargued to be pre-human and thus is as old, or older, thancultures themselves.
The academic term “bioethics” was coined 90 years ago by
Fritz Jahr (1927) in his paper, “The bioethical responsibilitiesof human beings to plants and animals”. We see efforts
throughout bioethics scholarship to emphasize the inclusion ofother beings into bioethics, but in the United States almost allbioethics scholars and departments focus on medical ethics.
Yet the term “bioethics” has often replaced the former term“medical ethics”. We cannot simply blame the “bioethicists” forthis however, since often those in the minority field of“environmental ethics” stress to emphasize that it is distinct
from bioethics, as they try to mark their own turf.
I would argue that all public health issues are bioethics issues,
but those in the field of bioethics often focus on individuals
rather than systems. However, work is needed to build bridges
between all these and other related fields to promote a holistic
understanding and approach to bioethics.
Even more

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

important than the name is the ideology we use, one ofinclusion, and one that includes a comprehensive
understanding that our individuality is a social construct.
We cannot simply look at religious texts on their own, but inthe way that they were applied by societies. In Asian bioethics
there has been a dialogue for decades on whether the
principalism of American textbooks is applicable to othersocieties, which may place more value on harmony, love,
relationships, or virtues. However we can see debates overprincipalism, virtue ethics, relational ethics, feminist
approaches, and so on, in public health ethics, environmental
ethics and bioethics. There is much to do in bioethics andpublic health, and bridge building through time, space, culture
and discipline is essential to ensure we have solid researchpolicy linkages to build our bridges to the future. Througheffective work of bioethicists we can bridge all the artificial
boundaries that stifle the progress of our society, for the sakeof all beings, our dear planet, for our heritage. Heritage
includes the concepts of past, present and future in one word,
Let us renew our efforts to make informed decisions so we canall make better choices in all realms of life. We thank all thescholars and our ancestors for what we have been given, andlet us promote evidence-based policy as the message ofbioethics for empowering individuals and our communities.

integration of the main project and each subproject.
Specifically, the following will be established: a sharedintelligent living cloud platform, research process archive, andstudy findings database. The teams assigned to each subprojectwill co-participate in and expand mutual exchanges between
organizations regarding their research processes and findings,
in order to 1). Construct a working model of indigenous
Taiwanese mental health with the biocultural and bioethicalorientations, 2). Generate social impact regarding the mental
health of indigenous Taiwanese, 3). Promote the creation ofindigenous communities and enhance the cultural industry.
Subsequently, through the mental health workshops, seminars,
and academic journals established by our research teams, wewill emerge on the international academic stage to produce
indigenous mental health knowledge that follows the principleof “Think globally, act locally” for exchange on the international
academic stage.

Adapting Bicultural and Bioethical orientations toconstruct an action model of mental health on
aboriginal Taiwanese- Vincent Shieh, National Kaohsiung Normal University,
Kaohsiung, Taiwan and H.W. Angela Lo, School of
Medicine, Kaohsiung Medical University, Kaohsiung,Taiwan; Shiah, Yung-Jong, Professor of Graduate
Institute of Counseling Psychology and RehabilitationCounseling, National Kaohsiung Normal University,
Kaohsiung, Taiwan
Email: vshieh@nknu.edu.tw

In February 2016, the 'Hospice, Palliative Care, and Lifesustaining Treatment Decision-making Act’ was legislated,following six years’ debate about forgoing life-sustaining
treatment after the Korean Supreme Court’s Decision on
Grandma Kim’s Case in 2009. The law is highly anticipated andwill respect the patient’s right of self-determination andguarantee his/her dignity by defining decisions regarding lifesustaining treatment. However, current legislation has some
limitations. First of all, the law strictly applies to the patients in’dying phase expecting rapid death,' not in ‘terminal-stage,'which can restrict choices of terminal-stage patients. Secondly,
it has no definition of the surrogate decision and prohibits thesurrogate decision without the consent of all members ofimmediate family, which gives no protection of the interest ofpatients without kinship. Thirdly, there is room for confusionin the introduction of the ‘plan for life-sustaining
treatment=POLST,’ which will be written by a physician in
consulting with the patient as the patient’s prior intention
other than the advance directive. Meanwhile, the law
emphasizes patient-centered advance care planning, which
may go ahead current culture of discussion by patients’families in end-of-life. However, Current legislation limits thepatient’s self-determination right by the concern of abuse, andfurther revision is necessary.

Health is a basic human right, and advanced countries
worldwide prioritize health care. The indigenous Taiwanese
have endured over a century of colonial suppression and havelong been culturally, economically, and politically marginalized
under the development of capitalism in contemporary society.
However, indigenous Taiwanese have always been adisadvantaged minority with little prospects due tosociocultural asymmetry and inequality in resource allocation,and thus tend to resort to overdrinking in order to escape theinjustice and disadvantaged position of health minorities they
face in the mainstream society.
A 3-year integrated plan is developed, which will, with thebiocultural and bioethical orientations, integrate the resource
networks of subprojects to create a model of mental health andcultural sustainability for indigenous Taiwanese. Following an
indigenous tribal meeting and a research ethics review of thismain project, both qualitative and quantitative action research
was adopted in urban indigenous communities and indigenous
tribal villages. Through the perspectives of ethnic and cultural
diversity, the existent limited biomedical approach andconventional ethnic essentialism were challenged as thedefaults of indigenous Taiwanese mental health module. The
intricate relationships between body, mind, society, andculture were rigorously considered to create a platform forintersubjective multicultural dialogue, mutual support, andaction motivation. The creation of a working model with thethree dimensions of health, well-being, and society that
promotes the mental health of indigenous Taiwanese can both
elucidate mental health knowledge production that exhibits
cultural sensitivity, as well as shape social impacts for the useof reflection and application by interdisciplinary fields.
The main project of this 3-year integration project will
construct internal and external quality control mechanisms
year-by-year to coordinate the vertical and horizontal

Introduction of Life-Sustaining Treatment DecisionMaking Act in South Korea and it’s Limitation- Eun Kyung Choi, Seoul National University Hospital,
Korea and Hye Yoon, Park, Seoul National University
Hospital
Email: qchoiek@gmail.com

Is Bioethics relevant today for Climate Change
Deliberations and the Future of Health?
- Mariadoss Selvanayagam, Loyola ICAM College ofengineering and Technology, India; Jesuits worldwide
Learning, Chennai, India and Francis P Xavier, Jesuits
worldwide Learning, Geneva
The World Health Organization (WHO), the world
Meteorological Organization, and the United Nations
Environmental Program have noted with grave concern, theimplication of climate change on human health. A legallybinding international treaty on climate change was signed by
195 countries in 2016. There are apprehensions and President
Trump announced on 1st June 2017, that the United States has
withdrawn from the Paris climate accord. The withdrawal, apolitical decision by the Trump administration, does notchange the science of how our planet works. Policies maychange, but the science does not. To ensure economic
prosperity and global health, we need a broad understanding of
the societal consequences of a warming planet as well ashonest and open communication of scientific evidence to the
public policy makers.

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
The climate change impacts are numerous which threatens
our own survival in terms of economic growth and sustainable
development. Climate change also threatens the health of ourpeople-children and grandchildren through increased disease,freshwater shortages, worsened smog and more.
As citizens of our nations and of our Earth, we are endowedwith certain rights, powers, and obligations, which demandthat we act both individually and as well as collectively toprotect and preserve the ongoing evolution of life on Earth,including our future generations. The human health is greatly
affected by the environment, but the provision of health carecan have substantial, adverse environmental impacts. The
bioethicists can explore the moral, philosophical, theological,
and legal foundations of environmental policy affected byclimate change.
Therefore, the bioethicists should take part in thediscussion about global warming with special reference tohuman health and contribute their perspectives to these urgent
issues.

Health Care, Justice and Rights: Examining
Approaches Based on Welfare and Opportunity- Napoleon Jr. Mabaquiao, Department of Philosophy, De
La Salle University, Manila, Philippines
Email: napoleonmabaquiao@gmail.com
The value of good health and consequently of proper healthcare to us is undeniable; and this is at least for two reasons.
One is that they are necessary for us to achieve or maintainwell-being or to live a flourishing life. Another is that they
enable us to access opportunities that are usually available tonormal people relative to existing social conditions. The
resources necessary to keep us healthy or to satisfy our healthcare needs, however, are usually insufficient. Regardless of its
causes, this unfortunate reality is bound to result in humansufferings and even deaths. For this reason, the accessibility
and allocation of such resources have become a serious moral
concern. There are, among others, two related ethical issues
raised in this regard. The first concerns the justice of allocatingthese resources. If allocating scarce resources wereunavoidably unequal, what principle of prioritization would
give justice to this kind of allocation? The second concerns thenature and justification of the right to health care. This relates
to the first question in that justice in resource allocation
assumes that people get what they deserve; but what people
deserve to receive from a certain distribution are defined bytheir rights or entitlements. And so, if access to health care is aright, then what kind of right is it, and what justifies this right?
In this essay/lecture, I shall critically examine the following
two currently dominant philosophical approaches to theseissues. The first is utilitarianism, which defines a just allocationof resources as one that maximizes the aggregate welfare ofeveryone involved in the allocation. This approach accordingly
regards the right to health care as a conditional right being
determined by the principle of maximizing aggregate welfare.
The second is the fair equality of opportunity approach, which

151

defines a just allocation of resources as one that secures
everyone’s normal range of opportunities by maintaining or
restoring everyone’s normal functioning. This approach
regards the right to health care as a special requirement of theright to equal opportunity (in the sense that the right to healthcare guarantees the possibility of the right to equal
opportunity). And since the right to equal opportunity is
regarded as unconditional, the right to health care isaccordingly deemed as an unconditional right. After analyzing
the respective strengths and weaknesses of these two
approaches as pointed out by various scholars, I shall argue forthe relative advantage of the fair equality of opportunity
approach over utilitarianism. Be this as it may, there are,however, some practical instances where the two approaches
supplement one another.

Constitutional Perspectives on the Paradigm Shift ofDecision-Making At the End of Life
- Juhee Eom, Adjunct Professor, Management Sociology
Department, Myongji College, Korea
Email: juheelight@gmail.com
As such, this presentation will focus on problems that thecurrent Korean law on decision-making at the end of one's life
has, as well as highlight the constitutional perspectives on eachissue that involve a person's right to maintain life with dignity,
self-determination, and right to health. Furthermore,suggestions to improve current methods of involuntarydecision-making at the end of one's life and better approaches
to the true will and preference of terminally ill patients will be
proposed.
In Korea, for the first time, relevant laws have come into effectregarding decision-making at the end of one's life. Over the
past 10 years since Kim's case (Severance Hospital case) in
2008, the controversy of death with dignity and euthanasia has
been topics of major interest in Korean society. Experts fromdifferent fields participated for several years in discussing anddeciding on a social consensus that include essential factors ofdecision-making at the end of one's life, i.e., scope of patients,
the extent of diseases, the process of withholding orwithdrawing life-sustaining treatments, the procedures ofadvance directives, etc.
Initially, there were seven bills submitted by congressmen
related to a social consensus. Later, these seven bills wereconformed into one amended bill and passed by the national
assembly. This bill that passed became the first Korean law thatenforces patients to make self-determinations at the end of
their lives. However, this law still has points of controversy
because its contents include involuntary euthanasia.
Furthermore, for patients who are incapable of voicing out
their decisions are to be decided by their legal guardians, andalthough the method of decision-making is stipulated, it still
remains controversial because some consider thisunconstitutional or unethical.

New End-of-Life Decision Making Act in Korea: Rightto Self Determination is Lacking- Claire Junga Kim, Ewha Womans University Medical
School, Seoul, Korea
Email: clairejungakim@gmail.com
The first legislation on end-of-life decision making in Korea,“Hospice/Palliative Care and Dying Patient’s Decision on LifeSustaining Treatment Act” will go into effect next year (2018).
This research discusses how the law can and should be
implemented, given that the law reflects certain values that,while considered typically “East Asian,” can create problems.
The law enables individuals to decide their own life sustaining
treatment or that of their family members. This is madepossible by legally authorizing documents such as advancedirectives or Physician order of life sustaining treatment(POLST), or by acknowledging two or more family members’152

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

statements, or by following the family’s unanimous agreement.
Although the law allows individuals some freedom to decide
future life sustaining treatment, confusion or undesirable
outcomes are anticipated in the future. This is because the law
does not recognize the individual patient’s self-determination
at a fundamental level. As for the anticipated confusion andundesirable outcomes, the author demonstrates five issues:
first, disapproval of a competent patient’s treatment refusal;
second, impracticability of advance directives; third, risk ofsurrogate decision making that does not reflect the patient’s
interests; fourth, unfair options for patients whose significant
others are outside the legal family; and lastly, low participationand confusion in advance care planning or shared decision
making. These problems may become obstacles toimplementing the new law in a clinical setting and patients intheir end of life stage will be harmed. Therefore, there is a direneed for a solution. Because the author believes that the lack ofself-determination is the root cause of the problem, the way toprevent harm is to recognize individuals’ self-determination ata more fundamental level. However, two rebuttals are
frequently raised in opposition to individuals’ rights of selfdetermination. One rebuttal is based on unique East Asianvalues and customs in end of life issues; this is the claim that
East Asians do not give primacy to self-determination in end oflife issues. The other rebuttal reflects different characteristics
of East Asian biomedical ethics arising from its different
development history. This is the claim that founding East Asianbioethics on the concept of rights is not feasible, because theconcept of rights is the product of Judeo-Christian tradition,liberalism, and the civil rights movement. Nonetheless, theauthor rejects these rebuttals, for two reasons respectively:First, the need to guarantee an equal chance of significant
interest in end of life in East Asia; and second, discernment on
the accuracy and justificatory power of description on culturaldifference. As a result, the author concludes that achieving selfdetermination should be given the highest priority inimplementing the new end of life law in Korea.

Influence of Universal Health Coverage Era inwithdrawing and withholding life support issue:
Indonesian situation- Dedi Afandi, Universitas Riau, Pekanbaru, Indonesia
Email: dediafandi4n6@gmail.com
Problems begin to arise when hospitals or health carefacilities must continue to conduct medical treatment while thecosts must be exceeded the ceiling has been set costs. So, there
is a shift in ethical dilemma from patient / doctor to thehospital or health service facilities. One of the Government ofIndonesia's efforts through the Ministry of Health has issued aregulation on the allowance of withdrawing and withholding
life support with certain procedures. However, this is notexpected to show significant changes, especially from patientfamilies who continue to ask for treatment although the issueof futility has been well explained by health care.
Towards the end of life, physicians face dilemmas of
discontinuing life-sustaining treatments or interventions. In
some circumstances, these treatments are no longer of benefit,
while in others the patient or family no longer wants them.
This is an emotional, ethical, economic, social and medicolegal
issue. The patient did not deserve the withdrawn of life
support, rather he deserved the appropriate interventions fortreatment and minimization of pain and ultimately to gain
justice, but here the preference was given to patient’s
autonomy and life support was withdrawn, but there is noliterature through which the withdrawal of life support on
patients’ wishes can be proved in conditions, where there arestill some hopes and chances of survival. The medical
treatments are financially burdensome to some patients; henceeasy accessibility to quality care at affordable cost can lessen

the financial issue adherent to the end-of-life care considering
the increase in the unaffordability of healthcare.
Since 2014 Indonesia began to implement universal healthcoverage program. All citizens are guaranteed optimal healthcare. The health financing system is implemented by actively
involving the community. For every medical treatment applies
cost system packages with a certain ceiling. Regarding
withdrawing and withholding life support issues in terminalpatients, this will have an impact on the reduced financial
burden in medical care. Likewise, with the treating physician,the financial guarantee then the doctor will give the best.

Ethical Issues about Truth Telling and DNR of
Terminal Situation- Wen Yu Hu, Professor/ Director, School of Nursing;
National Taiwan University Hospital; President, Taiwan
Bioethics Association
Email: weyuhu@ntu.edu.tw
Background: The Hospice Palliative Care Act has been legalized
for fifteen years in Taiwan. However, it still be recognized not
to be helpful in the promotion of the autonomy of terminalpatients which might be due to the difficult to practice in our
cultural context. It’s also lack of research about advance careplanning. The research purposes were to find out that therelative factors of truth telling and the DNR order
Methods: This study was designed with cross sectional survey
by questionnaire to collect data. The sampling method was twostage of non-proportional systematic randomization. The 1600
research participates were come from medical center or
district Hospital. The data was analyzed by the SPSS version 18
was used.
Results: Cancer patients and their families for "terminal cancer
patient told more positive", more inclined to think that thepatient should be informed of late disease; in addition topatients, health care professionals, patients and their families
to "hospice care more positively, more inclined to inform thepatient end of the illness, predictors of explained varianceeffectively was 18.8  ~63.1  . Health care professionals,
cancer patients and their families conscious of Health indicatesthat the higher level of understanding, you are more inclined toprovide patient’s information of AD. Predictor to provide
patient’s information of AD explained variance was 22.7
~69.5. Cancer patients and their families, "consciously on thehigher level of understanding of AD, I signed up at the end oflife choices palliative care of wills is more likely, more inclined
to sign ".
Discussion: The anticipatory results will be to establish an
appropriate model of advance care planning in Taiwan, and be
helpful to promote the quality of end-of-life care under the
Taiwanese cultural contexture.

Some Ethical Issues in Prehospital Emergency
Medicine- Hasan Erbay, Afyon Kocatepe University, Afyon, Turkey
Email: hasanerbay@yahoo.com
Prehospital emergency medical care has many challenges
which are basically classified into four groups: the process
before medical interventions, including justice, stigmatization,
dangerous situations, and safe driving; the treatment process,including triage, refusal of treatment or transport, andinformed consent; the end of life and care, including lifesustaining
treatments,
prehospital
cardiopulmonary
resuscitation (CPR), withholding or withdrawal of CPR, andfamily presence during resuscitation; and some ambulance
perception issues, including ambulance misuse, care of minors,
and telling of bad news. unpredictable patient profiles,
emergency conditions, and administration of care in a nonmedical area. Many conflicts occur in a prehospital setting that
require health care Professional to make ethical decisions,Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
immediately. Prehospital emergency medicine is quite different
from emergency medicine services in hospitals, and almost all
patients and situations are unique. Consequently, it needs tofocus on this unique health service in future, because of somedevelopments in technology create new ethical problems in
prehospital emergency medicine. It is important to have welleducated emergency health care providers recognizing the
ethical conflicts that occur in prehospital emergency medicine
and then acting ethically to the patient in needs of emergency
medicine.

Ensuring bioethical competence through experiencelearning - lessons from medical humanities
curriculum reform in Taiwan- Estela Lu, Social Empowerment Alliance, Taiwan; andDuujian Tsai, Pingtung Christian Hospital
Email: estela@sea2003.org.tw
Although bioethical discourses have been seemly
predominate in medical arena, bioethical competence is rarely
sufficiently put on focus in most recent humanistic medical
education reform in Taiwan. We define bioethical competences
through each clinical, researchers’, professional andsustainable lens.
This paper accordingly reviews all
experiences learning designed courses we have offered in 16
years and identifies the attributes of student’s achievementswith these dimensions. We will match the different course
designs, learning procedures and engaged contexts with thedesirable student achievements. In consequence, bioethicalcore competences will be identified and categorized throughaforementioned four lenses. Further curriculum designs forbioethical core competences are also proposed.

A Critical Examination of Organ Transplant: Ethical
Discourse on Family and Human Beings in Japan- Tsuyoshi Sotoya, Hitotsubashi University, Japansotsu244@gmail.com
The purpose of this paper is to consider ethical and cultural
factors affecting the peculiar trend of organ transplant from theextremely few deceased and many living donors in East Asia,
particularly Japan, compared to other Western countries. Overthe past decades, the reason behind this huge gap has been
ascribed to the wide belief that the remarkable rise in thenumber of living donors in Japan occurs in response to thesevere shortage of deceased donors due to cultural differences
about people’s views on life and death between Western andEastern societies. For instance, brain death is unclearly definedand not well recognized as human death but rather determinedby each individual under the current Organ Transplant Law inJapan. However, this argument does not suffice because it fails
to fully consider the influence of family among people in ethicaldecision-making. The power of family is also evident in the lawthat states the necessity of a family’s consent in harvestingorgans from a brain-dead donor. In this study, the author firstly
provides an etymological analysis of the word ‘family’ as miuchi(literally meaning ‘within one’s body’) with the perception ofmi (‘body’) as actualizing the great potentials beyond its
physical boundary, which can be opposite to the Cartesian wayof thinking. Secondly, in relation to family as miuchi, the author
examines the people’s conception of humans as ‘inbetweenness’ or ‘a relational being’ and its connection to thephilosophy of Zen Buddhism. Based on the conceptual analysis
of family and humans, the paper discusses the ethics ofinterdependency as in-betweenness and its relevance in thecontext of organ transplantation in Japan. By addressing theseelements, the author argues that the boundary-less attitude of
ethics based upon the sense of interconnection as a family
unity greatly impacts organ donation because the living donor
is typically a family member of the recipient while the deceased
donor is not. This ethics of unity, or a sense of togetherness,works positively with the closest relationship, or family

153

members, among people in Japan, as sharing their bodythrough living donation is a way to stay connected with theirfamily as miuchi. Finally, the study draws attention to the needfor the advancement of ethical discussion on organtransplantation from the cultural perspectives on family andhuman beings.

Doctors Attitude Towards Breaking Bad News Doctors
Experience In Banyumas Regency, Indonesia-Miko Ferine, Universitas Jenderal Soedirman, Indonesia
Email: mikoferine@gmail.com
The results of this study indicated that each doctor was awarethat information about the disease was the patient’s right andthe duty of a doctor was to deliver it to the patient. Based on
their practical experience, many patients with poor conditions
expected the doctors to provide information about the disease.
Although few doctors could deliver bad news directly topatients, most others could not perform these tasks well. There
were still many doctors who had difficulty in breaking bad
news. It was shown that the practicing doctors tried to avoid
the task of delivering bad news, especially in cases of end oflife, by, among others, 1) transferring their duties to otherdoctors or other staff considered to have better capabilities; 2)delivering bad news to families without the knowledge of thepatient; 3) choosing to be dishonest to cover the actual
condition of the patient; and 4) not conveying the prognosis of
the disease by distracting patients.
Most doctors felt uncomfortable to deliver bad news topatients. They tried to avoid such task by redirecting it tosomeone else, such as paramedics or the patient’s family. Some
doctor argued that in certain circumstances such as the end oflife, patients did not need to know the condition of the disease.
They preferred a way to protect patients from harmful
situations. Concealing the bad condition of the patient wasconsidered more humane and ethical. Therefore, they chose toconceal the real state of the patient and just pass it on to thefamily.
The hardest part of the process of breaking bad news was attimes when explaining the prognosis and life expectancy ofpatients. The difficulty led some doctors to choose to bedishonest to cover the patient’s actual condition. Anotherstrategy often used by the doctors was to provide incomplete
information. The information given was only the diagnosis andits management while the prognosis was not communicated tothe patient. When the patients asked, the doctors tried to
distract the patient or asked the patient not to think about it.
Explanation of poor prognosis or low life expectancy wasfeared to harm both patients and doctor 12.
This research could also identify some of the difficulties
underlying the doctors’ attitudes and behavior in delivering
bad news. The difficulties included 1) lack of knowledge andskills to break bad news; 2) the existance of perception ofdeath as a sad and scary thing; 3) the emergence of guilt on thepatient’s condition; 4) lack of confidence so that the doctor is
not able to communicate well; 5) the emergence of fear about
the patient’s response or condition after receiving information;6) the knowledge gap between doctor and patient; and 7) the
limitations of space and time.
Nevertheless, there were some things that could help thedoctors break bad news, such as the role of the family in thecontext of Indonesian cultural and religious beliefs andtraditions of the local community. These were widely used by
the practicing doctors as one of the strategies in delivering badnews to patients.
In Indonesia, with or without the permission of the patient,the family was always involved in the process of delivering bad
news. Circumstances that befell on the patient were not an
individual problem, but a family problem. This was one of thecharacteristics of families in Asian countries, especiallycountries in the predominantly Muslim. Conditions
experienced by the patient would be felt also by the family. A

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

disease that required a long term treatment might weigh on thefamily, both psychologically and economically. The family also
had an important role in providing support and was involvedin the management of patients.
Discussing with the patient’s family could help the doctors inovercoming the difficulties in the process of breaking bad
news. Patient families could help the doctors ensure theinformation required by the patient and the right time for theprocess of delivering bad news. Families could also assist thedoctors in preparing the patients mentally to accept theconditions of their body.
Indonesian people were known religious and still held local
traditions that became the guideline of the doctors indelivering bad news. Sickness was believed to be the will of
God and provided specific lessons for the sufferers. Pain was anopportunity to abort the patient’s sins. Caring for sick family
member could also be a field of reward.

Respecting patients as self-governors-Joo Eun Jeong, and Sang Ho Yoo, Hanyang University
College of Medicine, Republic of Korea
Email: jooeunjeong@hanyang.ac.kr
Respecting patient autonomy by providing full medical
information, which includes telling the truth regarding fatal
diagnosis, is considered one of the most important ethicalprinciples in contemporary medical practice. However, in East
Asian countries, such as Korea and China, where familism plays
a prominent role in medical decision-making, allow medical
practitioners to withhold information or even deceive patientswith the assent of the family to prevent further exacerbation of
their health. In this paper, we plan to argue that familism
cannot overcome that only patients themselves can govern
their life.
In addition to being receivers of medical treatment, patientsare governors of their life. Therefore, medical practitioners andmoral supporters must provide medical information to patients
not only as data but also as life-changing options under any
circumstance. Having multiple options, patients can take theinitiative in making decisions that affect both themselves andpeople around them, forming a nexus of relations. It is
undeniable that making even a simple decision can beburdensome to patients, whose mental and physical conditions
are temporarily or permanently declined. This is the main
opposing view on contemporary medical ethics thatemphasizes individual patient autonomy. Likewise, advocatesof familism assert that family members, the closest people topatients, are suitable candidates for patients’ spokesmen. To
compromise such two conflicting stances, we propose a newinterpretation of patients’ identity as a self-governor of one’s
life, which is interwoven within diverse familial and social
relations. Moreover, our interpretation will discuss how
medical practitioners and moral supporters can help patientsto lead such role throughout the treatment process. One’s
autonomy is established if and only if she is the governor of her
life; being able to respect others follows afterward. This
strategy, which considers both individual patient autonomy
and social influence upon patients, offers a way to vindicate
why even an inconvenient truth, must be disclosed to patients.

Philia- or sympathetic concern-based model ofdecision-making procedure in medicine- Seungmin Nam and Sang Ho Yoo, Hanyang University
College of Medicine, Republic of Korea
In this paper, I examine different decision-making procedure
models in the field of medicine and determine the mostadequate model in accomplishing the goal of medicine. Before
examining the decision-making procedure models, it should bemade clear what the goal of medicine is, since the subject itself
is a source of many misunderstandings. Simply put, the goal of
medicine is securing the best interest of patients and there is a

general consensus as to defining the goal of medicine as such.
Nonetheless discord usually occurs when the topic concerns
how to best achieve the goal of medicine, the discord withregard to decision-making procedure in the field of medicine
being one of them. Thus constructing coherent model ofdecision-making procedure can dissuade at least one source ofdisagreement among field of medicine.
I assess three familiar models and identify critical flaws ineach model, with which they cannot serve the goal of medicine.
Theyarerespect-for-the-autonomy-of-patients(RAP),
paternalism and familism. In contrast, Philia- or sympathetic
concern-based model does not share defects of the threemodels and is, therefore, the most suitable model for thedecision-making procedure in medicine.
First I assess the RAP model and identify its deficiencies. Thismodel argues that respect for patient's autonomy is necessary
in realizing the goal of medicine since someone other than apatient is unable to correctly examine the best interest of thepatient. The best interest of a patient is most apparent toherself and thus respecting autonomy of the patient is the mostappropriate way to achieve her best interest. However respect
for patient’s autonomy thus understood has certain
shortcomings when applied to actual practices of medicine.
There are cases in which serving the best interest of patientconflicts with respect for her autonomy, when a patient uses
her autonomy in a way that will evidently bring harm toherself.
As RAP model’s shortcomings are now exposed, we need tofind other models that can better accommodate the goal of
medicine. One possible candidate is a paternalistic model
whose legitimacy has often been claimed on a ground that thebest interest of patients is secured under this model.
Physician’s therapeutic privilege in withholding informationfrom patients is a representative case of paternalism.
Nonetheless paternalism also poses problems that stem from adisagreement in situations where the best interest of patientsconflicts with the wishes of patients. Thus, paternalistic modelis also deemed inadequate to successfully account for the goalof medicine.
Recently, familism has been developed in response to RAP
and paternalism. This model maintains that it can secure thebest interest of a patient while accommodating the East-Asianvalues that have often been overlooked in Western societies.
Familism answers to the problem of uncertainty with the bestinterest of patients, as shown in RAP model, by expanding its
scope to a patient’s family and is able to preserve objective
benefit for a patient by obtaining family’s assent in medical
setting. Nonetheless familism fails to defend important values
that it should have by limiting the scope of decision-making
unit to a patient’s family.
I argue that the decision-making procedure in medicine
should not deny the importance of professional opinion or
maintain blind respect for patient’s autonomy. From thisunderstanding, it follows that decision made by physicians orby someone-related-to-a-patient is permissible. And its
permissibility can be explained from Philia- or sympathetic
concern-based model of decision-making procedure.

Scientists’ Responsibility to Science and Technology- Miyako Takagi, Faculty of Human Welfare, Tokyo
Online University, Tokyo, Japan
Posing the problem
Science and technology’s development may sometimes impact
humanity negatively. But how much responsibility should ascientist contributing to such advancement take? And, if so,
how long should responsibility be taken?
In 1921, Thomas Midgley, Jr. 1) discovered that the addition oftetraethyllead (TEL) to gasoline prevented “knocking” in car
engines. General Motors (GM) Company named the substance“ethyl,” avoiding all mention of lead in reports and advertising.

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
In 1923, Midgley took a prolonged vacation to cure himself oflead poisoning.
In the late 1920s, air conditioning and refrigeration systems
employed compounds such as ammonia (NH3), propane, andsulfur dioxide (SO2) as refrigerants. Although effective, thesewere toxic or flammable, and in the event of leakage, could
result in serious illness or injury. Midgley’s team eventuallysynthesized the first chlorofluorocarbon (CFC), which they
named “Freon.” Freon and other CFCs soon replaced various
toxic or explosive substances previously used as refrigerants
and were later used in other applications, such as aerosol spraycans.
However Midgley’s fame has been scarred by his innovations’
negative environmental impact. His work led to release into theatmosphere of large quantities of lead all over the world, fromlarge-scale combustion of leaded gasoline. High atmosphericlead levels have been linked with serious long-term healthproblems from childhood, including neurological impairment.
Since the late 1970s, ozone-depleting and greenhouse gas
effects of CFCs in the atmosphere have become widely known,
but not until 30 years after Midgley’s death. Currently it is said
that his research has had the most negative impact on theatmosphere in Earth’s history.
Regarding TEL research, GM, including Midgley, knew that
ethyl contained lead components and certainly had negative
influence on human society. Therefore, Midgley and GM areunavoidably condemned for how leaded gasoline negatively
affected the atmosphere and humanity. However, we have used
Freon conveniently as a refrigerant without toxicity,
inflammability, leakage, etc. And more than 50 years later,
Freon in the atmosphere destroyed the ozone layer, and thegreenhouse gas effect of Freon became widely known. As ascientist who developed it, is Midgley charged withresponsibility for its ill effects? In this paper, I consider
scientists’ responsibilities to science and technology.
Dual-use nature of life science research
Scenarios in which results of well-intentioned scientificresearch can be used for both good and harmful purposes giverise to what is now widely known as the “dual-use dilemma.”
Debate has been growing about the dual-use nature of life
science research with implications for creating biologicalweapons.
Since late 2003, H5N1 viruses have infected at least 600
humans, mostly in Asia, and killed more than half of those
infected. But the virus, which can be acquired through close
contact with domestic fowl, does not easily transmit fromhuman to human, a phenomenon that led some scientists tobelieve H5N1 posed little threat as a potential agent for a
global flu pandemic.
In May 2012, the British science journal Nature published acontroversial study arguing that the deadly avian H5N1
influenza virus could become transmissible from person toperson if it were engineered to do so 2). Research on this was
led by Y. Kawaoka, a professor at the University of Tokyo andthe University of Wisconsin-Madison. The U.S. government
tried to block publication of these findings, fearing a terroristgroup might use the information to create a biological weapon.
The published study said that laboratory-modified bird–
human flu hybrid virus could become transmissible in an
animal model for human infection with just a handful ofmutations. Because in nature flu viruses are constantly
changing as they circulate and easily swap genes with other flu
viruses, the possibility of circulating H5N1 viruses became amuch bigger threat to human health.
A voluntary 60-day hiatus in avian H5N1 influenza virustransmission research was announced in January 2012 by theinternational community of scientists who work on influenza,
to provide time to explain such work’s benefits and its risk
mitigation measures. The pause provided time fororganizations and governments around the world to find bestsolutions for opportunities and challenges that stemmed from155

the work. Since the hiatus in H5N1 virus transmission studies
began, international organizations and governments havereviewed biosafety and biosecurity required for this research.
Some governments have implemented new policies orregulations (e.g., the U.S. Government Policy for Oversight ofLife Sciences dual-use research of concern).
The Japanese special situation in dual-use science andtechnology research
The Science Council of Japan (SCJ) was established in 1949,
to reflect on scientific research’s effects in the nation’s
administration, industries, and people’s lives. Despite its
position as a special organization under the Cabinet Office, it
conducts its mission independently. Its 210 members
represent some 840,000 researchers in such fields as naturalscience, engineering, social science, and the humanities.
The SCJ has adopted a statement and a report that calls on
universities and other organizations to regulate research that
could be used for military purposes to “establish a system to
examine the appropriateness of the research fromtechnological and ethical viewpoints.” The report raises theimportant point that for scientists to control how theirresearch results will be used is difficult. It notes that sincescientists cannot completely control their research’s “exit,”
they must judge carefully at its “entrance.” Depending on theircontent, research projects will be halted or modified during theprocess of such examinations. The SCJ’s opinion has no binding
power, but the call itself to examine research content has achilling effect on researchers.
Reflecting on scientists’ roles in World War II, the SCJ issued
statements in 1950 and 1967. In 1950, reflecting on Japanesescientists’ past cooperation with government war efforts, itdeclared “firm determination” that scientists in Japan will
never engage in research projects designed to achieve military
purposes. In 1967, it renewed this resolve by issuing a newstatement, following a revelation that the U.S. military had
provided funds to the Physical Society of Japan to help it holdan international conference the previous year. The SCJ plans tocontinue in this spirit.
Discussions were spurred by the spread of dual-use
technologies that can be used for both military and civilian
purposes, as well as by the launch of a Defense Ministry
program to provide research funds to institutions fordeveloping dual-use technologies. The ministry then has theright to use the research results. The budget set aside for the
Defense Ministry program has rapidly increased since its
launch, doubling from ¥300 million ($2.7 million) in 2015, to¥600 million ($5.4 million) in 2016. The fiscal 2017 budget
now before the Diet features ¥11 billion ($100 million) in suchfunds.
SCJ members’ views on the issue are mixed. Opinions callingfor changing or dropping the vow against defense-related
research were strong among natural science and engineeringscholars. Despite dissenting opinions, the SCJ did not discussmodifications. SCJ chief Prof. T. Onishi himself is facing
criticism for his position that appears to contradict thestatement and report’s cautious stance. A researcher at hisuniversity successfully applied for the Defense Ministry
program in 2015, proposing to develop a gas mask. Prof. T.
Onishi finds nothing wrong with that because a gas mask is not
an offensive weapon and can also be used to protect workers at
chemical plants in case of accidents.
The U.S. military’s widespread provision of funds toJapanese researchers
The SCJ has made clear its rejection of participation in
military research, but has failed to deliberate a related andsignificant issue: the U.S. military’s widespread provision offunds to Japanese researchers. The latest revelations by anewspaper investigation4) that Japanese researchers are
accepting funding from the U.S. military watered down thoseimportant arguments.

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

The United States Air Force provided funds totaling at least¥800 million ($7.3 million) to 128 university researchers andothers in Japan over 6 years, beginning in fiscal 2010.
Receiving funds from the U.S. military constitutes no legal
problem. But in 1967, the SCJ issued a statement banningmilitary research after revelations that some researchers andacademic societies had received funds from the U.S. military.
Those professors and others who have received such funds
have explained that their research was not military, that it was
conducted for peaceful purposes. But there remains thepossibility of the U.S. military using such research results formilitary purposes.
The fields of research conducted by Japanese professors
included artificial intelligence (AI) and laser technology. In its
technological strategy released in 2014, the U.S. Department of
Defense said it would attach importance to autonomous
systems leading to unmanned weapons equipped with AI. The
laser technology on which Japanese researchers conductedstudies overlaps with fields to which the U.S. military attaches
importance as technology for future weapons because it leads
to development of new weapons to replace bombshells andmissiles.
How is the US coping with dual use?
America has the strongest military power in the world, andmilitary and related research is actively and vigorously
conducted to maintain that power. Therefore, their worries
about dual use concern exclusively life science (e.g., a modified
virus of H5N1). In early 2017, at the National Academy of
Science meeting, researchers discussed the spread of dual-use
research’s findings and methods, and who should be
responsible for controlling their dispersal5). The following
options were considered:- Subjecting biology research to security classifications, evenin part.
- Relying on scientists to control their own communications
responsibly.
- Export controls, of the type used by the Australia Group with
its concerns about military/civilian dual-use of chemicals. The
Australia Group is a collection of 42 nations that together agree
to control export of certain materials to countries that might
use them to create chemical weapons.
Discussion
In a survey of Japanese students, respondents supporting
research in technologies that can be used for military purposes
outnumbered opponents. The most popular reason cited by
supporters was that avoiding research in technologies withpotential military applications would hamper research forcivilian purposes. To be sure, in this day and age, clearly
discerning in the first place whether scientific technology canbe used for military purposes is difficult.
Rocket and missile technologies have no great difference.
Computer and Internet technologies constitute militarysystems’ mainstay. The Global Positioning System, with its
origins at the heart of U.S. military technology, has been used
for car navigation systems, observations of earthquakes andvolcanic eruptions, and self-driving technology.
Many forms of technology have dual uses, that is, they apply
to both military and civilian purposes. Narrowing research
activities’ scope just because of possible military use could
inevitably lead to decline in Japan’s technological strength.
References
1) J.R. McNeill, Something New Under the Sun: An
Environmental History of the Twentieth-Century World, New
York: Norton, xxvi, 421 pp (2001)
2) M.Imai, T. Watanabe, Y. Kawaoka et al., Experimental
adaptation of an influenza H5 HA confers respiratory droplet
transmission to a reassortant H5 HA/H1N1 virus in ferrets, Nature,
486, 420–428 (2012)3) E. Johnston, Top science group votes no on arms research,
The Japan Times (2017/03/08)

4) Mainichi News Paper, U.S. military fund provision renders
rejection of military research ineffective (2017/02/08)
5) N.G. Evans and A. Commins, Defining dual-use research:
When scientific advances can both help and hurt humanity, The
Conversation, (2017/02/03)

Authorship in a publication- Shamima Parvin Lasker, Professor & Head of Anatomy,
MH Samorita Medical College, Dhaka, Bangladesh;
Secretary General, Bangladesh Bioethics Society;
Treasurer, WAME; Co-Chair, Ethics & Publication,
APAME
Email: splasker04@yahoo.com
Authorship is an important sign to the researchers, thescientific community, institutions and funding agencies forrecognition, evaluation, promotion and financial gains.
Misattribution of authorship undermine the public trust,challenges the integrity publication and damages the prestigeof the scientific community. According to International
Committee for Medical Journal (ICMJ), authorship is justified bysubstantial contributions in conceiving the ideas of theresearch, designing the study, conducting the study, analysis
the data, or drafting the manuscript. A study showed that of
44% of the articles among 18,41 manuscript published inLancet did not meet the ICJME criteria of authorship. There areworldwide controversies on authorship based on criterion of“substantial” and “contribution”. Can we consider authorship in
return for providing main equipment or sampling of an
unusual reagent or cell line as substantial contribution? Some
assertion that these contributions do not permit authorship but
warrant only an acknowledgment. Some have dilemma about
how may author should be in author byline in a manuscript.
Some justified as many as authors can be the authors in bylineof manuscript. Other limit the number authorship into six.
Ordering of authorship is another problem in publication.
However, Multi-centers research study, Pharma industries anddevice Company have complicated the authorship criterion,
who have not participated in conducting of research or in
preparing the manuscript nevertheless appear as an author
byline in the manuscript. In these case they appoint researcher
on behalf of them. This phenomenon is harmful not only
because it suppresses the contribution of authors but also
bestow underserved credibility to “ghost”- authors. These
questions need some core principles to answer for authorship.
It is unfortunate that researcher has no comprehensive
knowledge on authorship. Moreover, ethical principles andprofessional guidelines for authorship have not beendelineated more clearly and in concise form. With the aim to
decrease problems related to authorship this section focuseson principles to guide authorship-related decisions, practices,
responsibilities and policies.

Explore the evolution of campus smoke and drug
volunteer groups- Shu-Fang Su, Joh-Jone Haung, Ting- Hui Chiu and TzyJiun Chen, Kaohsiung Municipal Government HealthBureau, Taiwan
Email:sf0623@yahoo.com.tw
Background: On average it takes only nine months to startsmoking from time to time to use drugs. Therefore, theprevention of drug, access to the campus for tobacco control ismore important. Volunteers are informal staff can reduce theopposition between students and authority, more easily foundin the campus of the hidden population, To carry out volunteer
groups for the growth group, to strengthen its campus toprevent the vanguard of drugs
Purpose: The aim of this study is to explore the evolution ofsubjective feelings of campus volunteer groups in order toestablish an effective training modeEubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

157

Methods: This study was used convenience sampling.The
subjects were 15 Campus volunteers in Kaohsiung City.
Phenomenological method was used to analyze the quality data
which was suggested by Cloaizzi (1978). Purposive sampling
was designed to collect data from Campus volunteers in South
Taiwan. The participants were recruited and data was collected
after granting the permission of IRB and informed consent wasnoticed.
Result: The result was showed there were three essential
issued, which was " Breaking ice"
"Resonance"and "Deepplowing" was extracted from the quality data. The meaning of "Breaking ice " is to adjust the value of widening tolerance limit.
The meaning of “Resonance” is adjusting the frequency andcoming and going. The meaning of deep plowing refers to themaintenance of counseling and continuous learning.
Conclusion: The evolution of the volunteer growth group is achange in the attitude of the campus smokers. Because of theevolution of attitudes, the willingness of counselors of thevolunteer groups will be deepened

For this discussion, firstly, I examine the Buddhist
interpretation that the life is formed from the desire. Secondly,
I analyze the mechanization extending the realm of the life inview of human desire. Thirdly, I try to find the way in
Buddhism to overcome the problems of a machine civilization.
As part of that, I will analyze the Buddhist doctrines, the four
wisdoms of true-suchness[] acquired through the four
analytical inquiries and insights[]: a thorough and deep
insight on 4 things, i.e. names or meanings[ ], things ormaterials that originate from conditions[ ], essence or selfnature[] and differences of things or ideas[]. Finally, I
suggest that it is very important to see ‘the real’ correctly bycontrolling secular desires.

On the Moral Status of Maternal Somatic Support- Bunrong Kouy, National Central University, Taiwan;
Cambodia
Email: bunrong.k@gmail.com

Progress in science and technology in the 21st century gives
human beings new power to change and control thedevelopmental processes of all living species and theenvironment. One of the most salient technologies is modern
biotechnology and GMOs. Although modern biotechnology
holds many promises for the betterment of economy andimprovement of people’s lives, its "too rapid" advancement
have become the object of doubts, fears, concerns and as wellas an intense and divisive debate worldwide. The complexity ofissues related to modern biotechnology making it difficult forpeople to decide whether to support the technology or viceversa. Much of the controversy associated with development inmodern biotechnology and commercialization of modern
biotechnology products such as GM foods has been the result of
regulatory bodies failing to take account of the actual concernsof the public, which has fueled public distrust in the motives ofregulators, science, and industry. There is a wide gap between
how scientists and risk experts think about, define andevaluate risks compared to the lay public. The experts havelamented that the public reactions to scientific risk
assessments as ignorance and irrational but researchers haveshown that the public understanding of risk is driven by factors
not taken into account by the experts. These are two very
different starting points and not surprisingly, experts andconsumers often rank the relative importance of various risks
very differently. Scientists, in general, define risks in thelanguage and procedures of science itself. They consider thenature of the harm that may occur, the probability that it will
occur, and the number of people who may be affected. Most
citizens, in contrast, seem less aware of the quantitative or
probabilistic nature of a risk, and much more concerned withbroader, qualitative attributes, such as whether the risk isvoluntarily assumed, whether the risks and benefits are fairly
distributed, whether the risk can be controlled by theindividual, whether a risk is necessary and unavoidable orwhether there are safer alternatives, whether the risk isfamiliar or exotic, whether the risk is natural or technologicalin origin, and so forth. According to the cultural approach ofrisk research, the evaluative process of risk perception isdetermined by the norms, value systems and cultural
idiosyncrasies of societies or societal groups. The religious
beliefs of many people do not allow unrestricted interferenceof life by means of genetic engineering. This paper will
highlight the role of religion in bioethical decision making
related to modern biotechnology.

Maternal somatic support after brain death occurs when abrain-dead patient is pregnant and her body is kept alive todeliver a fetus. The moral controversy cracks into two different
extreme parties which one praised the worthiness on the
dignity of dying mother and the other insists the rights to life of
the unborn child. In other words, the moral status of the braindead mother and that of the fetus are of ethical question. This
paper aims to resolve the conflicting point-of-views in thematter of maternal somatic support.

ABA President’s Lecture- Bangook Jun, ABA President
Email: jun.bangook@gmail.com
Special Lecture: AI and Next Medicine- Uhn Lee, Gachon University Gil Medical Center
How to make a Korean Watson- Changrok Jeong, Department of Ethics Education,
Teacher's College, Kyoungpook National University
The Fourth Industrial Revolution and Bioethics fromthe Perspective of Catholic Teaching- Jinil Choi, The Catholic University of Korea
Seeing the Trans-Humanism through the Creation of
Christian Theology: related to the Createdness (asPassive Form)- Kan-Pyo Lee, Incheon National University, Institute ofGeneral Education
Buddhist Interpretation of the Boundary Between Lifeand Death - Focused on Human Life and Desires-Hwan-Ki Ahn, Seoul University of Buddhism
This paper aims to examine the change of the boundary
between life and death due to advances in science andtechnology from a Buddhist viewpoint. Especially I focus onhuman life and desires. Today the development of medicine
made us live healthier and longer. However, we also face many
problems such as preparation for old age, environmental
pollution and disconnection of communication. Modern
civilization, the result of human desire, is beneficial to us, but
leaves some difficulties to solve. At this point, I think it isnecessary to scrutinize the human desire itself.

Role of Religion in Bioethical Decision Making- Latifah Amin, Pusat Citra Universiti, Universiti
Kebangsaan Malaysia, 43600 UKM Bangi, Selangor,
Malaysia
Email: nilam@ukm.edu.my

Principles of Biomedical Ethics in the Universal
Concept of Islamic Religion- Shulhana Mokhtar, Universitas Muslim Indonesia,
Makassar, Indonesia

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

Email: shulmd@gmail.com
Bioethics is an interdisciplinary study of the problems posedby developments in biology and medicine and their impact onlarge society as well as its value system, present and future.
Society is always changing from time to time. Therefore,
ethics becomes an important thing in the life of society. In
interacting, ethics is used as a guide to do things for somereason. As more and more medical issues requiring this moral
solution, secular medical ethics developed into a new
discipline.
Medical bioethics is one of the special ethics and social ethics
in medicine that satisfy the praxeological (practical) and moral(normative) norms that serve as a guideline (das sollen) as well
as a reflective critical attitude (das sein), which is based on thefour basic moral rules and their derivative rules (autonomy,
beneficence,
non-maleficenceandjustice).
Initialunderstanding of basic moral rules is expected to be aprovision for the doctors' reflective-analytic ability in order toconstantly remind each other and to prevent deviations among
members of the profession that will ultimately foster ethicalresponsibility in accordance with the morality of the medical
profession.
The universal norm of general morality consists of a set of
actual and worthy moral norms. Morality in this universal
sense refers exclusively to the norm in the same morality. On
the contrary, "morality" in the peculiar sense of society
includes moral norms derived from certain cultural, religious
and institutional sources.
In Islam, morality and ethics are absolute and are rooted in
divinity. Human consensus that does not come from divine
decisions cannot be a source of ethical guidance. All thathumans do is apply moral and legal teachings into real life
situations.
Law is the expression and practical manifestation of morality
and is universal. Morality is wrapped in the term akhlaq means
temperament, character or system of behavior that one made.
Therefore, akhlaq (morals) can be good or bad, thoughsociologically in Indonesia, the word of akhlaq has a good
connotation.
The universalism of Islam or the validity of Islamic teachings
for all and for the whole world is a teaching accepted by
Muslims as a creed. Talking about the teachings of Islam will
not be separated from Islamic law. In general, the main sourceof Islamic law is the Qur'an, the holy book of Muslims. It is asource of Islamic teachings, occupying a central position not
only in the Islamic sciences but also an inspiratory, guiding andintegrating Muslim movements throughout the century.
Therefore Islam considers medical ethics to be the same as
ethics on other aspects of life.
There are many verses in the Qur'an that describe theconcept of Biomedical Ethics and are in line with theseprinciples. It is appropriate to make them a moral foundationin maintaining professional behavior so that doctors remain anoble profession in the future.

Reframing Ethics Course for Science Students via
Problem-Based Learning (PBL) and the use of a
Cultural Matrix: A Case Study- Mohd Salim Mohamed, Department Of Science &Technology Studies, University of Malaya, Malaysia
Email: mohdsalim@um.edu.my
Ethics courses have been developed for the medical andengineering profession but none have been developed as astand-alone course for the science profession. This paper
explores the development of an ethics course and effectivenessof the Problem-Based Learning (PBL) method to teach ethics
for science undergraduates of Faculty of Science, University of
Malaya. The course content is centrally based on the disciplineof ethics, which primarily utilizes the application of basic
ethical theories such as utilitarianism and deontology, four

principles autonomy, beneficence, non-maleficence and justice,
as well as Mertonian norms in any ethical dispute. Scientificresearch involving human and animal subjects, in particular,
would entail the use of these theories and principles. Various
issues such as unethical research and publication, laboratories
safety and risks as well as animal and environmental ethics
were given to students as case studies. A value-added ethics
learning session is provided for science undergraduates, which
consists of the application of ethical theories and principles
with a reflection of inherent religious value systems. Lessonplans are enhanced through the employment of an expanded
ethical matrix. The use of the matrix develops a structured andcontextual tool for students that assist decision-making. The
decision will later be assessed through harm test, faith test,
professional test and publicity test and be presented in theform of poster presentation. The study was carried out
throughout three semesters and the data was retrieved fromthe students’ online survey called Course and Teaching
Evaluation (CTES), in which it reflects students’ evaluation andresponses about the course. The outcome of this learnercentered program is an intense awareness of ethics and areengagement of religious ethics, which enriches the
Malaysian student’s thinking about his or her responsibilities
as a scientist.

Nursing ethics research in Korea- Shinmi Kim, Department of Nursing, Changeon National
University
Ethical Education using a Computer Program- Eun-Jun Park, Department of Nursing, Konkuk
University Glocal Campus

Ethical practice, as a nature of nursing, differentiates nursing
from other sciences or techniques. It is challenging for nursing
educators to foster nursing students to have competency for
ethical decision-makings. Traditionally ethical vignettes havebeen utilized in nursing ethics courses to teach ethical values.
However, vignettes in text have limitations to deliver reality,
severity, or complexity of clinical dilemmas and different
positions of relevant stakeholders. Nowadays computer
simulations are widely adopted in education with high fidelity
audio or video functions. Therefore, a case-based computer
program was developed with seven clinical dilemmas using
Integrated Ethical Decision-Making Model (IEDM) and Flashanimation and tested for its effectiveness as a complementary
tool in nursing ethics course.
A six-step IEDM includes (1) the identification of an ethicalproblem; (2) the collection of additional information to identify
the problem and develop solutions; (3) the development ofalternatives for analysis and comparison; (4) the selection of
the best alternatives and justification; (5) the development ofdiverse, practical ways to implement ethical decisions andactions; and (6) the evaluation of effects and development ofstrategies to prevent a similar occurrence. Using a pre- andposttest comparison design between a computer group and acontrol group, (1) perceived ethical preparation to deal withethical issues, (2) moral reasoning using the P (%) score, (3)analysis of hypothetical ethical cases in the pre- and post-test,and (4) satisfaction of ethics course in the post-test were
evaluated. The computer program was effective not only forenhancing ethical competency of nursing students but also for
provoking their curiosity and interest in learning ethics.
Though, there are some challenges to utilize a computer
program for training ethical decision-making: for example,
there is insufficient knowledge of diverse cognitive or affective
responses to ethical issues.

The influencing factor of Consciousness of Biomedical
Ethics, Moral Sensitivity and Critical Thinking
Disposition on the Code

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts- Gye Seon Jeong, Chosun Nursing College, Korea
Email:jeongs1206@hanmail.net
Background: Nurses who are working in clinical settingsneed to solve some bioethical ethical problems wisely in theirworking area with medical health personnel and keep theirworking according to the Code of ethics of nurses in Korea.
Purpose: This study was conducted to identify the influencing
factors of consciousness of biomedical ethics, moral sensitivity
and critical thinking disposition to Code of Ethics for nurse innursing students.
Method: A descriptive correlation research design was used
for this study. The subjects were 299 nursing students in two
big cities from 1st June to 31st July 2015. Collected data wasanalyzed using t-test, ANOVA, Scheffe's test and stepwise
multiple regression by SPSS 22.0 program.
Result: There are results of this study. Female subjects are 87%of subject on this study, mean age is 21.67 years. Awareness of
Code of Ethics for nurse has a positive correlation of between
the consciousness of biomedical ethics (p<.001), moral
sensitivity (p<.001), critical thinking disposition (p<.001).
However there are negative correlations of between the grade(p=.017), marital state (p=.012), the possibility of increasing of
ethical problem according to the development of bioscience(p=.012). The influencing factor of the awareness of the Code of
Ethics for nurses, there is significance in the grade (p=.013),
marital state (p=.030), consciousness of biomedical ethics(p=.017), moral sensitivity (p<.001), critical thinking
disposition (p=.001), and power of explanation was 26%.
Conclusion: The results of this study show that theconsciousness of biomedical ethics, moral sensitivity andcritical thinking disposition are influencing factors in the ethics
for nurses in nursing students.

Institutional Care for the Elderly People
Bangladesh: A Challenge of Change- Nahid Ferdousi, Bangladesh Open University,
Email:nahid329@yahoo.com

inElderly is a fast growing population group in the world. In thisstage they become more vulnerable and destitute due to lack ofproper attention of society, particularly in physical and mental
health care. Globally, developed and developing countries areseeking better ways to provide the best care for elderly people
and take initiative to formulate improved policies to ensure
proper care. The Government of Bangladesh recently has
become more aware of the elderly services but this is notenough for their nursing and caring. In this regard, ethics is afundamental part of older care and socio-legal settings are
significant factors for the protection of elderly people.
Moreover, the living arrangement and the familial relationshipare considered a major determinant of elderly care and wellbeing. In the Bangladeshi society, there are two types ofapproaches to offer services for the elderly, family andinstitutional care. But, institutional care for the elderly in the
country is still extremely limited. From both settings, they
suffer from sufficient health and medical care, proper food andclothing, recreation and financial support. Unfortunately, there
are no separate geriatrics departments for elderly care in bothprivate and public hospitals all over the country. However,there is no statistics whether the elderly prefer live ininstitutions or in family and how far the family or institutions
meet the needs of the elderly. This has remained as animportant question in the field of elderly care. Thus, elderly
population presents considerable challenges to governments
and the society to provide innovative and efficient ways todeliver essential care and facilities. In this backdrop, this paper
attempts to analyze the present institutional care services andchallenges whether it is sufficient for the elderly people in
Bangladesh.

The well-established cultural identification in East

159

Asia -Truth Telling to Terminal Cancer Patients: Asanalysis on willingness survey of in Japan, South
Korea, and China- Masami Maruyama, Kyushu University, Department of
Health Sciences, Japan
Email: masami@med.kyushu-u.ac.jp
The students were asked whether they want to be informed
their own disease, and whether they want their family to be
informed of truth in hypothetical situation that respondents ortheir family had a cancer. Relatively high proportion of
students in South Korea, especially female students want theirfamily member not to be informed of the truth. The differences
may be attributed to the degree of solidarity in a family or
bond-age of family traditional Japanese ethics. We conducted
two questionnaire surveys for university students in South
Korea (Maruyama 2006), and in Japan and China (Maruyama
2008).

Environmental protection as an ethical requirement
for community health-Gamil Saleh, Associate Professor, Faculty of Medicine,
University of Aden, Yemen
Email: Jameel5200@yahoo.com
Environmental ethics and sustainable development are
inexorably bound together as the decline of environmental
conditions affect the population health resulting in increase themorbidity and mortality rates. The objective of this paper is toanalyze the different factors contributing to environmental
protection identifying the roles and responsibility of
government, community and individuals. The methodology
used is a literature review and critical analysis showing theenvironmental factors affecting community health, thesocioeconomic conditions and quality of life and the
responsibilities for protection of the environment. The
different strategies for environmental protection are outlinedin this paper. The conclusions of the study is that the mainthreats to the world health, to stability and even to mankind's
existence itself comes from the synergetic interaction of thefollowing three factors: poverty, population and environment.
The study recommended the application of some strategies forbetter environmental protection such as policy, changing
organization behavior, education protection, and promoting
community educator and strengthen individual knowledge andskills.

POSTERSSocial aspects of ethics- Akram Rahmatov, Head of Division of Innovative
Technology, Institute of Chemistry, TAS, Tajikistan
Email: akramsr@mail.ru
Recently, it was reported that US lawmakers have banned theissuance of patents for human cloning, which implies theinadmissibility of issuing a patent for the replication of a living
person. And there are a lot of such examples of using scientificand technical progress for the "good" of mankind. The question
arises, should everything be technically possible? Where is theline through which it is not permissible to step over and how
should we regulate or control such experiments (including thetransfer of information, socio-economic relations) from the
ethical point of view?
In the same place, new sciences appear, such as: sectorial
ethics, biological ethics, Nano ethics, ethics in the media... The
society needs to regulate these disciplines, which implies thedevelopment and establishment of generally accepted
measures and standards. Thus, we need laws based on ethicalprinciples to prevent the emergence of a "new" specialist withdeviations from human and ethical norms.
In history, there are examples when industry experts(doctors, technologists, scientists) worked in concert with
politicians. The ugliest face of this cooperation is the massacre

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstractsof millions as a result of the movement of the Nazi eugenics"for the purity of the nation", the exploitation of other peoples,
seizure and aggression for the sake of building up theireconomies, conducting scientific experiments on living people.
Discussions on ethics began then at the Nuremberg Trials,
when the truth about the terrible deeds of Nazi specialists
became known to shocked humanity.
An important aspect of raising the consciousness of society on
ethics is a long education, from schools to universities. In our
opinion, training programs should include such topics fordiscussion and teaching as the ethics of advanced technology(information and communication technologies - ICT,
nanotechnology, biotechnology), ethics in economics anddevelopment (equality, access, environmental responsibility)and ethics of intellectual property (Use of development,
copyright protection, principles of duplication, traditional
property).
For example, when studying a discipline such as Ethics in
Economics and Development, there should be a section
containing ethical themes derived from the process of socialand economic change, called "development", and usuallycorrelated with modernization. Relevant topics should include
the dynamics of technology transfer, environmental
sustainability, gender and law, exploitation and inequality.
When studying the course "Information Technologies in
Economics" there should be a section "Ethics of Information
and Communication Technologies (ICT)". So, this is justified by
the fact that in the countries with a transition or developing
economy, which is Tajikistan, the most notable problem
regarding ICT is the "digital division". That is, the inequality inaccess to information and communication nodes throughtechnologies such as the Internet.
The progress of science, undoubtedly, is not only impossible
to stop, but it is senseless. The challenge is to follow ethicalprinciples, take control of newly developed methods andtechnologies as soon as they have reached the experimental
stage, and also before they become the subject of commerce.

An intervention for improving the informed consent
process in trauma patients undergoing the surgery ofdebridement- Yen-Ko Lin and Chia-Ju Lin, Kaohsiung Medical
University Hospital, Taiwan
Email: yenko@ms16.hinet.net
Background: Transnational marriages are already very
popular in Taiwan. The number of new immigrant’s pregnant
women has increased rapidly. The children.of new immigrants
In Taiwan have a direct impact on Taiwan's future. Therefore,
it’s very important to construct a physical and mental healthcare program for new immigrants pregnant women, fromprenatal to postpartum physical care and care for newborns .In
the promotion and implementation "Humanity oriented” andinto the “Different culture”, to strengthen human rights, toenhance physical and mental health and welfare to promote
the work.
Purposes: 1) Constructing Cognitive Groups of new
immigrants pregnant women; 2) Explore the effectiveness ofcognitive groups.
Methods: This study used convenience sampling. The subjects
were 36 new immigrants pregnant women in Kaohsiung City.
Evaluate before and after participating in cognitive groups. In
addition to the descriptive analysis of statistical methods ,alsousing the t- test set to participants.
Result: After the cognitive group, the physical and mental carecan be significantly improved from 85.33% to 97.59%, the ttest p =.001, showing significant differences in the course ofintervention.

Ethical framework for public health emergency:
reflecting MERS outbreak in Korea-Youngjun Kim and Sang Ho Yoo, Hanyang University/
Department of epidemiology and Health statistics,
Republic of Korea
Email: episomal@hanyang.ac.kr
In a public health emergency occurring due to an epidemicor pandemic situation, population-oriented public healthpolicies and programs have raised various ethical issues. In the2015 MERS incident in Korea, several ethical issues were faced
because there were no prepared ethical principles of publichealth to aid the situation. Thus, this study focused on defining
the ethical framework in public health that suite our context.
The important values were identified for each of the 4
stakeholders, namely individuals, groups, public agencies, andexperts, during an outbreak causing a public health emergency,
and the important ethical principles were derived.
Preparedness for a public health emergency and appropriatecompensations based on reciprocity should be considered as a
key point for all 4 stakeholders. The principles outlined in thisstudy can contribute to establishing public health policies anddecision-making in the next public health emergency.

Cross Cultural Issues in Prenatal Testing- Shizuko Takahashi, Department of Obstetrics andGynecology, Center for Biomedical Ethics and Law,
University of Tokyo, Japan
Email: shizukotakahashi1205@gmail.com

Among the industrialized countries, the frequency of womentaking prenatal testing is the lowest in Japan (3-4%). Such alow percentage has been partly attributed to the availability
and knowledge of the testing. Most other countries offering
testing, a higher proportion of women take these exams sinceoffering all prenatal tests has become a standard of care. The
purpose of this presentation is to explore the reasons andsocial implications of this difference through a case of a 35year-old Japanese woman, who had a prenatal check in the U.S.
and unexpectedly found that the fetus had a sex chromosome
condition XXY (Klinefelter Syndrome). Her impression of thetest was screening for Down Syndrome and was also surprised
to find the sex of her fetus. Skipping her referral to a genetic
counselor, she returned to Japan. After meeting with anobstetrician and pediatrician, she decided against diagnostic
tests and continued the pregnancy. Autonomous decisionmaking is difficult when faced with multiple choices andespecially for those whose culture has negative and unclear
images associated with words like “counseling,” and “genetics.”
The degree of availability and use of the prenatal testing
technologies has a profound impact on the perception ofpregnancy and the future child. These are reflected in Japaneseguidelines and practice, though they are based on theavailability of the testing in the West. With increasing medical
tourism around the globe, medical professionals need to bebetter prepared to offer routine testing to women from anothercountry.

Ethical Issues Surrounding Non-Invasive Prenatal
Testing in Japan: a Content Analysis of Newspapers- Suguru Okubo, CEO, BMS-Yokohama Inc. , Japan
Email: suguruokubo@gmail.com
Introduction: Non-invasive prenatal testing (NIPT) is
designed to screen for Down syndrome (trisomy 21), trisomy
13, trisomy 18, and sex chromosomal aneuploidies. Clinicalresearch on NIPT, which aims to evaluate genetic counseling,
was launched in April 2013 in Japan. Seventy-six facilities havebeen certified to provide NIPT to pregnant women and theirpartners. There are, however, some ethical problems with NIPT
(Nuffield Council on Bioethics, 2017). For example, parents
with positive NIPT results need to undergo the amniotic fluid
test if they want to obtain a definite diagnosis. These ethicalissues have not been openly discussed, despite that NIPT has

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

161

been documented by Japanese newspapers from the time theabove-mentioned clinical research was launched.
Objective: This study aimed to investigate the variety andfrequency of ethical issues surrounding NIPT reported inJapanese newspapers.
Methods: We conducted a traditional content analysis of four
major newspapers in Japan: Asahi Shimbun, Mainichi Shimbun,
Nihon Keizai Shimbun, and Yomiuri Shimbun.
First, wesearched articles referring to NIPT in each newspaper archive
using the term “prenatal testing,” not “non-invasive prenatal
testing,” to identify all relevant articles.
Second, wecategorized ethical issues surrounding NIPT based on a pilot
analysis of newspapers and discussions of categories. Ethicalissues identified were divided into four main categories basedon a time series of screening programs:
Results: Seventeen categories were identified. <<Ethical issues
before undergoing screening tests>> included the following
three categories: <appropriateness of genetic counseling>,<autonomy of the decision-making process>, and <unequal
accessibility to screening tests>. <<Ethical issues from the timeof screening to diagnosis>> included four categories:<miscommunication of screening test results>, <securing theoption to refuse receiving the results after screening tests>,<quality control of screening programs>, and <decision-making
about pregnancy continuation before diagnosis>. <<Ethicalissues after diagnosis>> concerning true positive results
included <decision to continue or terminate pregnancy after
diagnosis>,<decision-making
processofpregnancy
continuation or termination after diagnosis>, and<psychological burden of parents>. <<Ethical issues after
diagnosis>> concerning false-positive results included<psychological burden of parents> and <necessity of invasive
tests (amniocentesis) for diagnosis>. <<Ethical issues after
diagnosis>> concerning false-negative results included<psychological burden of parents>. <<Ethical issues through allprocesses of screening programs>> included <stigma with
undergoing screening tests>, <psychological burden of people
with Down syndrome, trisomy 13, and trisomy 18>, and<possibility of financial burden for implementing screening
programs>. Major Japanese newspapers frequently reported
ethical issues on <decision to continue or terminate pregnancy
after diagnosis> and <appropriateness of genetic counseling>.
On the other hand, ethical issues such as <unequal accessibility
to screening tests> and <the possibility of financial burden for
implementing screening programs> were rarely reported.
Conclusion: Frequency of reports pertaining to each categoryof ethical issues reflects medical, legal, and social situations
surrounding NIPT in Japan. Less reported ethical issues should
also be brought to light.

for advanced training and cooperation. The focuses ofcommunication are listed as following:
Promotion of concept of mental health: In Vietnam,
stigmatization of psychiatric disorders continued to be theburden for patients and family. We visited local healthdepartment and discussed with experts and supervisors ofmetal health. We shared our experiences of de-stigmatizationtopublics,
includingpublishingnewsletters(The
Communication of Kai-Syuan hospital), submission articles orgiving talks on all kinds of social media routinely. We also
psycho-educated the importance of timely medical
intervention for better treatment outcome.
Ethics and politics of mental health: As the pioneer toestablish Mental Health Act among East Asia, we discussedwith staffs of psychiatric service about the progress, samenessand differences of policies on mental health between countries.
We presented the intervention of involuntary community
therapy in our Metal Health Acts, which was legislated firstly
among Southeast Asia Countries. We shared the advantages
and difficulties during clinical practice under the current
policies.
Community psychiatry and Kai-Syuan model: We had
worked hard to strengthen our psychiatric service into thecommunities. The Kai-Syuan model of community therapy
includes preparation before discharged from acute or chronic
ward, day-care wards, halfway house and community
rehabilitation center. The Qualified Community Service
Program was built on 2016 to serve patient missing the follow
up after discharged form our hospital. We aimed to help
psychiatric patients go back to society gradually with basicallysocial-economical functions
Organization of systems among doctors, nurses,
rehabilitation therapists and occupational therapists: We
shared our organization on different departments of
employees in comparison with those in Vietnam. We hoped tointeract the sameness and differences between countries toimprove the systems.
To sum up, we hope to extend and deepen the collaboration
with other psychiatric service/hospital at Southeast Asia. The
current project could also promote cultural and religious
communication between countries.

From
TaiwantoVietnam,theRegional
Communication,
Collaboration,
andProspectExperiences from Kaohsiung Municipal Kai-Syuan
Psychiatric Hospital- Shu-Hui Wang, Dian-Jeng Li , Ming-Chou Li and ChengChung Chen, Kaohsiung Municipal Kai-Syuan Psychiatric
Hospital
Email: sandy00776@gmail.com

Good maternal and child health is related to the overall
health of a country, so it is necessary to promote the physicaland mental health care programs for new immigrants pregnant
women. The results show that cognitive groups can care for thephysical and mental health of new immigrants pregnant
women and provide a healthy and healthy environment for the
next generation of children.of new immigrants in Taiwan.

Our hospital provided experiences and discussed with staff
from psychiatric hospitals in Vietnam, including treatment ofpatients, rehabilitation of patients, and outreach service from
hospital to communities, social security network for severely illpatients, and organization of medical settings. Furthermore, we
visited our collaborated hospitals in Vietnam to deepen thecommunication and give our feedback. To date, we had
successfully interacted with specialists from Khánh Hòa
hospitals, Đà Nẵng hospitals, Xuân Dũ hospital, Hanoi First
hospital, and general hospitals in Nha Trang. Moreover, some
hospitals had signed Memorandum of Understanding with us

The Effect of Cognitive group on physical and mental
care and Newborns Care on New Immigrant’s
Pregnant Women- Ying-Se Kuo (Chief), Shu-Fang Su, Joh-Jone Haung, YinJu Haung, Kaohsiung Municipal Government HealthBureau, Taiwan
Email:sf0623@yahoo.com.tw

Effectiveness of Mindfulness-based Stress Reduction
Program forTrauma experience of the government
officials in Taiwan- Shu-Fang Su (Director-general), Joh-Jone Haung, LiShiu Chou, Wei-Jen Chen, Yin-Ju, Haung, Ya-Ching, Haung
Kaohsiung Municipal Government Health Bureau,
TaiwanEmail:sf0623@yahoo.com.tw
Background: Traumatic events have a great influence If thesupervisor can not cope with the traumatic situation, it willaffect the department's morale and work efficiency.
Mindfulness-based Stress Reduction Program (MBSR) can

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

enhance self-awareness through experiential activities, learn
self-care, and deliver positive warm energy care around staff.
Purposes: 1.Constructing Mindfulness-based Stress Reduction
Program for Trauma experience of the government officials.
2.Explore the effectiveness of Mindfulness-based Stress
Reduction Program.
Methods: This study was used convenience sampling. The
subjects were 26 government officials in Kaohsiung Municipal
Government Health Bureau. The the Cognitive, Attitude,
Behavioral (questionnaire KAPQ) (Expert validity.96)., andqualitative interviews were used as assessment tools
Results: Quantitative research results show: the overallsatisfaction was 6.46 (± 0.65) to 6.84(± 0.11) t=4.24 p=.000,
The KAP scale results showed:(1)the cognitive was 5.46 (±1.53) to 6.67 (±.52) t=3.29 p =.003, (2)the attitude was 6.31 (±0.84) to 6.83 (±.41) t=2.25 p =.039, (3)the behavior was 6.27 (±0.78) to 6.90 (±.10) t=4.79 p =.000, showing significant
differences. The Qualitative research results show :Change theturning point (1) The practice of life (2)The baptism oftime(3)The urgency of demand.
Conclusion: The results show that members of MBSR Program
are consciously able to assist in mental health and execution.

Swinging
betweenDestigmatization
andDemonization: Social Perspective of Psychotic
Disorder on Taiwanese Mass Media
Hsu, Wei-Tse; Chen, Hsuan-Cheng, Chou, Frank HuangChih , Kai-Syuan Psychiatry Hospital/ Department ofhealth, Kaohsiung City Government, Taiwan
Email: r97442013@ntu.edu.tw
Previous studies have suggested that that common
association of psychotic disorder with crime in many articles in
the mass media is one contributing factor to discrimination andstigmatization of schizophrenia. However, there have been nocomprehensive studies exploring the mass media portrayal of
psychotic disorder in Taiwan. A quantitative content analysis
was performed to investigate prevalence of stigma-related
contents in four of the most read online news media in Taiwan.
We used text mining to draw wordcloud and categorize the text
into stigma frames and stigma-challenge frames. We also
examined the relationship between different media framing
and the spreading and impact of the news. We associated thetrend of stigma framing to the milestone of human rights
protection and destigmatization movement. The results
showed some nonuniformity and may provide us a chance tore-exam our current strategies of reducing stigma. From ourresult, we also suggest that the socio-economic factor of
psychotic disorder and did not receive adequate attention.
Debate on the priority between human rights and social
security was another important ongoing issue. We suggest thatexperts of mental health should work in cooperation withmedia professional in order to provide the accurate andcomplete picture of mental health in social and cultural
backgrounds.
Mass media shapes our perspective toward public issue andmay affect mental health-related stigma. Previous studies
showeddestigmatization
movementandpublicpsychoeducation about stigma might result in the
improvement of quality of life for patient suffered frompsychotic disorder. Thus, understanding the trend andinteractive opinion formation of mass media is critical forpolicy making of public health.
In Taiwan, as in other Eastern Asian countries such as Japanand Korea, the name of schizophrenia was changed in order toreduce stigma. The medical term of schizophrenia was officiallyrevised in 2014 from “Jing-Shen-Fen-Lie-Zheng” (mind-split
disorder) to “Si-Jue-Shi-Diao-Zheng”(dysregulation of thought
and perception disorder). Meanwhile, the legislation reform of
Taiwan Mental Health Act in 2007 and Habeas Corpus Act in2014 highlighted human rights protection as the common

value in clinical practice. However, negative comment or
implication from mass media and debate on broadening
practices of compulsory psychiatric admission reappeared
after several episodes of indiscriminate killing recently. The
clinical practice of forensic psychiatry or community model ofrecovery was also called into question in some mass media.

Management Ethics for Developing International
Partnership in Mental Health Arena: Vietnam as an
example- Shu-Hui Wang (Chief), Cheng-Chung Chen, Ming-Chou
Li , Kaohsiung Municipal Kai-Syuan Psychiatric Hospital;
Duujian Tsai, Pingtung Christian Hospital, Taiwan
Email: sandy00776@gmail.com
Professional competence and ethics are always major
concerns for the international mental health collaborations.
Such concerns are essential professional reflections on therights of the mental ill patients. However, professional
manpower shortages as well as limited resource allocations areinevitable barriers in such collaborations. We therefore
propose management competence and ethics are nonethelessimportant, as comparing to professional competence andethics. A participatory action approach between mental
hospitals in Taiwan and Vietnam has been taken. With
management supports, service oriented approach are adopted
to replace the approaches on professional training. Patientcenter considerations are the essential part in such paradigm
shift.
While contextual features predominating theinternational mental health collaborations, we find thatmanagement competences and ethics are very important as
professional competence and ethics. Contextually sensitive
holistic approach is far more important in all efforts attempt toreduce mental health gaps.
Kai-Syuan Psychiatric Hospital (KSPH) has had a longtime
relationship with the Psychiatric Hospitals in the Southeast
countries since 2010. Vietnam can be a very practical example
for the detail description:
According to the MOU between KSPH and the three
Vietnamese hospitals, the Vietnamese hospital’s trainees havebeen invited to KSPH for a short-term training course for thepsychiatric medical nursing and occupational therapy
programs. Since 2015, KSPH dispatches the work teamincluding the medical doctors, nursing/OT staff andadministrative members to Vietnam periodically (in six months
span) to review/feedback the training effect if the trainees can
expand their works practically as on sit visiting and discussion.
In response to the request from Ching-Ho Psychiatric andGeneral Hospital, KSPH’s Ms. Shu-Hui Wang (Planning Office
Chief) was invited to Vietnam on March 2017 to lecture the
SWOT analysis and BSC (Balance Score Card) techniques which
will be used for them to establish the future
short/medium/long-range targets of their hospitals. The oneday course for nearly 100 trainees (including the top-levelsuperintendent) covers the theory introduction and the twoway communications, and the afternoon’s activities of thegroup discussions and presentations actually agglomerate theircommon consensus. Due to the enthusiastic response and thenecessary demand, a follow-up invitation for Ms. Wang can be
expected in the coming days include the assessments anddiscussions.
KSPH, as a hospital with the specialized field, has beenworking together with the Vietnamese Psychiatric Hospital in
the application of the nursing and occupational therapy
program as well as the start of a new business model for their
good future.

A Study on the Taiwan Patient 's Autonomy Right Act- Fu-Lung, Lee, Open University of Kaohsiung, Associate
Professor and Head, Department of Law and Political

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
Science, Taiwan and Ching-hsiu, the Department of Law,
Chuang, Kainan University, Taiwan
Email: ouk161123@ouk.edu.tw
In the CASE of LAMBERT AND OTHERS v. FRANCE (2014),
the European Court of Human Rights argued that restoring thepatient's life to a natural state of death didn’t violate the State's
obligation to protect the right to life.
The Taiwan Patient’s Autonomy Act was enforced in June
2019, which was not euthanasia or suicide bill. One purpose of
the Act is to implement the patient's will, the other one is toprotect the physician. Through the clear legal basis for theprotection, the physician performed the pre-medical plan andkept civil liability from arising. In the criminal law, also to
avoid criminal liability. So as to solve the case of patients who
do not comply with the Medical Mitigation Act and comply withthe provisions of Article 14 of that Act, and then restored theirlife to natural death, rather than the soul being detained under
the living body.
However, this Act still faced several controversial issues:
First, is the right of patient autonomy or others? Second,"Medical Appointment Agent" has the authority to act
positively or negatively? Third, some concepts are too vague,such as severe dementia or patient suffering unbearable, etc.
Fourth, "lack of the mechanism to confirm by third party about
the will of the patient. This article will explore from theperspective of medical appointment agent has positive or
negative authority, and make some suggestions.

Review for studies dealing with ethical aspects incancer clinical trials published in Korea- Han Gajin. and Ham Areum, Soram Korean Medicine
Hospital Institutional Review Board; Soram BioMedicine Research Institute, Korea; and Seong Sin and
Kim Sungsu, Soram Korean Medicine Hospital, Korea
Email: kmdhgj@naver.com
To our regret, there have been few recent studies about
ethical issue of cancer patients partcipating in clinical trials.
When the investigators conduct clinical trials related to cancer
patient, it is very important to obtain the informed consent
properly for specificity of cancer patients. In the process ofobtaining consent, it is needed that the subject could exercise
self-determination with voluntariness and the informer
consent form contains sufficient information. Furthermore,
more research about ethical issue in the clinical trial for cancer
patients needs to be done.
According to government figures announced by Ministry of
Health and Welfare, the number of cancer cases in Korea hasreached 210,000 in 2014. It is a significant increase compared
to 180,000 in 2004. Since 2000, the introduction of thebridging study system has enabled the approval of new drugs
through various clinical trials, and the clinical trial market has
expanded rapidly in Korea. In the case of clinical trial for
terminal cancer patients who have limitations in conventional
treatments, there are important decision-making questions
about whether to participate in the trial that can be the lastresort, or to finish the life without pain induced by theintervention. Because of the nature of cancer, treatment andclinical trials are recognized as the same concept. Therefore, it
is difficult to obtain sufficient information and understanding
from patients when obtaining consent for clinical trials. The
autonomy of patient decision-making in the hope of the lastopportunity for treatment and the choice of palliative careshould be more ethically protected. Therefore, we reviewed theliterature dealing with ethical aspects in cancer clinical trials
published in Korea to grasp the current situations. The
database such as Research Information Sharing Service (RISS),
KISS (Koeanstudies Informaiton Service System), NDSL(National Digital Science Library), Data Base Pia (DBPia), andNational Assembly Library, Oriental Medicine Advanced
Searching Integrated System (OASIS) was used. We used the163

search term such as ‘cancer’, ‘clinical trial’, and ‘ethics’. There
were 9 studies in total; 4 cases of RISS, 2 of KISS, 3 of NDSL. We
excluded 2 studies unrelated with ethical issue by reviewing
the full text. Two studies were published before 2000 and fivewere after 2000. Only two studies were published within thelast 5 years. One study was published in the journal of medicallaw. Most of the researches used the questionnaires, and there
was a study conducting both qualitative and quantitative
studies. A legal paper discussed precedents and legal principles.
All seven articles focused on the informed consent received
during clinical trials and the contexts varied. One study
analyzed objective and subjective perception of informed
consent and proposed the policy. The other study focused onvoluntariness when the investigator obtained consent fromsubject. So, the author examined the difficulty of informed
consent form and analyzed the consent process. In addition tothese substances, the contents were various as follows:investigating the subject’s overall awareness about the clinical
trial and consent, analyzing the necessity and problem ofconsent, and taking self-determination.

The actual situation of providing education/training
programs for Research Ethics Committee members inJapan- Ayako Kamisato and Sachiyo Yoshida, The University ofTokyo, Japan
Email: kamisato@ims.u-tokyo.ac.jp
Currently, there are more than 1,800 institutional Research
Ethics Committees (RECs) in Japan. As cases of research fraud
have increasingly been coming to light since the 2010s, quality
enhancement of reviewing at the REC has become an agenda.
The government has, therefore, undertaken initiatives torectify this, such as establishing an accreditation system for theREC.
In order to raise the quality of reviewing, it is important toprovide education/training opportunities to REC members sothat they can fully understand the roles of each position, suchas an expert in the field of natural science, expert in the fields
of human/social sciences or a person with a generalbackground, and conduct appropriate reviews.
Since 2015, Japanese ethical guidelines that regulate medical
studies involving humans have been strictly imposed, and each
REC member is required to attend education/training
programs at least once a year. The guidelines also obligate
universities and other institutions where RECs have been
established to take measures to ensure the participation of REC
members to education/training programs.
There are, however, no particular provisions regarding thecontents and methods of imparting education/training. These
programs are therefore diverse in terms of their methods:
some institutions conduct original education/training
programs, some use e-learning programs for researchers
created by external organizations, some just provide theinformation of seminar conducted by external organizations,and some only distribute books and materials related toresearch ethics to the members.
From our survey, we found that most universities and otherinstitutions provide education/training opportunities to their
REC members no more than three times a year. Reasons forsuch circumstances are that it is not easy for REC secretariats
to secure resources, manpower, and time for conducting
education/training programs.
In order to improve the quality of ethical reviewing, thefollowing points are pragmatically important: (1) to provide
education/training programs on a regular basis, such as morethan four times in a year, to REC members, (2) to holddiscussions for REC members in order to deepen theirunderstanding, (3) to not overburden the secretariat of theREC, and also (4) to not overburden the REC members.

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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

From these points, we believe that educational programs
that can be conducted before or after the reviewing meetingare necessary for providing education on a regular basis.
However, there are no such programs in Japan. Therefore, since
FY 2016, we have been developing video educational programsfor REC members and offering these free of charge on thewebsite http://rec-education.org/. We have more than 130
registered members.
In this presentation, we would like to demonstrate the actual
situation of providing education/training for REC members
and then extract the problems specific to Japan. We would also
like to introduce the video educational programs we havedeveloped.
Objective: This study is an attempt to determine whether
educational videos are superior to conventional discussion for
informing trauma patients undergoing surgeries about theprocedure, benefits, risks, alternatives, and postoperative care.
Methods: Audiovisual videos including information about
the procedure, benefits, risks, alternatives, and postoperative
care for the surgery of debridement were developed andapplied. A prospective randomized controlled trial was
conducted, and all trauma patients meeting the study interest
scheduled to receive the surgery of debridement in theemergency department were included. Patients were assigned
to the video group, in which patients watched an educational
video illustrating the surgery of debridement, in terms of theprocedure and its benefits, risks, alternatives, andpostoperative care, or to the control group, in which patients
had conventional discussion and received information fromtheir surgeon. A knowledge test and questions evaluating
satisfaction with the process of informed consent werecompleted by the participants after their educational sessions.
Primary outcomes were to evaluate whether the educational
videos were superior to conventional discussion for informing
patients. Secondary outcomes were compared to access thepatients’ satisfactions and refusals to sign consent.
Results: A total of 185 adult patients were solicited toparticipate during the seven-month study period. One hundredand forty-nine of the 185 patients were enrolled in the study
when research associates were available. Of these, one declined
and six were excluded owing to clinical instability. One
hundred and forty-two patients were enrolled, and 70 wereassigned to the video group and 72 to the control group. Meanscores of knowledge test were higher in the video group incomparison with conventional discussion. Patients in the videogroup had greater satisfaction than patients in theconventional discussion group. No patient refused to signconsent to receive the surgery of debridement.
Conclusions: Using educational videos are a good tool for
improving informed consent process for surgery in trauma
patients. Video-assisted informed consent may improve patientunderstanding of the surgery and satisfaction with the processof informed consent in trauma patients undergoing the surgery
of debridement. Future studies are recommended to accord
with the results of these precursory findings and exploredamong trauma patients with different types of injuries andseverities.

The Complex fiduciary relationship model – anormatively reasonable and practically fit DoctorPatient Relationship- Sung Hwan Ji and, Sang Ho Yoo, College of Medicine,
Hanyang University, Republic of Korea
Email: jisung507@hanyang.ac.kr

The Doctor-Patient Relationship (DPR) traditionally started
with the paternalistic relationship model, which doctors
authoritatively intervene over patients. However, as theimportance of human rights emerged in the 1970s, movementsfor patient rights began, and a shift to the contractual model
was made. The contractual model, which has been a popularmodel that explains the current DPR, establishes an equal
partnership by informed consent. Meanwhile, medical
essentialism emphasizes that the goal of medicine is topromote patients’ health, but this view might easily beoverlooked by the caveat of the contractual model. Fromacknowledging this weakness, the fiduciary relationship model
was first introduced. It concerns innate asymmetrical
relationship between doctors and patients. Patients trust theirdoctors and give them a discretionary power and, in return, thedoctors promote the best interests of their patients.
Among the three models, the fiduciary relationship modelseems to be the most fitting model to account for the DPR. Thismodel is able to secure both patients’ interest and autonomy byrecognizing patients’ authority to devolve discretion to doctors.
On the other hand, the paternalistic relationship can only
recognize doctor’s authority while ignoring patients’autonomy. And the contractual relationship fails to embrace
the goal of medicine from giving too much emphasis on theequal status between doctors and patients.
In this paper, we introduce the complex fiduciary
relationship model; a refined version of the current fiduciarymodel for the DPR. It is similar to the previous fiduciary
relationship in that patients put their trust in their doctors
thereby giving them discretionary power, and in return doctors
take up a duty to protect the patients’ health with the best of
their judgment. In addition to the shared foundation andfeatures, the model has three new major aspects that
distinguish it from the current fiduciary model. First, the levelof doctor’s discretionary power varies depending on patients’condition and situation. Doctors’ discretionary power overpatients is determined by level of contributions doctors canmake on patients’ health. Second, the complex fiduciary
relationship understands the DPR to be a subset of generalhuman interactions, thus it should reflect universal values andcommon sense found on such settings. Third, the complex
fiduciary relationship is rather trilateral with the additional
third party, ‘authority,’ appended to the previously bilateral
DPR. The ‘authority’ functions as a regulator of the doctor andpatient partnership and whose role manifests in the form of
medical policies and ethics. This new approach is able toassimilate both specific and universal aspect of the DPR, while,at the same time, retaining doctors’ discretionary power andpatient-centered thoughts.
Thereon, we will assess persistent ethical issues plaguing
medicine such as truth telling based on the complex fiduciary
relationship.

Systematic review of studies for Withdrawing of lifesustaining treatment in South Korea
Young Mi Yoon, Department of Nursing, Seoil University,
Republic of Korea
Email: profen@seoil.ac.kr
A systematic review was performed in order to gain acomprehensive understanding of domestic studies conductedon the withdrawal of life-sustaining treatment. A total of 211
studies were found by researching the database withwithdrawal of life-sustaining treatment as keywords for theperiod beginning Jan 1, 2000 and ending Dec 31, 2015. Of the
211 studies, 76 were determined to be appropriate in thecontext of this systematic review. 51 of the eligible studies
were categorized as pertaining to legislation and policies, 16 tophilosophy and sociology, and 9 to theology. 13 of the 76
studies adopted quantitative methodologies while 63 utilized
qualitative analysis. Collectively, the selected studies featured atotal of 348 keywords categorized into patient conditions,
treatments, and legislation and policies. The most common
keywords for patient conditions included vegetative state (7),terminal illness (6), and terminally ill patients (5), those fortreatments included withdrawal of life-sustaining treatment(69), euthanasia (12), and passive euthanasia (16), and thoseEubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
for legislation and policies included death with dignity (27),advanced directives (16), presumptive agreement (10), living
wills, and adult guardianship. A survey of the studies revealed
that awareness of the need for legislative reform and specificityof studies regarding life-sustaining treatment increased since
the occurrence of Mrs. Kim's case in 2009. Several studies were
especially focused on proving the legitimacy of the said policies
and legislation in the face of the Constitution and criminal
justice. Some studies also delved into specific supreme court
precedents to devise solutions to potential issues that may
arise should certain aspects of withdrawing of life-sustaining
treatment, such as obtaining advanced directives, presumptive
agreement, living wills, or adult guardianship, be ruled
unconstitutional or criminal. This systematic review clearly
reveals that the application of policies around withdrawal of
life-sustaining treatment in clinical setting is minimal. It is also
clear that future implementation of such policies cannot be
accomplished merely through agreement between academia
and coalition of physicians.

Bioethics in the Kyrgyz Republic- Ulankul Tilekeeva, Chairman, Committee on Bioethics
under Ministry of Health of the Kyrgyz Republic, Kyrgyz
Republic
Email: ulangul@mail.ru
In 2007, the Commission on Ethics of Clinical Research andClinicalPharmacology,
withintheDepartment
ofPharmacological Support and Medical Equipment, wastransformed into the Committee on Bioethics under the
Ministry of Health of the Kyrgyz Republic (KR). Since thistransformation, all researches must pass ethical review taking
into account national, cultural and mental values. Since 2007,
the 100 research projects have been conducted. This
Committee is a member of the Forum for Ethics Committees in
the Commonwealth of Independent States (FECCIS). In theframework of this Forum, representatives of the Committee
have presented the results of studies to several international
conferences. Our research has been carried out in close
cooperation with regional and international organizations,
including the WHO, Country Office in Kyrgyzstan, the National
Commission for UNESCO of the Kyrgyzstan, the European
Forum for Good Clinical Practice (EFGCP) and representatives
from different national ethics committees, particularly from
Belgium and CIS countries. The Committee was involved in the
Project for CIS states which focused on the creation andpublication of the book “The development of the ethical review
of biomedical research in the CIS states (social and cultural
aspects)”. The Project was based on the results of Expert
Consultations on networking in the sphere of ethics andbioethics. Research bioethics, applied aspects of health caresystem(s) and medical education are among the scope ofactivities of the Committee. This Committee was awarded a
grant from UNESCO for publishing the book “The Current Stateof Bioethics Education in the System of Medical Education in
the CIS Member Countries: Analytical Review”. There is aseparate part, which is devoted to Kyrgyzstan: historical andcultural background, legal regulations, education in bioethics,
the system of ethical review, perspectives and forms ofinternational cooperation. The concept of present work isbased on the implementation of the global trend in UNESCO
activity on the development and unification of bioethics
education in universities. This book is the first presentation ofa detailed analysis, with results and conclusions concerning
bioethics education in the system of higher medical educationin the CIS countries. Since 2009, the interdisciplinary subject,
Bioethics, has been introduced to undergraduate students of
the KSMA. Curriculums for this subject have been elaborated
and include: general medicine, pediatrics, public health,dentistry, advanced nursing and pharmaceutics. In eachprogram, special attention is paid to priority issues of that165

specialty. Two conferences have been organized and conductedin Bishkek: “GCP is the Ethical Standard of Clinical Trials” andthe Central Asian Conference “Clinical Trials in the KR: Current
Condition and Aspects of International Collaboration”. There
were the heads of health care organizations, representatives ofthe Ministry of Health of the KR, practitioners, representativesof pharmaceutical companies, and faculty members of the
KSMA. It is hoped that this introduction to the work of theCommittee will provide an opportunity to expand cooperationand establish links with colleagues involved in bioethics fromdifferent countries.

Deciding for Family: New End-of-Life Act in Korea and
Its Authorization of Family- Claire Junga Kim, Ewha Womans University, Korea
Email: clairejungakim@gmail.com

In East Asian bioethics, the family’s “unique” role in apatient’s end of life decision-making was allowed in practice.
For example, (1) withholding the diagnosis of terminal illness
to the patient and informing family members only; (2) medical
decision making by family even when the patient is competent;and (3) designating “family spokesperson” on a patient’s lifesustaining treatment by family rather than by the patient. In
this culture, families are uncritically assigned a fiduciary duty
for the patient. Moreover, several East Asian bioethicists justify
these practices with the theory that family, not the individual,
has autonomy. However, since family can have both asupportive and oppressive effect, giving family these powers
can cause either benefit or harm. Especially in the context of
end-of-life decision-making where family members are theones who both affect and are affected by a patient’s decision
making, critically examining current norms and practice isessential. The new law on end of life decision-making,“Hospice/Palliative Care and Dying Patient’s Decision of LifeSustaining Treatment Act” was passed in 2016 in Korea and thepowers of family under this Act are worth examining. Although
the law seems to follow a three tier standard --following
advance directives principle, substituted judgment principle,
and best interest principle in lexicographic order—in general,
its lack of explicit acknowledgement of best interest as acriterion, in the situation of no known patient’s wish is
problematic and contrasts with widely endorsed bioethicalstandards. This, along with the law’s lack of provision for
Durable Power of Attorney and with the current “familycentric” practice in everyday life, can give excessive andexclusive power to patients’ families. This excessive andexclusive authorization of family will trigger harm to individual
patients and to society as a whole. In order to prevent harm toindividual patients, the author anticipates the probablesequence of decision making in life-sustaining treatment, basedon current practice. Starting with low participation in advancecare planning on one’s own terminal illness and continuingwith the inactive role of Medical Institution Ethics Committees,
the decision making process may lack the patient’s input, andtherefore may conflict with the patient’s own interests.
Moreover, the harm is not confined to individuals, because thepractice of medical decision-making has a role in shaping
society in general. The author concludes that medical
professionals should pay heed to possible risk of family-centric
rules in end-of-life decision making and that hospital-level
policy should be put in place in order to prevent the possible
harms of over-authorization of family.

Current Review of the Influence of Chinese Tradition
and Catholic Church Teaching on Advance Directive
Ita Mo-Chi Fung a,b, Ying-Ying Lee a Healthcare ResearchCentre, Caritas Institute of Higher Education, Hong Kongb School of Health Sciences, Caritas Institute of Higher
Education, Hong Kong

166

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

Advance directive is part of advance care planning whichindicates the types of medical treatment to be used when one isincapacitated for decision making. When one is no longer
capable of making health care decisions for oneself, aspiring tomaintain health and well-being is complicated by many issues.
These include, who would be responsible for making decisions
for the incapacitated individual; given the options of careavailable, what kind of care would the incapacitated individual
want; and, what would be best for the incapacitated individual.
Confronted with an aging population, the deterioration in
health, accidents and certain diseases can also cause a loss indecision-making capacity. Indeed, various factors including
religious beliefs, ethical concern and cultural influences canaffect one’s views and philosophy about decision regarding
advance directives. In a westernized city like Hong Kong, thepopulation comprises people with different cultural andreligious backgrounds. As the majority of the population is still
ethnic Chinese, this presentation will, by means of a literature
review, explore how Chinese tradition and Catholic Church
teaching affect one’s decision in the choice of advance directive.

PODCASTS
Motivated Reasoning and Disabled People: EthicalImplications- Manel Djebrouni, and Gregor Wolbring, Community
Rehabilitation and Disability Studies, Department ofCommunity Health Sciences, Cumming School of
Medicine, University of Calgary
Email: manel.djebrouni@ucalgary.ca
Email:
gwolbrin@ucalgary.ca
Podcastathttps://www.dropbox.com/s/sardv7xw3ukmgn4/Motivated%
20Reasoning%20Asiamanelpodcast.m4a?dl=0
Background: Motivated reasoning describes how individuals
generate explanations that are adopted to explain a particulardecision or event [1]. It refers to the influence wishes, desires,and preferences have on individuals’ cognitive processes
including assessing, constructing, and evaluating [2, 3].
Research on motivated reasoning indicates that individuals
have the tendency to accept favourable information and bedismissive or critical of threatening information [2, 4, 5].
Motivated reasoning is found to impact partisan affiliations,inequality and is seen to enhance discrimination and injustice.
Researcher have emphasized the presence of motivatedreasoning in public debates whereby one author mentioned
disabled people as part of a listing of marginalized groups [6].
However the impact of motivated reasoning on disabled people
has not been analyzed so far.
Purpose: This study is an analytical one with the purpose of
exploring the impact of motivated reasoning on disabled
people through various lenses such as the Bias Free framework(Building an Integrative Analytical System For Recognizing andEliminating inequities)[7], Other-ism or Other-ness, risk
perception, ethics, making use of the few articles that cover the
linkage between ethics and motivated reasoning and to discuss
how one can decrease motivated reasoning’s negative impact
on disabled people.
Method: N= 400 abstracts in addition to n=104 full text articles
on motivated reasoning were downloaded from three academic
databases (EBSCO All (covering 70 other databases), Scopus
and PubMed) to obtain background literature on motivatedreasoning from various disciplines and analyze how often theterms “disabled people” or “people with disabilities” werementioned. We conducted a qualitative content analysis of thearticles and abstracts as a foundation to examine the impact ofmotivated reasoning on disabled people, using atlas.ti,
qualitative analysis software.
Findings and Discussion: Within the databases covered, notone article mentioned the terms “disabled people” or “people
with disabilities”. We found one article covering disabled
people through Google Scholar [6]. Our presentation will focus

on the impact of motivated reasoning on disabled people using
various lenses such as the Bias Free framework[7], Other-ism
or Other-ness, risk perception, and ethics.
Conclusion: We submit that our work will provide incentive todeepen the understanding of the impact of motivatedreasoning on disabled people. We also hope that it will enticethe conference participants to investigate motivated reasoning
from the angle of their own line of work since many aspects ofmotivated reasoning are under investigated.
References:
1. Rousseau, D.M. and S.A. Tijoriwala, What's a good reason tochange? Motivated reasoning and social accounts inpromoting organizational change. Journal of applied
psychology, 1999. 84(4): p. 514.
2. Kunda, Z., The case for motivated reasoning. Psychologicalbulletin, 1990. 108(3): p. 480.
3. Sharvit, K., et al., To feel or not to feel when my group harms
others? The regulation of collective guilt as motivatedreasoning. Personality and social psychology bulletin, 2015.
41(9): p. 1223-1235.
4. Molden, D.C., A.Y. Lee, and E.T. Higgins, Motivations forpromotion and prevention. Handbook of motivation science,
2008: p. 169-187.
5. Mata, A., M.B. Ferreira, and S.J. Sherman, Flexibility inmotivated reasoning: Strategic shifts of reasoning modes incovariation judgment. Social Cognition, 2013. 31(4): p. 465481.
6. Pérez Zafrilla, P.J., Is Deliberative Democracy an adaptive
political theory? A critical analysis of Hugo Mercier’s
Argumentative Theory of Reasoning. Análise Social, 2016.
51(220).
7. Eichler, M. and M.-A. Burke. Building an Integrative Analytical
System For Recognising and Eliminating inEquities. (BIAS
FREE
framework).
2006;
Availablefrom:
http://biasfree.org/full_BF.pdf.

Analysis of in HIV/AIDS health promotional coverageof disabled people in Canadian Newspapers andacademic literature: Ethical Implications- Syeda Farwa Naqvi and Gregor Wolbring, Bachelor ofCommunity Rehabilitation and Disability Studies,
Cumming School of Medicine, University of Calgary,
CanadaEmail: sfnaqvi@ucalgary.ca
Email:
gwolbrin@ucalgary.ca
Podcastathttps://www.dropbox.com/s/wfjhseg7uy71tcb/HIVAIDSpodcast.m4a?dl=0
Background: Health promotion is an essential
communicative aspect of preventative measures to reignin the global epidemic of HIV/AIDS (1). Global health aims
to address equity between various cohorts throughdispersing
healthpromotional
information(2).
Newspapers are one medium through which HIV/AIDSrelated health promotional material is made available tothe public. Academic scholars engage with healthpromotion with the aim to improve health promotion.
Disabled people are one group that depend on healthpromotional campaigns to receive important messages
and participate in effective health prevention of
HIV/AIDS, as they face unique barriers to achieving
health, including risks involving HIV/AIDS (3).
Objective: Purpose of this study was to ascertain the
coverage of disabled people within Canadian newspapers
as well as academic literature of health promotion with aparticular focus on HIV/AIDS.
Methods: A total of n=921 newspaper articles were
downloaded from the Canadian News stream databaseconsisting of n=300 Canadian newspapers, that contained
the term ”HIV/AIDS“ or “HIV“ and ”health promotion“. In
addition, a total of n=11512 academic articles wereEubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
identified from academic databases (EBSCO all (consistingof 70 databases, Scopus and Pubmed) that contained“HIV“ or “HIV/AIDS“ and “health promotion“ in the
abstract terms. An analysis was performed of how often andhow the terms “disabled people“ and “people with disabilities“
were mentioned
Results: Within the n=921 newspapers articles, only one
article contained the term “people with disabilities: none theterm “disabled people” Within the 11512 academic articles
identified only 19 articles contained the term “people withdisabilities” or “disabled people“ in the full text. We will
present what the 12 articles cover in the presentation.
Discussion: We will discuss in our contribution the ethicalproblems such invisibility of disabled people poses andthat such invisibility could be seen as unethical.
Conclusion: Disabled people face unique challenges in regard
to HIV/AIDS. However, our findings suggest that the healthpromotion coverage of HIV/AIDS ignores disabled peoplecausing them to be left behind. The exclusion of persons withdisability in HIV health promotion discourse needs to beaddressed.
References
1. Airhihenbuwa, C. O., & Obregon, R. (2000). A Critical
Assessment
ofTheories/Models
Usedin
HealthCommunication
for
HIV/AIDS.
Journalof
HealthCommunication, 5(3), 5-15. doi:10.1080/10810730050019528
2. Sparks, M. (2010). A health promotion approach toaddressing health equity. Global Health Promotion, 17(1), 7782. doi:10.1177/1757975909360742
3. Rohleder, P., Swartz, L., & Philander, J. (2009). Disability and
HIV/AIDS: A Key Development Issue. In M. Maclachlan & L.
Swartz (Eds.), Disability & International Development: Towards
Inclusive Global Health (pp. 137-147). New York, NY: Springer
US.

Analysis of Engagement with Ethical Concepts andTheories in Return-to-Work Academic Literature
Li, WenTao and Wolbring, Gregor, Bachelor ofCommunity Rehabilitation, University of Calgary, Canada
Email: wen.li2@ucalgary.ca
Email:gwolbrin@ucalgary.ca
Podcastathttps://www.dropbox.com/s/b5yra8668mvkify/ABC%20Conf
erence%202Wentao.mp3?dl=0
Background: There is great focus on return-to-work(RTW)/back-to-work (BTW) interventions [1, 2] due to theimportance of being occupied for health and well-being ofpeople [3]. Ethical discourses are to give guidance on how to do
things and why, and ethical theories and concepts are used toexpress that [4]. Sherwin, an eminent ethicist, stated, “we[ethicists] lack the appropriate intellectual tools for promoting
deep moral change in our society,” ([5] quoted in [4]) however.
Objective: Given Sherwin’s belief, the purpose of our study
was to investigate to what extent ethical concepts and theories,
the intellectual tools of expression, are employed to inform
RTW/BTW discourses.
Methods: Data was generated in two ways. We searched threeacademic databases (EBSCO all, consisting of over 70
databases, Scopus, Web of Science) for either “back to work” or“return to work” in the article abstract, in conjunction with
n=33 ethical concepts and theories derived from sources usedin [6] in the abstract or full text. We then recorded thefrequency of hits. We furthermore searched the threedatabases for either “back to work” or “return to work” in thearticle abstract in conjunction with the term ethic,
downloading the resulting n=82 abstracts and using ATLASTi©, a qualitative analysis software, to analyze them for how
the term ethic was used.
Results: For the 82 abstracts found, the term “ethic” was found
113 times. In 25 cases the term was used to confirm ethics
committee approval for studies. In 29 cases the term was167

briefly used about how RTW professionals must display ethicalconsiderations in their conduct. Personal work ethic wasmentioned 18 times. There were only four cases in which
ethical thinking was conceptually engaged in RTW literature. In
three cases, gender-based ethics of care and work were utilized
to evaluate the likelihood and productivity of individuals
returning to work, while only a single case outlined key ethics
concepts that RTW field should adapt.
As for the hit counts derived from the databases, only n=2
terms out of the n=20 ethics theories, egalitarian and care
ethics, were mentioned in more than two articles. N=6 theories
were mentioned in one or two articles and n=12 were notmentioned at all. For the n=13 ethical concepts, n=8 werementioned more than 100 times, such as ethic, harm,autonomy, justice, whereas n=5 were mentioned in less than
10 articles, such as beneficence or maleficence.
Conclusion: Ethical theories and principles were not used
extensively in RTW discourses. Given the existing andemerging ethical dilemmas linked to employment, such as thechallenges of people staying occupied after retirement or whendisplaced by automatization and robotics, using ethicalreasoning might be useful for RTW discourses to better deal
with such challenges. Our findings adds to the literature thatshows the lack of use of ethical concepts and theories outsideof ethics discourses [6, 7], suggesting that Sherwin might beright with her claim.
References
1. Lammerts, L., et al., Return to work of workers without apermanent employment contract, sick-listed due to a common
mental disorder: design of a randomised controlled trial. BMC
Public Health, 2014. 14.
2. MacEachen, E., et al., Systematic review of the qualitative
literature on return to work after injury. Scandinavian Journalof Work, Environment & Health, 2006(4): p. 257-269.
3. Stone, S.D., Workers without Work: Injured Workers and WellBeing. Journal of Occupational Science, 2003. 10(1): p. 7-13.
4. Wolbring, G., Ethical Theories and Discourses through an
Ability Expectations and Ableism Lens: the Cases ofEnhancement and Global Regulation. Asian Bioethics Review,
2012. 4(4): p. 293-309.
5. Sherwin, S., Looking Backwards, Looking Forward: Hope for
Bioethics’ Next Twenty Five Years. Bioethics, 2011. 25(2): p.
75-82.
6. Sirianni, S. and G. Wolbring, Lack of Ethical Reasoning in the
Innovcation Narrative of Occupational Therapy andOccupational Science. Eubios Journal of Asian andInternational Bioethics, 2017. 27(2): p. 53-62.
7. Ball, N. and G. Wolbring, Cognitive Enhancement: Perceptions
Among Parents of children with Disabilities. Neuroethics,
2014. 7: p. 345-364.

Asian Bioethics Association (ABA) Board of Directors(Nov 2016-2018)
President: Bang-ook Jun, Korea
Immediate Past-President: Prof. (Ms.) Miyako Takagi(Japan)Vice President for Asian Ethnic and Religious Minorities:
Hasan Erbay, Turkey
Vice President for China: Prof. (Ms.) Yanguang Wang
Vice President for India: Prof. M. Selvanayagam
Vice President for Indonesia: Prof. Endang Sukara
Vice President for Japan: Prof. Tsuyoshi Awaya
Vice President for Korea: Prof. Young-Mo Koo
Vice-President for the Pacific: Dr. Irina Pollard(Australia)
Vice-President for South Asia: Prof Arif Hossain(Bangladesh)

168

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

Vice-President for South East Asia: Prof. Latifah Amin
(Malaysia)
Vice President for Pakistan: Dr. Shahid Shamim
Vice President for Taiwan: Prof. Duujian Tsai
Vice President for West Asia: Prof.
Firuza Nasyrova (Tajikstan)
Secretary: Prof. Darryl Macer (Thailand/New Zealand)
Proceedings and Abstracts
ABC1 (Beijing, China, 1995),
ABC2 (Kobe, Japan, 1997),
ABC3 (Tokyo, Japan, 1998),
ABC4 (Seoul, Korea, 2003),
ABC5 (Tsukuba, Japan, 2004),
ABC6 (Sanliurfa, Turkey, 2005),
ABC7 (Beijing, China, 2006),
ABC8 (Bangkok, Thailand, 2007),
ABC9 (Jogyakarta, Indonesia, 2008),
ABC10 (Tehran, Iran, 2009),
ABC11 (Singapore, 2010).
ABC12 (Taipei, 2011).
ABC13 (Kuala Lumpur, Malaysia, 2012)
ABC14 (Chennai, India, 2013)
ABC15 (Beppu and Kumamoto, Japan, 2014)
ABC16 (Manila, the Philippines, 2015)
ABC17 (Jogyakarta, Indonesia, 2016)
ABA Constitution

Article 1 (Name)
The name of this academic organization shall bethe: Asian Bioethics Association (ABA). Hereafterreferred to as the Association.
Article 2 (Definitions)
In interpreting this Constitution the following
definitions shall be used: Bioethics is theinterdisciplinary study of philosophical, ethical,
social, legal, economic, medical, therapeutic,
ethnological, religious, environmental, and otherrelated issues arising from biological sciences andtechnologies, and their applications in humansociety and the biosphere. Asia is the regions,peoples, and cultures which constitute thegeographically largest continent of the world.
Article 3 (Objectives)
The basic objective of the Association is to promotescientific research in bioethics in Asia through open
and international exchanges of ideas among thoseworking in bioethics in various fields of study anddifferent regions of the world. In order to achieve
this end the Association will encourage thefollowing work and projects: (1) to organize andsupport international conferences in bioethics inAsia; (2) to assist the development and linkage ofregional organizations for bioethics; (3) toencourage other academic and educational work or
projects to accomplish their goals consistent withthe objectives of the Association.
Article 4 (Membership)

4.1 Membership of the Association shall be open to
any individuals and institutions sharing theobjectives of the Association.
4.2 A member of the Association shall be in goodstanding. There will be a voluntary payment ofannual dues. The Board of Directors may
tentatively set the suggested annual dues at adifferent rate for members with different income.
4.3 Membership shall be valid unless and until they
are rejected by the Board of Directors and/or by
the majority vote of members.
Article 5 (the Board of Directors)
5.1 The Board of Directors shall be nominated fromamong the members of the Association.
5.2 Institutional or regional members may
nominate delegate(s) for the Board, but thenominee, if elected, shall hold office in his or her
own right, and not as a representative of theinstitution or the region.
5.3 The Board of Directors shall consist of no morethan 15 members and no more than 3 members
from any one nation state. The nation state of eachmember should be defined by the member on thebasis of residence or nationality at the time ofnomination for election.
5.4 The Board of Directors may appoint, or
authorize the President to appoint, additional
officers, sub-committees, executive staffs to carryout specific tasks of the Association. In particular alist of regional representatives will be maintainedfor promotion of the ABA.
5.5 The board can co-opt, by consensus, associate
non-voting members to increase the diversity andgeographical representation of the board for thecurrent term. (Adopted by acclamation at the ABAGeneral Meeting on 5 November 2008)
Article 6 (the Officers)
6.1 Officers of the Association shall be thePresident, twelve vice-presidents (one from each of
China, India, Indonesia, Japan, Korea, the Pacific,
Pakistan, South Asia (East of Afghanistan), South
East Asia (East of Bangladesh), Taiwan, West Asia
(West of India), and Asian Ethnic and Religious
Minorities, and a General Secretary. They arenominated and/or elected by members of the
Association. The President can serve a maximum of
two years in office. The Other Officers should standre-election every two years
6.2 The Officers shall be responsible for the generalmanagement and the direction of business works of
the Association. The President and/or Secretaryshall have authority to execute, in the name of the
Association, all authorized deeds, contracts, orother instruments.

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts
6.3 The Vice-presidents shall provide secondary
leadership for the Association, substituting for the
President when needed.
6.4 A vice-president can be elected for a maximumof two successive terms as a vice president.
6.5 The General Secretary shall keep, or arrange tohave kept, a true record of the minutes of all
meetings.
6.6 The General Secretary shall have custody of the
Association's funds, keep full and accurate accountsof the receipts and disbursements, and deposit all
money in the name and to the credit of the
Association in the depositories designated by the
Board of Directors. The accounts shall be sharedwith all members of the Association every year.
Article 7 (Amendment of the Constitution)
This Constitution may not be amended, replaced, or
annulled except by an affirmative vote of two-thirdsof the members in secret ballot.
Supplemetary Note 1
The principles of this Constitution were initiallyadopted at the Inaugural Meeting of the East Asian
Association for Bioethics held in Beijing on the 5thof November, 1995, when the Officers of thisAssociation were also nominated. At the UNESCO
Asian Bioethics Conference, 4 Nov, 1997, theAssociation was broadened to become the Asian
Bioethics Association, and several further members
were nominated. This initial Board of Directors was
replaced by a new Board in November, 2002, at the
Fourth Asian Bioethics Conference in Seoul, andwhen the Constitution was formally adopted. The
2004 election was held on 10 November 2004, andelections have been held every two years since.
Article 6.1. of the constitution was amended
according to the provisions of article 7 on 12
September 2012, following a unanimous call for
modification at the Annual General meeting held on
30 August 2012.
Supplementary Provision 2
The secretariat of the Association was placed in the
University Research Center, Nihon University,
Tokyo, Japan, from 1998 to February, 2002. From
February, 2002 to February 2005 the secretariat
was: Prof. Darryl Macer, Institute of Biological
Sciences, University of Tsukuba, Tsukuba Science
City 305-8572, JAPAN. From February 2005 thesecretary and office moved to Prof. Darryl Macer,Apt 14C, G.P. Grande Tower, 55 Sukhumvit Soi 23,
Watana, Bangkok, Thailand. From February 2013
the secretary and office moved to 14M9 Phetkasem
Road Soi 50/3, Bangkok 10160,Thailand. The
official email of ABA is asianbioethics@yahoo.co.nz,
and the website www.eubios.info

169

For forthcoming conferences see:www.eubios.info or www.ausn.info
Email to Darryl@eubios.info for more information.
18th Asian Bioethics Conference, Seoul, Republic ofKorea, 25-27 October 2017
Joint AUSN-Gangneung-Wonju (GWNU) National
University Bioethics Conference, 28-30 October
2017, Gangneung, Republic of Korea
Joint AUSN-KAIST International Conference on
Ethical Policy, Science and Technology at KAIST,30
October – 2 November 2017, Daejoon, Korea
Eleventh Kumamoto University International
Bioethics Roundtable: Philosophy and practice of
bioethics across and between cultures, 18-19
November 2017, Kumamoto University, Japan
Nineteenth Asian Bioethics Conference (ABC19):
Bioethics for Smart Living in Asia and Beyond: Taiwan
as a hub for nurturing international partnerships andsustainable practices, 13-16 November 2018,
Kaohsung and Pingtung, Taiwan.

EJAIB Editor: Darryl Macer
Associate Editor
Nader Ghotbi (Ritsumeikan Asia Pacific University(APU), Japan)

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

ASIAN BIOETHICS ASSOCIATIONMEMBERSHIP 2017/2018
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American University of Sovereign Nations (http://www.ausn.info)
•
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Ph.D. in Bioethics, Sustainability and Global Public
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AUSN started in 2013, picking the cream of global academia. Our 80 facultyinclude leaders from academia, the business world, policy makers and Indigenous
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AUSN has over 30 cooperation agreements with Universities and Academic
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President: Professor Darryl Macer• Ph.D. from University of Cambridge, UK• Former UNESCO Regional Adviser• From Aotearoa / New Zealand• Professor of Bioethics and Biochemistry
since 1990, University of Tsukuba andUniversity of Kumamoto, Japan.
• Authored and edited 50 books and 300
papersAUSN has students/alumni from Australia,
Belgium, Bangladesh, Cambodia, Cameroon,
Canada, Chile, China, Congo, Egypt, Germany,
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Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

171

Eleventh Kumamoto
University Bioethics
Roundtable: Philosophy
and practice of bioethics
across and between
cultures18-19 November 2017
Kumamoto University, Japan

Come to Japan
to experience theautumn colors, warm
hospitality, delicious
food, hot springs, culture
and international
debate.
Confirmed speakers include professors: Takao Takahashi (Japan)[Convener], Darryl
Macer (New Zealand/USA), Akiko Ishihara (Japan), Chutatip Umavijani (Thailand), Nader
Ghotbi (Iran/Japan), Hassan Kaya (South Africa), Mayashree Chinswamy (South Africa),
Aruna Sivakami (India), O.K. Lai (Hong Kong), Sivanandam Panneerselvam (India),
Konstantin Khroutski (Russia), ASM. Bhuiyan (Bangladesh), Kwon Jong Yoo (Korea), T.
Watanabe (Japan), Kayo Uejima (Japan), Marlon Lofredo (the Philippines), Amrit Dhanal(Nepal), Christopher Ryan Maboloc (the Philippines) among others.

Call for papers, participation, and abstracts…
This all plenary conference will include presentations and discussion in an informal setting with some ofJapan’s leading bioethicists, and some international colleagues. The particular theme is to discuss the past
decade of cross cultural bioethics dialogue, and prepare a book.
Registration fee for 18-19 Nov is JPY2,000 including lunch and breaks; excluding Reception dinner fee(JPY4,000). Assistance can be provided in making economical hotel reservations for all nights(accommodation costs are estimated to be JPY7,000 per night. There is no financial assistance available.
Participants are also welcome to attend additional lectures on bioethics in each country on the 17th and 20th
November.
Submit 400 word abstracts to Secretariat: Kimiko Tashima, , HIGO Program, University of Kumamoto,Kumamoto, Japan Email: ktashima@kumamoto-u.ac.jp (for invitation letters); For details of associatedmeetings and tours, contact Dr. Darryl Macer, Email: darryl@eubios.info The workshop and lectures alsocount for postgraduate credit for AUSN Masters and PhD degree courses.

172

Eubios Journal of Asian and International Bioethics 27 (September 2017) ABC18 Abstracts

Eubios Ethics Institute Publications (Books sent by SAL post, Journal by Airmail - Price included)
Eubios Journal of Asian and International Bioethics (Annual subscription)
NZ$90
Shaping Genes: Ethics, Law and Science of Using Genetic Technology in Medicine and Agriculture
by Darryl Macer, Oct. 1990, 421pp.
NZ$50
Equitable Patent Protection in the Developing World
by William Lesser, May 1991, 150pp.
NZ$40
Attitudes to Genetic Engineering: Japanese and International Comparisons (Bilingual)by Darryl Macer, May 1992 330pp.
NZ$40
Human Genome Research & Society
Eds: Norio Fujiki & Darryl R.J. Macer July 1992
ISBN 0-908897-03-0 (English), 230pp. ISBN 0-908897-04-9 (Japanese), 240pp.
NZ$40
Intractable Neurological Disorders, Human Genome Research and Society Eds: N. Fujiki & D. Macer
Feb. 1994 ISBN 0-908897-06-5 (English), 320pp. ISBN 0-908897-07-3 (Japanese), 340pp.
NZ$40
Bioethics for the People by the People by Darryl Macer,... May 1994 ISBN 0-908897-05-7, 460pp. NZ$50
Bioethics in High Schools in Australia, Japan and New Zealand, by D.Macer, Y.Asada,
M.Tsuzuki, S.Akiyama, & N.Y.Macer March 1996, ISBN 0-908897-08-1, 200pp.(A4)
NZ$50
Protection of the Human Genome and Scientific Responsibility (English and Japanese Bilingual)
Editors: Michio Okamoto, Norio Fujiki & D.R.J. Macer, April 1996, ISBN 0-908897-09-X, 210pp. NZ$40
Bioethics in India Eds: Jayapaul Azariah, Hilda Azariah & Darryl R.J. Macer
June 1998 ISBN 0-908897-10-3, (includes 115 papers) 403 pp. (Printed in India)
NZ$60
Bioethics is Love of Life: An alternative textbook by Darryl Macer, July 1998 ISBN 0-908897-13-8,
152pp. (Note 2nd edition published on iTunes Store as an iBook in 2015)
NZ$40
Bioethics in Asia Eds: Norio Fujiki & Darryl R.J. Macer, (includes 118 papers from Nov.1997
conferences, ABC’97 Kobe and Fukui Satellite) June 1998 ISBN 0-908897-12-X, 478 pp.
October 1999 ISBN 0-908897-14-6 (Japanese), 320pp.
NZ$50
Ethical Challenges as we approach the end of the Human Genome Project
Editor: Darryl Macer, April 2000 ISBN 0-908897-15-4, 124pp.
NZ$40
Bioethics Education in Japanese High Schools (in Japanese only)
Editor: Darryl MacerApril 2000 ISBN 0-908897-16-2, 112pp.
NZ$40
Bioethics and the Impact of Human Genome Research in the 21st Century
Eds: Norio Fujiki, Masakatsu Sudo, & D.R.J. Macer March 2001 (English and Japanese bilingual, 350pp).NZ$50
Bioethics in Asia in the 21st Century
Eds: Song Sang-yong, Koo Young-Mo & Darryl R.J. Macer
August 2003 ISBN 0-908897-19-7, 450pp.
NZ$50
Challenges for Bioethics from Asia Ed: Darryl R.J. Macer
November 2004 ISBN 0-908897-22-7 656 pp.
NZ$70
A Cross Cultural Introduction to Bioethics, Editor: Darryl Macer 2006, 300pp. (A4)
NZ$50
(Note 2nd edition published on iTunes Store as an iBook in 2015)
Bioethics in Iran, Editor: Alireza Bagheri, 2014. ISBN 978-0-908897-25-4 262 pp.
NZ$50
Bioscience Ethics Education Curriculum for Pre-Schoolers to Elementary Age Children,
Irina Pollard and Amara Zintgraff,. 2017 ISBN 978-0-908897-28-5, 60pp. (A4)
NZ$50
Getting Along: The Wild, Wacky World of Human Relationship, Laura R. Ramnarace 2017
ISBN 978-0-908897-29-2, 73pp. (A4)
NZ$50
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