The Rome bioethics summit.

The Rome Bioethics Summit International analysis and direct government involvement, two phenomena that have been increasingly notable in the world of bioethics in recent years, came together for a week in Rome this spring. From April 10 to 15, the Italian government hosted the Fifth International Summit Conference on Bioethic, which focused on the efforts now underway to map and sequence the human genome. Originally proposed by Prime Minister Nakasone, bioethics "summits" were inaugurated in 1984 when the first such meeting was held in Japan. That session on the social impact of the new biological discoveries was followed by ones in France on artificial fertilization, in Germany on the neurosciences and society, and in Canada on human subjects research. It is expected that sponsorship will continue to rotate through the Group of Seven, with subsequent meetings in the United States and the United Kingdom, and perhaps in Brussels as well under the sponsorship of the European Economic Community (EEC), the summits' eighth participant. Like its predecessors, the primary purpose of the Rome conference was to provide advice to the heads of state of the seven major industrial democracies at their annual summit meeting (held this year in Toronto in June). Twenty-one national delegates, three representatives from the EEC, one from the World Health Organization, and one from the International Council of Scientific Unions joined summit chairman Professor Glauco Tocchini-Valentini for the five-day meeting. Six of the eight half-day sessions consisted of presentations by the delegates--scientists, physicians, clerics, lawyers, and government officials--on topics germane to their areas of expertise. These talks not only made clear that the new knowledge of the human genome will quickly generate momentous and complex ethical and social issues when applied to predictive and curative medicine, but also that the prospect of possessing this knowledge itself raises novel questions even as it holds enormous fascination for scientists. Indeed, the desirability and feasibility of an all-out scientific effort to map and sequence the human genome have been hotly-debated for the past several years. A National Research Council committee recently urged that the United States immediately commence a fifteen-year program at an estimated cost of $3 billion. The Department of Energy has expressed interest in running such a project, while the National Institutes of Health has moved to take leadership by budgeting twenty-eight million dollars for the first year of such an effort. The potential for both competition and collaboration is equally pronounced on the international level. The science ministers of the EEC nations have been debating establishing a cooperative European program to match the U.S. initiative and the "human frontiers" program recently launched by the Japanese. Some scientists fear that a crash effort aimed at genome mapping will divert research funds from other, more pressing objectives. They are also concerned it will prove more costly (and no swifter) than a more measured approach that would build on findings accumulated through investigations of particular genes and on continuing rapid improvements in molecular genetic technology. Yet the biomedical community seems not seriously to doubt that this massive undertaking--mapping the 100,000 human genes to their usual locations on the chromosomes and then establishing the actual sequence of the 3 billion nucleotide pairs that make up the genes and govern the body's production of proteins--will eventually be completed and will, among other things, prove of inestimable benefit in preventing and treating disease. The scientists at the Rome meeting were overwhelmingly supportive of the research, and the delegates recommended that "concerted national and international efforts should be undertaken through genetic mapping, sequencing, and other research to allow for rapid generation and dissemination of knowledge in this field. …