Bioethical Implications of Globalization: An International Consortium Project of the European Commission
Authors: Thomas E Novotny, Emilio Mordini, Ruth Chadwick, J. Martin Pedersen, Fabrizio Fabbri, Reidar Lie, Natapong Thanachaiboot, Elias Mossialos, Govin Permanand
Journal: PLoS Medicine (2006)

Policy Forum Bioethical Implications of Globalization: An International Consortium Project of the European Commission Thomas E. Novotny*, Emilio Mordini, Ruth Chadwick, J. Martin Pedersen, Fabrizio Fabbri, Reidar Lie, Natapong Thanachaiboot, Elias Mossialos, Govind Permanand T he term “globalization” was popularized by Marshall McLuhan in War and Peace in the Global Village. In the book, McLuhan described how the global media shaped current events surrounding the Vietnam War [1] and also predicted how modern information and communication technologies would accelerate world progress through trade and knowledge development. Globalization now refers to a broad range of issues regarding the movement of goods and services through trade liberalization, and the movement of people through migration. Much has also been written on the global effects of environmental degradation, population growth, and economic disparities. In addition, the pace of scientific development has accelerated, with both negative and positive implications for global health. Concerns for national health transcend borders, with a need for shared human security and an enhanced role for international cooperation and development [2]. These issues have significant bioethical implications, and thus a renewed academic focus on the ethical dimensions of public health is needed. Future developments in science and health policy also require a firm grounding in bioethical principles. These core principles include beneficence; nonmaleficence (to do no harm); respect for persons and human dignity (autonomy); and attention to equity and social justice. According to the World Health Organization [3], global ethical approaches should (1) monitor and update ethical norms for research, as necessary; (2) anticipate The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies. PLoS Medicine | www.plosmedicine.org ethical implications of advances in science and technology for health; (3) apply internationally accepted codes of ethics; (4) ensure that agreed standards guide future work on the human genome; and (5) ensure that quality in health systems and services is assessed and promoted. Box 1. The Delphi Method Delphi is a group communication technique designed to obtain opinions from a panel of selected experts on specific issues through the sending of questionnaires to be completed within a specified time. The experts are contacted individually and they do not know other group participants and their opinions—the aim is to submit the group participants to the same conditions. Participants do not meet personally, thereby avoiding undue influence. The process foresees the following points: • Identification of the problem • Selection of the relevant questions • Preparation and delivery of the first questionnaire • Analysis of the answers and elaboration of the first synthesis; preparation and delivery of a second questionnaire containing reformulated questions based on such elements as results from analysis of and comments upon the first questionnaire, illustrative of how other participants have answered previous questions • Analysis and synthesis of answers • Delivery of further questionnaires as required The process is repeated a number of times, until a convergence of all group members is obtained. The process ends with analysis of the answers and formulation of the final report. (Adapted from http://www.bigproject. org/dephi.htm) The Bioethical Implications of Globalization Project The Bioethical Implications of Globalization (BIG) Project is a 42-month dialogue funded by the European Commission that involves a series of expert panel discussions on four specific globalization and health subject areas: (1) mobility of people; (2) technological globalization; (3) liberalization of trade; and (4) new global health threats (bioterrorism). In addition, BIG includes a multiple- round Delphi Process (Box 1) to solicit input on these issues from a broad, interdisciplinary audience. The project’s purpose is both to raise short-term, practical considerations about globalization and health and Citation: Novotny TE, Mordini E, Chadwick R, Pederson JM, Fabbri F, et al. (2006) Bioethical implications of globalization: An international consortium project of the European Commission. PLoS Med 3(2): e43. Copyright: © 2006 Novotny et al. This is an open- access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abbreviations: BIG, Bioethical Implications of Globalization; GM, genetically modified Thomas E. Novotny is at Global Health Sciences, University of California San Francisco, San Francisco, United States of America. Emilio Mordini is at the Centre for Science, Society, and Citizenship, Rome, Italy. Ruth Chadwick and J. Martin Pedersen are at the University of Lancaster, Lancaster, United Kingdom. Fabrizio Fabbri is at the International Society of Doctors for the Environment, Rome, Italy. Reidar Lie and Natapong Thanachaiboot are at the University of Bergen, Bergen, Norway. Elias Mossialos and Govind Permanand are at the London School of Economics and Political Science, London, United Kingdom. Competing Interests: This project is supported by the European Commission (contract QLRT-2001- 01796). Thomas E. Novotny is on the editorial board of PLoS Medicine. * To whom correspondence should be addressed: tnovotny@psg.ucsf.edu DOI: 10.1371/journal.pmed.0030043 February 2006 | Volume 3 | Issue 2 | e43