Book Review

BIOETHICS FOR THE PEOPLE BY THE PEOPLEBy Darryl Macer

Eubios Ethics Institute, Christchurch, New Zealand,1994, pp. 452.

Working in clinical genetics constantly provides ex-posure to ethical problems and new challenges to moralthinking provided by scientific progress. Many peoplehave felt that the public has to participate in discussionof these issues. Bioethics for the People by the Peoplesummarizes and analyzes the results of a survey inwhich questionnaires were sent to individuals in Aus-tralia, Hong Kong, India, Israel, Japan, New Zealand,the Philippines, Russia, Singapore, and Thailand. In-troductory essays include perspectives from other partsof Europe and North America as well. Dr. Macer’s in-troduction emphasizes that throughout the world per-sons have similar opinions with respect to a number ofissues, and that the variation is similar to biologicalvariation: the variance within groups may be greaterthan the variance between groups.

The questionnaires addressed the issues of whetherpersons were interested in science, and whether or notscience contributed to the quality of life. A number ofquestions addressed the role of technology with respectto the environment and medical applications, includingcomputers, biotechnology, nuclear power, and pesti-cides. Questions about genetic screening and genetherapy involved prenatal and postnatal screening, at-titudes toward mental illness and AIDS, confidential-ity of information, and gene therapy. Most personsseem to agree that technology should be used if thereare perceivable benefits and if the system of distribu-tion is fair.

The responses to the questionnaire are used to sup-port the contention that there are ‘‘universal ethicalideas.’’ The fact that many individuals reach the sameconclusion may have a basis in biological evolution thatgives rise to similarities in social and spiritual expres-sion. Many people hope that we can achieve a sustain-able world with respect to our use of resources: the

need for human beings to be stewards of nature. Anidea that is stressed is that conflict itself may be asocial phenomenon that is propagated by individualsseeking individual power, using the media or distor-tions of religious belief to achieve that end. It is alsorecognized that economics governs what actually hap-pens.

There are contributions by others to the introductorysection, including surveys of trends, and some indi-vidualistic statements concerning medical issues andhealth care systems in a number of countries. Sincegenetics is frequently central to the discussion, there isan essay entitled ‘‘Genetic Information in the HealthCare Reform Era,’’ by Paul Billings. This includes astriking statement: ‘‘In addition, the master politicalstroke of Dr. James Watson, who was the first HGP(Human Genome Project) director, was to create theELSI (Ethical, Legal and Social Issues) program. Thissmall component of HGP was designed to assess, andpossibly mollify, the impacts of new human genetic in-formation. This novel self-consciousness of a scientificproject has been very useful in garnering continuedappropriations for what is largely a banal industrialexperiment to accurately sequence three billion basesof DNA in an era of shrinking federal budgets for sci-entific research.’’

Another seminal contribution is the essay by Jaya-paul Azariah entitled ‘‘Global Bioethics and CommonHope.’’ His perspective emphasizes the inclusion ofother problems besides medical care in bioethics. Thediscussion centers on three challenges: the preserva-tion of the natural world, the preservation of peace, andthe reduction of the effects of poverty. His argumentsuse techniques of system theory to include spiritualapproaches, particularly those of Asian philosophy, indesigning appropriate responses to human problems.

David J. HarrisChief, Section of Medical Genetics and

Molecular MedicineThe Children’s Mercy HospitalKansas City, Missouri

American Journal of Medical Genetics 70:102 (1997)

© 1997 Wiley-Liss, Inc.