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13 Ethical committees
J. G. Schenker

In the last two decades, ethical issues in medicine
have come to the forefront of public consciousness,
with concern focusing on several important areas.
Advances in scientific and technological knowledge
have created ethical dilemmas about what is right and
wrong, about life and death issues, as well as issues of
equality, justice, and personal preferences. Biomedical
ethics also raised issues on patients’ rights, which
required steps to be taken to protect the patient’s
welfare and to promote the patients’ autonomy.
Society’s concern for ethical issues in medical prac-
tice has led to a growing need for the medical profes-
sion to become fully aware of the public view not only
on individual patient–physician relationships, but also
on how medical developments affect social structure
and health policies. Health policy makers as well must
examine the ethical basis of decision making, prioriti-
zation, and conflicts of interest as they influence health
care locally, nationally, and internationally.
Biomedical ethical issues, guidelines, principles and
regulations cut across national boundaries and often
have universal implications. Although cultures differ,
certain values are common to all. In this context, the
most important is respect for human dignity, and this
should not be negotiable. The establishment of interna-
tional and interdisciplinary forums in which scientists
and lay people can exchange views on topics of imme-
diate concern, unhampered by administrative, politi-
cal, or other considerations was needed. They are
intended especially for the discussion of the scientific
and technical bases of advances in biology and medi-
cine and other related areas and their social, economic,
ethical, administrative, and legal implications.
The range of ethical questions raised by new scien-
tific achievements in the life science and methods of
taking care of women’s health, especially assisted repro-
duction, have been debated by international political
and professional bodies. Within international commit-
tees, diverse geographic, ethnic, cultural, linguistic, and
religious backgrounds are represented.
The Nuremberg Code
The first international code of ethics for research involv-
ing human subjects – the Nuremberg Code – was a
response to the atrocities committed by Nazi research
physicians that were revealed at the Nuremberg War
Crimes Trials. Many of their experiments had entailed
the deliberate killing of, or infliction of grievous injuries
on, prisoners whose rights to consent or refuse were
ignored. Thus, it was to prevent repetition by physi-
cians of such attacks on the rights and welfare of human
beings that human-research ethics came into being. The
Nuremberg Code, issued in 1947,1 laid down the stan-
dards for carrying out human experimentation, empha-
sizing the subject’s voluntary consent:
(1) The voluntary consent of the human subject is
essential. This means that the person involved
should have legal capacity to give consent;
should be so situated as to be able to exercise free
power of choice without the intervention of any
element of force, fraud, deceit, duress, over-
reaching, or other ulterior form of constraint or
coercion; and should have sufficient knowledge
and comprehension of the elements of the sub-
ject matter involved so as to enable him to make
an understanding and enlightened decision. This
latter element requires that before the acceptance
of an affirmative decision by the experimental
subject there should be made known to him the
nature, duration, and purpose of the experiment;
the method and means by which it is to be con-
ducted; all inconveniences and hazards reason-
ably to be expected; and the effects upon his
health or person that may possibly come from
his participation in the experiment. The duty
and responsibility for ascertaining the quality of
the consent rests upon each individual who ini-
tiates, directs, or engages in the experiment. It is
a personal duty and responsibility that may not
be delegated to another with impunity.
(2) The experiment should be such as to yield fruit-
ful results for the good of society, unprocurable
by other methods or means of study, and not
random and unnecessary in nature.
(3) The experiment should be so designed and
based on the results of animal experimentation
and knowledge of the natural history of the
disease or other problem under study that the

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140 Ethical committees
anticipated results will justify the performance
of the experiment.
(4) The experiment should be so conducted as to
avoid all unnecessary physical and mental
suffering and injury.
(5) No experiment should be conducted where
there is an a priori reason to believe that death
or disabling injury will occur, except, perhaps,
in experiments where the experimental physi-
cians also serve as subjects.
(6) The degree of risk to be taken should never
exceed that determined by the humanitarian
importance of the problem to be solved by the
experiment.
(7) Proper preparations should be made and adequate
facilities provided to protect the experimental
subject against even remote possibilities of injury,
disability, or death.
(8) The experiment should be conducted only by
scientifically qualified persons. The highest
degree of skill and care is required through all
stages of the experiment of those who conduct
or engage in the experiment.
(9) During the course of the experiment, the human
subject should be at liberty to bring the experi-
ment to an end if he has reached the physical or
mental state where continuation of the experi-
ment seems to him to be impossible.
(10) During the course of the experiment, the scien-
tist in charge must be prepared to terminate the
experiment at any stage if he has probable cause
to believe, in the exercise of the good faith,
superior skill, and careful judgment required of
him, that a continuation of the experiment is
likely to result in injury or death to the experi-
mental subject. All research involving human
subjects should be conducted in accordance
with three basic ethical principles, namely,
respect for persons, beneficence, and justice.
The Nuremberg Code document was criticized
because it does not distinguish between different
types of biomedical experimentation. The Nuremberg
Code makes the subject’s legal capacity to consent a
prerequisite to experimentation, thus excluding from
participating in research many people who might ben-
efit from the results obtained, including children, the
mentally ill, and others who are unable to give legal
consent.
UNESCO – The United Nations
Educational, Scientific and Cultural
Organization
The United Nations Educational, Scientific and
Cultural Organization (UNESCO) was established on
November 16, 1945.2 The main objective of UNESCO
is to contribute to peace and security in the world
by promoting collaboration among nations through
education, science, culture, and communication to
further universal respect for justice, for the rule of
law, and for the human rights and fundamental free-
doms that are affirmed for the peoples of the world
without distinction of race, sex, language, or religion.
At the international level, UNESCO has been one of the
principal promoters of the reflection on ethics of living.
In 1993, UNESCO created the International Bioethics
Committee (IBC). The IBC3 is a forum for debate and
reflection and for the elaboration of UNESCO’s norma-
tive actions, particularly with regard to the imple-
mentation of the Universal Declaration on the Human
Genome and Human Rights. It is up to the IBC to keep
up with progress in genetics while taking care to
ensure respect for the values of human dignity and
freedom in view of the potential risks of irresponsible
attitudes in biomedical research. The IBC has drafted
statutes and published reports on the ethical aspects of
human embryonic stem cell research and its use in ther-
apeutic research; ethical issues on genetic screening and
the testing, treatment, storage, and use of genetic data on
genetic screening; and human gene therapy.
WHO – World Health Organization
The Health Organization of the League of Nations was
set up in Geneva in 1919. In 1945, the United Nations
Conference on International Organization established
a new, autonomous, international health organization –
the World Health Organization (WHO). The objective
of the WHO is the attainment by all peoples of the
highest possible level of health.4
The WHO’s constitution affirms fundamental ethi-
cal principles, such as the equality of rights and the
unalienable dignity of all human beings. The WHO
has set technical standards and proposed guidelines
and codes of good practice in virtually all its fields
of activity, including the widely publicized areas of
organ transplantation, breast-milk substitutes, essen-
tial drugs, the marketing of pharmaceuticals, and,
more recently, reproductive health, environmental
health, and emerging diseases. The WHO also con-
tributes to harmonizing legislation and terminology
and fosters the dissemination and exchange of infor-
mation on these subjects. Ethics continues to provide
the basis for the WHO’s activities and functions. Several
WHO programs have their own ethical review com-
mittees; additional activities are carried by consulta-
tion on ethics and health at the global level.
The Declaration of Helsinki
The Declaration of Helsinki, promulgated in 1964 by
the World Medical Association, is the fundamental
document in the field of ethics in biomedical research
Kurjak-13.qxd 5/9/2006 11:33 AM Page 141
and has had considerable influence on the formulation
of international, regional, and national legislation and
codes of conduct. The Declaration, revised in Tokyo
in 1975, in Venice in 1983, and again in Hong Kong in
1989,5 is a comprehensive international statement
of the ethics of research involving human subjects. It is
the mission of the physician to safeguard the health of
the people. The physician’s knowledge and conscience
are dedicated to the fulfillment of this mission. Medical
progress is based on research that ultimately must rest
in part on experimentation involving human subjects. In
current medical practice, most diagnostic, therapeutic,
or prophylactic procedures involve hazards.
The purpose of biomedical research involving
human subjects must be to improve diagnostic, thera-
peutic, and prophylactic procedures and the under-
standing of the etiology and pathogenesis of disease. In
the field of biomedical research, a fundamental distinc-
tion must be recognized between medical research in
which the aim is essentially diagnostic or therapeutic
for a patient and medical research the essential object of
which is purely scientific and without implying direct
diagnostic or therapeutic value to the person subjected
to the research.
In 1992, International Ethical Guidelines for
Biomedical Research Involving Human Subjects were
introduced by The Council for International
Organizations of Medical Sciences and WHO based
on ethical principles.6 All research involving human
subjects should be conducted in accordance with
three basic ethical principles: respect for persons,
beneficence, and justice. Respect for persons incorpo-
rates at least two fundamental ethical considerations:
(1) respect for autonomy, which requires that those
who are capable of deliberation about their personal
choices should be treated with respect for their capa-
city for self-determination and (2) protection of persons
with impaired or diminished autonomy, which
requires that those who are dependent or vulnerable
be afforded security against harm or abuse.
For all biomedical and clinical research involving
human subjects, the investigator must obtain the
informed consent of the prospective subject. Informed
consent is based on the principle that competent indi-
viduals are entitled to choose freely whether to par-
ticipate in research. Informed consent protects the
individual’s freedom of choice and respects the indi-
vidual’s autonomy. In the case of an individual who
is not capable of giving informed consent (e.g. a fetus,
a newborn, or a small child), the proxy consent of
a properly authorized representative should be
obtained. In all human research, ethical guidelines
have differentiated between beneficial (therapeutic)
and non-beneficial (non-therapeutic) research. The
therapeutic research subject stands to gain as much
from the research, whether it be a procedure or a drug,
as to lose from it. In the non-therapeutic research, the
subject cannot possibly benefit himself, and any ben-
efits can therefore only add to others. The risks of a
The Declaration of Helsinki 141
non-beneficial research fall solely on the research
subject, whereas the benefits may extend beyond the
research subject to the population as a whole.
The spirit of the Declaration of Helsinki is that, in
medical research, the interests of science and society
should never take precedence over considerations
related to the well-being of the subject. Only a minimal
level of risk may be allowed for volunteers to subject
themselves for the benefit of others. However, it
remains a problem to decide what sorts of levels of
risk are acceptable in the case of pregnant women and
where the subjects of non-therapeutic research are not
autonomous (e.g. premature and newborn babies).
It is generally accepted that pregnant and nursing
women are not suitable subjects of clinical trials other
than those that are designed to respond to the health
needs of such women or their fetuses or nursing
infants. Clinical trials for conditions associated with
or aggravated by pregnancy and to test the safety and
efficacy of drugs, methods, and devices for detecting
fetal abnormalities and well-being are of primary
importance in the medical field of perinatology. The
justification for the participation of pregnant women
in clinical trials is that they should not be deprived
arbitrarily of the opportunity to benefit from investi-
gational drugs, vaccines, or other agents that promise
therapeutic or preventive benefit. In all cases, risks to
pregnant women, fetuses, and newborns should be
minimized, as far as sound research design permits.
As a general rule, pregnant or nursing women should
not be the subjects of clinical trials except when such
trials are designed to protect or advance the health of
pregnant or nursing women or fetuses or nursing
infants and for which women who are not pregnant or
nursing would not be suitable subjects.
Some therapeutic research on fetuses in utero must be
allowed. It contributes to the discovery of new methods
for treating fetal health problems. There is a consensus
that research on fetuses in utero should be treated as
human subjects research, and governed by the policies
for human subjects research. Because fetuses in utero
and pregnant women are linked to each other, research
on one may affect the other. Such research may have a
differential impact on the pregnant woman and the
fetus, with one benefiting while the other does not, and
may be harmful to the other. At the extreme, the
research that is beneficial to the one may actually be
harmful to the other. The fundamental presupposition
of all ethical policies is that the independent review
process for human subjects research must consider the
interests and rights of both parties in reviewing research
protocols. Most guidelines have also imposed addi-
tional requirements on the acceptable level of risk to the
fetuses involved in the research protocol. It is assumed
that fetuses have some moral standing so that some
concern must be devoted to their interests and rights.
Sir John Peel’s report, published in 1972,7 presented
governmental guidelines concerning the ethics of fetal
research. The recommendations were as follows:
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142 Ethical committees
• Viable fetuses should not be subjected to non-
beneficial research.
• Research is permitted on the whole alive previable
fetus, dead fetus, or its organs.
• Dead fetuses or tissues may be used in accordance
with the provisions of the Human Tissue Act, which
governs the postmortem use of human tissue.
• Parental informed consent should be obtained.
• The validity of the research should be assured.
The National Commission for the Protection of
Human Subjects in Biomedical and Behavioral
Research was established in July 19748 and issued its
recommendations. The guidelines have certain things
in common with the British guidelines but differ on
some grounds. The common points are that dead
fetuses and their tissues are to be afforded the respect
of other dead human bodies and tissues. Fetuses with
a chance of survival are to be treated like children.
Willful damage to the fetus in utero may not be
caused, presumably lest a mother change her mind
about abortion. Significant differences are that in the
United States, regulations fathers can veto the
research, whereas in the British guidelines there is no
such specific provision. In Britain it is proposed that
non-beneficial research is to be done on the fetus
in utero or on the viable fetus, whereas in the United
States it may be done if there is minimal risk.
Council of Europe
In 1985, the Council of Europe created a multidisci-
plinary body with experts appointed by each member
country. This committee has already produced docu-
ments on reproduction research on human subjects,
prenatal diagnosis and screening, and genetic testing.
Once the Committee of Ministers approves these docu-
ments, they become recommendations for the national
parliaments, which may or may not decide to follow
them. The European assembly and other committees
have also issued reports related to bioethical prob-
lems. The Council of Europe, which represents all the
democratic countries of Europe, has organized a
European Convention on Bioethics. The Committee
published protocols regarding human experiments
and organ transplantation.9
FIGO Committee for the Study
of Ethical Aspects of Human
Reproduction
In 1985, the FIGO Committee for the Study of Ethical
Aspects of Human Reproduction was established.10 Its
main objectives were the recording and study of gen-
eral ethical problems emanating from the research
and practice of human reproductive medicine, with
the aim of providing guidelines for the attention of
physicians and the public in developed and developing
countries.
From its inception this committee was not
intended to solve these ethical dilemmas, but rather to
raise discussion by suggesting the perspectives that
this group of health professionals, lawyers, and ethi-
cists arrived at after carefully crafted analysis and
debate over these issues. Given the rich field of ethical
issues in women’s health that derive from not only the
reproductive life cycle, but also the economic and
political status of women internationally – this com-
mittee will always confront new issues and even new
aspects of old issues that challenge ethical perspec-
tives and practice. There are continual variations on
themes the committee has raised in the past through
new medical developments. The social status of women,
the constraints on health care dollars, and the health
status of women have also increased the need for the
committee to address the broader set of rights and
economic issues that directly influence the health of
women and the ethical setting of their care.
The committee was composed of a range of inter-
national members who represented developing and
developed countries and had a significant interest and
expertise in medical ethics. The members of the FIGO
Committee are obstetricians, gynecologists, oncolo-
gists, lawyers, and public health workers, all of whom
represent diverse geographic, ethnic, cultural, linguis-
tic, and religious backgrounds. Among the 14 members,
13 were chairs of leading obstetric and gynecologic
departments.
The initial task of the FIGO Committee for the
Study of Ethical Aspects of Human Reproduction was
to identify and study the important ethical problems
confronting health care practitioners in human repro-
duction. The ethical problems identified were to be
brought to the attention of physicians and the public
in the developed and developing countries to provide
ethical guidelines where appropriate. This task has
assumed greater importance with the continuing
challenge of ensuring that women are granted human
and reproductive rights worldwide. Furthermore, the
complexity of incorporating the many ethical aspects
of reproductive issues in different societies, for issues
such as cloning, or patenting of the human genome,
argues for the need for such a consensus body.
There is no other body internationally that confronts
these issues with a view toward the impact on the
health care of women. Because of this, the opinions of
the committee are used by women’s health practition-
ers internationally to assist them in setting national or
local standards, to expand the depth of discussion of
these issues locally, and to support their advocacy for
improvements in the health and status of women inter-
nationally. In the face of rapid cultural and scientific
change, this is a critical role of ever-greater need.
Women are clearly vulnerable in countries where their
health care rights are either non-existent or threatened,
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FIGO Committee for the Study of Ethical Aspects of Human Reproduction
and thus, these guidelines can be a powerful force to
support the rights of women.
The work of the Committee: In its first Congress as a
standing committee, the Ethics Committee presented
three seminars: on medical ethics and medically assisted
reproduction, on AIDS with emphasis on ethical
aspects, and on refusal of obstetrical care (maternal
health, fetal health, and neonatal health), which were
published in the proceedings of the Rio Congress.
The early focus of the Committee, from 1985 to
1991, was clearly in areas central to obstetrics and
gynecology practice, with a focus on such areas as
sterilization, research on pre-embryo, and elective
reduction of multiple pregnancies. In the same time
period, however, the committee began to explore what
the ethical responsibilities of societies of gynecology
and obstetrics were for the broader issues of provision
of reproductive health care and women’s health in
general. This led to a seminar during the FIGO Singapore
Congress focusing on issues such as:
• How much are mothers worth?
• Distribution of resources between primary and
tertiary reproductive care.
• Availability of resources for newborn care.
• Macroethical issues in obstetrics and gynecology.
This key seminar was chaired by Profs. Sureau and
Schenker, and marked an important expansion of the
thinking of the Committee beyond that of the common
bioethical analysis of the time, which focused on
principles such as benefit (beneficence), harm (mal-
eficence), and patient autonomy in the area of human
rights and justice. During this time, the Committee
also began to align its meetings with regional meet-
ings that paralleled the focus of the committee on eth-
ical aspects of human reproduction. The first of these
took place in Cairo in 1991 and focused on bioethics
in human reproduction research in the Muslim
World. The committee meeting foreshadowed an area
of ongoing controversy in medicine – that of trans-
plantation. At that time the group considered whether
research on pre-embryos was required in order to
broaden our knowledge of the developmental process,
to improve the treatment of infertility and the control
of reproduction, and to permit genetic screening with
its potential for the prevention and treatment of birth
defects. The Committee recognized and tried to incor-
porate the diverse spectrum of ethical, cultural, and
religious values regarding the status of the pre-
embryo. However, agreement was reached on some
key areas even with these divergent views:
(1) First, research on pre-embryos is only ethically
acceptable when its purpose is for the benefit of
human health and only if animal models would
not suffice.
(2) The Committee felt that no developing human
pre-embryo might be kept alive beyond 14 days
143
after fertilization (not including any time during
which the embryo had been frozen).
(3) Research projects on pre-embryos should be
authorized by ethical and/or other appropriate
bodies in the country and, if allowed, appropri-
ate informed consent must be obtained before
undertaking research on pre-embryos, normally
from both gamete donors. Furthermore, provision
of gametes and pre-embryos should not be
subject of commercial profit.
(4) The Committee was unable to reach a consensus
as to whether research should be limited to sur-
plus pre-embryos or should also include pre-
embryos specifically generated for research, a
debate that continues worldwide. The discussion
over this issue established the precedent that
committee statements required consensus, and
where that was not possible, debates were either
not included or included with the caveat that
there was no consensus.
The deliberations are made public through committee
statements published in scientific journals and in
specific reports. The FIGO Committee has discussed
and provided guidelines on general issues in women’s
health and advocacy, issues on genetics, embryo
research, contraception, abortion, and reproductive
endocrinology issues regarding pregnancy, maternal–
fetal health, and neonates. The first bound publica-
tion of the collated Issues and Guidelines appeared in
1994, 1997, and 2000, and by 2003 had grown to a
body of work that, with the translations into Spanish
and French, covers 232 pages.11
The method of analysis adopted by the committee
evolved early on and consisted of position papers on a
topic identified by the committee that were circulated
prior to committee meetings in the working language of
the committee, English.
These research papers explicated the problem, the
present status of knowledge, and the various ethical
stances or issues that were identified in the literature.
At times, the committee invited outside experts in
areas where there was not felt to be adequate depth of
expertise or where there were other FIGO committees
working on the medical or rights aspects of the same
issue. The papers were presented at the meeting and a
consensus about the important background and ethi-
cal issues was identified.
Depending on the issues, further work on synthe-
sizing these into a set of reflections or guidelines
might take place at the meeting or over several meet-
ings, until every word of each document was reviewed,
read, and revised by all the members of the commit-
tee. Proposed statements were read line by line and
edited by the entire committee to assure that not only
the content was acceptable to the committee, but that
the translations to French and Spanish would not
contain errors because of the likely translation from
English.
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144 Ethical committees
The committee statements and opinion are inde-
pendent from FIGO member societies or the executive
board. The documents represent the result of that
carefully researched and considered discussion. This
independence has been particularly helpful to FIGO
in providing ethical guidance regarding the relation-
ship of the federation to industry, initially formulated
as internal ‘Guidelines for Relations between Industry
and FIGO’ in 1991. The committee collaborates with
international organizations – such as the WHO – on
various aspects of women’s health to ensure that the
ethical aspects are fully covered.
The committee members represent a wide spectrum
of religions and countries, and numerous members have
co-coordinated with multiple international committees
to encourage and ensure inclusion of these ethical
aspects in regular and extraordinary meetings.
WAPM – World Association
of Perinatal Medicine
In 1999, the World Association of Perinatal Medicine
established an Ethical Committee. The main objec-
tives of the committee are:12
• To study the ethical problems that emanate from
practice and research in perinatal medicine.
• To provide guidelines for the practice of obstetrics
and neonatology.
• To bring the ethical issues to the attention of physi-
cians, nurses, paramedical staff, and the public.
National Ethics Committees
National ethics committees are set up by governments
to advise on regulations or proposed legislation con-
cerning moral bioethical programs that raise contro-
versy among professionals and the public. National
committees were originally created due to an increas-
ing demand among doctors and researchers for some
authoritative guidance as to what was permissible in
issues where no law exists. The nature of the member-
ship of such committees is of even greater importance.
The chairman must be unrelated to the medical or
research profession. The members of national ethics
committees must represent a broad range of values and
professional expertise in the fields of medicine, law,
administration, media, economics, public policy, and
moral philosophy. Within committees dealing with
reproductive health, for example, at least 50% of
the members must be women. Governmental or non-
governmental bodies have issued reports on ethical
and legal aspects, especially in the fields of perinatal
care, assisted reproduction technologies, and human
experimentation. Scientific progress is ahead of what
society is willing to accept, and the reports of the
bioethical committees protect the public by monitoring
and, when necessary, regulating scientific practice.
There is no single solution to a moral problem. A com-
mittee must incorporate a number of different moral
ideals and reach a workable compromise. The law that
these committees create must be in step with moral
beliefs, or it will not be implemented. It is the task of the
ethics committee to try to produce some consensus,
based on all considerations, and to recommend it for
practice. Several problems arise in the setup of the
committees. Who should make moral decisions in
controversial public issues? How is the committee’s
membership to be determined? In a pluralistic, mainly
secular society there are no moral experts per se.
Committees who serve public morality must conform to
certain specifications of expertise. The committee mem-
bers must be capable of understanding the scientific
background of the subject matter of the issue. They must
be acquainted with moral philosophy and understand
the nature of ethics. The members must be intelligent
and creative and not dogmatic. It is imperative that
people who hold particular moral or religious views
that make them impervious to the language of consen-
sus are not included in the committee’s team. They may
be incapable of sympathy and flexibility and thus not be
of use. The members must also be readily available to
perform this extremely time-consuming task. One major
disadvantage of these committees is that sometimes the
advent of new technologies is ahead of committee delib-
erations. If a previous committee decision was opposed
to specific new advances, their use may be delayed until
the committee changes its original decision. In most
Western countries, committees are set up ad hoc to
address specific subjects of public bioethical concern.
The Warnock Committee on Human Fertilization and
Embryology (1984) had a great influence on subse-
quent legislation in the United Kingdom.13 In the
United States, legislation that seems to reinforce ethi-
cal conduct may actually replace the exercise of ethi-
cal judgment with unreflective obedience to law. The
Belmont Report (1979) identified the basic ethical
principles that should emphasize the conduct of
biomedical and behavioral research involving human
subjects and developed guidelines that should be fol-
lowed to ensure that such research is conducted in
accordance with those principles.14 The guidelines
provided by national committees are usually converted
into laws by legislation that introduces criminal
punishment for violation. The experience of Assisted
Reproductive Technology (ART) practice demonstrated
that countries with voluntary guidelines seem to enjoy
public confidence, and public pressure for a change
seems minimal. Countries with legislative surveillance
seem to agree that it works well, although there are
understandable complaints about the slowness of the
legislative process and the difficulty of having regula-
tions changed once they are in place, and thus, not be
of use.
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Summary
The range of ethical questions raised by new scientific
achievements in the life science, and methods of
taking care of women’s health especially, has been
debated by international political and professional
bodies. Biomedical ethical issues, guidelines, princi-
ples, and regulations cut across national boundaries
and often have universal implications. Although cul-
tures differ, certain values are common to all. In this
context, the most important value is respect for human
dignity, and this should not be negotiable. The estab-
lishment of international and interdisciplinary forums
in which scientists and lay people can exchange views
on topics of immediate concern, unhampered by
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Summary 145
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needed. They are intended especially for the discus-
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in biology and medicine and other related areas and
their social, economic, ethical, administrative, and legal
implications. Commissions appointed by institutions,
governments, and international bodies serve to relieve
the medical profession from making ethical decisions
and to protect human subjects from any harm. The
deliberations of these committees are usually followed
by guidelines of operation, which in many cases have
become abiding law. For these committees to be of full
advantage, they must convene promptly as issues
arise so as not to delay medical advances from being
implemented.
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