Ethics Committees: The Challenges Facing 21st-Century Bioethics

Interdisciplinary reflection on the applications of scientific and technological breakthroughs from the moment they affect human beings defines both bioethics and ethics committees. From the outset, bioethics has been accompanied by the establishment of research ethics committees, healthcare committees and national ethics committees on different levels, in different fields and with diverse functions, with the ultimate aim of protecting and promoting the rights of all involved and, in short, ensuring that scientific and social interests do not prevail over the interests of individuals. Ethics committees are mechanisms which, based on their independent and multidisciplinary nature, enable steps to be taken from theory to action in different areas where bioethics is present: advising on decision-making when healthcare disputes arise, analysing scientific adequacy and weighing up ethical and legal aspects in biomedical research or providing guidelines to assist politicians in amending or developing regulations and designing policies which best face the new challenges posed by “life sciences, medicine and associated technologies”.¹

The creation and implementation of ethics infrastructures has become a way to assess the relevant ethical, legal, scientific and social issues related to research projects involving human beings; provide advice on ethical problems in clinical settings; assess scientific and technological developments, formulate recommendations and in sum, foster debate, education and public awareness of, and engagement in, bioethics;² in sum, a way to “do bioethics”. Thus, ethics committees appear to be the most suitable mechanisms for operating flexibly and dynamically in the spaces created in our societies by science, new technologies or biomedicine and are promoted by international governmental organisations such as UNESCO³ and non-governmental bodies like the World Medical Association.⁴ States have even considered that their creation and operating need to be regulated.⁵ Regrettably, in many cases, the creation of ethics committees has been regarded from an institutional perspective as merely an indispensible bureaucratic procedure for achieving certain standards, particularly in the field of health and research, and their implementation has not been viewed as a procedural framework fostering joint thinking and team decision-making. It is said that ethics has always sold well, and even better when institutionalised.

Yet a critical view will show a certain level of distortion in this process, and it should not be ruled out that underlying the good intentions of their activity is the fact that these committees could have been set up to respond to government interests in line with certain policies, the business objectives and marketing strategies of the pharmaceutical industry,⁶ or worse, as a result of a conspiracy between the two in which there are no citizens but only docile bodies.⁷

From a critical perspective, 21st-century bioethics must strive to improve ethics committees and their procedures, which in different fields, whether compulsory or voluntary, have become necessary mechanisms for approaching the “ethical issues related to medicine, life sciences and associated technologies as applied to human beings, taking into account their social, legal and environmental dimensions”.⁸ Ethics committees have a serious function to develop in educating and promoting social debate with regard to controversial and thus potentially divisive issues to which closed, risk-free answers cannot be found, and so in a certain way, contribute to social cohesion. UNESCO’s Universal Declaration on Bioethics and Human Rights, an international legal instrument, backs this line of thinking and places ethics committees in a strategic position as mechanisms for applying the principles it supports.⁹ The Declaration marks a milestone for bioethics since it links the discipline directly to international human rights law. It must be said that the union between bioethics and human rights is not a straightforward issue for future debate. While some have never questioned this union, and it has been the starting point of their line of work in bioethics,¹⁰ others have fiercely criticised it, arguing, among other things, that bioethics and human rights have completely different discourses.¹¹

Underlying this are the different conceptions of bioethics; precisely because there is no unanimous answer to what it is and how it is defined, it will continue to be the subject of debate, and probably...