UNESCO Conference on Human Rights and Bioethics

UNESCO's Division of Human Rights and Peace, together with the USSR Academy of Science and the USSR Academy of Medicine, held an international bioethics conference in Moscow May 13-15, 1991. Twenty participants from the United States,¹ Europe, Asia, and South America participated.

To the extent that health and health education are seen as human rights, UNESCO properly claims a responsibility in the field of bioethics. Article 25 of the United Nation's Universal Declaration of Human Rights calls for

the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Article 26 defines the "right to education." Both articles call for efforts to support and improve the just distribution of health care, and to promote programs in health literacy.

UNESCO is a newcomer in the field of bioethics. In 1984 it included in its work plan for the first time an activity on "human rights and recent advances in science and technology" and charged its Human Rights Division with implementing it. The following year it sponsored an international symposium in Barcelona on the effect of advances in science and technology on human rights. That conference produced a number of recommendations, including the following: consider the impact of new reproductive technologies on the human rights of women; promote consideration of the human rights of patients, and in particular, standards for the use of neuroleptic drugs; and consider and assess the impact on human rights of current research on genetic manipulation and artificial procreation (Document SHS-86/ws/39).

The Moscow conference, which took place on the new campus of the USSR Academy of Social Sciences, addressed four topics: (1) organ transplantation; (2) informed consent; (3) bioethics and the law; and (4) institutionalization of bioethics.

Soviet academician A.A. Baev opened the conference by quoting a January 22, 1991 Declaration of Human Rights by the USSR Academy of Science, and then announced the formation of a national commission on bioethics. It will be chaired by academician Ivan T. Frolov, who is a philosopher and member of the Communist Party's Central Committee. In an emotional address, Baev stated that the rights of the individual were sacrificed for more than seventy years under Marxist-Leninist dictatorship in the Soviet Union. He pointed out that the new awareness of individual rights has not become reality everywhere in the Soviet Union and that, like a snake, the system has to replace its skin many more times.

Organ Transplantation

The session on organ transplantation addressed the just distribution of organs, presumed consent of the organ donor, and cultural diversity in defining death. In particular, inequality in the distribution of transplant organs between rich and poor countries was noted; it was well understood that the availability of organ transplantation and the procedures and costs of distribution are directly related to human rights. The tension between various cultural understandings of the integrity and autonomy of individuals, and the principles of solidarity and sharing was discussed. Participants concluded that issues of just distribution should be discussed further and that the definition of death would need further investigation in a cross-cultural context.

With the commercialization of organs renounced by WHO and banned in many countries, concern focused on the harms of a "black market" in organs. The conference recommended a new international, cultural, and ethical debate about the issues of reciprocity, solidarity, and mutual aid as they relate to donating organs.

Informed Consent

Participants noted that the concept of informed consent in physician-patient relationships, which is closely related to the concept of individual human rights and the autonomy of the person, is not widely accepted. This is due in part to the hierarchical structure of societies and the traditional paternalism in medicine. Decent levels of education and health awareness on the part of individuals were seen as important tools to building more cooperation...