December 8, 2023

Are we heading towards ‘bioethics nationalism’?

Different bioethics for different countries?

The coronavirus pandemic is placing unprecedented strains not only on economies and hospitals, but on bioethics, renowned bioethicist Jonathan Moreno observes in the blog of The Hastings Center.

National prestige and financial reward are uniquely and powerfully combined in a global pandemic that threatens to revise history. If ever international bioethics norms could be compromised this is the time, a public health crisis that presents existential risks of geopolitical destabilization.

Perhaps, however, expedience should rule the day. It could be argued that this is precisely the situation that justifies deviations from norms, just as mandatory vaccination has been justified for some infectious diseases though it limits freedom of choice. But abridging the ground rules for vaccine testing and distribution is harder to justify when so many other candidate vaccines are under expeditious development while also adhering to widely recognized ethical and methodological standards.

Do the Chinese and Russian actions amount to a form of bioethics nationalism? I think the answer is: not quite. Nothing reported so far indicates that the two countries will not in the final analysis be guided by internationally recognized drug development standards. Rather China appears to be relying on one view of military medical ethics that exempts members of armed forces from consent requirements for a nonvalidated product if commanders believe it is needed for force readiness. (Apparently this approval is strictly limited to the Chinese military for one year. So far there has been no reporting of illicit vaccine testing on the notoriously oppressed Uighur population, for example).

Russia’s rush to later phase trials may be pushing the methodological envelope, but it remains to be seen if the aggressive schedule will prove to have been warranted.

What one can conclude so far in this story–with the emphasis on “so far”–is that the global bioethical rules of drug development are strained by the pandemic but not torn. Whether bioethics will be an exception to the process of deglobalization now widely believed to have been accelerated by the pandemic remains to be seen.

Michael Cook is editor of BioEdge

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