Globalization and biotechnology: UNESCO and an international strategy to advance human rights and public health

American Journal of Law and Medicine

Volumn 25, Issue 4, 1999, Pages 479-541

  Taylor, Allyn L ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

BIOTECHNOLOGY; GENETIC ENGINEERING; HEALTH PROMOTION; HUMAN; HUMAN RIGHTS; PUBLIC HEALTH; PUBLIC HEALTH SERVICE; REVIEW;

BIOMEDICAL AND BEHAVIORAL RESEARCH; GENETIC SERVICES; GENETICS AND REPRODUCTION; LEGAL APPROACH; SOCIAL IMPACT; UNESCO; UNIVERSAL DECLARATION ON THE HUMAN GENOME AND HUMAN RIGHTS;

GENETIC ENGINEERING; GENETIC SCREENING; GENETIC SERVICES; HUMAN GENOME PROJECT; HUMAN RIGHTS; HUMANS; INTERNATIONAL COOPERATION; PUBLIC HEALTH; UNITED NATIONS;

EID: 0033391251     PISSN: 00988588     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (85)

1. See James D. Watson & Robert Mullan Cook-Deegan, The Human Genome Project and International Health, 263 JAMA 3322, 3322 (1990).
2. See Victor A. McKusick, Mapping and Sequencing the Human Genome, 320 NEW ENG. J. MED. 910, 915 (1989).
3. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 40.
4. See Graeme T. Laurie, The Most Personal Information of All: An Appraisal of Genetic Privacy in the Shadow of the Human Genome Project, 10 INT'L J.L. POL'Y & FAM. 74, 74 (1996).
5. Id.
6. See infra notes 47-51 and accompanying text (enumerating the limited availability of genetic screening tests for genetic disorders).
7. See FRANK P. GRAD, THE PUBLIC HEALTH LAW MANUAL 69-72 (1990) (describing circumstances under which state laws of the U.S. may require compulsory medical exams and clinical tests); see also Frank P. Grad & Ilise L. Feitshans, The Lawful Uses Of Knowledge From the Human Genome Project 292-308 (Apr. 15, 1994) (unpublished manuscript, on file with author) (providing an overview of the history of the U.S. federal and state genetic programs).
8. See FRANK P. GRAD, THE PUBLIC HEALTH LAW MANUAL 69-72 (1990) (describing circumstances under which state laws of the U.S. may require compulsory medical exams and clinical tests); see also Frank P. Grad & Ilise L. Feitshans, The Lawful Uses Of Knowledge From the Human Genome Project 292-308 (Apr. 15, 1994) (unpublished manuscript, on file with author) (providing an overview of the history of the U.S. federal and state genetic programs).
9. See Grad & Feitshans, supra note 42, at 304.
10. See id. at 352.
11. See id. at 346.
12. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 42. Globally, however, newborn and prenatal screening on a routine basis varies from country to country. See EUGENE B. BRODY, BIOMEDICAL TECHNOLOGY AND HUMAN RIGHTS 139 (1993).
13. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 42. Globally, however, newborn and prenatal screening on a routine basis varies from country to country. See EUGENE B. BRODY, BIOMEDICAL TECHNOLOGY AND HUMAN RIGHTS 139 (1993).
14. See Joe E. Smith, Ethical Issues Raised by the Human Genome Project, 50 AM. J. HOSP. PHARMACISTS 1945, 1946 (1993); Lori Whittaker, Clinical Applications of Genetic Testing: Implications for the Family Physician, 53 AM. FAM. PHYSICIAN 2077, 2077 (1996).
15. See Joe E. Smith, Ethical Issues Raised by the Human Genome Project, 50 AM. J. HOSP. PHARMACISTS 1945, 1946 (1993); Lori Whittaker, Clinical Applications of Genetic Testing: Implications for the Family Physician, 53 AM. FAM. PHYSICIAN 2077, 2077 (1996).
16. See Grad & Feitshans, supra note 42, at 350; ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 42.
17. See Grad & Feitshans, supra note 42, at 350; ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 42.
18. See Grad & Feitshans, supra note 42, at 354-57.
19. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43; see also THOMAS F. LEE, THE HUMAN GENOME PROJECT: CRACKING THE GENETIC CODE OF LIFE 15-17 (1991) (citing cystic fibrosis (CF) research as an example of the potential for genetic research to prevent disease).
20. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43; see also THOMAS F. LEE, THE HUMAN GENOME PROJECT: CRACKING THE GENETIC CODE OF LIFE 15-17 (1991) (citing cystic fibrosis (CF) research as an example of the potential for genetic research to prevent disease).
21. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43; see also Marcia Barinaga, From Bench Top to Bedside, 278 SCIENCE 1036, 1036 (1997); Zarir E. Karanjawala & Francis S. Collins, Genetics in the Context of Medical Malpractice, 280 JAMA 1533, 1533 (1998); Lawrence M. Fisher, Hope Near the End of the Pipeline, N.Y. TIMES, May 1, 1997, at D1.
22. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43; see also Marcia Barinaga, From Bench Top to Bedside, 278 SCIENCE 1036, 1036 (1997); Zarir E. Karanjawala & Francis S. Collins, Genetics in the Context of Medical Malpractice, 280 JAMA 1533, 1533 (1998); Lawrence M. Fisher, Hope Near the End of the Pipeline, N.Y. TIMES, May 1, 1997, at D1.
23. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43; see also Marcia Barinaga, From Bench Top to Bedside, 278 SCIENCE 1036, 1036 (1997); Zarir E. Karanjawala & Francis S. Collins, Genetics in the Context of Medical Malpractice, 280 JAMA 1533, 1533 (1998); Lawrence M. Fisher, Hope Near the End of the Pipeline, N.Y. TIMES, May 1, 1997, at D1.
24. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43; see also Marcia Barinaga, From Bench Top to Bedside, 278 SCIENCE 1036, 1036 (1997); Zarir E. Karanjawala & Francis S. Collins, Genetics in the Context of Medical Malpractice, 280 JAMA 1533, 1533 (1998); Lawrence M. Fisher, Hope Near the End of the Pipeline, N.Y. TIMES, May 1, 1997, at D1.
25. See LEE, supra note 62, at 14.
26. One of the most promising gene therapy experimental efforts to date involves delivering therapeutic genes to the lungs of patients with CF. See UI Researchers Find Potential Gene Therapy for Cystic Fibrosis, supra note 60; see also Peter G. Middleton & Eric W.F.W. Alton, Gene Therapy for Cystic Fibrosis: Which Postman, Which Box?, 53 THORAX 197, 198 (1998).
27. One of the most promising gene therapy experimental efforts to date involves delivering therapeutic genes to the lungs of patients with CF. See UI Researchers Find Potential Gene Therapy for Cystic Fibrosis, supra note 60; see also Peter G. Middleton & Eric W.F.W. Alton, Gene Therapy for Cystic Fibrosis: Which Postman, Which Box?, 53 THORAX 197, 198 (1998).
28. See S.F. Winter & H.D. Roger, Medical, Ethical and Legal Aspects of Somatic Gene Therapy, 2 EUR. J. HEALTH L. 45, 48 (1994).
29. see TOM WILKIE, PERILOUS KNOWLEDGE: THE HUMAN GENOME PROJECT AND ITS IMPLICATIONS 151 (1993); Fisher, supra note 63, at D6.
30. see TOM WILKIE, PERILOUS KNOWLEDGE: THE HUMAN GENOME PROJECT AND ITS IMPLICATIONS 151 (1993); Fisher, supra note 63, at D6.
31. See BRODY, supra note 46, at 131.
32. As a consequence, somatic gene therapy is largely considered ethically analogous to other medical therapies. See id.
33. Among other things, the possibility of germ-line therapy has raised strong concerns about the potential misuse of this form of therapy for eugenics purposes. See infra notes 140-44 and accompanying text.
34. See ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT, supra note 13, at 43-44.
35. A recent comprehensive global study confirms that the health problems of poor nations are increasingly converging with the health problems of rich states. See THE GLOBAL BURDEN OF DISEASE: A COMPREHENSIVE ASSESSMENT OF MORTALITY AND DISABILITY FROM DISEASES, INJURIES, AND RISK FACTORS IN 1990 AND PROJECTED TO 2020; SUMMARY 1 (Christopher J.L. Murray & Alan D. Lopez eds., 1996). The researchers found that the incidence of noncommunicable diseases is increasing in developing nations and replacing infectious diseases and malnutrition as one of the leading causes of premature morbidity and mortality globally. The changing pattern is caused by factors including the aging populations and, most important, the growing use of tobacco in developing states. See id. at 1; see also Taylor, An International Regulatory Strategy, supra note 94, at 257, 260-64.
36. A recent comprehensive global study confirms that the health problems of poor nations are increasingly converging with the health problems of rich states. See THE GLOBAL BURDEN OF DISEASE: A COMPREHENSIVE ASSESSMENT OF MORTALITY AND DISABILITY FROM DISEASES, INJURIES, AND RISK FACTORS IN 1990 AND PROJECTED TO 2020; SUMMARY 1 (Christopher J.L. Murray & Alan D. Lopez eds., 1996). The researchers found that the incidence of noncommunicable diseases is increasing in developing nations and replacing infectious diseases and malnutrition as one of the leading causes of premature morbidity and mortality globally. The changing pattern is caused by factors including the aging populations and, most important, the growing use of tobacco in developing states. See id. at 1; see also Taylor, An International Regulatory Strategy, supra note 94, at 257, 260-64.
37. A recent comprehensive global study confirms that the health problems of poor nations are increasingly converging with the health problems of rich states. See THE GLOBAL BURDEN OF DISEASE: A COMPREHENSIVE ASSESSMENT OF MORTALITY AND DISABILITY FROM DISEASES, INJURIES, AND RISK FACTORS IN 1990 AND PROJECTED TO 2020; SUMMARY 1 (Christopher J.L. Murray & Alan D. Lopez eds., 1996). The researchers found that the incidence of noncommunicable diseases is increasing in developing nations and replacing infectious diseases and malnutrition as one of the leading causes of premature morbidity and mortality globally. The changing pattern is caused by factors including the aging populations and, most important, the growing use of tobacco in developing states. See id. at 1; see also Taylor, An International Regulatory Strategy, supra note 94, at 257, 260-64.
38. See WHO INFORMAL LISTING (PARTIALLY ANNOTATED) OF LAWS, REGULATIONS, GUIDELINES, ETC. ON GENETIC SCREENING/TESTING, GENE THERAPY AND OTHER ASPECTS OF HUMAN GENETICS 14 (1996) [hereinafter WHO, GENETICS LAWS AND GUIDELINES].
39. See id. at 21.
40. See BRODY, supra note 46, at 148; Robert N. Proctor, Genomics and Eugenics: How Fair is the Comparison?, in GENE MAPPING, supra note 10, at 57, 57-72.
41. See BRODY, supra note 46, at 148; Robert N. Proctor, Genomics and Eugenics: How Fair is the Comparison?, in GENE MAPPING, supra note 10, at 57, 57-72.
42. see Patricia King, The Past as Prologue: Race, Class and Gene Discrimination, in GENE MAPPING, supra note 10, at 94, 95; Judith P. Swazey, Those Who Forget Their History: Lessons from the Recent Past for the Human Genome Quest, in GENE MAPPING, supra note 10, at 45, 50.
43. see Patricia King, The Past as Prologue: Race, Class and Gene Discrimination, in GENE MAPPING, supra note 10, at 94, 95; Judith P. Swazey, Those Who Forget Their History: Lessons from the Recent Past for the Human Genome Quest, in GENE MAPPING, supra note 10, at 45, 50.
44. See King supra note 115, at 99-100; see also Holtzman & Shapiro, supra note 59, at 852 (describing how exaggerated claims are made for genetic testing despite the major difficulties of predicting diseases accurately).
45. See King supra note 115, at 99-100; see also Holtzman & Shapiro, supra note 59, at 852 (describing how exaggerated claims are made for genetic testing despite the major difficulties of predicting diseases accurately).
46. See Henry T. Greely, The Control of Genetic Research: Involving the 'Groups Between', 33 HOUS. L. REV. 1397, 1408-11 (1996). Henry Greely points out that genetics research is likely to focus on families or groups of families with a high incidence of a particular genetic disease. See id. at 1410. These groups of people are defined not by citizenship but by common ties of heredity, including family, disease and ethnicity. See id. at 1411.
47. See Henry T. Greely, The Control of Genetic Research: Involving the 'Groups Between', 33 HOUS. L. REV. 1397, 1408-11 (1996). Henry Greely points out that genetics research is likely to focus on families or groups of families with a high incidence of a particular genetic disease. See id. at 1410. These groups of people are defined not by citizenship but by common ties of heredity, including family, disease and ethnicity. See id. at 1411.
48. See Henry T. Greely, The Control of Genetic Research: Involving the 'Groups Between', 33 HOUS. L. REV. 1397, 1408-11 (1996). Henry Greely points out that genetics research is likely to focus on families or groups of families with a high incidence of a particular genetic disease. See id. at 1410. These groups of people are defined not by citizenship but by common ties of heredity, including family, disease and ethnicity. See id. at 1411.
49. See Mary B. Mahowald et al., The New Genetics and Women, 74 MILBANK Q. 239, 241 (1996) (describing how political and social pressures may be brought on women who are carriers of genetic diseases); see also Allyn L. Taylor, Women's Health at a Crossroad: Global Responses to HIV/AIDS, 4 HEALTH MATRIX 297, 316-17 (1994) (describing how disease status can exacerbate stigmatization of women globally). See generally Robertson, supra note 110 (describing the impact of the human genome project on procreative rights).
50. See Mary B. Mahowald et al., The New Genetics and Women, 74 MILBANK Q. 239, 241 (1996) (describing how political and social pressures may be brought on women who are carriers of genetic diseases); see also Allyn L. Taylor, Women's Health at a Crossroad: Global Responses to HIV/AIDS, 4 HEALTH MATRIX 297, 316-17 (1994) (describing how disease status can exacerbate stigmatization of women globally). See generally Robertson, supra note 110 (describing the impact of the human genome project on procreative rights).
51. See Mary B. Mahowald et al., The New Genetics and Women, 74 MILBANK Q. 239, 241 (1996) (describing how political and social pressures may be brought on women who are carriers of genetic diseases); see also Allyn L. Taylor, Women's Health at a Crossroad: Global Responses to HIV/AIDS, 4 HEALTH MATRIX 297, 316-17 (1994) (describing how disease status can exacerbate stigmatization of women globally). See generally Robertson, supra note 110 (describing the impact of the human genome project on procreative rights).
52. See King, supra note 115, at 100.
53. See THEODORE MERON, HUMAN RIGHTS LAW-MAKING IN THE UN: A CRITIQUE OF INSTRUMENTS AND PROCESS 214-43 (1986) (discussing jurisdictional relations between human rights instruments and organs); Klaus T. Samson, Human Rights Co-ordination within the UN System, in THE UN AND HUMAN RIGHTS, supra note 294, at 620, 620-75; Theo van Boven, 'Political' and 'Legal' Control Mechanisms: Their Competition and Coexistence, in HUMAN RIGHTS IN PERSPECTIVE: A GLOBAL ASSESSMENT 36, 36-58 (Asbjöm Eide & Bernt Hagtvet eds., 1992) [hereinafter HUMAN RIGHTS IN PERSPECTIVE].
54. See THEODORE MERON, HUMAN RIGHTS LAW-MAKING IN THE UN: A CRITIQUE OF INSTRUMENTS AND PROCESS 214-43 (1986) (discussing jurisdictional relations between human rights instruments and organs); Klaus T. Samson, Human Rights Co-ordination within the UN System, in THE UN AND HUMAN RIGHTS, supra note 294, at 620, 620-75; Theo van Boven, 'Political' and 'Legal' Control Mechanisms: Their Competition and Coexistence, in HUMAN RIGHTS IN PERSPECTIVE: A GLOBAL ASSESSMENT 36, 36-58 (Asbjöm Eide & Bernt Hagtvet eds., 1992) [hereinafter HUMAN RIGHTS IN PERSPECTIVE].
55. See THEODORE MERON, HUMAN RIGHTS LAW-MAKING IN THE UN: A CRITIQUE OF INSTRUMENTS AND PROCESS 214-43 (1986) (discussing jurisdictional relations between human rights instruments and organs); Klaus T. Samson, Human Rights Co-ordination within the UN System, in THE UN AND HUMAN RIGHTS, supra note 294, at 620, 620-75; Theo van Boven, 'Political' and 'Legal' Control Mechanisms: Their Competition and Coexistence, in HUMAN RIGHTS IN PERSPECTIVE: A GLOBAL ASSESSMENT 36, 36-58 (Asbjöm Eide & Bernt Hagtvet eds., 1992) [hereinafter HUMAN RIGHTS IN PERSPECTIVE].
56. See Samson, supra note 304, at 659-62.
57. See id. at 621-23; see also infra notes 400-02, 405-13 and accompanying text (describing UNESCO's current supervisory procedures).
58. See Samson, supra note 304, at 620, 621-23.
59. In the field of human rights, the focus of the international community has shifted from standard setting to ensuring respect for established human rights. The emphasis on implementation of human rights is reflected in the Vienna Declaration and Programme of Action produced at the 1993 World Conference for Human Rights. See Vienna Declaration, supra note 135; see also Zdzislaw Kedzia, The Vienna World Conference on Human Rights: Failure or Milestone in Human Rights History, VIII INT'L GENEVA YEARBOOK 51, 58-59 (1994). In the field of environmental law, mechanisms to promote implementation are extensively examined in ENGAGING COUNTRIES: STRENGTHENING COMPLIANCE WITH INTERNATIONAL ENVIRONMENTAL ACCORDS (Edith Brown Weiss & Harold K. Jacobson eds., 1999).
60. In the field of human rights, the focus of the international community has shifted from standard setting to ensuring respect for established human rights. The emphasis on implementation of human rights is reflected in the Vienna Declaration and Programme of Action produced at the 1993 World Conference for Human Rights. See Vienna Declaration, supra note 135; see also Zdzislaw Kedzia, The Vienna World Conference on Human Rights: Failure or Milestone in Human Rights History, VIII INT'L GENEVA YEARBOOK 51, 58-59 (1994). In the field of environmental law, mechanisms to promote implementation are extensively examined in ENGAGING COUNTRIES: STRENGTHENING COMPLIANCE WITH INTERNATIONAL ENVIRONMENTAL ACCORDS (Edith Brown Weiss & Harold K. Jacobson eds., 1999).
61. The temporal dimension of international law implementation further complicates the assessment of monitoring procedures. See Abraham Chayes & Antonia Handler Chayes, On Compliance 47 INT'L ORG. 175, 184 (1993). Regulatory regimes characteristically seek to manage major international problems, and the significant changes in economic or social systems required by these instruments take time to accomplish. See id. at 195. In other words, because state behavior may be deeply embedded in social and political practices, efforts to change national behavior must operate over a period of time. Consequently, there may be a significant time lag between international regulation and national compliance. Further, many regimes contain long-term regulatory strategies that are designed to initiate a process that leads to changes in state behavior and the behavior of nonstate actors over time. Examples of such strategies include the convention-protocol strategy adopted in a number of environmental and other treaties, and the dynamic legislate strategy embraced by many international organizations of moving from nonbinding to binding instruments. See id. at 196; Taylor, An International Regulatory Strategy, supra note 94, at 283-98.
62. The temporal dimension of international law implementation further complicates the assessment of monitoring procedures. See Abraham Chayes & Antonia Handler Chayes, On Compliance 47 INT'L ORG. 175, 184 (1993). Regulatory regimes characteristically seek to manage major international problems, and the significant changes in economic or social systems required by these instruments take time to accomplish. See id. at 195. In other words, because state behavior may be deeply embedded in social and political practices, efforts to change national behavior must operate over a period of time. Consequently, there may be a significant time lag between international regulation and national compliance. Further, many regimes contain long-term regulatory strategies that are designed to initiate a process that leads to changes in state behavior and the behavior of nonstate actors over time. Examples of such strategies include the convention-protocol strategy adopted in a number of environmental and other treaties, and the dynamic legislate strategy embraced by many international organizations of moving from nonbinding to binding instruments. See id. at 196; Taylor, An International Regulatory Strategy, supra note 94, at 283-98.
63. The temporal dimension of international law implementation further complicates the assessment of monitoring procedures. See Abraham Chayes & Antonia Handler Chayes, On Compliance 47 INT'L ORG. 175, 184 (1993). Regulatory regimes characteristically seek to manage major international problems, and the significant changes in economic or social systems required by these instruments take time to accomplish. See id. at 195. In other words, because state behavior may be deeply embedded in social and political practices, efforts to change national behavior must operate over a period of time. Consequently, there may be a significant time lag between international regulation and national compliance. Further, many regimes contain long-term regulatory strategies that are designed to initiate a process that leads to changes in state behavior and the behavior of nonstate actors over time. Examples of such strategies include the convention-protocol strategy adopted in a number of environmental and other treaties, and the dynamic legislate strategy embraced by many international organizations of moving from nonbinding to binding instruments. See id. at 196; Taylor, An International Regulatory Strategy, supra note 94, at 283-98.
64. See Theodor Meron, Reform of Law-Making the UN: The Human Rights Instance, 79 AM. J. INT'L L. 664, 674-75, 677-79 (1985).
65. Despite the limitations of supervisory systems for human rights, "[one] has [to] permanently . . . keep in mind how revolutionary such . . . [supervisory systems] must appear contrasted with the pre-1945 structures and processes of international law." Simma, supra note 310, at 266; see also HENKIN, supra note 281, at 228-39 (analyzing development of human rights law); HENKIN, supra note 98, at 1-19; van Boven, supra note 312, at 3. In the realm of human rights, the development of supervisory procedures and other international measures "exposes to foreign scrutiny, criticisms and even more tangible reactions a realm which has traditionally shielded against such influences like no other aspect of sovereignty." Simma, supra note 310, at 267.
66. See PATRICIA W. BIRNIE & ALAN E. BOYLE, INTERNATIONAL LAW AND THE ENVIRONMENT 162 (1992).
67. Id.
68. See van Boven, supra note 304, at 37.
69. See Rachel Brett, The Contributions of NGOs to the Monitoring and Protection of Human Rights in Europe: An Analysis of the Role and Access of NGOs to the Inter-Governmental Organisations, in MONITORING HUMAN RIGHTS IN EUROPE: COMPARING INTERNATIONAL PROCEDURES AND MECHANISMS, at 121, 121-22 (Arie Bloed et al. eds., 1993) [hereinafter MONITORING HUMAN RIGHTS IN EUROPE].
70. See generally Sohn, supra note 293 (listing the implementation procedures used by member states of the UN and its agencies).
71. See Vojin Dimitrijevic, The Monitoring of Human Rights and the Prevention of Human Rights Violations Through Reporting Procedures, in MONITORING HUMAN RIGHTS IN EUROPE, supra note 325, at 1, 6-7.
72. See Laurie Wiseberg, Human Rights Information and Documentation, in MANUAL ON HUMAN RIGHTS REPORTING, supra note 317, at 29, 29.
73. See Pocar & Bernard, supra note 330, at 25.
74. See PETER M. HAAS, INTERNATIONAL ENVIRONMENTAL ISSUES 39 (1991) (describing the influence of publication of scientific information in developing consensus for the Montreal Protocol).
75. See Sand, supra note 358, at 233 (describing the effectiveness of publicizing national compliance with United Nations Environmental Programme (UNEP)-sponsored treaties).
76. See Chayes & Chayes, supra note 309, at 10.
77. See id. 10-17.
78. See Barbara B. Crane, International Population Institutions: Adaptations to a Changing World Order, in INSTITUTIONS FOR THE EARTH: SOURCES OF EFFECTIVE ENVIRONMENTAL PROTECTION 351, 390-92 (Peter M. Haas et al. eds., 1993) [hereinafter INSTITUTIONS FOR THE EARTH].
79. The issue of capacity may arise any time a treaty establishes an affirmative commitment. Supervisory procedures and technical and financial assistance, among other things, can effectively "merge in the process of jawboning - an effort to persuade" states in violation of international commitments to change their ways. Chayes & Chayes, supra note 309, at 204.
80. See Marc A. Levy et al., Improving the Effectiveness of International Environmental Institutions, in INSTITUTIONS FOR THE EARTH, supra note 451, at 397, 414-15.
81. See Chayes & Chayes, supra note 309, at 197-201.
82. Alternative types of procedures should be established if the failure to meet reporting obligations reflects the absence of political will. The submission of timely and complete reports by states is clearly central to the integrity of the reporting process. Procedures can be established to empower the monitoring body to request additional information from governments to supplement incomplete reports or to follow up on questions raised by the supervisory committee. See Dimitrijevic, supra note 327, at 14-15 (discussing the ability of states to comply with reporting obligations).
83. See Chayes & Chayes, supra note 309, at 198.
84. See Cecil Bernard, The Preparation and Drafting of a National Report, in MANUAL ON HUMAN RIGHTS REPORTING, supra note 317, at 17, 19-20.
85. The UN High Commissioner for Human Rights has encouraged countries to establish independent bioethics committees. See Human Rights and Bioethics, supra note 256.