Justice catching up with the real world order

Hastings Center Report

Volumn 33, Issue 5, 2003, Pages 34-44

  Cahill, Lisa Sowle ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANTI HUMAN IMMUNODEFICIENCY VIRUS AGENT;

ACQUIRED IMMUNE DEFICIENCY SYNDROME; ARTICLE; BIOETHICS; BIOETHICS AND PROFESSIONAL ETHICS; BIOMEDICAL AND BEHAVIORAL RESEARCH; BIOTECHNOLOGY; ETHICS; FREEDOM; GENETICS AND REPRODUCTION; GENOME; HUMAN; POLICY; RESEARCH; SOCIAL JUSTICE; SOUTH AFRICA; UNITED STATES;

BIOETHICS AND PROFESSIONAL ETHICS; BIOMEDICAL AND BEHAVIORAL RESEARCH; GENETICS AND REPRODUCTION;

ACQUIRED IMMUNODEFICIENCY SYNDROME; ANTI-HIV AGENTS; BIOETHICAL ISSUES; BIOTECHNOLOGY; FREEDOM; GENOME, HUMAN; HUMANS; PUBLIC POLICY; RESEARCH; SOCIAL JUSTICE; SOUTH AFRICA; UNITED STATES;

EID: 1542468785     PISSN: 00930334     EISSN: None     Source Type: Journal    
DOI: 10.2307/3528634     Document Type: Review

References (76)

1. F. Fukuyama, Our Posthuman Future: Consequences of the Biotechnology Revolution (New York: Farrar, Straus and Giroux, 2002).
2. L.C. Chen and G. Berlinguer, "Health Equity in a Globalizing World," in Challenging Inequities in Health: From Ethics to Action, ed. T. Evans et al. (Oxford: Oxford University Press, 2001), 35-44;
3. H. Epstein, "Time of Indifference," New York Review of Books, 12 April 2001: 33-38;
4. and J.K. Gal-braith, "A Perfect Crime: Global Inequality," Daedalus (Winter 2000): 11-25.
5. See F. Peter and T. Evans, "Ethical Dimensions of Health Equity," in Challenging Health Inequities, op. cit., 25-33.
6. S.D. Lane et al., "Towards a Public Health Approach to Bioethics," in Ethics and Anthropology: Facing Future Issues in Human Biology, Glohalism, and Cultural Property, Annals of the New York Academy of Sciences, ed. A. Cantwell, E. Friedlander and E.L. Tramm Volume 925 (New York: The New York Academy of Sciences, 2000), 26. Lane et al. illustrate this point with a long list of individual-oriented topics addressed in recent issues of the Hastings Center Report.
7. See T.F. Murphy and M.A. Lappe, eds., Justice and the Human Genome Project (Berkeley: University of California Press, 1994);
8. T. Peters, ed., Genetics: Issues of Social Justice (Cleveland: Pilgrim Press, 1998);
9. and A. Buchanan, D.W. Brock, N. Daniels, and D. Wilder, From Chance to Choice: Genetics and Justice (Cambridge and New York: Cambridge University Press, 2000).
10. F.S. Collins and V.A. McKusick, "Implications of the Human Genome Project for Medical Science," Journal of the American Medical Association 285 (2001): 540-44.
11. HUGO Ethics Committee, "Statement on Benefit-Sharing," 9 April 2000, at http://www.gene.ucl.ac.uk/hugo/benefit.html.
12. On the so-called erosion of national sovereignty, see for example R. Keohane and J. Nye, eds., Transnational Relations and World Politics (Cambridge: Harvard University Press, 1971);
13. S. Tarrow, Power in Movement: Social Movements and Contentious Politics, rev. ed. (Cambridge: Cambridge University Press, 1998);
14. M.E. Keck and K. Sikkink, Activists beyond Borders: Advocacy Networks in International Politics (Ithaca, N.Y.: Cornell University Press, 1998); and a focus section tided "Bridging the Globalization Gap" in Foreign Affairs 80 (2001).
15. B. Crossette, "Kofi Annan: An Idealist Who Took the Heat, Shook Up the U.N. and Keeps Top Post," New York Times International, 29 June 2001, A8.
16. The groundbreaking work of R.O. Keohane and J.S. Nye, Power and Interdependence: World Politics in Transition (Boston and Toronto: Little, Brown and Company, 1977) has been followed by innumerable analyses of the "post-West-phalian" era, including, as a recent example, R. Falk, Law in an Emerging Global Village: a Post-Westphalian Perspective (Ardsley, N.Y.: Transnational Publishers, Inc., 1998).
17. Fukuyama, Our Posthuman Future, 92-97.
18. B.M. Knoppers, M. Hirde, and K. Cranley Glass, "Commercialization of Ge-netic Research and Public Policy," Science 286 (1999): 2277-78.
19. See Keohane, Transnational Relations and World Politics; Tarrow, Power in Movement: Social Movements and Contentious Politics; Nye, Power and Interdependence: World Politics in Transition; Falk, Law in an Emerging Global Village: a Post-Westphalian Perspective.
20. One much discussed example is the conduct of AZT trials in Africa to prevent vertical mother-to-child HIV transmission. See R. Macklin, "After Helsinki: Unresolved Issues in International Research," Kennedy Institute of Ethics Journal 11, no. 1 (2001): 17-36;
21. C. Fluehr-Lobban, "Globalization of Research and International Standards of Ethics in Anthropology," in Ethics and Anthropology, 37-44;
22. and J.P. Kahn, A.C. Mas-troianni, and J. Sugarman, Beyond Consent: Seeking Justice in Research (New York and Oxford: Oxford University Press, 1998).
23. World Medical Association, Declaration of Helsinki (2000): Ethical Principles for Medical Research involving Human Subjects, Bulletin of Medical Ethics 162 (2000): 8-11;
24. National Bioethics Advisory Commission (2001) Ethical and Policy Issues in International Research: Clinical Trials in Developing Countries (Bethesda, Md.: National Bioethics Advisory Commission, 2001);
25. Council for International Organizations of Medical Science (CIOMS) in collaboration with the World Health Organization (WHO), International Ethical Guidelines for Biomedical Research involving Human Subjects (Geneva: CIOMS, 2002). These documents are available at the websites of the sponsoring institutions: www.wma.net,www.cioms.ch,www.bioethics.org.
26. See www.wma.net.
27. Ethical and Policy Issues in International Research, 7.
28. Ibid., 22.
29. Ibid., 14.
30. "International Ethical Guidelines," 3.
31. Ibid., 4-5.
32. Ibid., 11.
33. The Council for Scientific and Industrial Research, establish by the South African Parliament in 1945, has as its mission to promote scientific research and development. Publicity for its December 2002 conference on "Health Care and Food: Challenges of Intellectual Property Rights, Biosafety and Bioethics" can be found on the website www.nistads.res.in.
34. J. Gray, False Dawn: The Delusions of Global Capitalism (New York: The New Press, 1998): 234.
35. "Unresolved Issues," 34.
36. J.S. Nye, Jr., "Globalizations Democratic Deficit: How to Make International Institutions More Accountable," Foreign Affairs 80, no. 4 (July/August 2001) 2.
37. Ibid., 3.
38. R. Falk, Predatory Globalization: A Critique (Cambridge and Oxford UK, Maiden, Mass.: Polity Press, 1999), 59-60;
39. On Humane Global Governance: Toward a New Global Politics, the World Order Models Project Report of the Global Civilization Initiative (University Park, Penn.: The Pennsylvania State University Press, 1995) 14.
40. See also Law in an Emerging Global Village, 3-31.
41. Falk, Law in an Emerging Global Village., 219.
42. Ibid, 119-20.
43. R. Falk, "Toward Global Parliament," Foreign Affairs 80, no. 1 (2001): 214. See also Predatory Globalization, 138-39;
44. and P. Wapner, "The Normative Promise of Non-state Actors: A Theoretical Account of Global Civil Society," in P. Wapner and Lester Edwin J. Ruiz, eds., Principled World Politics: The Challenge of International Relations (Lanham/Boulder/New York/Oxford: Rowman and Littlefield Publishers, Inc., 2000), 261-74.
45. Keck and Sikkink, Activism Beyond Borders, 217.
46. M. Whitehead, G. Dahlgren, and L. Gilson, "Developing the Policy Response to Inequities in Health: A Global Perspective," in Challenging Inequities in Health, 322.
47. Wallach and Sforza, 121.
48. For a history and a discussion of recent issues in the evolution of patent law, see a special issue of Daedalus (Spring 2002) on intellectual property, especially R.S. Eisenberg and R.S. Nelson, "Public vs. Proprietary Science," 89-101.
49. D.G. McNeil, Jr., "Indian Company Offers to Supply AIDS Drugs at Low Cost in Africa," New York Times, 7 February 2001, A10.
50. D.G. McNeil, Jr. "Oxfam Campaign to Cut Drug Prices for Poor Nations," New York Times, 13 February 2001, A5.
51. H.E. Cauvin, "Trial in AIDS Drug Lawsuit Opens in Pretoria," New York Times 6 March 2001, A8.
52. T. Rosenberg, "Look at Brazil," New York Times Magazine, 28 January 2001, 26-26-31, 52, 58-60.
53. In addition to the documents mentioned in the next paragraph, the United Nations and affiliates published other supportive position papers, including an April 2001 resolution (#2001/33) of the UN Commission on Human Rights," Access to medication in the context of pandemics such as HIV/AIDS," followed by a January 2002 Report of the Secretary General with the same title(www.unhchr.ch/Huridocda);
54. a January 2000 document of UNAIDS and WHO, "Patent situation of HIV/AIDS-re-lated drugs in 80 countries" (www.unaids.org/publications );
55. a May 2000 UNAIDS "Report of the Meeting on the Evaluation of the UNAIDS HIV Drug Access Initiative (www.unaids.org/publica-tions); and an October 2001 report of the United Nations Development Program, "Corporate Strategy on HIV/AIDS" (www.undp.org).
56. The proposal, "Consensus Statement on Antiretroviral Treatment for AIDS in Poor Countries," and a 10 February 2001 New York Times op-ed piece on the topic may be found at the website of Harvard Center for International Development, http://www.cid.harvard.edu/cidinthe-news/pr/PR- 040401.html.
57. See www.un.org/ga/aids/coverage/Final DeclarationHIVAIDS.html.
58. Editorial, "Neglected Diseases," America (20 May 2002), 3.
59. Consult the website of Physicians for Human Rights, www.phrusa.org/cam- paign/aids.
60. On participation, see A. Gutman and D. Thompson, Democracy and Disagreement (Cambridge: Harvard University Press, 1996);
61. A. Etzioni, The New Golden Rule: Community and Morality in a Democratic Society (New York: HarperCollins, 1996): especially 97-118, 217-49;
62. and, for concrete applications in bioethics, R.A. Zilinskas and P.J. Balint, eds., The Human Genome Project and Minority Communities: Ethical, Social and Political Dilemmas (Westport, Conn.: Ptaeger, 2001);
63. and L. Eckenwiler, "Moral Reasoning and the Review of Research Involving Human Subjects," Kennedy Institute of Ethics Journal 11, no. 1 (2001): 37-70.
64. Declaration on the TRIPS Agreement and Public Health, at www.wto.org/engl/thewto-e/minist-e/min01-e/minde-cl-trips-e.htm. See also D. Barnard, "In the High Court of South Africa, Case No. 4138/98: The Global Politics of Access to Low-Cost AIDS Drugs in Poor Countries," Kennedy Institute of Ethics Journal 12, no. 2 (2002:) 159-74.
65. See C. Trojan, "The Developing Countries Came of Age in Doha," European Affairs 3, no. 1 (2002): 35-40.
66. "Caribbeans to Buy AIDS Drugs at Discounts," New York Times International, 7 July 2002, 4.
67. Reported 26 August 2002, on the Doctors Without Borders website, www.msf.org/countries.
68. M. Petersen and D.G. McNeil, "Maker Yielding Patent in Africa for AIDS Drug," New York Times, 15 March 2001.
69. R.F. Drinan, S.J., The Mobilization of Shame: A World View of Human Rights (New Haven and London: Yale University Press, 2001): 94.
70. S. Kanter, "GlaxoSmithKline Profits Up on Growth in U.S. Drug Sales," New York Times, 25 July 2001.
71. A proposal to support both the formation of citizen councils that would make recommendations to higher-level bodies, and organization by NGOs, as two forms of "global governance," is F. Fukuyama and C.S. Wagner, Information and Biological Revolutions: Global Governance Challenges-Summary of a Study Group (Santa Monica and Washington, D.C.: RAND, 2000).
72. Fukuyama, in Our Posthuman Future (182), proposes that nations should develop better regulation of biotechnology, then extend regulations to the international level by means of national and international regulatory agencies. More recenrly, Anne-Marie Slaughter has detailed "the quiet emergence of an informal global system of governance comprising networks of regulators around rhe world," a system that has parallels in judiciaries and legislatures around the world ("Everyday Global Governance," Daedalus [Winter 2003] 83). These networks develop collaboration based on "positive comity" and "soft power," and, according to Slaughter, "open new institutional horizons for the possibility of global justice" (89).
73. Six NGOs sent a letter to the WTO's TRIPS Council, urging that regulations governing the export of medicines be reinterpreted at Doha (see "NGO Letter on Compulsory Licensing and Exports," at the Consumer Project on Technology website, www.cptech.org/ip/health/art30exports.html).
74. For example, Doctors Without Borders, working with researchers in many counrries, is sponsoring a pilot project in which new drugs will be developed for the diseases of the poor, then sold to poor nations at cost ("The Plagues of Poverty," Editorial, New York Times, 19 March 2002). Information about this project, called the Drugs for Neglected Diseases Initiative, is available at the Doctors Without Borders website, www.accessmed-msf.org/dndi. In December 2002, the Biotechnology Industry Organization and the Bill and Melinda Gates Foundation sponsored a "Partnering for Global Health Forum" in Washington, D.C., that brought together 400 people "interested in finding biotechnology-based solutions for malaria, tuberculosis (TB), typhoid, leishmaniasis, sleeping sickness, cholera, dengue fever, river blindness, AIDS, and other diseases" (Vicki Brower, "Finding Biomedicines for Infectious Disease: Forum Addresses Biotherapeutics for Nations in the Developing World," Genetic Engineering News 23, no. 2 [15 January 2003] 1/ www.genengnews.com).
75. P. Piot, "Speech to the 58th Session of the United Nations Commission on Human Rights," 3 April 2002 (www.un-aids.org).
76. In his presidential address to the American Political Science Association, 2000, R.O. Keohane argues that liberal and democratic institutions should foster persuasion by influencing values and beliefs ("Governance in a Partially Globalized World," American Political Science Review 95, no. 1 (March 2001): 1-13. The International Labor Organization has achieved its success largely by influencing the "framework" of national discourses about social welfare (D. Strang and P. Mei Yin Chang, "The International Labor Organization and the Welfare State: Institutional Effects on National Welfare Spending, 1960-80," International Organization 47, no. 2 [Spring 1993]: 235-262).