In 1978 a small group of editors of general medicine journals met informally in Vancouver, British Columbia, to establish guidelines for manuscripts submitted to their journals. The resulting “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” was published in 1979 and has become the standard editorial policy guiding the medical literature.

At a large bioethics conference in the early 1990s, the International Bioethics Institute presented a panel discussion on the newly-hot issue of “medical futility.” Erudite experts held forth from various perspectives, with convincing if conflicting arguments. During the question-and-answer session that followed, however, one attendee gently offered the one remark most recalled from that session. He was, if memory serves, a Latino physician working near the Mexico/USA border. “Thank you for your presentations,” he said, apparently with great sincerity. “I learned a lot. But on behalf of my own patients, I would ask that before you give them the right to say ‘no’ to medical treatment, we first give them the option of saying ‘yes’.”

Three of the bioethical issues recently discussed in Sweden appear to be particularly interesting also to an international audience. A new law allowing restrictive use of preimplantation genetic diagnosis (PGD)/human leukocyte antigen (HLA) (“savior siblings”) has been implemented, a new recommendation for the cessation of life-sustaining treatment has been issued, and the scope of individual responsibility for medical mistakes has been rather thoroughly discussed.

Today Asia is attracting attention in the area of bioethics. In fact, the potential of bioethics is beginning to be discussed seriously at academic centers across Asia. In Japan, this discussion began a decade ago with the publication “Japanese and Western Bioethics.” The book is one of the principal explorations of biomedical ethics involving Japan to date. Tom Beauchamp, an author of one of the book's chapters, compares Japanese and American standards of informed consent and refutes relativistic positions, concluding that:

Informed consent is a perennial topic in bioethics. It has given the field a place in clinical practice and the law and is often the starting point for introductory instruction in medical ethics. One would think that nearly everything has been said and done on this well-worn topic.

Healthcare systems in Singapore, Hong Kong, and mainland China are strikingly distinct from those in the West. Economically speaking, each of the aforementioned Eastern systems relies in great measure on private expenditures supplemented by savings accounts. Western nations, on the other hand, typically exhibit government funding and wariness about healthcare savings accounts. This essay argues that these and other differences between Pacific Rim healthcare systems and Western systems should be assessed in light of background Confucian commitments operating in the former. In the Confucian context, bioethics and healthcare policy have a unique content, texture, and set of implications that often affront Western assumptions about the appropriate individual autonomy of patients and the appropriate character of social safety nets for healthcare.

We report here on recent developments in Israel on the issue of sex selection for nonmedical reasons by preimplantation genetic diagnosis (PGD). Sex selection for medical reasons (such as in cases of sex-linked genetic diseases) is generally viewed as uncontroversial and legal in European and American law. Its use for nonmedical reasons (like “balancing” the gender ratio in a family) is generally illegal in European countries. In the United States, it is not illegal, although in the opinion of the Ethics Committee of the American Society for Reproductive Medicine (ASRM), it is problematic. This position is undergoing reconsideration, albeit in a limited way.

In this article we highlight the main points of the development of bioethics and ethics committees in France. We argue that the French cultural context of medicine and its current political transformations favor new models of hospital ethics committee and we provide an example of such a model developed at Paris's Institut Curie, the oldest French cancer treatment and research centre.

There are not many international consensuses in the governance of biomedicine. One that exists concerns a general reluctance toward a commercialization of organ procurement. However, with reference to the problem of “organ scarcity,” there is an increasingly louder call in ethical and legal discourse to “give urgent consideration to any option that may make up the shortfall,” and to establish a debate on financial incentives “without any taboos.” Other ethicists and jurists criticize this development, and warn of injustice, exploitation of the poor, and a commodification of the human body.

These CQ Sources were compiled by Bette Anton.

“Dissecting Bioethics,” edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated.

The themes covered in the section so far include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration.

All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala at [email protected].

In a recent set of papers, Aaron Spital has proposed conscription or routine recovery of cadaveric organs without consent as a way of ameliorating the severe shortage of organs for transplantation. Under the existing consent requirement, organs can be taken from the bodies of the deceased if they expressed a wish and intention to donate while alive. Organs may also be taken when families or other substitute decisionmakers decide on behalf of the deceased to allow organ procurement for the purpose of transplantation. When patients or families do not consent to organ procurement, many transplantable organs are lost. This is a tragic yet avoidable situation. The dead are beyond any benefit or harm, and their organs could be used to prevent harm by saving and improving the lives of many people suffering and dying from end-stage organ failure.

Walter Glannon argues that our proposal for routine recovery (also known as conscription) of transplantable cadaveric organs is unacceptable “even if the consequence of [continuing to require consent] would be fewer organs for transplantation and fewer lives saved.” After carefully reviewing his counterarguments, we conclude that, although some of them have merit, none are sufficiently strong to warrant abandoning this plan. Below we respond to each of Glannon's concerns.

This section is meant to be a mutual effort. If you find an article you think should be abstracted in this section, do not be bashful—submit it for consideration to feature editor Kenneth V. Iserson care of CQ. If you do not like the editorial comments, this will give you an opportunity to respond in the letters section. Your input is desired and anticipated.