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Abstract

The establishment of international ethics committees started in the 1980s in Europe, along with the expansion of bioethics and in the wake of its institutionalization process. They maintain the characteristics of ethics committees, that is, multidisciplinarity, pluralism, independence, and an advisory function; speciﬁcally, they contribute to international cooperation and to the implementation of the fourth generation of human rights worldwide.

This research paper reviews the main international ethics committees, their origin and mission, the role they play, and their main accomplishments. It underlines the most important common goals to all of them, that is, the establishment of the best practices in the ﬁeld of bioethics, to be identically implemented in a growing number of countries. At the bioethical level, this is a major contribution to its validity and credibility; at the same time, it has implications at the legal level, in what concerns international law; and both levels depend on political decisions. One important challenge that stands up in the context of international ethics committees is the relation between bioethics, biolaw, and biopolitics, seeking to prevent that overwhelming legal norms suppress ethical reﬂection and instead guarantee each one’s complementarity.

Introduction

International ethics committees arise from the expansion of bioethics worldwide and come along the process of institutionalization of bioethics.

Although their scope is wider than that of other kinds of ethics committees, local or national, the characteristics that identify all ethics committees remain, that is, multidisciplinarity, pluralism, independence on their constitution, and their advisory nature. “Multidisciplinarity” refers to the different academic backgrounds and professional expertise of the members who integrate an ethics committee. It is particularly important that humanities and science scholars both have a seat on these committees, which should speciﬁcally include academics on ethics, knowledgeable in bioethics. Likewise, it is important that among the science scholars, there are experts in the main sciences that will most probably be called to that committee’s ethical debates.

“Pluralism” refers to the different convictions, either religious, ideological, or others, represented in the committee, which should correspond roughly to the heterogeneity of the society it addresses. It is worth underlining that local and national ethics committees in some parts of the world, mainly Asia, tend to include representatives of the different religions; on the other hand, the western world tends to guarantee the secularity of the ethical debate. This different orientation can have an impact on the constitution of international ethics committees.

Ethics committees are also independent, that is, their members do not represent institutions, professional orders, or groups of interest, although they can be designated by them. This requirement is of paramount importance to guarantee an objective and free opinion of its members. However, some international ethics committees, such as intergovernmental, can be the exception since their members are frequently appointed by political forces that expect an alignment with the strongest ideological orientation of the current government. These are mainly advisory boards, that is, of a “consultative nature.” Broadly speaking, ethics committees do not have decisionary power, except research ethics committees whose decisions are legally binding. Ethics committees, in general, study the proposed issue, reﬂect upon it, and debate it, and at the end, they recommend a course of action by a written opinion. They do not have, by themselves, legal power.

Nevertheless, the work of national and international ethics committees is propaedeutic in what concerns legal initiatives. The ethics committee’s opinions sometimes constitute the right opportunity and a strong inﬂuence for the revision of an existing law or even for the basis for a new law. This is easier to achieve at the national level than at the international one where agreements are harder to achieve. International ethics committees contribute most frequently to build up wide consensus on core issues and shared concerns, promoting dialogue and the uniformization of best practices and encouraging international cooperation and solidarity.

When bioethics expands worldwide, clinical practices should tend to be the same all over the world to avoid, for example, medical tourism and the consequent discredit for bioethics; in what concerns biomedical research, the same rules of good practice should prevail internationally to avoid, among other hazards, the exploitation of the most vulnerable. Overall, international ethics committees, each one in its own way, can play a decisive role in the promotion of global justice and in the implementation of human rights worldwide.

The Institutionalization Of Bioethics

The history of bioethics is not yet a long one. The neologism “bioethics” was introduced in December 1970 by Van Rensselaer Potter and in July 1971 by Andre Hellegers. But its development ever since has been very intense, and the new ﬁeld grew exponentially throughout these last decades. Bioethics moved fast away from that time, in the 1970s, when Warren Reich was starting the organization of an Encyclopedia of Medical Ethics and wished to name it “of bioethics” but hesitated because he was afraid the word and the ﬁeld of “bioethics” would not prevail (Reich 1994). The publication of the Encyclopedia of Bioethics, 1978, was an important step to the formal recognition of bioethics as a new discipline; also the growing number of scholars, with different academic backgrounds and professional experience, dedicated to bioethics, and the increasing volume and diversiﬁcation of bibliography on the ﬁeld were very important for the consolidation of bioethics. But the most decisive step to the sound establishment of bioethics, ﬁrst in the United Sates and later in Europe and in the rest of the world, was its institutionalization.

The institutionalization of bioethics refers to the establishment of organizations dedicated to bioethics, bodies that can have a different structure, capacity, and mission but are all committed to the ethical questions raised by biotechnological progress. From a historical perspective, as the bioethical movement intensiﬁes and bioethics shapes itself as a transdisciplinary ﬁeld of theoretical–practical nature, its uniqueness is strengthened by its process of institutionalization. This process contributed not only to the rising number of different professionals who started to work on bioethics, and therefore to the increasing diversity of disciplines involved, but also to a professional specialization in bioethics. Through the institutionalization process, bioethics comes out of the conﬁned academic circles of discussion and launches itself into society, involving public opinion.

This process started at the local level and still mostly addressed to academics. The ﬁrst bioethical institutions were centers for reﬂection and study of bioethics issues: the Institute of Society, Ethics, and Life Sciences, widely known as The Hastings Center, was created in 1969, in New York, by the philosopher Daniel Callahan and the psychiatrist Willard Gaylin, and the Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics, most commonly known as The Kennedy Institute of Ethics, was created in 1971, in Washington DC, by the obstetrician Andre Hellegers. These reﬂection centers multiplied not only in the United States but also in Europe (the ﬁrst one was the Institut Borja de Bioética, created in 1976 in Barcelona by Francesc Abel) and in the main academic centers all over the world. These centers were the ﬁrst to promote free and pluridisciplinary debate on bioethical issues through teaching, debates, research, and publications. They contributed to the fast dissemination of bioethics among scholars and professionals and also within society and kept on being reference centers for further bioethical developments. Besides, these local forums were also important to promote in-depth reﬂection on the values of speciﬁc community, their history and culture, and the way these aspects inﬂuence bioethics and bioethics should respect them. These centers quickly became international, attracting scholars with different backgrounds and coming from different parts of the world, sharing the same concerns and searching for adequate solutions for their own communities.

At the local level, the institutionalization of bioethics proceeded by the foundation of ethics committees in hospitals, either for research or for clinical purposes, and later designated in the United States as Institutional Review Boards (IRBs) and Institutional Ethics Committees (IECs), respectively. The IRBs were legally enforced in 1974 by the US Congress in the aftermath of the Tuskegee case (400 African–Americans were left untreated for syphilis, after the discovery of penicillin, as subjects of a clinical research). However, the National Institute of Health had already proposed its creation in 1966, after the publication, in the same year, of Henry Beecher’s “Ethics and Clinical Research” (where the author exposed 22 clinical research projects of that time, involving humans who had not been given informed consent). IRBs evaluate all research projects enrolling human subjects, both scientiﬁcally, because bad science can never be morally acceptable, and ethically, to assure the free will and safety of all participants. A rejection from an IRB is legally binding.

The IECs were ﬁrst regulated in 1975 in the aftermath of the Karen Quinlan case (young woman who stayed in a persistent vegetative state for 11 years after a legal battle between her parents and the hospital for the right to die). Still, they were only implemented after 1983 and the Baby Doe case (a baby with Down syndrome who was born with an esophageal atresia and needed surgery to be fed and survive, which was refused by the parents, which led to the baby’s death), following the report, in the same year, of the President’s Commission for the Study of Ethical Problems in Biomedical and Behavioral Research. This report strongly recommended the creation of ethics committees to assist decision makers facing questions on the use of life sustaining interventions. IECs were created to assess difﬁcult concrete cases from an ethical perspective, to draw guidelines for current cases and especially for future ones, and to promote ethical education for healthcare professionals in order to act preventively (trying to avoid dilemmas before they happen) and help them to be more conﬁdent along the decision-making process.

Both IRBs and IECs are usually independent, multidisciplinary, and pluralist, and their institutionalization in local or regional healthcare institutions was fundamental for the recognition of the positive and most needed work of bioethics for healthcare professionals, researchers, and overall for patients and families, contributing decisively to their well-being and also to the improvement of the scientiﬁc and ethical soundness of clinical practice and research. Bioethics is not only recognized as a forum of pertinent debate but also a valuable way of action in speciﬁc ﬁelds of professional activity.

This movement for the establishment of research or clinical ethics committees in the main local healthcare institutions spread worldwide throughout the following decades, and it is worth mentioning that UNESCO’s Division of Ethics of Science and Technology encourages the institution of research ethics committees especially in less developed countries and helps them set up a national ethics committee if they wish to do so.

Indeed bioethical institutions spread from their local or regional establishment to a national level. The three kinds of ethical institutions mentioned so far follow the ﬁrst goal of the institutionalization of bioethics: to think and act locally on what concerns the application of biotechnologies to individuals and communities in order to take the maximum advantage of progress without affecting what is essential to each and all human beings. Nevertheless, a second goal affected the direction of the institutionalization process: to decide and intervene globally in what concerns the ends and the procedures of biotechnological progress.

The ﬁrst ethics committee of national dimension was founded, once more in the United States, in 1974. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was an ad hoc body, that is, created with a well-deﬁned and speciﬁc mission in what concerns goals and time frame. It was constituted to reﬂect on the basic and most important ethical principles to be respected in clinical research with human participants. In 1978, this National Commission published the Belmont Report, Ethical Principles and Guidelines for the Protection of Human Subjects of Research, and once its mission was accomplished, it was dissolved.

The second ad hoc national ethics committee was the Warnock Committee, founded in the United Kingdom, in 1982, to inquire into the technologies of in vitro fertilization (IVF) and embryology in the aftermath of the birth of Louise Brown in 1978, the ﬁrst baby to be conceived in vitro. The committee published the Warnock Report in 1984 which, among other points, proposed the establishment of a regulatory authority with the remit of licensing the use of human embryos outside the human body in treatment, storage, and research, which would later become the Human Fertilization and Embryology Authority, a national regulatory agency. The Warnock Committee ended after accomplishing its mission.

The ﬁrst country in the world to create a permanent national ethics committee was France, in 1983, establishing the National Consultative Ethics Committee for Health and Life Sciences with the mission to identify the most important issues arising from developments in the life sciences, speciﬁcally in the ﬁelds of biology, medicine, and health, to give opinions on the ethical problems and societal issues involved and to submit them for society’s consideration. Many other European countries followed this initiative during the late 1980s and early 1990s, and this movement is still spreading worldwide. These national ethics committees are essential for the uniformization of best practices and therefore for the credibility of bioethics, as well as for a sound base for legal initiatives.

These same reasons, with a larger base and a more comprehensive aim, are also at the origin of the evolution of the institutionalization of bioethics into the foundation of international ethics committees.

International Ethics Committees: Constitution, Scope, And Achievements

International ethics committees are, indeed, more ambitious than the national ones in what concerns the goals they share, most essentially the reaching of common guidelines for practice that should become the same on an ever-growing number of countries. At the same time, they face speciﬁc problems such as the level of representativeness in what refers to their constitution, the selection and prioritization of issues to work on in what refers to their scope, and the consensus needed to propose whatever it can be.

In fact, international ethics committees tend to be quite large but never enough to gather representatives from all the countries belonging to the international institution where that ethics committee was founded. Besides, when certain countries designate a person to become a member regardless of the other choices, it is almost impossible to assure a balance in what concerns multidisciplinarity, pluralism, and also gender. The issues that take precedence and are subject of reﬂection and action correspond to the interest of the majority of members but are not necessarily those that are more urgent to regulate or have a stronger impact on society. At the same time, they might be chosen taking into consideration the consensus they will probably be able to generate.

At The Council Of Europe

The Council of Europe (CoE) was founded in 1949 to promote human rights in Europe at different levels and through different actions, namely, through the cooperation between member states in what concerns legal standards. Before becoming members of the CoE, all countries signed the European Convention on Human Rights, a treaty designed to protect human rights, democracy, and the rule of law. Today, the CoE includes 47 member states and is the continent’s leading human rights organization.

Within its action to develop and implement human rights and rule of law standards, the CoE was the ﬁrst international institution to acknowledge the need for an international body to address bioethical issues and to work on what would later be recognized as a fourth generation of human rights, those in the ﬁeld of biomedicine, biological rights, or rights related to the application of biology and medicine to human beings.

The Committee of Experts on Bioethics/ CAHBI was set up in 1985, under the direct authority of the Committee of Ministers, who wanted to intensify the work that had already started to be developed on the impact of the progress of biomedical sciences on human beings. The main concerns were to guarantee the person’s integrity and the respect for human dignity and also to draw common guidelines to all member states to deal with the new situations created by the rapid development of life sciences.

The CAHBI was pluridisciplinary, gathering lawyers, biologists, medical experts, ethicists, and human rights experts from member states and from nonmember states, as well as from different international institutions. It became responsible for the intergovernmental activities of the CoE in the ﬁeld of bioethics, also identifying the legal and political gaps produced by biotechnological advances in life sciences. Nevertheless, the CAHBI was an ad hoc committee until 1992, when it became permanent under the name of Steering Committee on Bioethics (CDBI).

The work of CAHBI, and then of the CDBI, has led to the preparation of the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (1997), the ﬁrst international treaty in this ﬁeld, and its protocols on Cloning (1998), Transplantation of Organs and Tissues of Human Origin (2002), Biomedical Research (2005), and Genetic Testing for Health Purposes (2008).

In 2012, following the reorganization of intergovernmental bodies at the CoE, the Committee on Bioethics/DH-BIO took over the responsibilities of the CDBI “for the tasks assigned by the Convention on Human Rights and Biomedicine as well as for the intergovernmental work on the protection of human rights in the ﬁeld of biomedicine” (http://www.coe.int/t/dg3/healthbioethic/cdbi/default_en.asp). The mission of the DH-BIO is speciﬁcally to “conduct regular re-examinations foreseen in the Convention and its Additional Protocols; develop further the principles laid down in the Convention on Human Rights and Biomedicine, as appropriate; contribute to raising awareness and facilitating the implementation of these principles; assess ethical and legal challenges raised by developments in the biomedical ﬁeld; co-operate with the European Union and relevant intergovernmental bodies, in particular with a view to promoting consistency between the normative texts” (http://www.coe.int/t/dg3/healthbioethic/cdbi/mandat%202014-2015% 20e.pdf).

The DH-BIO is composed of representatives of the member states (members with the right to vote) and participants and observers without right to vote (Parliamentary Assembly of the CoE, Consultative Committee of the Convention for the Protection of Individuals with regard to Automatic Processing of Personal Data/T-PD, Committee (Partial Agreement) on Transplantation of Organs and Tissues (CD-P-TO), and Committee (Partial Agreement) on Blood Transfusion (CD-P-TS); committees or other bodies of the CoE engaged in related work, as appropriate; and also representatives from the European Union, Observer States to the CoE: Canada, Holy See, Japan, Mexico, the United States, and other international organizations such as European Science Foundation (ESF), OECD, UNESCO, and WHO).

The most prominent achievement of the CoE’s ethics committee was the Convention on Human Rights and Biomedicine. Since then, the CoE developed the consensus reached on speciﬁc issues in the Convention, resulting in four additional protocols to the Convention. Further developments were also achieved in what concerns the protection of the human embryo and fetus (articles

14 and 18). But, although the consensus reached on the Convention was deepened, the diversity of opinions in many issues persisted, and it was not possible to draw a common approach. A report on the debate that took place within a Working Party designated to propose further protective provisions was published in 2003.

Pursuing its main goal of protecting the dignity and the human rights of persons with regard to the application of biology and medicine, the CDBI decided, in 2011, to include the elaboration of an additional protocol on human rights and psychiatry in its work program for 2013. On this matter, the CoE implemented a public consultation which was carried out on a white paper, and in 2004, a recommendation concerning the protection of human rights and dignity of persons with mental disorder was adopted. The protocol is under preparation.

Some other works are in progress, namely, about predictivity, genetic testing and insurance, medical treatment in end-of-life situations, and biobanks. In 2014, the major topic was the total ban on any form of trading in human organs. Studies about emerging technologies are also being carried on and are expected to be presented in 2015.

In sum, the international ethics committee of the CoE focuses on today’s major bioethical issues in its member states, identifying the most important situations of severe vulnerability in order to assure that the person’s dignity and human rights are respected in these extreme situations and that additional protection is offered with the same legal standard in all member states.

At The European Union

The European Union is run by several institutions of different natures and different competencies, namely: the Commission, the executive body, currently composed of a president and 27 commissioners in charge of different areas and designated by the members states; the Parliament, with 751 members from all the member states; and the Council, which gathers the ministers of all member states. These two bodies hold the EU’s legislative authority.

In 1991, the European Commission, under the presidency of Jacques Delors, created the Group of Advisors to the European Commission on the ethical implications of biotechnology/GAEIB to promote ethical discussions on the development of biotechnology and take into account the ethical reﬂection on the decision-making process for community research and technological development policies. It was quite a small ad hoc advisory body to the Commission, independent, pluralist, and multidisciplinary. Its 6 members at the time, just like the current 15, enjoyed total freedom of opinion, working independently and not as representatives of the member states, and were designated for their expertise and geographic distribution in an attempt to reﬂect the diversity in the European Union. This ethics committee is also independent from the Commission, advising it on the issues it is asked and others that it considers important enough to present an initiative and a nonbinding report.

The GAEIB was restructured into the European Group on Ethics in Science and New Technologies (EGE), in 1997, widening the remit of the Group to “Science and New Technologies,” instead of the original GAEIB’s more restrictive remit of “Modern Biotechnology.” New disciplines such as informatics were added, and the number of members increased, thus strengthening its role in the consideration of the ethical aspects of science and technology in all the activities of the European Commission and speciﬁcally in connection with community legislation and policies.

The mission of the EGE is “to identify and deﬁne the ethical issues raised by biotechnology; to assess, from the ethical viewpoint, the impact of the Community’s activities in the ﬁeld of biotechnology; to advise the Commission, in the exercise of its powers, on the ethical aspects of biotechnology and to ensure that the general public is kept properly informed.” (http://ec.europa.eu/bepa/european-group-ethics/archive-mandates/ mandate-1991-1997/index_en.htm).

The EGE works with the European Parliament and the Council, as well as with national ethics committees and nongovernmental organizations, and before approving an opinion, a round table is organized on the issue, to which are invited representatives of the Institutions of the European Union, experts in the ﬁelds, and parties representing different interests, including NGOs, patients, consumer organizations, and industrial stakeholders (http://ec.europa.eu/bepa/europeangroup-ethics/docs/genactrep05_en.pdf).

In sum, the international ethics committee of the European Commission focuses on a wide variety of bioethical issues, ranging from biomedicine to animal welfare and from agriculture to information and communication technologies, focusing not only on today’s problems but also on tomorrow’s concerns, following cutting-edge biotechnological advances and the European political agenda. So far, it has issued 28 opinions.

At The UNESCO

The United Nations was founded in 1945, integrating the majority of the countries of the world, with the mission to promote peace, security, and economic development worldwide. It is the most representative institution in the whole world, working through 6 principal organs, 15 agencies, and several programs and bodies. UNESCO, the United Nations Educational, Scientiﬁc, and Cultural Organization, is one of its most prominent agencies and has been nonsystematically and formally involved in the ﬁeld of bioethics since the 1970s. Nevertheless, it was only later that it ofﬁcially created two ethics committees: the International Bioethics Committee (IBC), in 1993, and the Intergovernmental Bioethics Committee (IGBC), in 1998.

The International Bioethics Committee (IBC) is composed of 36 independent experts, who meet at least once a year, and its mission is “to promote reﬂection on the ethical and legal issues raised by research in the life sciences and their applications; to encourage the exchange of ideas and information; to encourage action to heighten awareness among the general public, specialized groups and public and private decision-makers involved in bioethics; to co-operate with the international governmental and non-governmental organizations concerned by the issues raised in the ﬁeld of bioethics as well as with the national and regional bioethics committees and similar bodies; to contribute to the dissemination of the principles set out in the UNESCO Declarations in the ﬁeld of bioethics, and to the further examination of issues raised by their applications and by the evolution of the technologies in question.” (http://www.unesco. org/new/en/social-and-human-sciences/themes/bio ethics/international-bioethics-committee/). The Committee produces advices, recommendations, and reports on speciﬁc issues.

The Intergovernmental Bioethics Committee (IGBC) comprises 36 member state representatives who examine the advices and recommendations of the IBC, meeting at least once every 2 years. It “informs the IBC of its opinions and submits these opinions along with proposals for follow-up of the IBC’s work to UNESCO’s Director-General for transmission to Member States, the Executive Board and the General Conference.” Both ethics committees work together and submit their proposals to the UNESCO’s governing bodies.

UNESCO also established a World Commission on the Ethics of Scientiﬁc Knowledge and Technology (COMEST), an advisory body and forum of reﬂection set up in 1998. The 18 leading scholars from scientiﬁc, legal, philosophical, cultural, and political disciplines from various regions of the world are appointed by the UNESCO Director-General, along with 11 ex ofﬁcio members representing UNESCO’s international science programs and global science communities. The COMEST works in very different areas such as environmental ethics, the ethics of nanotechnologies, ethical issues relating to technologies of information, and gender issues in ethics of science and technology, formulating ethical principles as relevant criteria for policy decision-makers (http://www.unesco. org/new/en/social-and-human-sciences/themes/ comest/).

In sum, the international ethics committees of UNESCO are the most representative in the world. The consensuses they reach are the widest, and the programs they develop are the most inclusive and far reaching. UNESCO’s bioethics program has been focusing on four action areas: intellectual forum, standard-setting action, advisory role and capacity building, and education and awareness raising. The IBC and the IGBC focus especially on international policymakers’ advisory, and their most prominent achievements were the three Declarations on Human Genome and Human Rights (1997), on Human Genetic Data (2003), and on Bioethics and Human Rights (2005). Although they are not legally binding, their political strength is signiﬁcant.

(Global) Bioethics, Biolaw, And Biopolitics

The range of action of international ethics committees is not and cannot be limited to ethical reﬂection. Although, formally, they have a strictly ethical competence, they cannot ignore that the real impact, the efﬁciency of their work, lies on the legal translation of their ethical deliberations and on their political implementation.

International ethics committees are advisory boards, but due to their common mission to widely promote equally high standards of biomedical practices, they are also supposed to contribute to the writing of new regulations and laws for the ever new situations produced by the advances of biotechnologies and to inﬂuence decision-makers and politicians, to take the legislative initiatives needed or to support them and to put them into practice. International ethics committees play an important role not only at the ethical level, soundly grounding a global bioethics, but also at the legal and political level, leading to the birth and development of what has been referred to as biolaw and biopolitics.

At the ethical level, international ethics committees build up wide consensuses that overcome many geographic, political, and cultural frontiers, establishing an ethics of minimums in what truly constitutes a global bioethics. Indeed, bioethics is more global the more minimalist it is. In any case, international ethical deliberations and proposals always present themselves as advices, and their sole strength is drawn from representativeness and prestige of the body that issues them. They depend on goodwill. They lack legal force and sanctions for noncompliance, and therefore, there is no guaranty that ethical consensus will be implemented.

Bioethics requires biolaw. The latter does not simply refer to the application of existing laws to the ever emerging issues raised by biotechnologies, as it was done when the ﬁrst bioethical dilemmas appear. At the time, the association of law to bioethics became quite common, mostly in English-speaking countries. The term “biolaw” is more frequently used in Europe and elsewhere. But the difference between “law and bioethics” and “biolaw” is far from being simply geographic. Biolaw refers to the legal initiatives addressed to the totally new situations produced by the biotechnology’s progress and is issued from the bioethical consensus formerly reached. Biolaw converts the ethical consensus into legal dispositions. Nevertheless, and mostly at the international level, biolaw cannot be established, neither will it be ever implemented outside political agreement.

Bioethics requires biopolitics. Broadly, biopolitics refers to the public and also to the international policies regarding the applications of biotechnologies to human beings and societies in order to take the most advantage of them and duly prevent hazards. Speciﬁcally at the international level, biopolitics has been dedicated to avoiding exploitation of underdeveloped countries and vulnerable peoples and to upholding the claim for cooperation and solidarity of developed countries toward the others, sharing the beneﬁts of biotechnological advances. International ethics committees are the ﬁrst stakeholders to call the general attention to the new areas that arise and where international cooperation could be beneﬁcial for mankind, to identify the main ethical issues at stake and how to address them, formulating the ethical principles implicated, and to propose what ought to be done.

Bioethics does require for biolaw and biopolitics to reach its goals; biolaw has to ground on bioethics to avoid the violence inherent to a law that is not asked for by the majority and asks for the support of biopolitics; in its turn, biopolitics has to trust bioethics and its wide consensuses in order to work and also to contribute to biolaw. International ethics committees are at the core of this trilogy.

Conclusion

The establishment of international ethics committees was a consequence of the spreading of bioethics worldwide and, at the same time, a decisive step toward the development of a global bioethics. They have indeed contributed to the standardization of best practices at the three main domains where bioethics is involved – clinical, research, and public policies – and in the few issues on which consensuses were possible.

The small number of consensual issues and the lack of legally binding deliberations are the two main handicaps for the work of international ethics committees. Nevertheless, their very existence already constitutes a testimony of a wide and strong commitment toward a standardization of practices in the application of biotechnological progress to mankind. There is still much to be done, but a lot has also been achieved in few decades, both in what concerns a widening consensus in ethical deliberation and in what concerns legal and political standards of principles and practices.

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