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Abstract

Although the existence of a global ethics and bioethics is questioned, one can without a doubt show that the global community has accepted a universal ethics. A global religious “bioethics” was formulated in 1999 and it can be viewed as a precursor to the universal bioethics accepted by UNESCO in 2005.

Introduction

In his book Hope for a Global Ethic, Lepard (2011) contends that the religiously motivated 9/11 (2001) attack on America brought the question of a global ethics to the fore again, but he is of the opinion that it is at present only a possibility. Further to this, Nezhmetdinov (2013) is of the view that, although bioethics is a global phenomenon, there is still “a search for a uniﬁed human platform to solve the global problems.”

Ten Have and Gordijn (2014) offer another angle when they point out in an article on global bioethics that some scientists are of the opinion that the claim to a normative universality within the ﬁeld of bioethics (and religion) is unsubstantiated (also see Gracia 2014). It can at best be said that a Western bioethics was exported to the rest of the world, and it therefore constitutes no more than an imperialist imposition of ethical values on the global community. American bioethicists like Albert Jonsen and Dan Callahan argue that bioethics is an American product since it is an American invention and is intimately interlaced with the American ethos. Over the course of their reasoning, Ten Have and Gordijn refer to three articles that recently appeared in the book Bioethics Around the Globe (2014), in which scholars from both the developing and First World environments view universal bioethics as a “story of exportation” of Western values. In light of these perspectives, something like global bioethics cannot really exist and universal bioethics is merely an exportation of Western bioethics. In this sense bioethics in the rest of the world consist only of American values that are adapted to the idiosyncrasies of the non-American countries.

Academics that move and think within the abovementioned perspectives for the most part emphasize the enormous cultural diversity. Anthropologists heavily underline the cultural diversity of ethical norms, which inevitably comes down to ethical relativism, and they offer this as a reason why shared ethical values are impossible (Gracia 2014). Bioethics should always have a local origin and a local ﬁeld of application. A bioethics for South Africa can therefore only originally be applied in South Africa. Any form of ethical guidelines from outside the local social environment is invariably Western value imperialism that slights non-Western traditions and is consequently insulting and unwanted. On the other hand, the Western person ﬁnds global bioethics unnecessary and impossible (Ten Have and Gordijn 2014).

The problem statement of this entry can be conveyed by the following statement of Ten Have and Gordijn (2014):

Global bioethics in this perspective will primarily address different traditions, religions, and cultures, but is less interested in the question what they have in common.

The following questions arise from the above explanation: First, are global (religious) values and principles that are shared by all people a possibility or a reality? Second, is it possible to establish a global bioethics that is international and transcultural and that is not suspected of a Western ethos? Last, is there any direct or indirect relationship between global religious values and global bioethics (Gracia 2014; Ten Have and Gordijn 2014)?

These questions are not only of academic importance but have deﬁnite practical ramiﬁcations. If a global ethics can be identiﬁed, such a value system can serve as common ground for a peaceful approach to emerging political, economic, technological, and environmental problems. Then again, if the hope of a global ethics is a mere illusion, the chances of a peaceful solution to global problems are very slim. In a global world a global value system will enhance the hope for peace, while the absence of a shared ethics will result in a clash of civilizations.

Global Ethics And Religion

Introductory

In answer to the abovementioned problem statement, Gracia (2014), as well as Ten Have and Gordijn (2014), holds the view that the religions of the world have already shown that a global ethics is indeed possible. In a certain sense one can make the claim that the religions of the world indirectly helped prepare and create the spiritual climate for the establishment of a global bioethics. “Global ethics” implies a critical minimum of shared human values, criteria, and goodwill (Ten Have and Gordijn 2014). However, one should acknowledge that there are not only great differences between religions but also between forms of life, scientiﬁc views, economic systems, social models, and religious communities, all of which make complete ethical consensus impossible (Kung 1997).

The Questioning Of A Global Ethics

Many scientists are suspicious of universal ethical guidelines that promise to transcend cultural differences (Ten Have and Gordijn 2014). There are some people who deem ethical consensus between religions impossible, since there are just too many dogmatic differences and stumbling blocks to ﬁnd ethical consensus among religions. What is more, the experience is that good relations between religions are often blocked by every possible form of dogmatism. In view of the differences between religions, religious self-assertion, and fundamentalism, ethical consensus should be dismissed as a beautiful illusion (Kung 1997).

In his book, The Clash of Civilizations, the well-known political analyst, Samuel P. Huntington, offers the view that different cultures and religions cannot but be in conﬂict (Kung 1997). The various religious content and moral values of the different religions are in principle irreconcilable and can therefore only lead to continuous, violent confrontation (Gracia 2014; Kung 1997). The world-renowned ethicist, H. Tristram Engelhardt, Jr., is of the opinion that consensus is impossible in the postmodern world and that a global (bio)ethics is therefore unattainable. The question is asked if shared values between all people are, in reality, possible:

Anthropologists are aware of the diversity of moral norms in different cultural and religious traditions. They assume generally as a postulate the so-called “cultural relativism” also in the moral domain .. . Could it be possible, then, to formulate some universal moral principles? Are there some moral contents that can be called global? (Gracia 2014; Ten Have and Gordijn 2014)

The Possibility Of Global Ethics

The point of departure of this entry is that shared truth is not only a theoretical possibility but an irrefutable reality.

First, one can point out that shared values are not only a theoretical reality but a demonstrable anthropological phenomenon. Michael Walzer, professor of social sciences, points out that one can observe an element of universality during political conﬂict (Walzer 1994). His research indicates that people all over the world, regardless of the boundaries of nations, culture, and religion, spontaneously know what values and criteria are transgressed during conﬂict. Walzer remarks that it has become clear to him and others that during a conﬂict, an “easy friendliness and agreement” in connection with truth and justice is observable. A system like apartheid has shown that countless men and women worldwide, notwithstanding their nationality, culture, or religion, could spontaneously identify and show solidarity with people whom have been wronged. The reason for this is the fact that everyone could with easy friendliness agree on, for instance, the almost undeﬁned values of truth and justice. People who protest against this brutality do not do so based on any (religious) theory on justice but based on a common knowledge (some religious traditions describe this as natural law) that such actions are not right. People unite in spirit with protesters based on a shared, indeﬁnable value or some knowledge that something is right or wrong. When people do gather ofﬁcially, these shared values can be formulated as a “core morality” or elementary ethical standards and, in the abovementioned case, the pursuance of justice. This core principle (“thin morality”) is then founded and supplemented based on the different cultures and religious backgrounds (“thick morality”) (Kung 1997).

Second, shared values are also a historical reality. In 1983 a tradition was unofﬁcially born in Chicago, namely, the Parliament of the World’s Religions (PWR), where representatives of all religions and spiritual persuasions gathered in the persons of their leaders, scholars, theologians, and other interested persons to consider the place of faith and spirituality in the modern world together. This was the ﬁrst formal global gathering of the religions of the world, but unfortunately it was Eurocentric in nature and did not include the Tibetan Buddhists, Africans, and Native Americans (Gensler 2013).

In 1993 the abovementioned Parliament of the World’s Religions was reborn with a gathering of 8,000 representatives (approximately 200 leaders of approximately 40 different religious and spiritual traditions) from all over the world. During this gathering there was deliberation on the role of religious communities in solving the problems of the world. The assembly held the conviction that cooperation between diverse religious groups cannot take place other than within a context of shared values. The result was that the Council for a Parliament of the World’s Religions prepared a document, Towards a Global Ethic: An Initial Declaration (Global Ethic), and presented it to the representatives. In spite of the fact that several of the religious groups were involved in bloody wars at the time, the followers of different religions, large and small, East and West, as representatives of innumerable believers on Earth, made this historical declaration their own by ratifying it (PWR 1999).

All the religions of the world have shared values that can be described as follows: Humanity is a basic, ethical point of departure. Based on this point of departure, all the religions of the world accept two principles, namely, that every human being should be treated humanely and that you should do unto others what you wish for yourself (the familiar golden rule).

Based on the abovementioned values, the religions of the world formulated and accepted four irrevocable ethical guidelines that form part of a global religious ethic. The ﬁrst guideline is formulated negatively as “do not kill” and positively as “respect for life,” which implies a commitment to a culture of nonviolence and respect. Secondly, one may not steal and one should do business honestly and fairly, a principle that involves a culture of solidarity and a fair economical order. Thirdly, one may not lie, but should speak the truth and act honorably, which implies a culture of tolerance and a life of trustworthiness. Lastly, one may not commit any sexual immorality and people should respect and love each other, which means that there should be a culture of equal rights and partnership between men and women (Gracia 2014; Kung 1997; PWR 1999). The contention can be made that one could infer from the Global Ethic that the above ethical principles are meant to be used as possible guidelines for a global bioethics (PWR 1993):

A universal consensus on many disputed ethical questions (from bio and sexual ethics through mass media and scientiﬁc ethics to economic and political ethics) will be difﬁcult to attain. Nevertheless, even for many controversial questions, suitable solutions should be attainable in the spirit of the fundamental principles we have jointly developed here.

With reference to the above, the astonishing happened and the Parliament of the World’s Religions expanded Global Ethic to a “Global Bioethic.” In 1999 the Parliament of the World’s Religions met in South Africa. During this meeting the Council for a Parliament of the World’s Religions pleaded with urgency for continued reﬂection on the ethical responsibilities as they appear in the Global Ethic and a pursuit of a new mode or environment in which to apply the ethical principles. During this gathering the Parliament of the World’s Religions formulated a follow-up document, A Call to Our Guiding Institutions (Gracia 2014). The assembly was of the opinion that very strong institutions exert considerable inﬂuence on people and on the future and that institutions should therefore be called to evaluate their values, perspectives, and assumptions in light of the Global Ethic. The following institutions are called upon in the Call: religion and spirituality, government, agriculture-labor-industry-trade, education, work and communication, science and medicine, international intergovernmental institutions, and organizations of civil society.

The Call can be viewed as the application and expansion of the ethical guidelines found in the Global Ethic and are described in the document as an “expression of beliefs and convictions already deeply held – and held in common – by the world’s religious and spiritual communities” (PWR 1999). It is clear from the Call that the Parliament of the World’s Religions, representative of the totality of the religious world, is of the opinion that medicine and science without a doubt pose challenges to the global community and therefore want to offer a moral vision of a better world within bioethics. This vision is dealt with under the theme The Call to the Science & Medicine (PWR 1999). The document links ethics and human rights, while bioethical principles like autonomy, informed consent, beneﬁt, non-harm, respect for vulnerability, consideration of the future, protection of the environment, solidarity, social responsibility, health, and sharing privileges are presented as a moral vision (PWR 1999). For the sake of clarity, the document is quoted directly:

We envision a world in which … access to knowledge and to the healing arts is not a privilege but a right.
Researchers and teachers, physicians and engineers, physicists, chemists, and biologists should be committed to beneﬁting human life and reducing suffering.
The inﬂuence and power of science, medicine, and technology are now so enormous that scientists, physicians, and engineers bear an unprecedented responsibility for the future.
Not only their knowledge and technical skills, but also their conscientiousness and prudence are critical to what we make of ourselves and our world in the next decades.
Each is invited … to resist efforts at control, redirection, or even domination of scientiﬁc and medical enterprises by narrowly deﬁned interests, whether economic, political, military, or religious.
Each is invited … to give priority, in the development of new programs of research, application, and outreach, to those children, women, and displaced peoples around the world who have little access to advanced systems, tools, and modalities of healing.
Each is invited … to take always into account, in the design of experimental protocols, public health programs, laboratories, research centres, clinics, and hospitals, the constellation of values, cultural norms, and spiritual concerns of local communities.
Each is invited … to ﬁnd ways to focus the creative energies of science and medicine more intentionally, systematically, and intensively on the most pressing issues of human survival, such as food, health, demographic change, and ecological sustainability.

It is interesting that these religious “global bioethical” values were formulated about 6 years before UNESCO’s Universal Declaration on Bioethics and Human Rights. (One can claim that the global religious community realized the relevance of a global bioethics and that this realization prepared the global community and indirectly called them to the formulation of a global bioethics aimed at the governments of the world, as well as individuals, groups, communities, institutions, and corporations.)

Global Ethics In Context

What circumstances contributed to a global ethical discourse and its realization? First, one can argue that the human rights discourse prepared the way for the possibility of a global ethical discourse because human rights also have a global vision (Ten Have and Gordijn 2014).

Second, a global ethics is a result of globalization. The world can indeed be described as a “global village” these days. The philosopher Pierre Teilhard de Chardin (1881–1995) predicted that the world will become a global village, not because humanity accepts a single truth or desires cultural unity but because humanity is more and more under the impression of a shared dependence and future. Modern methods of communication, like radio, television, and Internet, mutually link people worldwide. Distances between people have become much smaller and the boundaries between nations have become insigniﬁcant. It has never been so easy to know other people. This communication brings a growing uniﬁcation within complex diversity, as well as a greater feeling of solidarity between people. Persons from different nationalities, cultures, and religions from all over the world are linked and are becoming particularly aware of each other’s circumstances. This awareness has as a consequence that (religious) human beings have come under the impression of each other’s similar or shared humanity. People recognize their own humanity in other people and can therefore identify with each other’s joy, pain, suffering, struggle, and essential human needs (PWR 1999). People understand other people’s suffering and want to show their solidarity. This realization has brought people all over the globe to realize that shared humanity in itself is a given value, and this is the reason why they speak of inhumane treatment or crimes against humanity. This reality implies the possibility of even more shared values (Gracia 2014; Kung 1997; Ten Have and Gordijn 2014).

Third, a global ethics is attainable because most large religions and philosophical traditions offer identical ethical material. In his discussion of the drafting of the Global Ethic, Kung points out that he avoided quotes from holy texts because each religion would want to use a special text from its faith tradition, which could lead to an endless quoting of texts and possible tension. Yet, almost all religions across the world agree on the use of one religious text that appears in almost all Holy Scriptures, and that is the familiar golden rule (Kung 1997). Kung remarks that this fundamental golden rule serves as an impressive indication that a common global ethics is not a new invention, only a new discovery (Kung and Kuschel 1993). Quoting the different formulations of this golden rule brings this reality home much more powerfully:

– Hinduism (c. 400 BC): “One who regards all creatures as his own self, and behaves towards them as towards his own self, attains happiness. One should never do to another what one regards as hurtful to one’s own self. This, in brief, is the rule of righteousness. In happiness and misery, in the agreeable and the disagreeable, one should judge effects as if they came to one’s own self.” (Mahabharata bk. 13: Anusasana Parva, § 113)

– Jainism (c. 500 BC): “A monk should treat all beings as he himself would be treated.” (Jaina Sutras, Sutrakritanga, bk. 1, 10: 1–3)

– Confucius (c. 551–479 BCE): “Don’t do to others what you don’t want them to do to you.” (Analects 15:23)

– Buddha (c. 563–483 BC): “There is nothing dearer to man than himself; therefore, as it is the same thing that is dear to you and to others, hurt not others with what pains yourself.” (Dhammapada, Northern Canon, 5:18)

– Rabbi Hillel (c. 30 BC–10 AD): “What is hateful to yourself, don’t do to another. That is the whole Torah. The rest is commentary. Go and learn.” (Sanhedrin of the Babylonian Talmud 56a)

– Jesus (c. 4 BC–27 AD): “Treat others as you want to be treated, for this sums up the Law and the prophets.” (Matthew 7:12)

– Muhammad (610): “None of you is a true believer unless he wishes for his brother what he wishes for himself.” (Bukhari 1:2:12; Muslim 1:72f; An-Nawawi 13)

Global Ethics As Dialectic

It is important to remark that one speaks here of shared values and not dominant values. Studies that examine the phenomenon of globalization, as well as the globalization of ethics, show that there is a dialectic between the global and local existence. The design, development, and realization of a global bioethics should therefore not be seen as a domineering one-way process in which the global dominates the local. Several local events are shaped by other events from a distance, while global events are sometimes inﬂuenced by a local context and circumstances. Globalization is not a process in which the one global culture dominates the other. There is no antithesis between global and local. On the contrary, they can beneﬁt from each other. Instead of oppressing the local sphere, the rise of a global moral framework offers an opportunity for universal expression. A range of native ethnic groups that were wronged in their own countries changed their situations by appealing to human rights on a global platform. The idea is that a global bioethics is a colonizing power and does not take into account the interaction between the global and the local, but underestimates the power of a local value system (Ten Have and Gordijn 2014).

It all depends on how globalization is viewed. If it is judged to be an unstoppable process that transforms, mars, and subverts the local, human beings are in all probability at the mercy of external forces that are difﬁcult to identify and control, that homogenize local culture, and that transform all identity and values and that can at best be endured. In this sense a global bioethics entails values and principles that exist universally with the aim of dominating local value systems. However, if the global and local dialectics are taken more seriously, globalization can be viewed as globalization from the bottom up. “What we understand to be ‘global’ is itself constituted within the local; it emanates from very speciﬁc agencies, institutions and organizations whose processes can be observed ﬁrst-hand.” Therefore, globalization is not something that is received or experienced passively, but something that already exists or is created at a local level. Ten Have and Gordijn (2014) summarize this as follows:

Globalization is therefore not only experienced passively, but in many cases actively produced by groups of citizens, agencies, and institutions at the local level. In this view, global bioethics does not refer to ethical values and principles that are transcending various cultures or are imposed on them from outside, but global values are produced in interactions with local value systems. The global ethical framework is emanating from the fast growing manifold interconnections between people worldwide.

It is important to mark what is not regarded as global ethical consensus or global ethics: It is not a new ideology or superstructure and it does not want to make the ethics of different religions seem redundant. It is no replacement of the Torah, the Sermon on the Mount, the Quran, the Bhagavad Gita, conversations with the Buddha, or the proverbs of Confucius. A global ethics does not imply one global culture, much less one global religion.

Although a global ethics is questioned by some scientists, one can (without a doubt) show that such a global ethics does exist. The religions of the world have established a global ethics and have expanded this to a global religious bioethics that can in a certain sense be seen as the forerunner of a later political global bioethics. Attention subsequently shifts to the theme of global bioethics.

Global Bioethics And Religion

The Origins Of Bioethics

The discourse above has already demonstrated that a global ethics has been established in the religious world. The discussion subsequently indicates that a global bioethics is indeed possible and that it forms a reality within the modern world.

Bioethics is a recent phenomenon that in all probability has its origin as a topic and a science in the West (Gracia 2014; Ten Have and Gordijn 2014). The term “bioethics” appeared in America around the 1970s with both a wider and a narrower meaning. The word “bioethics” was ﬁrst used in its wider context in 1970 by the American scientist Van Rensselaer Potter (1922–2001) in a scientiﬁc article (Potter, 1970) and shortly thereafter, in 1971, in his book with the title Bioethics: Bridge to the Future (Ten Have and Gordijn 2014). In 1973 Dan Callahan published an article with the title Bioethics as a Discipline. The claim was recently made that the word “bioethics” was used in Europe long before Potter. The German minister Fritz Jahr used the term “Bio-Ethik” in a 1927 publication. The value of this claim is that it brings into disrepute the thought that bioethics is an American invention.

As an oncologist Potter was persuaded by cancer research to adopt a broader vision of medical ethics, because medical science (in this case oncology) has essentially developed into an interdisciplinary science. The discourse on cancer can no longer exclusively focus on the individual (e.g., pain relief and treatment) and biological perspectives (e.g., cell mutation), because cancer is often linked to lifestyle and environmental factors. Cancer can therefore no longer be addressed on an individual level only but should also receive attention on the level of the broader community (e.g., the prevention of cancer by limiting smoking). This conviction receives attention in the ﬁrst few chapters of Potter’s 1971 book (Ten Have and Gordijn 2014). However, Potter thought even wider than only oncology or medical ethics and deemed there to be more important life problems in the world that should receive attention, such as overpopulation, war, violence, pollution of the environment, politics, and the negative consequences of progress. These problems endanger the survival of humanity and necessarily lead to concern about the future. What is needed, in Potter’s view, is a new discipline that is not only aimed at traditional medical ethics problems but on a broader science, and he calls this “bioethics.” As early as 1975 Potter drew a distinction between “medical bioethics” and “environmental bioethics” (Ten Have and Gordijn 2014). As part of his broader understanding, Potter (1971) emphasizes that he wants to contribute to the future of the human species. The reason why the future is in danger is that the two cultures found in society, namely, the natural and human sciences, are not engaging in a discourse with one another, and he is of the opinion that bioethics can facilitate this conversation (Ten Have and Gordijn 2014).

The above clearly shows Potter’s broader understanding of bioethics as something more than individual medical matters and perspectives (in other words more than the immediate present), and he continues to expand on the fact that the life sciences and philosophy should be linked. The aim of bioethics is the combination of science and practical philosophy, so that “knowledge of how to use knowledge” is developed with a view to the survival of man and the improvement of quality of life. The knowledge that should be brought together is on the one hand biological knowledge of the science of living systems (from there “bio”) and on the other hand the knowledge of human value systems (from there “ethics”; UNESCO 2008). Bioethics is multidisciplinary; all disciplines are involved in the search of ideas “that are susceptible to objective veriﬁcation in terms of the future survival of man and improvement in the quality of life for future generations.” The ultimate product of science combined with values is called “wisdom,” which will enable human beings to survive and to live a quality life (Gracia 2014; Ten Have and Gordijn 2014).

At more or less the same time that Potter was using the term “bioethics” in its broader sense, the concept was used in its narrower meaning by André Hellegers (1926–1997). In July 1971 this Dutch medical practitioner established an institute at the Georgetown University in Washington, DC, with the assistance of the Kennedy family. From there is the name the Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics. For this group bioethics is only a slightly expanded continuation of medical ethics that mainly pays attention to medical matters and technology (Gracia 2014). The focus of the Kennedy Institute falls mainly on the short-term consequences of medical and technological intervention (lengthening of life) from the perspective of the patient (how medical technology can improve life, maintain it, or lengthen it), and no attention is paid to social, cultural, and political environmental determinants of human life. There is furthermore no emphasis on the link between medicine and health care (Potter 1988; Ten Have and Gordijn 2014).

In Potter’s tradition the term “bioethics” was quickly accepted and widely used; UNESCO (2008) summarizes the meaning of the concept as follows:

One profession dealing with life during centuries and millennia, especially with human life, has been medicine. But today there are many sciences and professions working in this ﬁeld. Therefore, bioethics should not be confused with medical ethics, which is only one of its branches. The ﬁeld of bioethics is as wide as the facts of life, and its study is divided in many branches, each one with its speciﬁcity: Ecological or environmental bioethics, Medical bioethics, Clinical bioethics.

The Continuation Of Global Bioethics

Introductory

Where does the concept “global bioethics” come from? Global bioethics as a topic and science in all probability, like bioethics, also has its origin in the West. “In any case, it was into Potter’s tradition that the concept of ‘global bioethics’ appeared,” Gracia writes (2014). In the second half of the 1980s, Potter uses the term “global bioethics.”

His ideas are expressed in his second book, Global bioethics – Building on the Leopold Legacy (Potter 1988; UNESCO 2008), and in this book Potter elaborates on the broader concept of bioethics by paying attention to the ecological perspectives. According to Ten Have and Gordijn (2014), who studied Potter’s second book in depth, Potter understands a “global bioethics” to be a uniﬁed, enveloping global ethical system.

Global Bioethical Agreement

As already indicated, a global bioethics can be viewed as a crucial minimum of shared bioethical norms. It is a basic consensus of binding values that, despite the differences and diversity, are conﬁrmed by all cultures. The most explicit example of the irrefutability of the existence of a global bioethical framework is found in UNESCO’s Universal Declaration on Bioethics and Human Rights (UDBHR) (Ten Have and Gordijn 2014). Donnelly (2012) points out that 172 countries (88 % ratiﬁcation rate) have committed to the six international core human rights agreements by 2012. As opposed to this, the UDBHR was unilaterally accepted by the global community of 191 member countries in 2005, which means that the declaration is the ﬁrst and currently the only bioethical (political) text to which all governments in the world have committed. Other inﬂuential bioethical instruments of human rights are either regional, like the Convention on Human Rights and Biomedicine of 1997, or related to a profession, like the WMA’s Declaration of Helsinki in 2013. Global bioethics is aimed at all people all over the world. The goal of the UDBHR is “to provide a universal framework of principles and procedures to guide States in the formulation of their legislation, policies or other instruments in the ﬁeld of bioethics.” The declaration succeeded in formulating 15 global bioethical principles that have been accepted by the global community for use by governments, individuals, groups, communities, institutions, and corporations (art. 1).

The UDBHR is a global or universal ethics in several regards (see UNESCO 2008).

Global bioethics means that all people as rational beings have the capacity and right to make their own ethical decisions (art 3–5; Gracia 2014). The UDBHR as global bioethics also includes all the so-called Western principles of Beauchamp and Childress (autonomy, non-harm, beneﬁt, and justice; art. 4, 5, and 10), as well as the more non-Western principles of solidarity, social responsibility, and sharing of beneﬁts (art. 13, 1, and 15). It, for instance, includes the combination of medical and societal ethics. Another (non-Western) principle on which the global community agrees is that cultural diversity has to be respected (art. 12), but in such a way that this principle does not dominate other ethical principles. This means that a health practice that affects human dignity cannot be justiﬁed by invoking the principle of respect for cultural diversity. Take informed consent (art 5–7) as an example: African countries have a communitarian point of departure based on which the group discusses the problem and the community leader takes the lead with the decision. In Arabic countries the husband makes the important decisions rather than the wife. Despite these cultural practices, the principle of informed consent requires that the individual involved should give informed consent. In the application of this principle, local values and norms can play a great role; in North America persons are required to sign extensive documentation, while verbal consent is acceptable in African and Arabic countries and a signature is seen as a sign of distrust (Ten Have and Gordijn 2014).

Global bioethics is also understood as ethics and responsibility not only aimed at people who live during certain periods but also future generations. The UDBHR formulates this global bioethical principle as follows in article 16: “The impact of life sciences on future generations, including on their genetic constitution, should be given due regard” (Gracia 2014). Global bioethics not only includes the virtual person but also the nonhuman culture. The UDBHR gives special expression to this in article 17, which is aimed at the protection of the environment, biosphere, and biodiversity (Gracia 2014; Ten Have and Gordijn 2014). It is clear that global bioethics, as it is expressed in the UDBHR, is indeed global and all embracing.

Global Bioethics As Dialectical Process

It has already been indicated that the formulation of a global ethics was not a process of domination, and the same goes for a global bioethics. The drafting of the UDBHR was the product of a dialectical process (“two-level process”) between the global and local worlds. There was a continuous dialogue between the global platform (UNESCO) and local contexts (cultures, traditions, and religions). The member countries of UNESCO negotiated for about 2 years before they reached consensus. A variety of activities took place in the different countries. Experts participated in conferences held in countries like Lithuania, Turkey, Indonesia, and Argentina. Regional conferences took place regularly in Latin America, the Arabic regions, and Africa. Experts from different countries completed questionnaires and wrote commentaries and recommendations. The universal principles of global bioethics are the result of unceasing and multilateral articulation, consideration, and production (Ten Have and Gordijn 2014).

It is of special importance for this topic to also point out that global bioethics and human rights not merely result from political consensus but also a (supposed) religious consensus and a further example of a dialectic between the global and the local. UNESCO involved all the great religions of the world in the process of the creation of this declaration. Ten Have and Jean (2009) offer an in-depth discussion of the preparation and drafting of the Universal Declaration on Bioethics and Human Rights. All the members of the International Bioethics Committee (IBC) who gathered in Paris, France, in August 2004, received a second draft declaration in advance. This session of the IBC was attended by approximately 250 participants from 80 countries. A large part of the session was dedicated to hearing the representatives of different religions and spiritual perspectives. Speakers from Islam, Confucianism, Buddhism, Hinduism, Christianity (Roman Catholicism), and the Jewish tradition participated (IBC 2004). Each speaker gave a presentation focusing on that speciﬁc tradition’s perspective on global bioethics, and some traditions commented on the second concept text. Ten Have and Jean, who were closely involved in the drafting and development of the text, give their opinion on the religious discussion as follows:

One lesson from the presentations and discussions was that although there are differing moral views, common values can be identiﬁed … In the end ofﬁcial representatives of states, but also of cultures, traditions, and religions, could agree on 15 ethical principles of global bioethics. (Also see Ten Have and Gordijn 2014)

Global Moral Community

It is clear from the above discussion that global ethics and bioethics are part of the modern world and one can therefore claim that this phenomenon indicates the existence of a global moral community. This means that most citizens of the world, regardless of their nation, culture, or religion, acknowledge and want to enact an ethically responsible behavior based on shared values. “Our duties are always the promotion and implementation of values” toward all people, UNESCO (2008) says. This idea of a moral global community within bioethics is in general conﬁrmed by the acceptance of the UDBHR and in particular the new principle of beneﬁt sharing (art. 15). The principle is, among other things, important in the context of bioprospecting, since the discovery of natural materials can lead to the development of new medications. Several developing countries are rich in natural resources, and the traditional knowledge of some native ethnic groups is exploited and used to manufacture new proﬁtable medicines without the native groups receiving any compensation (“biopiracy”). The principle of beneﬁt sharing now has as its goal to promote justice. A global morality implies that citizens of high-income countries may no longer be indifferent to obscure research practices or organ trade in low-income countries, since the same moral values and standards are applicable to the whole of the global community (Ten Have and Gordijn 2014).

The global moral community wants to address universal bioethical difﬁculties that arise from globalization. The fruits of globalization include the existence of global markets, which creates new problems such as organ trade, medical tourism, corruption, and bioterrorism. Bioethical issues such as pandemics, malnutrition, and hunger require coordinated global policy and action. Health care (philanthropic aid programs) is also a global phenomenon these days. Some developing countries were afraid that they would be excluded from the beneﬁts of the fast developing and globalizing medical science and research. In addition, there was great concern that international medical research and health care will be practiced with double standards, so that people in developing countries receive inferior care and participants in clinical research will be involved without the necessary ethical protection. Traditional bioethical problems are confronted with new challenges. Today, it is common practice that clinical research is conducted in developing countries. This reality confronts the concept of informed consent, with some cultural traditions viewing individual decision-making as a foreign concept. According to Ten Have and Gordijn (2014), global bioethics is not an independent product of globalization, but it originated spontaneously as a narrative within the abovementioned bioethical problems and the global moral community wants to manage it.

Conclusion

The introduction to this entry on the one hand points out that the existence of a global bioethics is questioned as a Western product, while on the other hand there is the claim that a global bioethics does not value pluralism and cultural differences. Whatever historical research may uncover on the precise origin of the ideas that show that slavery and racial discrimination are wrong, the information found will have no bearing on the universality of the mentioned norms. “The origin of norms does not affect their universality or lack thereof,” writes Ten Have and Gordijn (2014). It is interesting that the development of a global bioethical framework was expressly requested by the developing countries. This request demonstrates that global bioethical principles are not necessarily being forced on the rest of the world by rich and powerful countries. The development can be initiated and driven by countries that are not that powerful (Ten Have and Gordijn 2014). From this argument, one can deduce that a global ethics exists that is supplemented by the presence of a global bioethics. A global religious “bioethics” was formulated in 1999, and it can be viewed as a precursor to the universal bioethics accepted by UNESCO in 2005.

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