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Friday, September 7, 2007

Session 5: Nanotechnology and Ethics: Eurpoean and Global Perspectives

Henk A.M.J. ten Have, M.D., Ph.D.
Director, Division of Ethics of Science and Technology
United Nations Educational, Scientific, and Cultural Organization

CHAIRMAN PELLEGRINO:  Good morning.  This whole morning will be devoted to the subject of nanotechnology and the ethical issues associated with nanotechnology.  Our first speaker is Dr. Henk ten Have, who is Director of the Division of Ethics of Science and Technology of UNESCO.  In another part of my own life, he was my boss, since I'm a member of his International Bioethics Committee.

We're delighted to have him.  I've told Dr. ten Have we do not indulge in long introductions, and he is relieved to know that as well.  You do have his background, however, in the book.  So without further ado, Henk, we're going to turn it over to you, and we'll have the opportunity later for the Council to raise questions.

DR. TEN HAVE:  Mr. Chairman and members of the Council, thank you very much for the opportunity to speak on this topic.  I will try to give you an overview of the recent European ideas on ethics in nanotechnology and try to broaden it also into more global perspectives.

I was lucky that recently there had been quite a few reports in Europe and European countries on ethics in nanotechnology.  The European Commission in May 2004 published a strategy document.  Subsequently, one year later in June 2005, after an extensive and open consultation, they adopted an action plan for the implementation for a safe, responsible, and integrated strategy for nanosciences and nanotechnologies going into the time frame of 2010.

These documents are specifically interesting because they show that there are two different types of concerns, at least at the level of the European commission. 

First of all, economic concerns.  Concerted efforts are necessary in the field of nanosciences and nanotechnology in order to address the needs of citizens, and they are specific about these needs in public health, energy, transport, sustainable development, but also to contribute to the European Union's economic growth, competitiveness, and productivity.  And it's clear that Europe is worried that it is lagging behind.

Global spending in research and development in this area shows that 37 percent is spent in the US, 28 percent in Japan, and only 24 percent in Europe.  The per capita investment in the 25 member states of the European Union, and that is 2005 was 3 euros, compared to 4.5 euros in the US and 6 euros in Japan. Private investment in Europe is even lower with approximately 1.5 euros per capita, compared to 6 in the US and more then 12 in Japan. Future spending will not significantly change this picture even when total expenditures are increasing.  So this is an economical concern, and it's also interesting that it is closely linked to the ethical concerns.

In research policy, as is argued in these reports, it is important to ensure that ethical principles are respected, that social considerations are integrated in the research and development process at an early stage and that a dialogue with citizens is encouraged in order to safeguard that citizens' concerns and expectations are taken into account.  And, as I will try to show, this emphasis on involvement of citizens is very strongly emphasized in all the reports.

To make sure that these concerns are properly addressed, the European Commission announced that it will ask the European Group on Ethics in Science and New Technologies to carry out an ethical analysis of nanomedicine. The analysis will identify the primary ethical concerns and enable future ethical review of proposed nanoscience and nanotechnology research and development projects to be carried out appropriately. That was 2005.

In the last few years, reports on the social and ethical implications of nanotechnologies have been published in several European countries. An influential role is played by the comprehensive report published in 2004 by the Royal Society and Royal Academy of Engineering in the United Kingdom. It has separate chapters on social and ethical issues and on public dialogue. It argues that most of the ethical issues arising from applications of nanotechnologies will not be new or unique. Nevertheless, when these issues arise they need to be addressed seriously and timely. It recommends to fund interdisciplinary research of the social and ethical issues and to introduce formal training on these issues for all research students and staff working in the area of nanotechnologies.

The report of the Health Council of the Netherlands in 2006 emphasizes mechanisms of risk governance and public dialogue. It advocates to establish a special national commission with representatives of science, industry, and civil society in order to identify and communicate risks at the earliest possible stage. This will also be...  I will come back to that later.

The Federal Ministry of Education and Research in Germany published its action plan in 2007, quite recently. The emphasis is primarily on the economic concerns. Germany is number one in nanotechnologies in Europe. About half of the nanotech firms in Europe are German firms. But ethics is only briefly mentioned.  What is needed, primarily emphasized in the report, is an intensive social dialogue to inform the public about the potential benefits and risks.

In France the report of the ethics committee of CNRS, the national research organization, from last year is primarily focused on ethics, but the emphasis here is on the responsibility of the scientific community itself. What is necessary is vigilance éthique, ethical vigilance. The report recommends concertation of all relevant stakeholders, an orientation on ethics in all stages of the scientific career, the development of ethics guidebooks for scientists, and the establishment of what they call espaces éthiques, ethical spaces, in research centers. Also, the National Ethics Committee in France has earlier this year published its report, and it has a more philosophical approach in the elaboration of ethical issues. It argues that the dynamics of nanosciences and nanotechnologies are driven by the interplay of two approaches, in fact two different models of rationality.

First of all, [there is] the desire to intervene, to rearrange, and to reconstruct matter, mastery through analytical decomposition, which is the classical dream of engineering, or the désir de controle.

At the same time, there is a second type of approach [to] rationality: the desire to synthesize and to make molecular objects capable of self-assemblage and self-replication, which is a kind of approach to make nature, [to] make [its] objects more perfect, [i.e., the] désir d'emergence, to overcome the failures that are in the naturally given objects.

The European Group on Ethics in Science and New Technologies is a neutral, independent, pluralist, multidisciplinary body composed of fifteen experts appointed by the European Commission for their expertise and personal qualities. The task of the group, I think like your Council, is to examine ethical questions arising from science and new technologies. It issues opinions, and the opinions need to be preceded by a roundtable before the opinion is adopted.

The European (group) published its opinion on the ethical aspects of nanotechnology in...  January of this year, 2007.  The emphasis is on nanomedicine, the application of nanotechnologies in the area of medicine. The fundamental starting point of the ethical consideration is that the interests of science are legitimate and justified insofar as they are compatible with human dignity and human rights. Protection of human rights is fundamentally articulated in various European documents: the Charter of Fundamental Rights, the European Convention on Human Rights, and the Oviedo Convention, which deals explicitly with biomedicine and bioethics. Human rights are rooted in the principle of human dignity. Together human rights and human dignity, as it is said in the opinion, they shed light on core European values: integrity, autonomy, privacy, equity, fairness, pluralism, and solidarity.

The opinion, however, also introduces a broader perspective. It refers to the United Nations Millennium Development Goals, arguing that there is a moral duty to make affordable health care and biomedical technologies available to all who need them on a fair and equitable basis.

The European Group distinguishes several ethical issues in connection to nanotechnologies, nanomedicine in particular. Similar distinctions are made in the national reports but sometimes with different emphases, and I will briefly discuss those considerations.

First is safety. The second is concerns about research ethics. The third is the emphasis on public participation and involvement, and the fourth is responsibility of the scientific community.  And finally there are some other ethical issues that are briefly dealt with in the reports: the issue of legal implications, the issue of goals of development, and the issue of social ethics. 

Now, first the focus on safety. It is pointed out, in fact, in all reports that concerns for safety are of vital importance. There is a lack of data on possible risks. The European Group makes a distinction between direct risks and indirect risks. Direct risks can emerge when patients are undergoing an application of nanomedicine, for example in a clinical trial or a medical treatment. Indirect risks are associated with the possible harmful impacts of free nanoparticles on public health and the environment, so-called nanopollution, and they can be harmful for all individuals. In practice, it is impossible to draw a precise borderline between the two kinds of risk.

The European Group argues that risk assessment, therefore, should be a top priority. The lack of data is a cause of concern. There are considerable difficulties, of course, because there are uncertainties, knowledge gaps.  There also is a difference between short-term and long-term risks. There is also a more substantial difficulty because it is uncertain whether the current mechanisms to identify, estimate, and manage risks are adequate for these new technologies.

In the recent report of the French National Ethics Committee it is stressed that enthusiasm among scientists to examine risks is rather low until now. In 2005, only 0.4 percent of the total research and development expenditures for nanosciences and nanotechnologies, according to the report, have been used for research on risks. It means, according to the committee, that there is first of all the temptation to produce, to sell, to disseminate the objects rather than to study and understand them.                     

It is important to note that for the European Group risk assessment is not only a technical issue. Safe governance of nanotechnology is a key factor for the protection of human dignity and autonomy of persons directly or indirectly at risk. This means that assessing risks should take into consideration specific values. Here, the Group argues, like both French reports and the Dutch report, that the precautionary principle as a general risk management tool should play a role. This principle applies when three conditions are occurring: the existence of a risk, the possibility of harm, and scientific uncertainty concerning the actual occurrence of this harm. In these conditions, the precautionary principle requires [one] to identify the acceptable risk threshold, not the zero risk threshold, so it's not, as I was reading in the proceedings of your June meeting, what Professor Ferrari called the "Prince Charles" approach.  It's not zero risk.  It's more what we can call the "John Snow" approach. John Snow was a medical doctor in 1854 who removed the handle of the Broad Street water pump in London in order to stop a cholera epidemic.

So it is necessary to identify the acceptable risks and to balance the potential benefits as well as the potential harms, respecting the values at stake. For example, human dignity.  It's obvious that value judgments play a role already in the determination what is a risk itself. 

I know that the precautionary principle, there are a lot of discussions essentially here.  Maybe there is a big difference between the European approach and the North American approach.  In UNESCO we made a publication on the precautionary principle, not to explicate it but to explain what it includes and how it can be used.  And maybe I can also try to see if we can make it available for you, because here you notice that in most of the European reports the precautionary principle is emphasized as an important issue in risk management. And even in some countries like France they have also included references to the precautionary principle in legislation.

Now, in this perspective - and I think also here it's important to put the precautionary principle into a broader context - a broader approach to technology assessment is advocated. In addition to the usual retrospective assessment, there should be a prospective technology assessment at the national and European level, and the European group in its opinion makes it clear you focus on safety in connection to environment, public health, food; also security, the possible dual use of technologies, impact on bioterrorism, military research, and on social issues: impact on social and economical and institutional structures. So those are issues that need to be taken into account in a broader approach of prospective technology assessments.

This view has also been endorsed by a resolution of the European Parliament, recognizing that a responsible strategy in this field of nanotechnologies does integrate social, ethical, health, and safety aspects into the technological development of nanotechnologies and nanosciences.

The second topic of concern is research ethics. Nanotechnologies and nanosciences will give rise to special ethical concerns in the field of research. The European Group identifies the following areas where problems can emerge.

First, research priorities.  Nanomedicine can create new opportunities to meet the needs of patients. But, as the European Group argues, the overall goals of health-related research must be seen in the context of fair distribution and the overall goal of alleviation of the global health status. So it's not only that you can look at research itself, but it is taking place in a broader context, and ethical questions should therefore be raised concerning the criteria used in priority setting.

It is also argued that the current emphasis on commercialization, patenting, private gain derived from research, especially when research is funded by public money, raises the issue of the fair sharing of burdens and benefits. There is also a need to clarify the ways in which public investments in this area - and most of the investments are in the public area - will benefit the citizens of Europe. The Group again refers here to the UN Millennium Development Goals. So not only the citizens of Europe but, as said earlier, the global health status should be taken into account.  Obviously they don't explain what kind of criteria for research priority setting should be used or can be used.  It's a little bit of a general statement here. 

The second area in research ethics is more specifically concerned with clinical medicine. Several ethical concerns are raised in regard to clinical research, problems as informed consent. In the context of lack of knowledge and uncertainties it is difficult to provide adequate information and to obtain consent. It will be necessary to develop new methods of providing information, not to qualify the principle of informed consent but to try to find new methods, new approaches of providing information. But, again, here the group does not provide any suggestions.

Another issue is ethical review.  Researchers have the responsibility to make sure that adequate ethical review processes are carried through for studies of nanomedical devices when it concerns human beings. In this context it is recommended that there should be a better information exchange between research ethics committees in the European member states.

And then also the issue of privacy is raised. Privacy is a concern because in all the reports when information is obtained by new diagnostic methods it can be can be used by third parties, but again here there is no detailed elaboration of how the issue can be addressed.

In general, possible solutions to these clinical research problems require serious interdisciplinary research. Like has been done in the context of the Human Genome Project, a considerable amount  and the group suggests 3 percent  of the budget for research in the European Union should be reserved for research on the ethical, legal, and social implications of nanomedicine, what they call NELSI. This research needs better coordination and cooperation. Not only should there be some kind of NELSI projects, but there should also be a European network on nanotechnology ethics, also one of the specific recommendations made by the European Group.

Such research should have a broader perspective than merely going into the clinical ethical issues. Studies should also focus on the more fundamental issues, in particular on the philosophical and anthropological questions raised, for example concerning individual responsibility, the concept of the self, personal identity, societal goals of research, and global healthcare. One of the basic questions, for example, is how our concepts of human being will change under the influence of nanotechnological developments.

At the same time, the French National Ethics Committee, although it itself extensively addresses philosophical questions, gives a warning. The philosophical questions of l'homme-machine, which is important in the context of nanotechnology - they are important, but they should not be used to hide or to cover up the more urgent ethical issues related to the introduction, what they call the "subterranean intrusion," of nanoparticles, which is mainly driven by technological performance and commercial interests. So there is a need to focus, first of all, upon the questions concerning nanoparticles because it's already there, and then of course we should not forget to focus on the philosophical questions. But we cannot use the philosophical issues as a kind of diversification strategy.

The third area of ethical concern has to do with public participation. All European reports so far agree on the need for more and better involvement of civil society. The European Group explains that there are two reasons for this focus on public involvement or participation. First, Europe is characterized by pluralism with a tradition of mutual respect and tolerance. Deliberative democracy requires a culture of debate and communication.

Secondly, nowadays there is a need for trust and confidence building between the scientific community and the public.  It is important that the involvement of the public in the debate on nanosciences and nanotechnologies is focusing on uncertainties and knowledge gaps, not only on safety issues but also, for example, on policy choices such as the funding of research and development, the goals of scientific development.

The involvement should go beyond informing the public as if this is a prerequisite for effective marketing of commercial products. What is needed is transparency and openness, not only on the possible benefits but also on the harms and risks, even if uncertain and unknown. What is interesting, they also refer in this connection not only to risk management but also to benefit management. In order to create more realistic views among the public of the prospects of the new technologies, it is a challenge to find a middle road between hype and justified optimism and pessimism.

Several models of public dialogue have already been developed and tested, such as, for example, the nano juries in the UK and a program of what they call nano trucks in Germany, where they go around the country with trucks with information about nanotechnology.

But there is also a need for developing new methods of engaging the general public about issues raised by technologies. The European Group makes several proposals.  They want to prepare surveys of public perception of the benefits and risks of the applications of nanotechnologies. They want to create a European website on ethics and nanomedicine. They want to organize public debates as a kind of road show in different countries. And what is also important is they want to give attention to the question of labeling nanomedical products. And here you see also perhaps one of the historical lessons in Europe with genetically modified food in particular, that there is a lot of public mistrust about technological developments. At least what you can do is to inform the public whether or not some products contain genetically modified components, and here it may be the same for nanomedicine. But if you want to really be open to the public, you have to indicate whether nanomedical products are included in the objects that are available.

The European Parliament has supported the proposal of the European Commission also to set up special ethics committees in this area. They can provide independent scientific advice and help ensure that the public is properly informed, creating a climate of trust. But it is not so clear whether these will be separate committees specially for nanotechnology or that the mandate of existing committees will be expanded. But it is important that here obviously we are thinking about a kind of bully that can mediate between scientific claims and the public in order to make sure that the information that is provided about risks, about benefits, can be trusted and is not exaggerated by the scientific community.

These kinds of committees can also be a kind of motor of public involvement and public debate. The emphasis on public involvement is not without problems, as is also discussed in several of the reports. The French National Ethics Committee discussed the disconnection between the discourse and the reality of the nanocosmos. There is much talk about the revolutionary development of nanosciences for the treatment of diseases that are incurable today, but for the moment there is only, and that is what the public will perceive, there is only new paint, new textile, and new cosmetics using nanomaterials.

This situation - I think it is important - resembles that of the development of GMOs and [genetically modified] food.  Ideologically, the discourse here was very much focused on idealistic goals like eradicating hunger in the world, but the actual products  and the public very well knows it — the actual products were marketed in the interests of the agro-industry companies of the rich countries. So there is a disconnection between the discourse that is focused on eliminating very important problems and the actual reality.

Also the reports on nanomedicine and ethics in the Netherlands elaborates the point that scientific research can only prosper if there is a climate of trust in society. This is not only a matter of informing the public. It is vital that science itself subjects itself and its own performance to continual critical reflection. What is true for science is also true for institutions such as government agencies, policy-making bodies, research organizations, and companies.

Again it is reiterated that lessons should be learned from the problematic introduction of genetically modified food in Europe. It is clear that many misperceptions about public opinion exist. Scientific and technological knowledge among the general public is limited indeed, but it does not mean that concerns about a technology are due to lack of knowledge or incorrect information. Concerns, therefore, cannot be removed through scientific education and information. On the contrary, there are indications that more knowledge and information promotes skepticism and polarized views.

Of prime importance, as the report is arguing, is free choice, transparency, and personalized information. The public knows very well that it is necessary to balance the harms and benefits. But at the same time the public has the impression,  at least in quite a few European countries, that they never hear how this is done and that their views are really taken into account. They therefore are suspicious that in the end economic interests are more important in policy-making and risk management than idealistic considerations concerning health and the environment. And of course we have affairs like BSE, mad cow disease, dioxin intoxication.  They have not so much illustrated a lack of knowledge and information about biological processes among the public, but rather they have illustrated failing institutions, carelessness, incompetency, lack of resources, and even fraud. So experts' declarations denying or downgrading risks create more confusion and are in the eyes of many citizens disturbing and unreliable.

Instead of strategies to make the population more rational and inform them about developments, which is necessary, of course, but instead of only focusing on making the population more rational, also institutions should pay more attention to their own conduct. Trust must be earned by expertise, performance, integrity, openness, and accountability.

The recent Eurobarometer one year ago, which is a survey of citizens' views in all European member states, is a little bit confirming this picture. When asked whether nanotechnologies  will improve our way of life in 20 years' time, 40 percent of the respondents in European countries replied positive, 5 percent negative, but 42 percent did not know how to answer. On the other hand, support for nanotechnologies, whether the technology should be encouraged, totals 55 percent, varying between 33 percent in Ireland to 72 percent in Finland. So the majority view among European citizens, 66 percent is positive and without concern that the technology is risky. If you compare it with surveys in the US and Canada, Europeans consider nanotechnology as more useful for society and have greater confidence in current regulatory arrangements.

The fourth area of discussion in European reports is focusing on responsibility of the scientific community.  The French National Research Center report in particular emphasized that a fundamental transformation is necessary in the mentality of researchers. In the area of research, ignorance or reluctance often prevails in relation to ethics. The awakening of ethical reflection on science and technology is not a one-time, incidental event introduced by ethics specialists but a long-term effort focused on and sustained by all researchers. This is what they call vigilance ethique. It demonstrates the responsibility of the scientific community itself. This is the counterpart of transparency, the clarification of information and involvement of the public, involvement of the public at the same [time with] the responsibility of the scientific community.

Transparency as well as responsibility is required because nanotechnologies are developing in a social context that is sensitive to problems emerging from scientific and technological progress. Again, it is not only a matter of researchers explaining the results of their research but of showing that researchers themselves take into account, are aware, and sometimes worried about the possible implications for the life of citizens and society in general. The scientific community is therefore faced with three challenges.

First, they have to rethink the ethos of research. The changing conditions and social structure of science makes it necessary to redevelop, to rethink, the existing codes of conduct and to promote ethics education. The current ethical system exemplified in codes of conduct is no longer sufficient.  Researchers have to take care that they themselves, they make and reiterate, rearticulate, revise their codes of conduct.

Second, there needs to be an emphasis among researchers themselves on prevention and precaution. Reflection on the possible consequences of research results should pay more attention to prevention of risks. This is not only limited to nanoparticles but should also consider the possible long-term impact on the individual and society. That is a duty of the researchers themselves. It cannot be delegated to specialists like ethicists, but researchers themselves should show that they have this concern. The same responsibility requires precaution in the face of uncertainties.

Then third, there is a need for reflection on values and ends. Given the political and commercial interests in which nanotechnology programs are stimulated, it is difficult to maintain, according to the French report, the neutrality of sciences. Scientists themselves should therefore reflect on the values underlying their work. Nanotechnologies, in particular, transcend fundamental cultural values such as the distinctions between natural and artificial and between natural and cultural. There are also important questions of meaning that every researcher should address: Why this research? What is its purpose? Who will benefit from it?

In order to take this responsibility of the scientific community seriously, a sustained effort is needed to inculcate ethics throughout the careers of researchers. This should start in their early education and continue in their training, the formulation of projects, the laboratory work, and the evaluation. The aim is to make scientists themselves more reflective and to create spaces for ethics, espace ethiques, within the daily business of research.

Then the are some ethical issues that are briefly addressed in the reports.  For example, the issue of legal implications. The European Group does not propose new regulatory structures. What is necessary in its view is, in first place, to monitor developments in order to make sure that regulatory systems do really occur - all developments, especially concerning nanomedicine products.  And, secondly, that it is necessary to implement existing regulations.

A second issue that is briefly addressed is concerning the goals of nanotechnology. The European Group points out that the distinction between therapeutic goals and enhancement goals may become less clear with the development of nanomedicine. It emphasizes that it is important to maintain the distinction between medical and non-medical uses.

Then third, social ethics. In many European reports it is stated that nanotechnologies are not only significant for individuals but have consequences for society as a whole. Nanotechnologies will furthermore have global consequences. They will influence the use of natural resources and the distribution of wealth. They can potentially contribute to the creation of a more sustainable society, promote the health of future generations, and therefore help to realize the Millennium Development Goals.

However, as is pointed out in the Dutch report, without consistent efforts to translate technological developments towards the circumstances of developing countries, it is unclear whether these countries will enjoy the benefits of technological progress.

The European Group distinguishes two aspects in the issue of equal distribution. First, intergenerational issues. They concern the distribution between current and future generations. Particularly the problem of sustainability is important here. Applications of nanotechnology can promote better use of natural resources and energy, water purification systems, and removal of waste. This would be important for future generations, but at the same time more knowledge, of course, is necessary concerning the environmental impact of nanomaterials themselves.  They will be important also for future generations.

The second issue here is intergenerational questions.  They concern the distribution among present generations. This is the problem with the possible use of nanotechnologies to address the needs of the developing world. It is unclear whether developing countries will really benefit. At present, for example, vaccination is available for many diseases and relatively inexpensive but nonetheless infrequently used. Because the driving forces of technological development are primarily focused on developed countries, the materials and objects produced are first of all in the interest of people in these countries.

This brings me to discussing the more global perspective, as is also one of the tasks of UNESCO.  From a global perspective, we need to be sure that ethical reflection also discuses the benefits and harms in a wider perspective.

In early 2004, UNESCO's World Commission on the Ethics of Scientific Knowledge and Technology decided that nanotechnology was a subject meriting UNESCO's attention due to the enormous potential benefits, but also the challenges to regulators, scientists, and society at large.

As one of the first UN agencies, UNESCO started anticipatory studies concerning ethical and social impacts of nanotechnology and its applications. The subject was first explored during the meeting of the world's ethics committee in Rio de Janeiro in 2003. It was further discussed in the next meeting in Bangkok in 2005. With the aim of mapping the ethical dimensions of nanotechnology from a global perspective, a multidisciplinary group of experts on ethics and nanotechnology was established later that year with the participation of ten experts from nine countries.

The expert group set up a twofold strategy. The first phase involves the preparation of a state-of-the-art study on ethics and nanotechnology. The aim of this study is to explain what kind of ethical issues are related to the development of nanotechnology so that policymakers, and especially policymakers in developing countries, will have a better idea of the challenges. As a result of this, you will have the brochure on the ethics and politics of nanotechnology that has been made available for you.

It is important to be aware that in most of our 192 member states, there is, of course, no development in the area of nanotechnology, and many of the policymakers are not very much aware of the possible impact of this technological development for their own country. But nonetheless, all countries will be confronted with the potential impact of this technology in the near future. So the brochure is trying to explain.  It doesn't take a position. It tries to explain that this is an important area of concern.

The expert group also engaged in a more fundamental study of the ethical issues.  They met several times in Paris, they prepared papers, and finally they have published a book on ethics and nanotechnology, which I will also make available for you, which is a more in-depth explanation of the ethical issues involved. 

Then finally the ethics committee, the World Ethics Committee, also tries to deduct from the studies the potential activities that could be undertaken by the member states of the organization, policy recommendations that has just been published two weeks ago, which is a number of policy recommendations for the member states of UNESCO. The policy recommendations, they focus at least on four areas.  One is the need to articulate the ethical framework.  It is argued that further reflection is needed on the ethical principals that could guide the development of nanotechnology.  And here in UNESCO, of course, the example is a recently adopted declaration on bioethical principles. This is a declaration on bioethical principles that has been unanimously adopted by all member states, and it's the starting point for many activities in the organization in the area of bioethics.

The question is whether the set of bioethical principles can also guide the development nanotechnology, because nanotechnology is much broader, it seems, than only the area of nanomedicine bioethics.  But further explanation is necessary to see whether there can be a framework of ethical principles that could help guide the development of nanotechnologies.

It is also argued that there is a need for capacity building in member states, maybe a need for special bodies to deal with the ethical issues in member states, as has been explicated by the European Group.

The second area of recommendations is that there is a need for awareness-raising and debate.  It is necessary to create public debates to focus on the environmental impact on those issues that are better mechanisms for risk analysis. So all these issues are also explicated to help specifically developing countries to prepare themselves for this scientific revolution.

The third area is emphasizing the need for ethics education. There is a general need for ethics education, but especially like the French committee has argued it is necessary for research in this area, not only for research in medical schools but in fact for all scientists who are incorporating into this endeavor of nanotechnologies.

And then finally it is emphasized there is a need for research and development policies. More scientific and technical knowledge is necessary. It is necessary to involve the social scientist in studying this area of science.

It is necessary to start  and the same is advocated here  to start into this research on the social, ethical, and legal issues. And it is also necessary to focus specifically on the link between nanotechnologies and the concept of development. What does it mean for developing countries that these technologies are developing? And there is a need to have a debate on the goals of this technological development, goals that could be related to the framework of the Millennium Development Goals.

Now, these recommendations have now been circulated among the member states of UNESCO policy-making bodies, and in October there will be a general conference of all the member states, and then we have to wait and see which kind of activities the organization can undertake in the near future.

Now, summarizing, nowadays the possible benefits and harms deriving from nanotechnologies are increasingly discussed, also the implications for international relations in science and technology policies. Many initiatives are being carried out in order also to provide an early, informed, and interdisciplinary public debate. It is expected, and especially strongly emphasized in the European reports, that these activities be able to preserve or sometimes restore trust in science and technology. This is especially relevant because in order to maximize the benefits of nanotechnology it is also necessary to anticipate and discuss the possible eventual risks. Academic researchers, developers, potential users and other important actors need to be involved in this trust-building exercises in order to ensure that there is an adequate representation of societal forces included in this effort so that the future of nanotechnology is not only shaped by researchers or policymakers but in fact by the general public as such.

The failure to have such a broad and inclusive public debate and involvement is to a large extent, at least in the European context, the cause of criticism and public mistrust. Several issues in the past, like genetically modified food, animal experimentation, crisis in the agro-industry, this is causing criticism and public mistrust regarding scientific advancement.

At the same time, in a global perspective, there is also increasing concern that all countries should be able to benefit from scientific and technological progress, especially developing countries and those developing countries that at the moment are not involved in the nanotechnology revolution. Rather than emphasizing the particular European perspectives  they do that, but they go beyond it.  Policy reports in Europe seem to raise the question how Europe can contribute to make nanosciences and nanotechnologies relevant and beneficial for humankind in general.

This global perspective, I think, opens also opportunities for international organizations such as UNESCO. You know, it's the only UN organization with a mandate in the area of sciences. I think UNESCO can take up the challenge and assist member states and policymakers in the development of nanotechnologies contributing to reach the Millennium Development Goals.

Thank you very much.

CHAIRMAN PELLEGRINO:  Thank you very much, Dr. ten Have.  Dr. Peter Lawler has consented to open the discussion.  Peter?

PROF. LAWLER:  This is not a contract but a covenant. I consented to do this out of ignorance. I know this is a very important topic.  I thought maybe the Council should take it up but not because I'm the world's leading expert on it but because it's something I think, as an alleged expert on bioethics, I should know more about.

In your fine presentation, you talked about democratic control, technology governance, that public deliberation  should control the development of biotechnology with human dignity in mind, human rights in mind, with health and safety in mind. And in order for deliberation to be effective, we have to avoid the two extremes, the one extreme of nano-hype, or falling victim to wild promises and letting those wild promises distort research agendas and so forth, but also nano-fear, or "Prince Charles" disease or any introduction of an uncertainty into the world is to be avoided and so let's not do anything.

And so in the same way we have to distinguish between near-term uses of biotechnology, things which were already going on in paint, textiles, food, cosmetics, and drugs. And the more advanced and visionary views of nanotechnology in terms of a basic transformation of the world and how we view the world.

But I'm not so sure we can separate the near term from the visionary, precisely because the visionary is so astounding yet so plausible. The experts disagree - and I have no idea who is right - on whether molecular manufacturing is right, these self-replicating machines that will build things from the bottom up atom by atom. And that does seem a bit farfetched to me.

On the other hand, they actually, when you look carefully, seem to agree that the goal of nanotechnology is the complete control of the physical structure of matter, and this genius Fineman in the later 1950s wrote that the principles of physics do not speak against the mastery of things atom by atom. And I think the scientists don't disagree on this as a prospect, they just disagree on how it might be done.

And so public education here becomes sort of a problem because it depends on knowledge of what's possible, knowledge of basic physics, which is not so basic - basic not in the sense of easy but basic in the sense of fundamental - and a knowledge of basic chemistry, which again is not so basic.

So it's not so clear to me.  It seems to me a big issue whether there can be public control, democratic control, of the progress of nanotechnology, especially in view of one thing I think you didn't have time to mention, and that is the inevitable military use of nanotechnology, the inevitable arms race, all sorts of weapons possibilities. Weapons that are smaller or smarter or more precise, easier to use.

Now, the article you gave us by Schummer says very truly military uses shouldn't distort science, but military uses will distort science, and won't the arms race here produce nanotechnological rapid developments which will have applications in many other areas of life? And so there probably will be an arms race between the United States and China with nanotechnological implications. Bioterrorism - we'll have to have a defense against it, and a defense against bioterrorism will cause another kind of nanotechnological arms race.

So isn't it true in the long term if we reflect on this, we have to reflect on the fact that nanotechnology is necessarily going to introduce into the world irreversible processes which we may or may not be able to control? This is like a huge problem to me. So Prince Charles isn't simply nuts to worry about this.

So we have the paradox that greater human control will produce greater uncertainty about what is actually going to happen. And we also have reason to worry and be hopeful about the possibility that nanotechnology or the likelihood that nanotechnology will allow us to take control of living materials in the capacity for self-organization, will actually bring this self-organization under our control.

This is will change not only our understanding of life but sort of what life is, which you alluded to, but I think it's a real problem. So shouldn't we up front be studying and trying to understand these changes with the candid recognition that we will probably be unable to prevent them if they're possible.

So with respect to all the problems you mentioned so well, the environment. You could understand the possibility of environmental devastation either through bioterrorism or the unintended consequences of attempts to control the environment. You could also anticipate a complete solution, or almost complete solution, to the environmental problem.  We'll be able to solve a unique human need with a lighter and lighter touch on the actual environment. This might also be possible.

With respect to the economy, there could be global displacement. The world could be divided into the nano-haves and the nano-have-nots. Natural resources could become more or less irrelevant with horrible consequences, perhaps, for developing countries.

On the other hand, maybe we could conquer scarcity. Not only will things become sustainable, but finally we'll achieve the Marxist dream of having plenty of everything with very little work.

In the same way, with respect to health, some of these experts seem to now understand disease as simply unfavorable molecular configurations that we can change. And then the experts who write against this seems to say, well, not all diseases.  That won't apply to anorexia, which I guess. So there are some diseases that can't be understood this way, but maybe plenty of diseases can be understood this way.

And then you have things I'm not competent to go into:  enhancement. This line between health and enhancement should be maintained but it may be tough to maintain because enhanced people may be more healthy people, in fact.  Then you have to the two areas: physical enhancement, which could be basically a good thing, but then you have cognitive enhancement, which becomes a problem for all sorts of reasons.

And then you have what to me might be the biggest issue finally, would be the total eradication of privacy where you have a capacity to store huge, an almost infinite amount of information on every particular human being and a sort of intimate surveillance of every human action. I think this is really possible.

So what we have here is a possibility of human beings coming to be understood as just complex molecular structures and nothing more, so you have the world where some complex molecular structures are transforming other complex molecular structures, and this turns out to be a very fundamental question of philosophy, which depends upon answers to very fundamental questions of science. And it also depends upon, I think, a certain inevitability of what can be done being done. And it's hard for me to see how all of this can remain under democratic control, proper deliberation and dialogue, and all the good things you talked about.

So should our Council jump in early on this — not so much because of what's going on now, but what will likely happen in the long run because of the promise of nanotechnology?

CHAIRMAN PELLEGRINO:  Thank you very much, Peter. Dr. ten Have, do you care to respond?

DR. TEN HAVE:  I think what is interesting in the development of nanotechnology is that it makes particularly acute two very old basic questions concerning science. One is, as you mentioned, how should we assess technological development? Is it autonomous, or can it be influenced? And that, of course, is not a new question, but because of the rapid evolution of nanotechnologies it is becoming more urgent.

And you can say, well, of course this development is really autonomous. It can hardly be influenced, and it will go on. And then the only thing you can do is to resist it or to comply. And that is precisely what you can notice sometimes in European context, that you have all kinds of groups having this view. And the only thing we can do is resist it.

Every summer you have groups burning fields of genetically modified crops, and they are arrested by the police, they are burning down McDonald's. That's the only thing you can do. You can also say scientific development is the result of choices made at some levels of policy-making, and the choices should be influenced by values. There is not an autonomous process, but we deliberately allocate money for particular developments, especially in medicine.

Maybe there are some developments that are really autonomous. For example, most of the products in France, they are using nanomaterials in cosmetics.  L'Oréal is very active in having any control, and now people are arguing maybe there should be more control, more safety studies done on the nanomaterials brought into use through cosmetics. So I think this is a basic question here in how scientific development can be influenced and where are the value choices made.

The second basic question  and I think it has become more acute during the last 20 years  is concerning the ethos of science. What does it mean to be a scientist? What kind of responsibilities do you have? And I think that is very well addressed in the French report. The Mertonian system of values is no longer working very well. But what is the alternative? What are the values that scientists themselves should address? Where is the organized skepticism that is important for being a scientist, because we hear all these claims of people and, of course, this is not only in the context of nanotechnology because people remember the Korean case. There was a case with a Norwegian doctor and all kinds of cases illustrating that science is more driven by commercial and other interests than by a value system of its own.

So that's why it is important also for the scientific community to make clear that they have a value framework. They need to make it clear because otherwise they will lose the rest of the population, and that's a concern in the European context, that science is not an activity in itself but is an instrument to benefit society as a whole, the community. So scientists should show that they earn the trust of the public by showing themselves more concerned about the developments. And that's also why scientists sometimes are now criticizing each other, because they make unsubstantiated claims in public about what nanotechnology can do. And they say we should be more careful, we should be more skeptical, we should be more critical about our own work.

But these are also - those are two basic questions concerning technological progress and the ethos of science that are now more acute in the area of nanotechnology, and they will require more adequate reflection.

CHAIRMAN PELLEGRINO: Thank you very much. Now open to the members of the Council. Alfonzo?                        

PROF. GÓMEZ-LOBO: I have an information question, but let me explain a little bit what my worry is. I understand our body to be a body devoted to the study of bioethics and to clarifying bioethical issues to the American public and to make recommendations to the American administration. Now, as I've understood our task, what we've tried to do is to clarify issues that are disputed. For instance, there is the ethical question, is it morally right or morally wrong to clone humans, for instance. Would it be morally right or morally wrong to set aside the dead donor rule?

I think those are the kinds of ethical questions we've been asked to address, and I'm a little bit lost in the case of nanotechnology as to what are the disputed ethical questions such that we would  we should engage in reflection and examine the different positions and perhaps have, you know, either a unanimous recommendation or a split recommendation. In other words, from what I'm hearing, there are, of course, risks involved with nanotechnology. But, of course, if there are risks, they are risks for harm for humans. It's fairly clear that it would be morally wrong to engage in the production, say, of certain nanotechnological materials that would cause harm. But I don't see it as an ethical problem. I think the ethical problem is clear.

Now, many of the other problems you mentioned, Dr. ten Have, seem to me to be extremely important, but I view them more as issues in politics or issues in general prudence, things that should be done, for instance, to re-insert science in the political community, for instance, to regenerate trust. But, again, I'm not... maybe I'm blind to this. I don't see the specific ethical issue that would require reflection which solutions are correct and which are incorrect.

I would be grateful for some clarification on those points.

DR. TEN HAVE:   Of course, it depends on, of course, how do you demarcate the area of ethics. And I think that it's a kind of... also in UNESCO it is often argued that risk is a technical issue, it doesn't involve any ethical issues. And if you talk about the social ethics, it's more political. I think what is at stake in both is reflection on the values. So ethics is not only using an algorithm of principles, but maybe we don't know exactly which are the principles that should guide a particular development but are important values involved, which is more or less also the strategy in the European opinion to say, well, we have value and respect for human dignity.

We don't know exactly how nanotechnologies are impacting on human dignity. At the same time now technologies can contribute to promote health. This is an important value. And the reflection is ethical. Also, if you want to focus on risks as they are doing now in, for example, in OSED, you still have to define what you consider to be a risk or not, and it's related to what do you see as a significant harm? And this is not a technical issue. It's a kind of balancing of different levels of what is acceptable, what are benefits, what are harms?

So in the end it's an ethical issue that will be translated in very technical details. The same for, let's say, the question about the responsibility of scientists. To my mind, that is a basic ethical debate that needs to be encouraged by governments but is mainly the responsibility of scientists themselves. In what way are they honest? Are they showing integrity in explaining the research they do, in reporting the results? And it's not legal. It is a duty that you need to have in order to be a scientist in distinction to people with other professions. So it's maybe also here a kind of not only do you have the professional ethics of medical doctors, you also have the professional ethics of scientists. And that is ethics.

So in my view, ethics is broader in a sense that it concerns a reflection on the values that are at stake.

CHAIRMAN PELLEGRINO: Dr. Schneider and Dr. Dresser.

PROF. SCHNEIDER: A couple of times you mentioned proposals to educate scientists in ethics. I'm curious to know what that means in real life. There is a lot of discussion of educating scientists so that they can do human subject research in the United States. What that means is somebody has to decide what the right thing to think ethically is, at least this is how it works out in practice, and instruct scientists on the correct way of thinking about the ethics of their undertaking. And then in order to be sure that this education has been effective, scientists have to take a test, and the test, which is often done on the Internet, measures how well they have learned their ethical lessons.

The tests I have seen suggest that the authors of the test are very confident about the correctness of their ethical views and that their ethical views aren't very complicated. So what does this proposal for educating scientists about ethics work out to mean in real life?

DR. TEN HAVE:   You know that there is a lot of ethics education in the area of bioethics, primarily in medical schools, and in UNESCO we are trying to make a database of ethics teaching programs in different countries and different areas, not only bioethics. But there is a tendency, I think, in many countries to reduce ethics teaching in the area of bioethics to primarily research ethics, and I think  maybe I'm wrong, but Dr. Pellegrino told me some time ago that at the moment in your country here there is less ethics teaching, in fact, than 20 years ago. And the number of programs have also been concentrating on a more limited area of research ethics.

If you look at other countries, and especially in Europe, it is not so well developed. In France you don't have a lot of ethics teaching, even in the area of bioethics. In other countries maybe it's a lot better, but in most of the European countries ethics  in general ethics teaching, even in the areas of bioethics, is not well developed. So we try to promote, and what is also explicated in the reports, is that in fact it is necessary to have ethics introduced in the training, in the curricula, of all scientists.

And then there are different ways to do that. One way - and you pointed out - is instructing scientists what are the rules, what are the codes of conduct, and what do they have to learn in order to behave properly.

That, I would say, is a view of ethics as it is used also in companies where you say, well, you have to follow particular rules and then it's okay. But what I usually try to argue, especially also in the French report, is ethics is not instructing, it's more making scientists reflect on the implications of their work and to think about the value choices that they are making, that they are promoting, in their types of research without sometimes having clear answers. But you can communicate your own uncertainty and your own difficult choices in a way that shows that you are concerned with the implications even if you are not completely certain. And if you can do that as a scientist, you can also better communicate, perhaps, with the public.

So they try to introduce ways of teaching ethics, for example, not by instructing or lectures but by giving them assignments, by small group teaching, by discussion, because the primary aim is to make scientists aware that they are not only like engineers, and even for engineers it would be important, not only having a technical job but their work is taking place in a context and will have social implications; and it's their duty to think about that, and they have to learn how to analyze those problems and how to reflect on those problems and how to communicate those issues.

So I don't think that testing, for example, through the Internet will be a good way to do it. It's more like showing that you have certain concerns about the implications of your work that be the vigilance they take in the French report.

PROF. SCHNEIDER: So who does this education?

DR. TEN HAVE:   In most of the teaching programs we have described, the scientist themselves, like in bioethics. Most of the bioethics programs are taught by medical doctors, and then, of course, you have specialists like - well, the same for gerontology. You have specialists who are in a particular area, but in fact every doctor has to deal with all the patients. So every doctor should be able to teach ethics. And maybe there are some specialists who can go in more depth.

So here there is a need also that some of the - let's say, the more experienced or more concerned scientists, they should have room to teach ethics and to introduce ethics in mathematics and engineering and biology and then make other younger people more interested so that there is a kind of professionalization, maybe, in how to teach and how to do these kinds of things.

That is what we also try to do, to make the experiences available. In our database we now have 200 ethics teaching programs in different countries. So if you want to start an ethics course in engineering ethics, you can find some examples in the database.


PROF. DRESSER:  Thank you. I appreciated your paper. I thought it presented a very organized, understandable review of ethical issues, and I think your talk added to that. So thank you. I think you all are much farther ahead in this area than we are in the U.S.

To me this is a similar situation to the human genome project, where at the outset there was a realization that we're entering a complicated area of science that will have ethical and socio-legal implications. Part of the ethics work is to figure out what the issues are as well as then to start thinking about how to work through them. So it's not like cloning where we have, you know, yes or no. It's not that developed yet, but you need people with ethics backgrounds to sort of think through what are the issues and possibilities.

So much of this is anticipatory. We don't really know where we'll go. And, again, that's similar to genetics, and then we've seen, of course, with stem cell research and things like gene therapy and the artificial heart.

So we have to speculate about different outcomes and different risks and benefits. For me one of the biggest irritants is the hype factor you mentioned, positive hype as well as negative hype, the disaster scenarios. So one principle that I think might be useful in thinking about scientific responsibilities is truth-telling responsibility, where the scientific community should have as a goal in public discourse and among themselves doing the best they can to be accurate about the different possibilities.

I always draw an analogy to medicine, where we now think that in general a physician should tell patients about a poor prognosis. Now, they can't know exactly what will happen, but there's a duty to be honest about the possibilities. And so here I would say that the same thing holds true. And so maybe that involves debate among scientists who have the positive views of benefits and then the more cautionary views that can be held in a public forum, sort of a marketplace of ideas where the public gets a sense that you don't necessarily want to listen to just the positive hype.  And they're the ones, of course, who get quoted in the newspapers and other media. But you might get a range of opinions.

I don't know if you've read Ray Kurzweil's book, The Singularity is Near. There are a number of people out there writing about nanotechnology, and I think they're making a lot of money from it, but they put this very utopian spin on it, and I just think it's so important for the countervailing views to come out, and I hope that the scientific community as well as the intellectual community will speak out with the differing views, because I think if you do have this model of democratic control, people have to hear from speakers and writers other than those who are promoting these ideas for their own agendas, whether it's commercial or otherwise.

DR. TEN HAVE:  I fully agree. Nothing to answer.


PROF. MEILAENDER: I appreciated your - what we might call your summary of the various issues that are getting discussion, at least in Europe, but I'd like to see if I could get you to move beyond that summary of the issues. I'd just be curious about your own normative views. You said a number of things along the way that might provoke one to further reflection. You talked about how there needs to be a debate about the goals of nanotechnology, but it's one thing to say there needs to be a debate; it's another thing to have the debate.     

You talked about the possible implications for things like concept of self and personal identity, though that's not supposed to sort of divert us from other issues. You talked about a need to rethink the ethos of research, but again it's one thing to talk about the need to rethink it; it's another to actually rethink it.

You talked about transcending the distinction between the natural and the artificial which, at least if applied to human beings, is certainly a provocative thought. So what I'm wondering is, in your own normative views, now, not just summarizing what the European discussion has been about, whether in this whole package of things you talked about there is some area or some sort of concern where you think, for lack of a better word, human dignity really is at stake, where something that significant either in terms of something that would be a great step forward for human dignity or something that's a real danger to human dignity.

I mean, is there something here that you think is important not just to say, "Well, people should talk about this," but "Here's something I'd like to say about it"? I mean, I'd be curious to hear the center of your own normative concerns on this matter.

DR. TEN HAVE:   Thank you very much. Of course, I'm speaking not as somebody working in UNESCO, because that's the limitation. But I think for me what is fascinating in nanotechnology is the possibility of what is called in the French report, "the dream of the engineer," because we can manipulate and produce new materials, and that could potentially be very beneficial in order to have a much better use of resources, assuming that it has no negative impact and it's safe. I think it will also be very important for many developing counties. It will be a danger because they will be out of control of their natural resources, but it can help us to solve basic problems for humankind.

I am much more skeptical about the second area of interests, what is called in the French report, "the desire to have transcendency," because you notice at the same time  and that's a difficulty in discussions of nanotechnology  that it's driven without being very clear by a kind of transhumanistic agenda, that people want to improve humankind, not only make better materials, but they want to improve the human being itself.

And then I'm very critical, because who is driving this move? In what way are we improving human beings? Because my inclination will be to say, "Well, in many cases human beings, they are already in a very well-situated position. If I look in UNESCO and see all these people in different countries, there's a lot to improve in their own conditions without improving themselves. So I think that for me one of the ethical problems is that there is continually this mix of two different motives: the motive to improve human beings, which could be, let's say, having a very negative impact on the whole idea of human dignity because it's not clear how this is in any way related to the idea of human dignity. It seems that it's even contrary to human dignity, because you want to improve and make people better.

The whole debate is related to that, but there is a basic transhumanistic agenda, and the mix with how we can improve, how we can produce better materials for the use of human beings. So personally I am very much in favor of trying to keep the distinction between what is natural and artificial when it comes to human beings and trying to overcome the distinction from the point of view of human beings between natural and artificial when it concerns our context.

CHAIRMAN PELLEGRINO:  Further questions? Leon.

DR. KASS: Thank you very much for a very clear and synoptic presentation. I tended to listen primarily with the question in mind of what is there in this area that is of possible interest as work for this - for a body such as ours. I don't agree with Alfonso that our task is somehow limited in the way in which he has described it. In fact, the statutory  or in the executive order that created us - and we've repaired to this many times  the first submission, our first function, is to conduct fundamental inquiry into the human and ethical meaning of advances in biomedical science and technology before one gets to the question of what are the ethical issues and before, then, one gets to the question of how they should be resolved.

So I'm not bothered by the fact that this is an area that doesn't immediately lend itself to saying yea or nay. My difficulty comes in trying to get a handle on what precise kinds of significance that we face here, particularly because this is such an amorphous field. I was trying to think of analogies. If one were to say, look, there is something called information technology. What are the human and ethical implications of this? Or push the clock back and say, well, there's organic chemistry. We now have capacity to synthesize carbon compounds. And one could have - one didn't have such a discussion, but one could imagine retrospectively, and that covers just, you know, from pesticides to cures for cancer to new forms of apparel and so on.

Genetics is even more focused than this. I think Rebecca is in a way right that this was a certain - in this country especially when the genetic revolution was underway, people were calling attention to this, and the ELSI aspect of the genome project was a direct reaction to this. But I don't even see with comparable clarity what the parameters are, and maybe you could help point to a sub-area of nanotechnology that would be suitable kind of focus substantively. That would be one question.

And the other this is to sort of follow up on Peter's question, also in a way by implication from Carl Schneider's question. The analytical approach of what we need that you've summarized surely gives - is based upon one answer to the question that scientific and technological developments are not autonomous, that they at least yielded part  that they are a product of the human decision, and that therefore they yield in part to what we do, and we will do better the degree to which we understand what the issues are.

But it does seem like it has a kind of rationalist cast of its own comparable to the science it seeks to regulate, because it looks as if all of this could be rendered somehow manageable though a political process if all of these things took place, and I wonder whether, especially in the absence of a concrete sense of what actually are the operative norms here, human dignity, as this Council has discovered, is not a unifocal thing about which all of us agree. So I wonder whether  the first question is, what is a subpiece of this such that we could see, ah, yes, these are the kinds of ethical questions that we could sink our teeth into; and the other is, short of this kind of global project for what's necessary to govern technology in general and using nanotechnology as the kind of latest vehicle to try to get a handle on the juggernaut, what's a reasonable way to think about how ethical reflection can contribute in a world which isn't really fundamentally governed by the kind of schematism that you offer?

I mean, people don't simply think about these things along these lines. Well, the second part wasn't clear, but maybe you could make something of it.

DR. TEN HAVE:   Concerning your first question, I'm not sure that you can argue that nanotechnology is raising new ethical questions. Maybe that's not even a relevant - for ethics I would say it's not so  such a relevant question, because in effect some people say, well, everything we do is making footnotes to Plato. So we have new developments, and we want to reflect on the impact of the development even if not completely new questions are raised. But at the same time, it's not clear that the framework we have developed to articulate ethical issues will apply to this new area, because as we tried to indicate also in this report, maybe one of the basic characteristics of nanotechnology is its invisibility.

It is on a level that makes it absolutely impossible to control, so it means that you cannot only wait until the products or the visibility is there. You have to put a much higher trust in a preceding stage in making sure that people are following some principles, which is also not a new question, but now here we are for the first time confronted with a technology that can be completely concealed and hidden. So I think we have to see whether the usual approach in ethics is sufficient here, and we don't know. So there is a need for more refection.          

It's too soon to start making guidelines and legislation and whatever because we don't even know what - at the same time it's also clear that if we wait - and that's the experience particularly in the European counties. If you wait too long, it's too late, because now we have a chance to be on top of the developments, and that is the lesson from genetically modified food, for example, that the ethical refection  and also another area is like in reproductive medicine - that the ethical reflection only started when the development was already made.

So here this is a need to bring ethics and science much more together. That's one of the reasons why we often have these pleas for interlinking science and ethics. Now, you should have scientists  or you should have an ethicist who is actually working in a nanotechnology laboratory or center. That's the plea for the French ethical space in research centers. Like anthropologists, you should bring an ethicist in the middle of the research to identify what are the ethical reflections that are necessary. So it also calls for a somewhat different, more proactive, more integrated approach in the ethics of science in order to avoid the usual complaint that ethics is always too late. Now here we have a chance.

I think also for the policy-making community it will be important. For the ethics community it will be important. For the science community and also for the policy-making community because they are increasingly worried about the impact of science in the community that you can see. You cannot simply assume that the public will accept all these scientific developments. If there is one, let's say, big scandal about nano products, maybe the whole climate will change.

So now you have a chance. That is maybe not  I am not able to say, well, these are the main issues, but there is a kind of a general challenge that we need maybe to transform our usual thinking about ethics a little bit more in order to have it much more integrated with scientific development.

The second question.  Of course, you're right that scientific development is not driven by ethical concerns. There are a lot of other issues, and there are certainly limits to policy-making. At the same time, in my view, ethics has specifically the task of being idealistic because without having an idealistic approach you'll be sure the development will go in the direction that is driven by all kinds of other concerns. So there is a need to create some kind of counterweight to developments in terms of emphasizing values like human dignity or autonomy or confidentiality, knowing that it will be difficult to implement. Especially in the context of UNESCO, that is certainly the case.

What is maybe even more important is that we have a medical debate in our countries, like in the US and in Europe, but nowadays let's say most of the publications in peer-reviewed journals in nanotechnology are Chinese. What ethical debate is there in China? None. So there is need from the perspective of UNESCO to say also we need not only to have an ethical debate here to develop all kinds of guidelines in the responsible policy here, but there is need to broaden this and to make all counties, especially the countries where you have a lot of development nowadays.  Also concerns about the ethical impacts because they will have the burden of irresponsible behavior first of all among themselves. So here there is a possibility, even if scientific development is not manageable in this respect, the possibility at least to bring ethical concerns also on the global agenda.

I think safety is a good candidate to start because nowadays there is a lot more concern about possible risk and safety. OECD is working on that. Even Chinese scientists are more concerned about that now. So that would a good starting point for making people more aware of ethical issues.

The more fundamental question about what kind of goals are accomplished by scientific developments in this area, they will require a debate among countries themselves because now the agenda is driven by national interests. But even if you are pessimistic about, let's say, the effectiveness of such a debate, I think we should have a debate about the ethical implications and the goals of scientific development in terms of the Millennium Development Goals because all the countries have accepted that these should be the goals for the near future.

So how can their science policies contribute at least partially to make these goals more in reach? And if we don't do that, I think it will be a very pessimistic assessment of what, as a scientific community, internationally we can accomplish. So I think it's the duty of ethics never to give up and to try, knowing that the results will be limited. But if nobody raises the questions, they will never be discussed.


DR. CARSON:  Thank you for that presentation. You know, back in the early to mid 1800's people, the scientists of the day, thought that everything broke down to the smallest unit, and they thought that the smallest unit was the cell. You know, subsequently it was discovered that there was a whole lot going on at the subcellular level, and many areas of science have blossomed from that discovery, the whole field of molecular biology, et cetera, with its concomitant ethical issues have blossomed. And my question is, what percentage of the nanotechnology advances that we're talking about are the result of our discovery of things that already existed that are not really new things that have been created versus new things that have been created?

DR. TEN HAVE:  I don't really know the answer to that, but I think, as argued by Schummer, it also depends on how we define our technology, because you can bring in a lot of existing programs if you have a definition that is only focused on a narrow skill. So there are different ways to define and to construct nanotechnology, and that relates also to the question of whether there are new ethical issues. Because if you say, well, it's kind of a reorganization of the work that has already been going on in chemistry, there are hardly any new ethical issues, implying there will not be any debates on ethics necessarily because there are no more issues. If you focus, as is sometimes clear, on the more transhumanist agenda so that we can be focused more on enhancement, there will be new ethical issues but not only in relation to nanotechnology, of course. But there is a bigger need for medical debate than in the first definition.

So I think for me the answer all depends on how you construct this notion of nanotechnology.

CHAIRMAN PELLEGRINO: Thank you very much. We're right on time. We appreciate your presentation and the questions. We will reconvene at 10:30.

(Whereupon, the proceedings in the foregoing matter went off the record at 10:21 a.m. and went back on the record at 10:54 a.m.)

  - The President's Council on Bioethics -  
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