and Human Rights
Salvador Dario BergelAbstract
The Universal Declaraion on Bioethics and Human Rights of UNESCO, on 2005, represents a radical change between the “classical bioethics”, devoid of a social and poliical view, and the “new bioethics” witch inserts man into a global stage with their peers and other components of the biosphere. Ten years ater its entry into force, the paper relates its history, as well as its social and poliical value of the Declaraion, highlighing its more signiicant contribuions and concluding with a vision of the future.
Keywords:Human Rights-Bioethics. Policy-Treaies. Internaional acts-Social jusice.
Resumo
Dez anos da Declaração Universal sobre Bioéica e Direitos Humanos
A Declaração Universal sobre Bioéica e direitos Humanos da Unesco, de 2005, signiica um ponto de corte entre a “bioéica clássica”, desprovida de uma visão social e políica e a “nova bioéica” que situa o homem em um cenário global com seus semelhantes e demais integrantes da biosfera. Após dez anos de sua vigência o arigo relata os antecedentes assim como o valor jurídico, políico e social da Declaração, ressaltando seus aportes mais signiicaivos e concluindo com uma visão de futuro.
Palavras-chave: Direitos Humanos-Bioéica. Políicas-Tratados. Atos internacionais-Jusiça social.
Resumen
Diez años de la Declaración Universal sobre Bioéica y Derechos Humanos
La Declaración Universal sobre Bioéica y Derechos Humanos de la UNESCO de 2005 signiicó un punto de corte entre la “bioéica clásica”, desprovista de una visión social y políica, con la “nueva bioéica” que ubica al hombre en un escenario global junto a sus semejantes y a los demás integrantes de la biósfera. A diez años de su vigencia el arículo relata sus antecedentes, así como el valor jurídico, políico y social de la Declaración, subrayando sus aportes más signiicaivos y concluyendo con una visión del futuro.
Palabras-clave: DerechosHumanos-Bioéica. Políicas-Tratados. Actos internacionales-Jusicia social.
Doutors.bergel@zbv.com.ar – Cátedra Unesco de Bioéica en la Universidad de Buenos Aires, Buenos Aires/DF, Argenina.
Correspondência
Florida 537, piso 18º C1005AAK. Buenos Aires/DF, Argenina.
Declara não haver conlito de interesse.
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The history of the Declaraion
Ten years ater the signing of the UNESCO Uni-versal Declaraion of Bioethics and Human Rights1,
an assessment has to be made of its importance, the fulillment of goals pursued and its future projec-ions. The Declaraion was not an improvised text, the fruit of an idea launched in one of the many Unesco meeings, but on the contrary, arose from a long process of elaboraion through many very en-lightened debates.
Going back to its history, we would have to return to the 30th of March of 2001, the date on which the President of France launched the idea of developing a universal instrument devoted to bioethics within the United Naions Commission on Human Rights. Based on this idea, the Inter-naional Bioethics Commitee (IBC) of UNESCO commissioned the doctors Giovanni Berlinguer and Leonardo De Castro to report on the possibili-ty of developing a universal instrument concerning bioethics.
Based on the prepared report, the IBC entered upon the task of its implementaion, beginning in January 2004. Three phases took place in this
pro-cess:
1. Consultaions during the irst months of 2004, with the Member States of Unesco, governmen-tal and non-governmengovernmen-tal organizaions, as well as the IBC, on the cover page, objecives, struc-ture and content of the fustruc-ture declaraion; 2. Drating of the text of the declaraion by an
edi-torial group of the IBC.
This phase was characterized by consultaions with Member States, governmental and non--governmental organizaions, ethics commitees and specialists. The work group was made up of specialists from Europe (France, Italy, the United Kingdom and Lithuania), Asia (Japan, the Philippi-nes, Israel and Lebanon), Oceania (Australia and New Zealand), Africa (Morocco and Rwanda), and America (Canada, Mexico, and Uruguay). It should be noted that three disinguished inter-naionalists were included in the group: H. Gros Espiell, M. Ida, and M. Roucosimas;
3. Compleion of the text of the future declaraion, in the seing of two meeings of governmental experts, extensive discussion within the IBC and inally the approval of the Declaraion, which was unanimously raiied by the Member States of UNESCO 2.
As can be observed, the Declaraion was carefully prepared and suiciently debated within UNESCO. The unanimous vote is resounding proof of this. While it was never translated into a treaty, there is no denying the binding force that it has on the internal order of the States, as we present below. The texts, as Badía Marí airms, mean the consoli-daion of bioethics in internaional relaions beyond the scieniic dimension, its full incorporaion in the relaions between States with their implicaions in the economic, poliical and social ields, entering fully into the internaional arena.
The author claims that the Declaraion sill has the indisputable merit of incorporaing the sub-ject of bioethics in the internaional legal order, in the hands of an issue so sensiive and universal in nature, such as human rights, which opens a new scope in this order which is not easily dealt with due to the diversity of interests at stake and the mulidi-mensional character of the mater 3.
The indissoluble link between bioethics and human rights
Beginning with its itle, coninuing with the explanaion of its history, this Declaraion is to be understood in a manner consistent with domesic and internaional law in conformity with human rights law; the aims of this Declaraion are to pro -mote respect for human dignity and protect human rights, by ensuring respect for the life of humans be -ings, and fundamental freedoms, the inimate link between bioethics and human rights that it estab-lishes is very clear 1.
In doing so, it did not try to seek a protecive shield for bioethics – which it otherwise did not need – but rather emphasized in conveying to its recipients that bioethics provides for a concrete ap-plicaion of human rights in the ield that is its own (the life, health and welfare of human beings) and this not only with regard to the progress of the tech-nosciences, but also in a much more open ield: that of the social and economic determinants of life and human health. Both construcions speak the same language and note a common objecive in the inal analysis: the defense of human dignity before the pifallsof a world that advances precipitously, leav-ing out large masses of the populaion which remain trapped through their dramaic exclusion from the most diverse areas of life.
The 1948 Universal Declaraion of Human Rights 4 was not the fruit of an invenion carried out
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by a handful of enlightened people, which while the world was emerging from one of the most grueling catastrophes in history sought to protect human dig-nity, shielding it with a catalogue of elemental and essenial principles for organizing a peaceful and lasing coexistence. It was much more than this: the awareness of this need could perhaps be the most relevant merit of the instrument voted in 1948.
We say that it was not an invenion, as much as it limited itself to translaing– perhaps masterfully – principles and demands already loaing in collecive consciousness. The Declaraion of 1948 did not in-tend to constrict human rights into a closed catalogue and if there is anything that may be learned from it, it is the need to move forward in the search for new rights, in accord with the natural preoccupaion of human beings with improving the condiions of their existence for their own enjoyment and to transmit to future generaions a legacy superior to that received.
In its shadow – as the always remembered E. Rabossi described it - an extremely complex, very dynamic legal, poliical, ideological and mor-al phenomenon, of globmor-al scope and revoluionary consequences, has been developed. The phenome-non, Rabossi observes, is not anarchy, as it provides a macro scenario in which the interests at play are confronted, logic intersects and soluions (some-imes) are reached 5. As far as these rights are
human, they represent needs, primary criteria, so-cial, economic and cultural material without which the individual cannot develop his life with dignity 6.
Several classiicaions have been developed over the years, which not only aimed to organize the material, but also intended to establish a hierar-chical order of human rights, according to economic capabiliies of fulilling this. All these classiicaions, deep down, aim to explain or atest the null or di-minished validity of economic and social rights, which are – coincidently – the ones most persistent-ly violated. The reality is that all human rights have the same reason for exising and all must be applied and respected on an equal fooing. Cataloging only contributes to weaken their pracical applicaion. Violaion of these rights marks, precisely, a ield of struggle, a demandthat only ceases with their efec-ive entering into force.
In this picture, proclaims the UNESCO Declara-ion proclaims, in essence, is a set of human rights that are systemaically violated in the ield of human life and health. It did so with regard to the reality of the moment at which it was signed, which did not imply that in the future, other rights could be incor-porated according to the arising of new demands
and the progressive character assigned to them. In short, the Declaraion of 2005 is integrated with that of 1948 and other instruments that were generated at the internaional or regional level through the in-luence of social and poliical demands on the ield of human rights. Among other rights menioned: • the right to respect for personal autonomy; • the right to respect for personal integrity; • the right to enjoyment of the highest atainable
standard of health;
• the right to quality health care;
• the right of access to essenial medicines; • the right to adequate nutriion;
• the right of access to drinking water;
• the right to the meeing of basic needs (poverty reducion);
• the right to literacy;
• the right to enjoyment of the results of scieniic research;
• the right to an unpolluted environment 1.
“In establishing human rights among its princi-ples,” Dora Porto points out, “the social dimension was recognized as intrinsic to bioethics” 7. Bioethics
thus incorporated – preponderantly –human rights issues relaing to the social and economic condiions of human life and health.
The legal, poliical and ethical value of the Declaraion
It is known that under internaional law, a dec-laraion does not have the same efeciveness as a treaty or convenion. Based on this diference, it has been held that the contents of 2005 Declaraion are not binding for the countries that signed it. Faced with this aitude from those who try to relegate the Declaraion to a simple expression of good wishes signed by representaives of the States, Héctor Gros Espiell, an outstanding igure in internaional law and driving force of the three UNESCO Declaraions on Bioethics, wonders: What does ‘non binding’ mean?, That which does not create links? And he answers: It can not be said that a Declaraion adapt -ed by the Unit-ed Naions General Assembly does not create links. For Gros Espiell and for the majority of the doctrine it is a source of rights 8.
When the Universal Declaraion of Human Rights (1948) was adopted, some delegaions also
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argued that it was merely a moral text that would serve as an example for domesic law. That same day, the French delegate, René Cassin, one of the authors, said: on the contrary. In a masterful and premonitory speech, he said that the Declaraion of 1948, as a projecion and reinement of the United Naions Charter, had its own legal value and would come to be a source of rights9.
Later, in the Tehran Conference of 1968 and Vienna Conference of 1993, it was established that the Universal Declaraion was obligatory for the en-ire internaional community. This materialized in doctrine which is paricularly unanimous today on this mater and repeatedly sustained by the Interna-ional Court of Jusice. Concluding his observaions, Gros Espiell expresses that the Universal Declara-ion has a binding character, not only morally and poliically, but also binding as an eventual source of rights, from a legal point of view.
In this same line of thought, Maria Yolanda Gómez Sánchez, Professor of the Naional Univer-sity of Distance Educaion (Universidad Nacional de Educación a Distancia - UNED) and former member of the IBC, considers that the Universal Declaraion of UNESCO, adopted by the Member States of the United Naions, is an internaional legal document, from which commitments are derived, and also le -gal materials with respect to its content for all of the countries which have adopted it 10. In its
construc-ion, there is a disincion between the legal value of the Declaraion and its internal legal efeciveness in each of the States which have signed it.
When the principles of internaional law de-ine the concept of a ‘binding document’ for the States, she states, they are alluding to the internal legal sphere of each of the States subscribing to the internaional document, but not to the general legal value derived from its adopion by the States within a paricular internaional organizaion. The legal val-ue of the Declaraion applies equally to all the States that signed it and with regard tothe commitment of each state (which is subject to internaional law) to the internaional community.
Consequently, the author notes, the content of the Declaraion will always be binding, in a gen-eral sense, for all of those States which have signed it, with regard to their internaional commitments 10.
‘Internal efeciveness’ alludes to the posiion of the Declaraion in the internal legal systems of the States and their hierarchical relaionship (supremacy of some rules over others). Although both the interna-ional value and the internal legal efeciveness would be essenial elements of the Declaraion, the second
is a determining factor for the pracical implementa-ion of the Declaraimplementa-ion in the internal systems of the various States, since it allows the deining of the leg-islaive and execuive goals of a given State, and in each paricular case, the possible legal protecion to be recognized in the Declaraion.
The acceping of the “non-binding” thesis to the Declaraion, would lead to the legal incongru-ity that the states can commit internaionally to while not being bound by to the commitments un-dertaken. In this direcion, Aricle 3 of the Vienna Convenion on the right of the treaies to determine which internaional accords do not remain included within the scope of the same states:
The present Convenion does not apply to in -ternaional agreements concluded between States and other subjects of internaional law or between such other subjects of internaional law, or to inter -naional agreements not in writen form, shall ‘not afect the legal force of such agreements’ 11. This is
all the more reason why these principles should be applied to a writen instrument signed by the States.
A compelling example of the legal status of an internaional Declaraion in domesic law is ofered in aricle 75, subsecion 22 of Argenina’s Consitu-ion, the second paragraph of which establishes that the American Declaraion of the Rights and Duies of Man, and the Universal Declaraion of Human Rights
…have consituional hierarchy, do not repeal any
aricle of the First Part of this Consituion and are to be understood as complemening the rights and guarantees recognized herein12.
In short, the Declaraion on Bioethics and Hu -man Rights, unanimously signed by the Member States of the United Naions and raiied by the Gen-eral Assembly of one of its organs (UNESCO), has a tangible legal status in the internal order. While in our country it does not yet have consituional status, its the corresponding legal value cannot be denied due to the sole fact of it being a Declaraion, raiied by the States.
What has not been translated into a treaty does not impede recogniion of the legal value of the Declaraion, which was widely discussed for two years and passed by the unanimous vote of the sig-natories. What does not enable the demand of the obligaions assumed by one or various states from the non-compliant, does not mean that, in their in-ternal order, the signing of the Declaraion amounts to assuming the obligaions of the State to its cit-izens. Moreover, regardless of its legal status, the Declaraion has an important ethical value in terms
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of its efect on the current agenda, incorporaing ethical issues whose importance cannot be ignored, as will be seen in the next development.
From a poliical point of view, the Declaraion provides suicient tools for those aspiring to a bio-ethics which is closer to the problems and dilemmas of everyday living for large masses of the global pop-ulaion.
The Contribuions of the Declaraion
Beyond the depths and heights of the debate that preceded the approved text, it is only fair to recognize the fundamental contribuion made by Lain American bioethics, especially Brazilian, to the content of the Declaraion. In this direcion, it is worth menioning the grand Congress of Bioeth-ics in Brasília in 2002, which took place under the suggesive slogan “Bioethics, power and injusices”.
The Congress of 2002, as noted, “poliicized” in actual pracice the internaional bioethics agen-da. The principles of autonomy, beneicence, non-maleicence and jusice – despite being indis-pensable and central to bioethics – ceased to be the only theoreical and methodological tool available to researchers and scholars. The pracical result has been gradually incorporated into the internaional epistemological context of bioethics 13. These
contri-buions were translated into the “principles” of the Declaraion. These principles not only consitute the axis along which the “new bioethics” travels, but – essenially – consitute guides to acion.
This is how they were understood by the cul-ivators of bioethics in their meeings and would serve to move the future agenda. From these prin-ciples we take those that in our judgment are the most original contribuions:
a) Health Promoion
The Declaraion refers to various health-re-lated rights: the right to the highest level of health, the right to quality health care, the right of access to medicines, all of these regardless of economic and social health condiions. In its introducion, it stresses that health does not solely depend on the progress of scieniic and technological research, but also on psychosocial and cultural factors.
Berlinguer, the illustrious bioethicist and Italian sanitarian, tells us of a society in which the possible does not oblige to medicine the sad duty of engaging itself in reparaive acivity, which is late
and generally useless on the damages caused out-side its ield of acion 14. Both primary prevenion
and health promoion jointly propose prevening disease and improving the psychophysical condi-ions of the individual. These types of prevenion tend to mobilize the prevenive capacity that is the fruit of decisions made in other areas, the spread of educaion, the humanizaion of work, the improve-ment of housing and urban living and the spirit of coexistence and solidarity between ciizens 15.
As outlined, all medicine has health as a goal, but only prevenion has as its intrinsic character and speciic aim the equality of every ciizen in the ield of health. Aricle 14 of the Declaraion begins by airm-ing that health promoion and social development for their people is a central purpose of governments, shared by all sectors of society 16. The right to quality
health care translates into care that guarantees the adequate selecion of an indicaion in accordance with evidence or at least with some scieniic support that shows its usefulness; an adequate assessment of risks and possible harms it can cause, a human care that respects the rights of the paient and that complies with the criteria of jusice 17.
The rights of access to health services and medicines are essenial components of the right to health. When health sufers, the most basic of rights that can be exercised is that of access to health ser-vices; access in adequate ime and with the required quality according to the type of care. The existence of people who cannot count on the possibility of such access, consitutes an ofense to the human species. Parallel to the right to health care is that of access to medicines. The World Health Organiza-ion (WHO) periodically draws up a list of so-called essenial medicines. Beyond this, the provision of medicines is imperaive, without major disincions – which should be a primary beneit from the State.
The power to heal – returning us to Berlinguer – has become a direct, legiimate and explicit funcion of money, and due to this there is airmed in prac-ice, and someimes in the laws, the right to medical care and health proporional to wealth 18. These
sit-uaions, which unfortunately even today many countries display, should be deiniively overcome and the Declaraion points to this in its Aricle 14.
Primary prevenion and health promoion are oten outside the bioethics agenda. The issue of health – it has been noted – is rarely present in bioethical de-bates. These increasingly favor extreme situaions like “ariicial” births, organ transplants, the survival condiions of terminal paients, neglecing the fact that health and disease are for all a universal ield
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of experience, of relecion and also of moral choic-es. Health is commonly denied ennoblement as an object of ethics and in the best cases it is atributed only the value (which for some is considered philo-sophically irrelevant and intellectually plebian)of a social issue 19.
b) Poverty, malnutriion and illiteracy
For the irst ime, a universal document on bio-ethics places the focus of atenion on these themes which were commonly considered beyond its man-date. Poverty is sill the main cause of illness and is a factor which is beyond immediate control. Material poverty (as well as cultural) as well as necessitat-ing insalubrious labor aciviies, which brnecessitat-ing litle saisfacion, causes the acion of all disease-specif-ic factors, hindering the adopion of preventaive measures, and making healing more diicult 20.
Around poverty – as we pointed out on an-other occasion – a perverse circle is formed, which leads to malnutriion, environmental degradaion, marginalizaion, social disintegraion, crime, pov-erty, illiteracy, and the loss of self-esteem; a circle which makes leaving diicult for those who enter it, since they tend to reproduce these condiions in their descendants 21.
The 1995 World Summit on Social Develop-ment, in Copenhagen , had stated that the lack of income and producive resources to guarantee sustainable livelihoods generated hunger and mal-nutriion, ill- health, lack of access or limited access to educaion and other basic services, increased morbidity and mortality caused by diseases, dis-criminaion and social exclusion 22. Closely linked
to poverty is malnutriion, which in the irst years of life, produces devastaing efects. The right to food – speciied as safe, healthy and adequate food – presents as the most speciic ield of global cii-zenship. Through adequate and safe food, not only the body is nourished, but also the dignity of the person 23.
Fiteen years ago, the illustrious Brazilian ge-neicist and bioethicist Eliane Azevêdo published a fascinaing essay itled “O direito de vir-a-ser após o nascimento” (The right to exist ater birth) 24, which
stresses the need for adequate nutriion in the irst years of life. Malnutriion of children, she not-ed, slows cell division, DNA synthesis and the total number of cells in the brain, up to the point of inter-fering with the process of myelinaion, recalling that in a 1998 UNICEF document 25 it was recognized that
malnutriion impairs intellect, producivity and the
potenial not only of the person, but of the whole society. Azevedo adds that the absence of the min-imum condiions of food and shelter, required by the human body, funcions as a nulliier of geneic potenialiies, driving people to an early death, pre-ceded by a sub-biological life. Denying the essenial minimum to anyone is to usurp the most sacred of the essenial rights, that is, the right to full develop-ment of the biological and develop-mental potenialiies that it brings 24.
Years later, Stefano Rodotá, a prominent Ital-ian lawyer and bioethicist – perhaps without having read Azevedo – returned to the issue in similar terms. The right to exist, he expressed, entails sur-passing the zero degree of existence, that is, freeing oneself from a biological reducionism which guar-antees a minimum subsistence. In the already lengthy discussion that accompanies the recogni-ion and rejecrecogni-ion of this diicult right, we oten ind an overlap, a confusion between survival and existence. This is due to the fact that this discussion is born in the ield of poverty that accompanies sev-eral of its overt manifestaions through ime and in varying cultural contexts, dramaically linked to ter-rible condiions 26.
Since 2001, G. Keyeux reminds us, more than 100 million children were born with severe birth defects and geneic disorders 27. The impact is
par-icularly serious in low and middle income countries where 94% of births occur in those condiions. Un-doubtedly – to be speciic - geneic disorders are socially determined; 90% of these children are born in poor households, with degraded living condiions, to parents with low levels of educaion in the context of systems that provide minimal health packages for the poor and most vulnerable. Birth defects and ge-neic diseases, the author emphasizes, are not so much diseases of genes as of poverty.
Experience gained over the last 50 years in high income countries shows that mortality and disability caused by birth defects could be reduced by up to 70% in low income countries, if measures were implemented which are relaively simple and low cost, but highly efecive, which would encom-pass from educaion to prevenion, from prenatal diagnosic and pre-concepion services to early ac-cess to the insitutes menioned 27.
I allowed myself to transcribe these three con-tribuions from illustrious contemporary thinkers, in order to show the efects of poverty and under-nourishment on human life and development. In light of these realiies, it is easy to conclude that bioethics needed to include economic and social
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determinants of health in its analysis and in its pro-grams. Otherwise, the placid contemplaion of the damages , caused by poverty, undernourishment, social exclusion, lack of clean drinking water, with-out warning of their consequences to the health and lives of men, simply means divering the path of thought.
Without the pretext of applying an asepic bioethics, which limits itself to borderline problems, excluded from its reach are central themes of urgent importance. The inclusion of social and economic determinants of health and life can be described as an gateway from bioethics to poliics, which is nothing bad. The defense of an apoliical bioethics is a poliical posiion that is objecively contributes in favor of the reconciliaion of interests within the exising social status quo, as Sotolongo says 28.
The Declaraion of 2005, with all the edits that had to be accepted for there to be consensus, con-situted – without doubt – a strong step towards the integraion of economic and social determinants of human life and health. In this sense, Aricle 14 plays a central role in the achievement of such ends.
c) Protecion of future generaions
UNESCO had already shown its concern in a speciic declaraion on the rights of future genera-ions 29. Now the Declaraion of 2005, by reiteraing
this concern, points in paricular to efects that could engender the applicaion of advances in scieniic research to the geneic makeup of the individuals who will succeed us.
This is not a minor issue: when Man has man-aged to penetrate into the innermost secrets of heredity, when he has managed to modify geneic capital through techniques such as recombinant DNA – used today in ields other than human, such as agriculture –concern is born about what limits can be imposed when applying it to the human species.
The human genome is by nature evolving, as recognized by Aricle 3 of the UNESCO Declaraion on the Human Genome; but this variability born of natural evoluion of species cannot authorize a “directed variaion”, since in this case future gener-aions will not be condiioned by natural processes, but the intenional paricipaion of Man would come to play a role. This is obviously dangerous as there are no parameters to determine the limits of such intervenions, which could lead to alteraion of cer-tain characterisics in future generaions.
Science and technology, the adventures of hu-man thought, do not recognize limits and if they are
hypotheically ixed, can easily be vulnerable. The desiny of the human being is a disinct thing that imperaively demands respect, beyond and despite the projecions of the biotechnical sciences, in the concepion of Fermin Roland Schramm 30. Today the
possibility of altering geneic informaion to enable transmission of hereditary diseases may be debat-ed. This is a topic on which diferent criteria have been outlined, which must be duly respected and debated.
What should deserve general revulsion is the eventual intent to alter geneic informaion to incorporate in the ofspring certain features of “enhancement” according to the criteria to be de-termined by those who pracice them. Here the prohibiion on afecing the rights of future genera-ions plays a strong part.
There are diicult reasons for opposing trans-humanist posiions, – as Per Puigdomenech teaches – but one of these is to protect the generaions that follow us from the problems caused by inequali-ty between individuals that will occur under these condiions. If some day we achieve precise control over the genome modiicaion process on the germ line, this may be one of the most important factors that should be taken into account when making de-cisions about the use of these technologies 31.
d) Protecion of the environment, biosphere and biodiversity
“Classic” bioethics – so to speak – is charac-terized by accentuated anthropocentrism. It was only interested in man, and where possible, iso-lated from his habitat and society. In the UNESCO Declaraion of 2005, as R. Junges points out 32 – envi
-ronmental protecion appears to be a human right, but this anthropocentric perspecive is corrected by the sustainability of the biosphere and biodiversity. In other words, the environment is only preserved when there is a complex vision which comprises the environment as an integral system of interde-pendence (biosphere) and for this system to be in homeostaic equilibrium, there needs to be biodi-versity, which enables these interrelaionships. Only this systemic vision of the environment illustrates to organize social coexistence, and around its own eco-systemic vision of health, is a basis for understanding health as a human right and the environment as a basic component in the ield of health 32.
The inclusion of this principle, in the midst of an extremely concerning situaion, generated by the consequences of irraional exploitaion of
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the planet, marks the road ahead. In this process, this principle is interconnected with that referring to the rights of future generaions. We noted, on a previous occasion, that discourse about future generaions involves a broader direcion than the defense of Man in the future. In advocaing, as the center of the debate, the defense of the quality of life of the generaions to come, , there is an implicit tendency to improve the living condiions of all pres-ent or future living beings 33.
Final Consideraions
The UNESCO Declaraion of 2005 took an im-portant step. We have tried to demonstrate that far from being a simple “declaraion”, a simple intellec-tual essay formulated by state representaives to jusify the reasons for their meeing, it is a legal and poliical instrument which creates obligaions in the States and correlaiverights for their inhabitants.
The exirpaion of pockets of extreme pover-ty, access to drinking water, food compaible with development, access to health services and to es-senial medicines, and an environment neither polluted nor polluing, consitute not only the du-ies of the signatory States, but also, in parallel, the rights of their inhabitants. The Declaraion has the merit of showing these defects, but makes it in-cumbent on the ciizens, in the broadest and most comprehensive sense of the word, to demand and ight for such goals.
If a task is imposed on the basis of the Declara-ion, it is to deepen the analysis of problems linked to public health and social medicine. Thus, the Dec-laraion consitutes a great batle lag that has the virtue of exposing an issue that for many years was absent from the debates. It is the duty of all who approach a ield as fecund as it is fascinaing, that of bioethics, to work towards spreading the underlying
principles of the Declaraion and at the same ime to paricipate in acions which are aimed at expand-ing them.
To celebrate the 20th anniversary of the UNES-CO Bioethics Program, several authors have created a book enitled, Why a Global Bioethics?34. Among
the contribuions, H. Ten Have, Director of the Divi-sion of Ethics of Science and Technology at UNESCO, wrote a brief essay itled, “Bioethics needs bayo-nets” 35, noing the need to intensify acions to make
efecive the principles issued in the Declaraion. Here it is worth reairming the eforts for bioethics to be conducted within a broad social and cultural movement, directed to defending life and promot-ing health.
Social movements have demonstrated their efeciveness beyond the existence or nonexistence of legal norms. An unquesionable example given was the social reacion, not only internal but also extended to the internaional arenas in the case of medicines to combat AIDS, which brought the South Afcrican government to ignore treaies aimed at enabling its inhabitants to have access to essen-ial medicines; an example later followed by Brazil under the Lula da Silva administraion, which even-tually led to moderaing the Doha Agreement (REF) with regard to industrial property.
I consider that the condiions have been met to proceed with the signing of an internaional trea-ty on bioethics. The principles of the Declaraion have been studied, in depth, and discussed in innu-merable internaional forums, its doctrine has been extended considerably in the direcions noted here, and the lack of adequate response to many of the problems which the Declaraion ariculates, make necessary a stronger commitment in the interna-ional order, without prejudice to the intensiicaion of eforts to achieve the proposed objecives in the internal order.
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Disponível: htp://unesdoc.unesco.org/images/0023/002315/231540S.pdf Recebido: 29.5.2015
Revisado: 24.8.2015 Aprovado: 25.9.2015
