How can we respect others’ cultural beliefs and positions on a sensitive issue such as stem cell research, and yet maintain a competitive edge in the quest to defeat diabetes?

Response from Ole Döring, Ruhr University, Bochum, Germany:

Biomedicine is a global business, demanding global perspectives on health, medical progress and the pharmaceutical markets. The diversity of ethical and social challenges raised by different cultures requires respect.

Ethics in medicine helps to appreciate a vision that integrates moral, scientific and business interests under the paradigm of sustainability. The success of this arrangement depends upon trust. Patients trust that doctors treat them as well as possible, the public trusts that politicians are concerned with the commonwealth and that scientists pursue a better understanding of the real world.

Throughout current medical ethics debates, from Germany to China, the trustworthiness of key players has been questioned. There is a tendency to take personal greed, double standards and a merely rhetorical reference to moral arguments for granted. These trends carry an imminent danger that might jeopardise the success of the vision of sustainability.

Like other social contracts, sustainability relies on the resolve of society’s leaders to demonstrate honesty, responsibility and trustworthiness. Given biomedicine’s new global horizons, stakeholders from sciences and industry should take the lead in exhibiting good conduct, especially when, as in many developing countries, national regulations are inefficient to protect their citizens. Trust will also be built when companies keep their profile transparent and actively support public debate and a rigorous ethical review of important issues.

Critical voices from all backgrounds should be treated with respect. Philosophical objections to research on human embryonic stem cells remind science and individuals that there is considerable debate about what defines life. Such research should be assessed with due sobriety, transcending religious beliefs and scientific enthusiasm.

Public engagement involves risks; however, that is the price for social peace and trust.

Drs. Ole Döring, a philosopher, sinologist and expert on medical ethics in Germany and China, is a research fellow with the Institute of Asian Affairs in Hamburg and the department of Chinese Philosophy and History at Ruhr University, Bochum, Germany. He participated in the roundtable discussion on stem cells hosted by Novo Nordisk in August 2002.