A matter of life and death

By Qi Xiao (China Daily)
Updated: 2010-06-10 11:46
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A matter of life and death
Qiu Renzong, 78, is a pioneer in the development of bioethics in China.
 Jiang Dong / China Daily

As new technologies like stem cell treatments and DNA therapy become a reality, medical ethics are more important than ever, bioethics pioneer Qiu Renzong argues. Qi Xiao reports

You are a doctor, what would you do if a dying patient could only be saved by an immediate operation, but his or her family refused to sign the consent paper?

A terminally ill patient is in unbearable pain would you end their suffering?

These are just two of the life and death decisions that doctors confront.

What they choose to do will not only have an impact on their patients and themselves, but also affect the wellbeing of many others.

"What is bioethics?" Qiu Renzong asks. It is a question that has been constantly put to him since he first introduced bioethics to China over 30 years ago.

"To put it simply, bioethics is philosophical study of ethics in bioscience and medicine," Qiu says. "More specifically, we look for the right decisions for the aforementioned situations."

The 78-year-old professor, a researcher with the Institute of Philosophy under the Chinese Academy of Social Sciences, is a pioneer in the development of bioethics in China.

He chairs or co-chairs many of the bioethics centers, institutions and ethics committees, and serves as an advisor to a number of government agencies and international organizations.

Last December, Qiu became the first Chinese recipient of the UNESCO Avicenna Prize for Ethics in Science, the most prestigious award in the field.

His father was a businessman and his mother never went to school and Qiu wasn't expected to study philosophy, much less bioethics. "I know I wasn't supposed to be where I am today," he jokes.

But his primary education in a Confucius school had a profound influence on his future, he says.

"We read and recited the texts of Confucius and Mencius every morning," he explains. "To be honest, I didn't understand much of the texts at the time. But their meaning - their emphasis on virtue and on being humane - gradually sank in."

In the 1950s, he was assigned to teach general education courses at the Beijing-based Peking Union Medical College after graduating from the department of foreign languages at Tsinghua University.

There he learnt the medical knowledge that would later help lay the groundwork for him to break into the field of bioethics.

"If you don't know a thing about medicine, you won't understand what the crux of the matter is," he says.

Qiu concedes that his research before 1988 was actually largely done in an "ivory tower". It was a case on euthanasia that forced Qiu to confront the realities of practical bioethics.

In 1986, a doctor in Hanzhong city, Shaanxi province, administered euthanasia to a terminally ill patient at the request of two of the patient's children. The patient's other two children, who had been uninformed, sued the doctor. In 1987 the public prosecutor officially reprimanded the doctor, but imposed no punishment. It stirred the first nationwide debate on euthanasia and bioethics.

"I thought to myself what did I study bioethics for," Qiu recalls. "Not simply to learn its history and theories, but to tackle real social problems."

"In cases such as this - which we call ethical dilemmas - when there are conflicts of obligations, all stakeholders' rights, values and interests should be taken into account, and the decision made based on the least harm and the minimum risk," he says.

Qiu likens the two approaches to bioethics as "flying a kite", where scholars exchange theoretical ideas in the "sky" but never touch the ground, and "riding a bicycle", where they set out the destinations and ride towards them.

After spending years following the first approach, Qiu has moved towards the second over the past two decades, leaving his mark on almost all the Chinese guidelines and regulations related to biomedicine and health that might otherwise neglect bioethics, including assisted reproduction and AIDS prevention, stem cell research and research involving human subjects, and animal rights .

"By doing all these things, I just hope we can live more humanely," he says.

Even at his advanced age Qiu still follows all the latest developments in medicine, life science and biotechnology, his latest concern is the recent breakthroughs in creating synthetic cells - artificial life.

"Bioethics is a constantly developing subject," Qiu says. "You have to keep up with all the newest breakthroughs in sciences."

However, despite the overall development of bioethics in China, Qiu is not overly optimistic about its future in China.

"Younger talents are few and far between, and education institutions in bioethics are scarce," laments the professor, who still teaches at Peking Union Medical College.

Another problem is a lack of bioethical oversight on medical research and practices.

"A lot of hospitals and medical institutions have not set up bioethical review committees or these committees are not working well," he says. "With the flowering of new technologies like stem cell treatments and DNA therapy, research and practices without bioethical oversight could lead to serious consequences."

Currently, Qiu and his fellow colleagues have been assisting the Ministry of Health to establish a three-tier bioethical review structure - national, provincial and institutional - and to help train researchers.

"I hope it will work," he says.