In this interview given the day before a seminar for the creation of a National Bioethics Committee in Trinidad-and-Tobago, held in Port-of-Spain on 28 February and 1 March 2013, Dr D. Simeon, Director of the Caribbean Health Research Council (CHRC), expresses his hope that the creation of such a structure will contribute to a better comprehension of the relation between bioethical challenges and development issues, especially in Small Island Developing States.
How will the creation of a National Bioethics Committee (NBC) contribute to the advancement of bioethics in Trinidad and Tobago, and at which levels?
The development of a National Bioethics Committee is an exciting prospect for Trinidad and Tobago. There are a number of areas where it can make an impact.
Critically, there is the need for an agency to promote bioethics in the country. As a nation, we are not sufficiently aware of bioethics. Indeed, most persons do not know what bioethics is and how it can benefit them. The NBC will inform the public about bioethics through public education and awareness campaign, and work with the Ministry of Education, providing support for the inclusion of bioethics on school curricula.
A recent survey was conducted on existing research ethics committees in the country. Among the recommendations was the need for a coordination mechanism to ensure that they complement each other and there is no overlap of functions and jurisdictions. The NBC can be expected to perform this role.
The existing ethics committees in the country address issues related to healthcare and research ethics. There are no facilities to address other areas of bioethics such as the environment, for example.
In 2009, the Bioethics Society of the English speaking Caribbean hosted a 2-day Forum entitled “Bioethical Standards: People and the Environment”. It was very successful and drew attention to the ethical issues related to the environment. However, since then there has not been the follow-up action that was expected or indeed needed. We truly hope that when the NBC is established, it will provide leadership in this area as well.
There is also a huge gap in the area of ethical oversight in science and technology. While the Government, through the Ministry of Science and Technology, has a comprehensive plan to build capacity in this area, which is expected to lead the progression to Developed Country status, there is a clear need for these plans to be taken into consideration or be guided by bioethical principles.
Why is the development of bioethics so important for Trinidad and Tobago?
Trinidad and Tobago is a Small Island Developing State with strong aspirations to achieving the Developed Country status by 2020. Consequently, it has engaged in a series of initiatives to develop various industries. Some of the projects may have crucial implications for the wellbeing of its population and environment. While there are some facilities in place to provide oversight, bioethical issues are often overlooked. This may be due to ignorance on the part of some officials, the lack of a bioethics culture in the country as a whole and the absence of relevant institutions with legislative authority to take action, when necessary.
Another area of relevance is the conduct of health research. There are researchers who do not appreciate the need to obtain approval from the relevant Ethics Committee before they conduct their research. This is more prevalent among researchers from the social sciences than the medical sciences. Given the sensitive nature of some of the health research conducted by social scientists, bioethical oversight is critical. There are clear implications for the inclusion of bioethics in curricula of all tertiary institutions. Indeed, the case can be made for it to be taught at secondary school level so that the population would be empowered to appreciate the importance of bioethics, and recognize and take action against unethical behaviours and programmes.
Of course, there are bioethical issues in Trinidad and Tobago that go beyond health research. One obvious area is the protection of the environment. Since the economy of the country is energy-based, some of the industries that were established and are being proposed have clear implications for the environment. It is therefore critical that Government officials as well as the communities affected or at risk be aware of the ethical implications.
How is the relation between UNESCO and Trinidad and Tobago transforming and improving the bioethics approach in the country?
UNESCO and particularly the Trinidad and Tobago National Commission have been playing an important leadership role in advocating for bioethics in Trinidad and Tobago. Indeed, three activities come to mind immediately.
In 2006, in collaboration with the Mexico UNESCO Office and the National Institute of Higher Education, Research, Science and Technology, the Trinidad and Tobago Commission hosted the “Latin American and Caribbean Conference on Bioethics”. It was a success to bring together a number of regional experts in bioethics to learn more about what each one was doing. It was also educational as the audience included a number of stakeholders who were interested, but their knowledge of bioethics was insufficient. One of the recommendations coming out of the Conference was the establishment of a National Bioethics Committee in Trinidad and Tobago.
The UNESCO National Commission also played an important role in the success of the Bioethics Forum that was hosted in Trinidad and Tobago in 2009. It was involved in the planning of the Forum and also sponsored the participation of two regional bioethics experts. The Forum contributed to raising the profile of bioethics in the country.
The third activity that I wish to highlight is its work towards the creation of a National Bioethics Committee for Trinidad and Tobago. Although many challenges were faced, considerable progress has been made. Key stakeholders have been engaged and a draft Paper has been prepared, which will be shortly submitted to the Government for approval and adoption. This initiative has also resulted in the hosting of the 2-day “Seminar on the Establishment of a National Bioethics Committee”, which will be held on 28 February and 1 March in Port-of-Spain. This seminar, which includes the participation of a wide cross-section of stakeholders, is expected to contribute to preparing the country for the imminent establishment of its NBC.
Interview by Susana Vidal/Cathy Bruno-Capvert/Paula Santos