Changes in Contexts, Issues and Ethical Approaches:Encyclopedia of Applied Ethics--From First Edition to Second Edition / 中国医学伦理学

Since the publication of the first edition of the Encyclopedia of Applied Ethics in 1998 , the world has changed .The post-millennium and post 9/11 context brought with it a shift of emphasis concerning the re-sponse to terrorism , for example , including growing interest in measures such as biometric identification technolo-gies.But it is not only in the socio -political context that we see a change .In science the sequencing of the human genome , the promise of stem cell science and the rise of synthetic biology have all led to considerable debate .Ethi-cal issues also increasingly have a global dimension .The second edition of the Encyclopedia of Applied Ethics in-volved some issues that not or little mentioned in the 1998 version.Neverthless, it still reserved those classicpa-pers and updated when necessary , to reflect the progress of applied ethical approaches .Here, I tried to draw the outline of the main trends and ways of debates during this time .I think these ways can be divided into three catego-ries, due to the changes in contexts , issues and ethical approaches .

Genomics, public health and identity

This paper questions the utility of the ethical principles that are usually invoked to deal with genomic issues, particularly genetic databases. Concepts such as solidarity, benefit sharing, equity, public participation, and collective identity are discussed. The author argues that genetic banks are precipitating new concern over group interest, as opposed to concern over issues arising from individualistic medical ethics. Genomics era needs new paradigms in ethics. An individualistic approach based on choice and autonomy is not useful, because we make choices not only as individuals but also as members of different groups. The doctrine of informed consent evolved in different historical conditions from the ones we face in the era of genomics. This is complicated by the global context of genetic research, in addition to powerful commercial interests. This suggests that it is not sufficient to move from an individual-centred ethic approach to a morecommunity-centred one; an approach of renegotiating the relationship between individual and community. We need also to be clear about what the interests at stake are, which may mean reconceiving the terms ÔindividualÕ and "community" in this context and the ways in which their interests are affected, identifying the sources of collective identity that are at stake.