Ethical and regulatory issues in human gene editing: Chinese perspective.

This paper focuses on the ethical and regulatory issues raised by gene editing. In the introduction of this paper, authors provide the background where the ethical and regulatory issues by gene editing have been raised including the scientific dimension of gene-editing techniques. In the second part of the paper, the authors focus on ethical issues in human gene editing with the start of Huang Junjiu case and He Jiankui case. Here, the authors discuss the criteria for evaluating action, general ethical issues in gene editing, and try to answer two crucial questions: is it ethically justifiable to use human embryo in ex vivo genome editing study and is it ethically justifiable to perform heritable human genome editing? In answering the second question, the authors discuss the arguments against and for heritable human genome editing, methodological problem, and the building of an ethical framework for heritable human genome editing. In the third part of the paper, the authors focus on regulatory issues in gene editing including proactionary approach versus ethically thinking ahead approach, self-regulation versus top-down regulation, transparency versus confidentiality, and education versus punishment.

Reactions to the National Academies/Royal Society Report on Heritable Human Genome Editing.

In September 2020, a detailed report on Heritable Human Genome Editing was published. The report offers a translational pathway for the limited approval of germline editing under limited circumstances and assuming various criteria have been met. In this perspective, some three dozen experts from the fields of genome editing, medicine, bioethics, law, and related fields offer their candid reactions to the National Academies/Royal Society report, highlighting areas of support, omissions, disagreements, and priorities moving forward.

A Strategy to Prevent and Control Zoonoses?

The authors argue that in preventing and controlling the pandemic of Covid-19, we should have taken an offensive or proactive strategy rather than a defensive or reactionary one because the former type of approach can bring about more health benefits and fewer harms than can the latter. The offensive or proactive approach consists of two parts: The first part is to preemptively establish a barrier between a novel virus and humans in order to prevent the spillover of the virus into humans, and the second part is that, when a spillover fails to be prevented, we should take public interventions, such as contact tracing, social distancing, and quarantine and isolation, as early as when there are several dozens or one hundred or more cases that manifest symptoms with an unknown etiology in order to prevent an epidemic that is still limited to relatively small groups from developing into an outbreak.

Impassable scientific, ethical and legal barriers to body-to-head transplantation.

This article consists of four parts. In the first part it briefly describes the history of body-to-head transplantation (BHT) and the surgical plan proposed by Drs. Sergio Canavero and Ren Xiaoping on a human subject. In the second part it argues that the BHT procedure that they propose is scientifically invalid and technically infeasible so therefore would end in failure. In the third part it argues that the present conceivable procedure of BHT cannot be ethically justified because it would bring great harm to the human subject, it is uncertain who would be the possible beneficiary, and valid informed consent cannot be obtained. In the fourth part it argues that the action of performing the procedure of BHT might violate China's current criminal and civil laws. The conclusion that follows from the arguments above is that BHT should be prohibited now and also in the near future. However, this conclusion does not preclude scientists, neurosurgeons and bioethicists doing research into scientific, technical, surgical and ethical issues raised by BHT.

Healthcare sector reform and its influence on public hospitals in mainland China.

The government has launched the healthcare sector reform since the 1980s. From the beginning, the reform has been controversial. What is then the real purpose of the reform? Is it only to reduce the government's burden of health care or establish a just and effective healthcare system? Can healthcare be geared by the market or should the government play a guiding role in it?

Sexual rights and gender roles in a religious context.

A common feature of the five faiths discussed in this article is change over time. This allowed diversity within the religions, and generally led to a degree of liberalization, but in some faiths or their sects, resulted in a narrow or rigid interpretation. For example, the golden Vedic Period of Hinduism in India when "women were worshipped" gradually faded, ushering in the social evils of female feticide, child marriage, and "sati." The advent of Islam in the seventh century banned female infanticide, but has been unable to abolish many tribal pre-Islamic customs such as female genital mutilation in Africa and "honor killings" in parts of Asia. On the other hand, in China, the inferior status of women accorded by Confucianism has been rectified to a large extent by legislation; this has, however, been offset by a restrictive population policy allowing only one child or two children per couple in some areas of the country (with no limit in Tibet), which has led millions of women to resort to prenatal sex diagnosis and abortion if the fetus is female. In the West, the debate over the use of biomedical technology continues, with various rabbinic rulings permitting the use of assisted reproductive technologies by Jews to fulfill the obligation to procreate, and the Vatican reinforcing its opposition to these and to genetic testing on embryos and embryonic stem cell research.

What has bioethics to offer the developing countries.

My paper consists of three parts. In the first part I try to explain the intellectual basis of bioethics in developing countries. In the second part I describe the bioethical dilemmas facing these countries. In the third part I shall discuss the changes that have to be made in bioethics if it is to take root in these countries, and thereby help them to improve the human existence.

Morality in flux: medical ethics dilemmas in the People's Republic of China.

The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia... More research and discussion among people from various fields is needed. Progress will be made one step at a time, and I recommend that we proceed now to win acceptance of brain death criteria; to make clear the distinctions between passive and active euthanasia,...to encourage the use of living wills; and to protect the interests of newborns who are not terminally ill, including those with mild defects. In the changing context of modernization, in which different and even incompatible value systems must coexist, it is best for us to approach the ethical dilemmas facing us with mutual respect and understanding.

"No feeding tubes for me!

KIE: A 65-year-old competent nursing home patient, suffering from amyotrophic lateral sclerosis and respirator dependent, refuses a nasogastric feeding tube even though she realizes that her refusal will result in death. The nursing staff and the patient's husband support her decision but two of her three children want her life prolonged. Nicholson, Qiu, and Koch and Ulshoefer discuss whether the refusal would be honored in Britain, China, and West Germany respectively. In Britain, this patient would receive palliative care, and both the respirator and the nasogastric tube would be considered extraordinary and not offered. In China, medical technologies are scarce, physicians are divided on treatment refusal, and the family's attitudes would be influenced by the Confucian tradition of filial piety and whether or not the patient was eligible for free care. In West Germany, this case would be legally considered "passive euthanasia" and the patient's refusal would be honored.^ieng