Washington, DC, January 24, 2002 - Given the many pressing challenges facing public health in Latin America

Not so, says Dr. Fernando Lolas, director of the Pan American Health Organization's Regional Program on Bioethics. Far from being merely an arcane philosophical niche with few real-life applications, he says, bioethics offers the most incisive and socially inclusive way of examining the pressing moral issues raised by medicine and public health today.

"Bioethics is the creative use of dialogue to formulate, articulate, and hopefully resolve the dilemmas that arise in psychosocial and biomedical research and health care," says Dr. Lolas. "There is no aspect of health care or biomedical research that is beyond bioethical consideration. From decisions about appropriate legislation in areas such as euthanasia and assisted suicide, to values-based questions on justice in resource distribution, to environmental ethics-all of them are appropriate areas for bioethical analysis."

PAHO's Regional Program on Bioethics was established in 1994 in Santiago, Chile, through an agreement with the Chilean government and the University of Chile, where Dr. Lolas then served as vice rector. A technical program under PAHO's Division of Health and Human Development, its mission is to work with public and private groups to develop and apply concepts and procedures that will ensure the ethical sustainability of decisions regarding scientific research, technical training, professional education, and health care.

PAHO adopted bioethics as a new sphere of action to assist its Member Countries in discussions of a wide range of traditional and emerging public health issues. Among these are justice and equity in the allocation of health resources; patients' rights; death with dignity; palliative care; ethics at the beginning and end of life; and ethics in the relationship between institutions and populations, in research, in the use of drugs, and in environmental matters.

The emphasis of the program has been on building Member Countries' capacities to engage in bioethical analysis, primarily through training and education of members of research and clinical ethics committees, as well as individuals seeking to make advanced contributions in this field.

"More than 80 people have been carefully trained during the five years of the program, and many hundreds have been exposed to these issues through conferences, short courses, and publications," says Dr. Lolas. The program publishes a journal (Acta Bioethica) and a newsletter (Bioética Informa), which are widely distributed electronically and in print.

For Dr. Lolas, one of the greatest impacts of the program has been in raising awareness among authorities and the public about the need for ethical dialogue to analyze matters of concern in public health. "Although the laws in our countries can still be considered permissive in many areas, we are moving toward the consolidation of a set of common criteria for regulating social practices in connection with research and health care," he says.

Such common ethical standards are needed to help countries develop legislation, for example, to prevent people from being used as "human guinea pigs" in medical experiments not subject to adequate regulation or oversight. The program works to make officials and lawmakers in the Region aware of bioethical principles and use these to reduce the "moral vulnerability" of their populations, contribute to their well-being, and ensure that decisions in health are not only economically but ethically sustainable. "This means not only ensuring that a practice is technically viable and feasible but also legitimate and morally defensible," says Dr. Lolas.

PAHO serves as the Regional Office for the Americas of the World Health Organization. Officially established in 1902, it is the world's oldest international health organization and works with all the countries of the Americas to improve health and raise the standard of living.