Firma Institucional
conbioetica-mexico.salud.gob.mx
Inicio > National Commission of Bioethics
National Commission of Bioethics

The National Commission of Bioethics in Mexico has gained more importance and status over time. It was first establish in 1992 as a group of academics that wanted to discuss issues related to bioethics.  In 2000 a presidential agreement declared it as a permanent body. Finally, since 2005, it has been recognized by a presidential decree, as more independent body. It is a descentralized body from the ministry of health, which means, it has technical and operational autonomy. The budget still comes from the ministry of health, and the president of the Council and the Council members are appointed by him and change every two years. Nevertheless, the structure of the Commission is based on permanent members. Those people are responsible for the operation of the Commission and for putting in place the policies and programs approved by the Council. They access the job through civil service, meaning, public advertisement of the jobs and an independent selection process and cannot be removed by political changes.

The mission of the Commission is to build a bioethical culture in Mexico. Its mandate is directed to activities in public policy, building infrastructure and creating public awareness. It is the official body responsible  for defining national policies on bioethics, for establishing public health policies related to bioethics and to act as the national body to be consulted on specific issues on bioethics

Issuing reports is not its main task. In fact, reports are not issued as such. The aim is to be able to systematize the ethical issues involved in bioethical issues that are of social concern. In such a way, the Commission pretends to provide society with relevant, sound and objective information and with the diversity of founded ethical arguments on the debated topic. The Commission wishes to promote and support people´s reflective attitude; the ability to deliberate in a respectful, informed, sounded, multidisciplinary and pluralistic way.

The Commission has diverse strategies to fulfill this aim. It has a website in which interesting information is posted to the general public and enables people to contact in case of questions and needs. It is in the process of establishing a Center of Bioethical Knowledge, CECOBE, which is more than a library and a newspaper library; it is an intelligent service that will be able to identify potential users and send them useful information for their activities. By now, CECOBE has an important collection of electronic journals and books, helps freely retrieving papers and gives free access to the research ethics committees and the clinical committees to the collections. There is a library which printed books and journals and has the service of interlibrary exchange.

Other activities oriented towards society are the publication of what is called Debate Bioetico, or Bioethical Debate; it is a publication on a particular issue (ie. therapeutic cloning, the debate at UN on cloning), which systematize the ethical arguments and diverse perspectives  and written by members of the Commission or by an external author by the Commissions request. The issue is circulated among different stakeholders and their views and opinions are included in a second edition to be further circulated.

The Commission has organized two public forums, one on dying with dignity and the second on the impact of homophobia on health care. The forums have been multidisciplinary and plural, analyzing diverse aspects related to the topics; from hard evidence to social, psychological, philosophical, medical, ethical, perspectives. One of the outcomes of those forums, are a publication of each, containing all the talks.

The last strategy to be mentioned is the publication in a newspaper of wide circulation in the country of the systematized ethical arguments on abortion when the controversy over a new law was taking place.

As for the advisory activity, the Commission has issued opinions and recommendations to the legislative on initiatives of law related to bioethics: abortion, assisted reproduction, advance directives, palliative care, cloning, among others. There is a formal mechanism of communication between the legislative and the executive and the Commission uses that mechanism to make its recommendations.

Activities regarding public policies are those involved with priority setting in social protection system. There is an agreement of collaboration between Harvard Medical School and the Mexican ministry of health. Dr. Norman Daniels has been working very close to the Commission, so the model used by the Commission is the Accountability for Reasonableness. The objective is to develop a priority setting methodology based on the perspective of justice and equity; to  analyze the  ethical implications of the  priority setting of high cost interventions on health. It is important to explore if the inclusion of elected interventions contribute to increase the equity in access to health, real or potential, particularly to the poorest and more vulnerable.

To accomplish the goal of building an infrastructure of bioethics, the Commission has the mandate to promote the establishment of bioethics commissions in every federal state; to promote the establishment of research ethics committees and hospital bioethics (clinical) committees, at public and private health institutions and to support the training of the members. To produce and disseminate guidelines for research ethics committees as well as for hospital (clinical) bioethics committees.  Mexico is composed by 32 federal states, the health system is decentralized, so the National Commission coordinates and guides the process respecting their own needs and priorities but sets the criteria for them to operate on specific issues such as the establishment of research ethics  and clinical committees. In 2005, 9 federal states had bioethics commissions installed, today there are 20 of them.

Up to date, the Commission has issued the National Guidelines for the integration and functioning of Research Ethics Committees, and such guidelines for the Clinical Committees will be ready soon. Permanent working groups have been established, one for the research ethics committees and another for the clinical committees. The Commission will started a national registry of both types of committees, and discussion forums will start soon for each working group on the Commission´s website.  A database with the information of the protocols being reviewed by committees and their status and rationale for rejection will be shared by the research ethics committees. A training course for 105 members of ethical committees has just finished.

The Commission has been endorsing and re.wrote an initative of law that is expected to be voted specifying the function and the differences between research ethics committees and clinical committees. The text of the initiative was discussed and approved with the health sector institutions and is as follows:

Every public, private or social institution for health care, belonging to the national health system according to their complexity  and resolution level will have:

 

  1. A hospital bioethics committee that will be responsible for the analysis, discussion and support in decision making related to bioethical dilemmas that emerge from health care delivery, or teaching. For promoting the elaboration of institutional guidelines/protocols for health care delivery and teaching.  And for promoting permanent bioethics training among its members and the institutional personnel.

     

  2. A research ethics committee which will be responsible for the ethical evaluation of the research protocols on human beings. For elaborating institutional guidelines for health research, and for the following up on its recommendations.

 

It is interesting to mention that the Commission was a member of the working group convened by the Council of Health which aimed to produce an Agreement on Transparency with the Pharmaceutical Industry. The group was composed by all the medical schools and academies, representatives of the private hospitals and of hospitals of the social system, the ethics committee of the pharmaceutical industry and the national association of pharma laboratories. Important clauses from the bioethical perspective were approved, among them, the commitment of the pharmaceutical industry to provide medication to participants when the research is over; not to pay to researchers for enrolling patients. The agreement can be read at the website.

Lastly it is interesting to mention that the Commission has been part of the Intergovernmental Bioethics Committee of UNESCO and participated in the discussions and final draft of the Universal Declaration of Bioethics and Human Rights. Currently, it is also attending the meetings of the CDBI at the Council of Europe, since Mexico has been accepted as an observer state. The Commission is also participating in research projects funded by the European Commission on ethical issues of benefit sharing of genetic material in developing countries.

Bioethical Knowledge Center
National Commission of Bioethics
alma.macedo@salud.gob.mx


Última modificación :
Viernes 13 de Abril de 2012 por Centro del Conocimiento Bioético
COMISIÓN NACIONAL DE BIOÉTICA - ALGUNOS DERECHOS RESERVADOS © 2012 - POLÍTICAS DE PRIVACIDAD

Calzada Arenal No. 134, Col. Arenal-Tepepan, Deleg. Tlalpan

Distrito Federal CP. 14610, Tel: (55) 5487 2760 Ext. 59474 y 59546

Comentarios sobre este Sitio de Internet