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Global challenges raised by biomedical advances require global responses.

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Human rights as a legal framework for international bioethics
- Biomedicine and international human rights law: in search of a global consensus

Perhaps the two most distinctive features of international instruments relating to biomedicine are the very central role given to the notion of "human dignity" and the integration of the common standards that are adopted into a human rights framework. This is not surprising if we consider that human dignity is one of the few common values in our world of philosophical pluralism (5). Moreover, in our time, a widespread assumption is that the "inherent dignity ... of all members of the human family" is the ground of human rights and democracy (6). It is indeed difficult, if not impossible, to provide a justification of human rights without making some reference, at least implicitly, to the idea of human dignity. This notion is usually associated with supreme importance, fundamental value and inviolability of the human person. In the words of Kant, dignity means that people must always be treated as an end in themselves and never only as a means (7). Of course, attempts to explain and justify human dignity will encounter enormous theoretical difficulties in our post-modern world. However, it seems that, at least for practical reasons, we desperately need this notion if we want to ensure a civilized social life (8). As Dworkin argues, anyone who professes to take rights seriously must accept "the vague but powerful idea of human dignity" (9).

The reference to human dignity in the two aforementioned international instruments is impressive enough that dignity is sometimes referred to in the literature as "the shaping principle" of international bioethics (8, 10). Nevertheless, it should be recognized that dignity alone is unable to provide a concrete solution to most challenges raised by scientific advances. "Dignity" is not a magic word that can simply be invoked to solve bioethical dilemmas. We should explain the reasons for considering that a given practice is in accordance or not with the principle of human dignity. This can enable us to see more clearly why the idea of dignity normally operates through other more concrete notions, such as informed consent, bodily integrity, non-discrimination, privacy, confidentiality and equity, which are usually formulated in the terminology of rights.

Another motive for this strategy is the current worldwide political consensus on the importance of protecting human rights. Like the notion of dignity, but providing a more complete and articulated formulation, human rights can be viewed in our fragmented world as "the last expression of a universal ethics" (11, 12) or as a "lingua franca" of international relations (13).

The global success of the human rights movement in contemporary society is probably due to the fact that a practical agreement about the rights that should be respected is perfectly compatible with theoretical disagreement on their ultimate foundation (14). The Universal Declaration of Human Rights of 1948 is the best example of this phenomenon, because it was drafted by representatives of particularly diverse, even opposed, ideologies. Upon this strong legislative foundation has been built an extensive network of human rights mechanisms designed to develop international standards, monitor their implementation and investigate violations of human rights. Today, the Declaration of 1948 can be considered as "the single most important reference point for cross-national discussion of how to order our future together" (15).

It is true that global bodies often lack the ability to deal with the violations of human rights. In spite of all its weaknesses, however, the current human rights system is the only mechanism available to protect people. This is why the integration of some principles relating to biomedicine into a human rights framework seems fully justified. It should not be forgotten that what is at stake in some bioethical issues, such as human genetic engineering and reproductive cloning, is nothing less than the preservation of the identity of the human species. Thus, it is not an exaggeration to say that we are confronted here with "the most important decision we will ever make" (16). In other words, it seems clear that, in the case of conflict between the preservation of humankind from harm and the protection of purely financial or scientific interests, international law should give preference to the first option (17).

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