A Basis for Action - Commission de l'éthique de la science et de la ...

Position Statement of the Commission de l'éthique de la science et de la technologie
In addition, given nanoparticles’ ability to cross the blood-brain barrier, they have obvious potential for use
in treating neurological diseases like Parkinson’s, multiple sclerosis, or Alzheimer’s. But this is also a cause
for concern. The blood-brain barrier is the brain’s last defense against the external assaults of certain
micro-organisms. The fact that new ways have been found to bypass the brain’s natural defenses using
technologies not yet fully mastered and that are invisible to the naked eye could have harmful
consequences without proper guidelines for nanotechnology R&D. The use of nanotechnology in
neurology for therapeutic purposes—and perhaps to improve brain function—is intimately tied to the
field of neuroscience. The Commission plans to prepare a position statement on this topic in 2007 that
will address the ethical issues raised by the variety of possible uses for nanotechnology and the
concerns these have created.
Information is sorely lacking for the Commission to infer the potential economic impact of the
introduction of new nanotechnology-derived diagnostic and treatment methods. In all likelihood, some
of these new technologies will bring about savings for health services, whereas others will incur
prohibitive costs. The issue is the much broader concern of resource allocation and governance, where
society will have important decisions to make.
There are concerns about economic access to the full benefit of nanomedicine in a public health
system. Who will have access to these new technologies? What diseases will be given priority and who
will benefit? These questions, about access to care and the type of medical coverage the community
wants and is able to provide, deserve to be debated in the public arena. This would have the merit of
enhancing public awareness about the ethical and social issues raised by the development of new
technologies and the convergence of certain scientific disciplines—nanotechnology, biology,
information science, and cognitive science (NBIC) 237 —with health care.
Likewise, the Commission questions the idea of offering diagnostics (through nanotechnology or
otherwise) without the appropriate therapeutics to match—for example a test to diagnose a given
disease for which no preventative or curative treatment yet exists. This situation already exists and calls
to mind the position statement previously published by the Commission on genetic databases, and
specifically on the right to know or not to know. 238 In its position statement, the Commission also
expressed its concerns about seeing a sort of personal eugenics emerge in the practice of procreation.
For example, in the event of a positive prenatal diagnosis of a genetic disease that may or may not occur
(susceptibility test) for which no treatments currently exist, the only medical choices available to the
future parents are to monitor the health of the unborn child or voluntarily interrupt the pregnancy.
Nanotechnology could therefore play a role in amplifying a dilemma parents already face and that has
yet to be debated by society.
237 Lorraine SHEREMETA, “Synthesis Paper. Nanotechnology: the NE 3 LS Issues,” Prepared for Health Canada,
July 18, 2005, p. 6.
238 COMMISSION DE L’ÉTHIQUE DE LA SCIENCE ET DE LA TECHNOLOGIE, Les enjeux éthiques des banques d’information
génétique…[The Ethical Issues of Genetic Databases…], op. cit., p. 48.
Chapter 3 – Nanotechnology: Ethical Concerns 57