Comments from participants

What was it like to attend the Indian Journal of Medical Ethics’ Second National Bioethics Conference? The organisers of NBC 2 wrote to some participants and asked them for their feedback, good or bad. We have carried them here in full. Responses sent by March 1, 2008 will be published in the April 2008 issue.

I want to thank the organisers of the Second National Bioethics Conference (NBC 2007) for putting together an exceptional conference. I had an opportunity to also attend the first conference in Mumbai which I thought was an first-rate production but you outdid yourself with this year’s effort. The theme–ethics and biotechnology–was particularly appropriate. The plenary sessions were excellent and the level of discussion has surely gone up a notch or two. The joint sessions that I attended were all very good (I wish that I could have attended them all) and the movies added yet another important dimension. There’s no doubt in my mind that the two conferences have done much to raise the level of awareness and dialogue on so many important issues in biomedical ethics. I was particularly pleased to see so many college and university students in attendance. These conferences were so important to further interest and dialogue in this critical area and I would urge you to continue this important work with future conferences.

Richard Cash, Harvard School of Public Health, USA

In the aftermath of the very successful second NBC-2007, I write to commend you on the success of the conference, and to make a couple of suggestions for future conferences. I was most pleased to be not only an invited participant, but also a member of the audience for the entire time of the conference. The presentations were of uniformly high quality and I benefited from listening to presenters from India and abroad.

Like almost every conference held anywhere in the world, there was a bit too little time for questions and discussion with the audience in most sessions. That is usually not the fault of the organisers, but rather of speakers who go beyond their allotted time. While a few sessions did allow time for ample back-and-forth, others did not. I’m not sure what can be done, other than to build in some additional time in all sessions.

My one disappointment was that I was unable to attend the sessions held simultaneously with the ones where I was presenting. Here I have a suggestion for the future. Several concurrent sessions were grouped together under the heading “international.” It would be better in the future to spread those sessions out at different times, so that those of us especially interested in international topics could attend more than one of those sessions. I realise that organisation is difficult, as there may be other concurrent sessions that participants would wish to attend. Such overlap is inevitable.

With this minor exception, I found everything at the NBC 2007 to be efficient, well-organised, and engrossing. I wish you all success in the next endeavour, two years hence, and hope to be able to attend, once again.

Ruth Macklin, PhD, professor of bioethics, Albert Einstein College of Medicine, Bronx, NY USA

I am very happy that I had a chance to attend the bioethics conference in Bangalore. It was an extremely well organised meeting. Not only was the organisation superb, but the level of the presentations was consistently high. I can say without any doubt that the quality is at the level of the top international bioethics meetings. This conference deserves all the support that it can get, also from international sponsors.

Reidar Lie, National Institutes of Health, USA

It was a pleasure for us to have represented the Centre of Biomedical Ethics and Culture, Pakistan at the Second National Bioethics Conference (NBC 2007). The conference was very well organised right from the time the first announcements were sent off till the time of its closing and all components of the very large National Organising Committee managing the meeting seemed to be working according to a clear plan.

Although there were a number of international speakers and participants, the NBC 2007 had a distinct Indian and subcontinental flavour which made the proceedings meaningful to the 500-odd participants. We feel that this “local-regional” focus was a significant strength of the conference and should be maintained for future events.

The plenary session’s talks were very pertinent and speakers were well chosen. The issues selected for the talks covered most of the major ethical debates including ethical issues in primary health, socioeconomic dimensions of healthcare, ethical issues in the use of technologies and so on. The parallel sessions were also well planned to encompass a wide spectrum of ethics discourse.

It was heartening to note that the NBC 2007 was able to attract individuals involved in bioethics from across the country and add to the richness of the discourse at the conference. This added to the diversity of the talks in the sessions. What was also noticeable was the depth of interest in bioethics which was reflected in the research work that many speakers presented. This was especially interesting for us, coming from Pakistan, because on many occasions the issues discussed by speakers underlined the similarity of concerns in both nations.

Because of the large number of free papers, an unfortunate compromise was the parallel sessions arranged in order to accommodate the large number of speakers. One ended up missing some of the talks that otherwise one would have attended.

An interesting component of the conference was the use of videos. We feel that the use of this modality was an excellent idea as they added a different dimension to the proceedings.

The meeting also served as an important south-south networking opportunity and we can see many other local and regional initiatives emerging as a result of this meeting.

We realise that the organisers were working within a very limited budget with precluded financial assistance for travel and stay for all foreign participants. This limitation is most certain to have excluded valuable contributions from several developing country institutions. We would like to suggest that in future conferences efforts should be made to have some funds to assist at least a few such participants who would otherwise not be able to attend. Even if full support is not possible, perhaps local stay at a reasonable hotel for those applying for such support could be organised. We feel that the NBC has acquired enough credibility to enable local and international funding agencies consider it a worthy recipient of such financial support.

The NBC has already proven itself to be an important event on the international bioethics calendar and every effort should be made to continue this tradition.

Farhat Moazam, professor and chairperson, Aamir Jafarey, associate professor, Centre of Biomedical Ethics and Culture, Karachi 74200 PAKISTAN

I thought the quality of speakers was excellent, both Indian and international and that the organisation of the conference was to be commended. Everything ran amazingly smoothly from my perspective and that’s never an easy feat. I certainly learnt a lot, both about bioethics generally and the Indian take on it. I think the process of translating western bioethics debates into the Indian context is one of the most fascinating exercises I’ve come across and one I’m looking forward to thinking more about both at the next conference and in the intervening period.

My only disappointment with the conference was that all the international speakers were on at the same time, which made it difficult for us to see each other’s presentations. This is only a minor comment – I was a little disappointed not to be able to see Ruth Macklin speak.

Brad Crammond, research fellow, human rights and bioethics, department of epidemiology and preventive medicine, Central and Eastern Clinical School, Monash University, The Alfred Melbourne, Victoria 3004 AUSTRALIA

The second NBC was an incredible, inspiring experience on so many levels. As a medical student, I am often exposed to the theoretical importance of bioethics clinically but not to the importance of bioethics as a means of constructing equitable healthcare systems and of doing responsible research. The papers and presenters at the NBC posed extraordinarily important questions through their research and presentations that made me think about how to approach everything about my future career in terms of a commitment to the principles of bioethics. I think that the papers and presentations should be compiled and be made compulsory reading for medical students and public health practitioners because the work pushes us to re-think the ways that healthcare providers and healthcare systems can re-invent justice in both small and big ways. And in a world where equity is becoming a luxury, the dialogue that took place at the conference was inspiring and comforting. It is my hope that because it was so inspiring and powerful, this dialogue will continue in classrooms, hospitals, and clinics long after the conclusion of the NBC.

Sunita Puri (paper presenter), medical student, University of California (San Francisco), USA.

The organisational arrangements, the presentations and the panels at the conference were overall top-notch. The spirit of the presenters and attendees was one of interest and engagement. The inclusion of students as attendees and reporters was an excellent feature and should be retained in future meetings. This is an educational opportunity for them, both in terms of learning from the discussions and in terms of speaking to the presenters and participants. The use of film, in the morning sessions as well as on some evenings dedicated to films, proved an excellent tool for stimulating education and discussion.

While I know such logistics can be difficult, in the future housing of all participants in one place would help interaction among participants.

Since this was the second conference, and a large number of participants came, I think the purpose of raising awareness, interest and discussion about bioethics in India has been realised. Whether the next conference should try to present an overall view of bioethics is a point to be considered. It would seem that planning for the next conference should revolve around various concerns. In speaking with some attendees, I found that they themselves had expertise in some area of bioethics, and felt some presentations and panels could have been more in depth. On the other hand, some attendees had no background in bioethics and were working hard to absorb all the new information. Moreover, I think some issues raised at the conference indicate that health professional groups (doctors, nurses, etc) may need to have a visible and active presence at this type of conference, to ensure interaction about what their professional organisations are doing, or not doing. As suggested during the conference, the inclusion of health practitioners and researchers in traditional medical systems (ayurveda, unani, siddha, and homeopathy) should be considered.

Since the Indian Council of Medical Research is conducting education and training on issues such as establishing institutional review boards, etc, it does not seem this type of technical training is the appropriate task of the NBC. However, some type of focused conference would seem a valuable next step. Perhaps a focus on health professional concerns or developments in bioethics, or how to convey bioethical issues to the lay population, or whatever topic seems critical to advance the development of bioethics in India. Another avenue may be to have regional conferences, focusing on health professionals, institutions, and other concerned individuals and programmes in that particular geographic region. Given the uneven development of healthcare services in India, such regional conferences would be a way to address the differing needs of each region.

Helen Sheehan, South Asia Studies department, University of Pennsylvania, USA

The NBC held during December 6-8 2007 in Bangalore was one of the well-organised health conferences I have attended. The good quality presentations and plenaries were a treat. It was wonderful to attend an Indian conference with Indians chairing and leading all the sessions. A few critical observations for the organisers to consider are as follows:

Include at least one session focusing on economics of healthcare as the cost of healthcare and the economic impact of illness and care have important ethical implications.

It may be best to have two-three plenary speakers with longer talking time rather than four-five shorter speeches in a session. Plenary speakers should be asked to adhere to their time and chairpersons should not be timekeepers. Only speakers who are well known and are good speakers should be invited for these. At the NBC, some of the plenary sessions were excellent. However, a few were too long and the speakers not very impressive.

For the general session, some of the sessions had very good, concise and clear presentations. New and relevant information was reported and appropriate conclusions were presented. However, some sessions had average or below average presentations where speakers spent most of the speaking time in introductions. Very little new information was presented. The abstract selection process could therefore be more robust. Most important, only one presenter per paper should be allowed to present. The workshop format is interesting unless one author or speaker takes up all the time. Perhaps more specific guidelines to the presenters and a careful selection of topics for each session would make this format even more interesting and informative.

Beena Varghese, senior health economics specialist, Public Health Foundation of India, New Delhi INDIA
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