In the summer of 2019, the authorities did not warm to the idea of ​​preparing for a possible pandemic – “Nothing was learned from Corona”, says a bioethicist

In summer 2019 Heikki Saxén Among others, a virologist at the Institute of Health and Welfare participated in the meeting Mika Salminen with. It considered a project in which plans would be drawn up in case of a pandemic or bioterrorism.

The ministries and the defense forces did not warm to this. In March of the following year, the corona lockdowns began. The pandemic took Finland and the rest of the world by surprise.

“Around 2020, the Ministry of the Interior was asked if you had such a project. It was too late then. These should be planned in advance. It seems that nothing was learned from the corona. Bird flu can become the next pandemic, maybe worse,” says Saxén.

Saxen’s worry is not blown away. It is certain that sooner or later there will be another pandemic. Plans should be drawn up on how treatments are prioritized and on what basis citizens are ordered to be quarantined.

Those questions belong to bioethics and that is Saxén’s field. It is a fairly new field of research and quite unknown to the general public. Saxén heads the Institute of Bioethics and works as a researcher in the field at the University of Tampere.

Bioethics began to challenge medical ethics in the 1960s. It deals with much the same questions, but in a more pluralistic way.

“The culture of discussion between doctors and patients was incredibly bad. Bioethics played a part in it becoming more humane.”

Saxen did a degree in thinking about justice, which seemed abstract. He realized that in modern times it is basically concretized in the life and death questions of health care.

In principle, bioethics would also include animal and environmental issues, but in practice it has focused on studying the problems of healthcare and medicine.

Therefore, bioethics does not really deal with, for example, the genetic manipulation of crops, which has recently sparked a lively discussion. That question also seems to have disappeared from the public in recent years.

“It’s a good question why we don’t talk about genetic manipulation of plants anymore. Even human genetic manipulation has not been discussed since the initial uproar, although it has developed rapidly in recent years.”

Discourse got busy when a Chinese researcher He Jiankui said in 2018 that he had created the first genetically engineered babies. He ended up in prison for his efforts.

In Saxén’s opinion, there are basically no problems with genetic engineering as long as it cures diseases and it works reliably.

Gene scissors are already used quite widely in medicine. The field promises great things, but Saxén also sees it as a job for bioethicists. If a person’s genes are studied enough, diseases or at least risks can be found in everyone.

“Not all information is necessarily always good. Who decides how people’s genetic information is used? What if employers and insurance companies want to make decisions based on them?”

How about would it be acceptable for the new treatments to be available only to the rich? Could a person be cured by genetic manipulation? And if you can, which changes should be made hereditary so that they are passed on to descendants?

The heritability of genetically modified crops has already caused problems when the new properties have spread to the organic fields of the neighbors. New versions can completely supersede the old ones.

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“Now, especially in care for the elderly, patients are often treated for too long in terms of suffering. Could it be possible not to prolong their pain? Bioethics must take an active role in that discussion.”

Many of the things Saxén brought up sound like things from science fiction movies. Some of them will not become relevant until 10–20 years from now, but Saxén thinks that it would be good to think about them in advance and not only when it is necessary and in a hurry.

Some things are already today. In healthcare, human blood and tissue samples are collected in biobanks. People send their genetic data to private companies to get information about their family history. Saxén is concerned about data protection issues.

“For years, attempts were made to amend the Genome Act. Did not work out. The use of genetic information in healthcare is becoming more common all the time. On the private side, genealogy companies sell genetic data on in the same way that social networks sell data that people share about themselves. It breaks privacy.”

Saxén warns that genetic information once sent to the world cannot be taken back. The threats may not come true, but the risks are big.

“Whether it’s a good thing or a bad thing, once again no conscious decision is made, but here too we just end up in a situation where the genetic information is already in the banks and they are used however they are used.”

Last euthanasia, i.e. euthanasia, which belongs to the core area of ​​bioethics, has been discussed in the past.

“Courage would be needed to highlight the different options and discuss them. Now, especially in care for the elderly, patients are often treated for too long in terms of suffering. Could it be possible not to prolong their pain? Bioethics must take an active role in that discussion.”

The Institute of Bioethics strives to highlight the field. Saxén emphasizes that it does not only deal with crises.

In Pirkanmaa, the institute has, among other things, tested a project where the hospital staff maps difficult treatment cases from a wide range of perspectives and not just through doctors’ diagnoses. The purpose is the same as in the 1960s: to make care more humane and better.

What would you tell your 20-year-old self?

“You’re on a good path, even if you don’t know it yet.”