Regulating biomedicine in Belgium and France: neighboring countries, diverging policies.

1. Introduction

The invention of the technique of in-vitro fertilization (IVF) in the late 1970s and its routinization in the mid-1980s created the basis for new medical techniques, such as intracytoplasmic sperm injection (ICSI), pre-implantation diagnostics, genetic screening and engineering, as well as new fields for biomedical research, such as research on embryos and stem cells, as well as therapeutic and reproductive cloning. The development of these new assisted reproductive technologies (ART) and subsequent biomedical research offers the hope of great benefits, such as the cure of degenerative diseases. However, these innovations have also given rise to grave concerns over their potential negative effects, such as the return of eugenics in the form of embryo selection techniques. In the face of these controversial perspectives, ART and biomedical research have been, since the late-1970s, widely discussed in the media and have become a salient issue on the political agenda (Durant et al. 1998; Gaskell and Bauer 2001; Bauer and Gaskell 2002). Furthermore, a number of advanced industrialized democracies have passed national legislation in response to these debates (for a comparative overview of these "biopolicies", see Bleiklie et al. 2004).

Our contribution - as political scientists - to the ongoing debates over the regulation of biotechnology consists in examining "how" and "why" governments pursue particular courses of action or inaction (Heidenheimer et al. 1990) in the fields of ART and biomedicine. Hence, we aim primarily to provide a broader empirical knowledge base on how public policies are designed and chosen in two particular European countries, Belgium and France. Despite the considerable amount of political activity and the public attention surrounding these biotechnology issues, there is still a deficit in terms of political science research on this topic (Rothmayr and Varone 2002). This seems particularly evident if we compare what has been undertaken in the growing fields of bioethics, biolaw, and bioeconomics to the still missing - or at least underdeveloped - political science research in "biopolitics".

At a first glance, one might expect France and Belgium to formulate and implement similar ART policies (see for example Bennett 1998 and Seeliger 1996 on the theory and methodology of "policy convergence"). Several factors could be listed in support of this assertion. First, the French and Belgian publics partly share similar opinions on ART and on biotechnologies in general. The Eurobarometer 58.0 study, for example, revealed that France and Belgium had a similar degree of relative optimism towards biotechnologies from 1991 to 2002 (53% for Belgium and 56% for France in 1991, up to 40% in Belgium and 39% in France in 2002). Both countries obviously supported-in the same proportion -genetic tests, the cloning of human cells and xeno-transplantation, more than they supported genetically modified organisms and food (in 2002, at least 50% support for genetic tests compared to at least 50% opposition to GM food).

Secondly, Belgium and France are neighboring countries and have several cultural traits in common. This geographical proximity and shared cultural values could facilitate lesson-drawing and policy transfer processes (Rose 1991; Dolowitz and Marsh 1996). Emulation between Belgium and France could, for example, occur if policy-makers in one country were dissatisfied with their ART policies, shared the values of their neighboring state and had knowledge of this state's policies. As an illustration of such a process, Belgian Parliamentarians sometimes mention French decisions or other foreign countries in support of their own bills (1).

Finally, as investigated in the scientific literature for other countries (see for instance Hoberg 1991 for an analysis of the American influence on Canadian environmental regulation), one could assume that the size of the country affects the policy-making process. The presumption is that larger countries are more likely to influence small states than vice-versa, especially when geographically adjacent to one another. As a matter of fact, Belgium settled a licensing procedure for ART centers (1999) ten years after France (1988). The same time lag applies to the creation of a National Bioethics Committees in France (1983) and Belgium (1995).

However, a detailed analysis of the ART policies adopted in Belgium and France, and an overview of other bioethical issues (e.g., the partial decriminalization of abortion and euthanasia), show that this common sense presumption of similarity is somewhat misleading: convergence of public opinion, geographical proximity, cultural proximity and differences in size are not sufficient conditions for convergent public policies.