6. Maori and Xenotransplantation

There are several reasons why Maori must be accorded particular consideration when decisions about biotechnologies such as xenotransplantation are being made. Firstly, the Crown has a special relationship with Maori as tangata whenua and Treaty partner. Secondly, Maori have poorer outcomes in many areas and some biotechnologies have the potential to either widen or close these gaps. Thirdly, New Zealand is the only country where Maori culture, Maori knowledge systems and the Maori world view matter and have been accorded protection.

The Bioethics Council has an explicit requirement in its Terms of Reference to seek out and consider Maori views. However, Maori are likely to have a range of views: some views will be similar to those of other New Zealanders, some will differ and some will be unique, but all will be Maori views. In trying to distil out Maori views some unique factors need to be taken into consideration.

• To form their views, Maori, as with other people, may require clear, accurate and relevant information on matters that may seem abstract or irrelevant to others.
• Full disclosure by Maori of relevant Maori knowledge may be an unreasonable expectation, because some knowledge may be sacred or private, or only articulated adequately in te reo Maori. The Council respects Maori decisions about the degree of disclosure that Maori choose to make.
• No advice to the Crown/Government will be acceptable unless it explicitly considers Maori positions.

The Council considers that its advice to the Government would be inadequate without explicit consideration of Maori positions. The Council undertakes to make Maori positions on xenotransplantation explicit in its report to the Government.

A range of Maori views

Three scenarios that may represent possible Maori views are presented below. These scenarios may assist Maori readers determine where their own position lies. Maori readers may agree with all or part of any of the scenarios, or a combination of them.

Scenario 1

Technologies that meddle with the natural order of te ao Maori are wrong. Irrespective of the possible positive consequences of xenotransplantation, the risks to te ao Maori are just too great to contemplate. Maori lore must be adhered to.

Maori expect that their Treaty partner, the Crown, will protect te ao Maori and heed our advice in this regard.

This view resides at the more conservative end of Maori opinion.

Scenario 2

Maori should benefit from every modern advantage; no-one has the right to make decisions for individuals - Maori or otherwise. The fact that Maori do not feature as significant donors means that xenotransplantation offers an alternative pathway to the benefits of modern medical advances. There could be real advantages for whanau, hapu and iwi in this approach.

Maori should enjoy all of the rights and privileges available to a modern world and should be able to rely on scientific safeguards to protect us all. Whanau would still have the right to decline treatment if they wanted.

This scenario resides at the more liberal end of Maori opinion.

Scenario 3

A cautious approach which judges risk in Maori terms should be adopted. While some Maori may also adopt other cultural stances (for example, religious or philosophical), decisions should principally balance Maori priorities with Maori concerns.

In a health setting, concepts of hauora and whanau ora are key. Maori should be involved in a collective sense.

As a bottom line, though, unacceptable 'Maori-risk' should determine decisions without question. A Maori 'no' is a 'no' for New Zealand.

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