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07/24/2014

Presidential Bioethics Commission 101

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was formed by Congress and charged with identifying fundamental principles for research involving human volunteers. It completed its work and was ended in 1979. That commission is recognized as the first contemporary U.S. bioethics commission and since its formation, bioethics has had a steady but varied presence within the federal government. For a list of U.S. bioethics commissions visit the history page on bioethics.gov. But what is a U.S. bioethics commission?

First and foremost, the key characteristic of each and every U.S. commission, including the current Presidential Commission for the Study of Bioethical Issues (Bioethics Commission), is that it is term limited. Each commission since 1975 has been independently established by Congress or, more often, by the sitting President. The commissions have been established for different purposes – some to examine single issues, like the Advisory Committee on Human Radiation Experiments and others to advise on bioethics writ large. Each commission has been equipped with its own members, staff, and unique name. As a result, there have been a total of seven federal bioethics commissions over the past 40 years. President Obama first established the current Bioethics Commission on November 24, 2009 with Executive Order 13521. Like all federal advisory bodies, his Bioethics Commission must be renewed every two years.   The Executive Order under which the Commission currently operates expires in September 2015. Even if President Obama extends his order and issues an additional continuance for the Commission, due to the nature of federal bioethics commissions it is expected that the Commission, in its current form, will likely complete its term at the close of President Obama’s second term.

Many other countries have standing bioethics commissions. For example, the Nuffield Council on Bioethics (Nuffield) is a permanent bioethics council based in London. Nuffield is an independent body that was established in 1991 to address concerns over the lack of a bioethical governing body in the U.K. Nuffield operates as a permanent standing council with rotating members; temporary subcommittees are established as needed in order to address specific topics and to allow for the inclusion of subject matter experts. Since its formation, the Nuffield Council has continued to maintain its independence and is considered to be a leading international authority on bioethics policy and debate.

There are advantages and disadvantages to having standing bodies like Nuffield versus temporary commissions like ours here in the United States. Jason Schwartz, a historian of medicine at Princeton University and a former staff member for the current U.S. Bioethics Commission, explains that because each U.S. bioethics commission is established by a presidential administration or Congress, they are able to better reflect the values and priorities of the administrations they serve. Appointed members collectively bring broad expertise to the issues they study, while each commission is able to establish a unique identity and approach, independent of those of its predecessors. However, because each new commission effectively starts ‘from scratch,’ this deliberate absence of continuity and institutional memory can also pose challenges as commissions undertake their work.

Schwartz says that these structural features of U.S. bioethics commissions are particularly apparent when multiple commissions have examined topics of perennial interest and concern, such as how to ensure the protection of participants in human subjects research. Overall, fresh perspectives on enduring questions in bioethics can be of great value, he adds, especially in light of the rapid pace of new developments in science and medicine.

As for this Commission, work continues on Gray Matters, Vol. 2, the second installment in its response to President Obama’s neuroscience related request. Its next public meeting is scheduled for August 20, 2014 and will take place in Washington, D.C.

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