Ethics commissions are government advisory commissions mandated to give expert advice on contentious moral issues. As this requires making explicit value judgments, members with expert knowledge of ethics have a natural place as members of such commissions. Apart from these commissions being widespread, their recommendations assume a special normative authority within the legislative process. This raises many fundamental questions concerning the nature of moral expertise and how such commissions should deal with the (...) political contexts in which they operate. Through a reading of the relevant discussions in the literature in which the underlying normative ideals are located, this article reconstructs four normative models of the proper role of ethics commissions. This reconstruction seeks to contribute to analytical clarity and to elucidate the underlying disagreements concerning our expectations of ethics commissions. The four models, labeled ‘commission consensus model’, ‘society-proxy model’, ‘correctness model’, and ‘deep pluralism model’, differ from one another in terms of two main dimensions: the expertise and the public/political dimensions. After describing the models, giving examples from the literature on how they can be explicated, and describing an empirical example of a commission that has approximated the ideals, the strengths and weaknesses of the four models are discussed before the article concludes by asking whether there is one correct model of ethics commissions. (shrink)

Ethics commissions provide expert advice to governments on what policies to implement regarding pressing ethical issues, most often in bioethics. These commissions distinguish themselves by having members from the professions we are most likely to think of as moral experts, if we believe that these exist. The relationship between moral experts and the composition of ethics commissions is worthy of further exploration, especially because of the highly controversial nature of whether moral expertise exists and, if (...) so, how, and whether, we can identify moral experts. Moreover, it has been argued that the emergence of ethics commissions and how they have been composed have led to a “thinner” debate. In the first part of the article, the problem regarding checks for identifying moral experts is discussed. I argue that one way to handle this difficulty is through the application of Rawls’ concept of comprehensive doctrines. These doctrines have inherent standards that function similarly to independent checks, making it possible to identify moral experts from within such different doctrines. Using this approach makes it manageable to appoint moral experts to ethics commissions. In the second part, I consider the implications of seeing moral expertise through the prism of comprehensive doctrines for the composition of ethics commissions. One natural conclusion is that we should select moral experts representing different reasonable comprehensive doctrines to serve as members of ethics commissions. I consider six challenges to my proposal and demonstrate why these lack merit, and I point out some practical concerns that need further inquiry. (shrink)

Bioethicists working on national ethics commissions frequently think of themselves as advisors to the government, but distance themselves from any claims to actual authority. Governments however may find it beneficial to appear to defer to the authority of these commissions when designing laws and policies, and might appoint such commissions for exactly this reason. Where does the authority for setting laws and policies come from? This question is best answered from within a normative political philosophy. (...) This paper explains the locus of moral authority as understood within one family of normative political theories—liberal political theories—and argues that most major “liberal” commentators have understood both the source and scope of ethics commissions’ authority in a manner at odds with liberalism, rightly interpreted. The author argues that reexamining the implications of liberalism for bioethics commissions would mean changing what are considered valid criticisms of such commissions and also changing the content of national bioethics commission mandates. The author concludes that bioethicists who participate in such commissions ought to carefully examine their own views about the normative limits of governmental authority because such limits have important implications for the contribution that bioethicists can legitimately make to government commissions. (shrink)

This study analyzes the ideals of responsibility and accountability, asking such questions as when it is legitimate to blame top officials of an organization for mistakes made by personnel below them in the bureaucratic hierarchy; when things go wrong in a large and complex organization like the Canadian Forces, who is responsible and accountable; and whether a plea of ignorance is a good excuse. The study also analyzes the doctrine of ministerial responsibility in both the British and Canadian parliamentary traditions, (...) asking whether it is realistic to expect that a government minister should be held responsible for everything that goes wrong in his/her department. Finally, traditional military values are examined, considering the kinds of attitudes and values expected from Canada's armed forces and the differences between the military and civilian sectors. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law (...) and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

In May 2009 the World Health Assembly passed a resolution on reducing health inequities through action on the social determinants of health, based on the work of the global Commission on Social Determinants of Health, 2005–2008. The Commission's genesis and findings raise some important questions for global health governance. We draw out some of the essential elements, themes, and mechanisms that shaped the Commission. We start by examining the evolving nature of global health and the Commission's foundational inspiration – the (...) universal pattern of health inequity and the imperative, driven by a sense of social justice, to make better and more equal health a global goal. We look at how the Commission was established, how it was structured internally, and how it developed external relationships – with the World Health Organization, with global networks of academics and practitioners, with country governments eager to spearhead action on health equity, and with civil society. We outline the Commission's recommendations as they relate to the architecture of global health governance. Finally, we look at how the Commission is catalyzing a movement to bring social determinants of health to the forefront of international and national policy discourse. (shrink)

Government has played a pervasive and largely overlooked role in journalists' ethical decision making. Federal Communications Commission (FCC) rules governing program content, and a libel law system run amok, are only two wats government influences journalists' behavior. This substitution of government ethics for private ethics creates minimum standards of conduct rather than challenging journalists to an ethical ideal. More subtly, government erects structural barriers to the development of the very technologies (like cable TV) that (...) can offer journalists a more ethically hospitable environment. In the information age, ethicists will need to be aware of, and wary of, government attempts to control development of the very media that hold the greatest ethical promise. (shrink)

Focusing on the work of one bioethics commission, the New York State Task Force on Life and the Law, this article explores the role played by moral consensus in public ethics. Task Force members, who were appointed to represent diverse interests in New York State, identified a culturally strong value of individual autonomy as the ethical basis for their work on life-sustaining treatment. This moral consensus permitted the members to unite across their differences and develop public policy recommendations that (...) substantially reformed a highly troubling New York law. However, the principle of autonomy insufficiently guides decisions by caring family members for incompetent adults in cases where little is known of patient preference. A different, more innovative moral vision is required – one that grants a more robust moral authority to the family. While government efforts that rely on moral consensus developed in a broadbased and well-reasoned manner can serve us well, in some cases the consensus will provide inadequate moral guidance. Government bioethical efforts must guard against the limits of moral vision in light of their disproportionate societal power. Keywords: autonomy, consensus, family decisionmaking, government bioethics, incompetent patients, life-sustaining treatment, surrogate decisionmaking CiteULike Connotea Del.icio.us What's this? (shrink)

This section is focused on some areas of concern which were identified in The Report of the Royal Commission into Commercial Activities of Government and Other Matters (1990–1992). In the Report a number of situations were examined in which some individuals acted without recourse to any ethical guidelines. Most of the people mentioned in the Report held responsible positions in either Government or the private sector, and all were very well known in the community. The Report of the (...) Royal Commission made a number of findings of serious impropriety on the part of several individuals, although there was comparatively little evidence of illegal or corrupt conduct. This section shows what happened to a governmental system in an Australian state when a number of Ministers and their advisors placed their personal or party advantage over their constitutional obligation to act in the community''s interests.Those who cannot remember the past are condemned to repeat it. (shrink)

On August 28, 2008, Michael Marmot, Chair of the Commission on Social Determinants of Health, formally handed over the Commission’s Final Report to Margaret Chan, the Director-General of the World Health Organization, at the Palais des Nations in Geneva. It was a significant moment. Dr. Chan addressed a hall packed with representatives of the world’s communications media in a speech that was remarkably direct. Dr. Chan reiterated the Commission’s position that to improve health and health equity action needs to be (...) taken not just across the health sector but across all social and economic policy areas, and stated, “Social deprivation is not a matter of fate. It is a marker of policy failure.” This was a bold statement from one of the world’s leading diplomats. Policy failure! The phrase echoes the Commission’s assertion that “a toxic combination of poor social policies, unfair economic arrangements and bad politics is killing people on a grand scale.” The Commission’s messages are far reaching. (shrink)

This paper discusses the reform of the European Commission in the wake of the mass resignations of March 1999. It places reform in the framework of the global business ethics movement by making the case for business ethics in government. It examines the Committee of Independent Experts’ report as well as the Commission’s White Paper on reform. It argues that effective Commission reform is not possible without fundamental culture change, and puts forward thirteen recommendations that, if implemented, (...) are calculated to improve ethics in the Commission’s culture, thereby reducing the incidence of questionable conduct. It concludes by maintaining that effective reform is possible, albeit difficult. (shrink)

In an open, unregulated and globalised economy, it is logical that the problem of corporate government not only occupy the time of academics, but also preoccupy both companies and the public administration. Corporate governance varies depending on several factors, such as the culture of a particular country, the economic situation and the organisational structures. Thus, there is no single recipe which can be applied automatically and is universally valid in all contexts. However, it is possible to propose some general (...) principles which have duly stood the test of experience and are recognised as providing valuable guidance for efficient corporate governance.The aim of this article is to present the Spanish "Olivencia Report", which is an attempt to draft an "ethical code" containing a number of practices and principles, which, if they were to be applied, could improve the governance of the larger Spanish companies listed on the Stock Market. (shrink)

This article provides a critique of the IWC's traditional focus on anthropocentric conservation in the governance of whaling. It is argued that this position, which relies on accepting the view that we have no direct moral duties to whales, is out of step with the moral status that now tends, in theory and practice, to be granted to animals. More specifically, anthropocentric conservation conflicts with the widespread acceptance, in theory and practice, that non-human animals such as whales have moral standing, (...) that what we do to them matters to them directly. This does not mean that whaling should necessarily be prohibited on ethical grounds, although the animal welfare analysis of whaling sketched in this article does suggest that, on balance, it is difficult to defend morally. Rather, it is being claimed that it is morally objectionable to deny, as the whaling nations do, that the IWC ought to be mandated to consider the welfare implications of whaling. (shrink)

Taking advantage of the China’s recent anti-corruption campaign, we attempt to examine the effect of public governance on a firm’s incentive to commit fraud. Using enforcement actions data from the Chinese Securities Regulatory Commission (CSRC) from 2004 to 2014, we find that, due to enhanced public governance, firms are less likely to commit fraud in the post-campaign period than in the pre-campaign period. We further show that the effect of public governance is more evident in privately held listed firms, in (...) firms with weak legal environment, and in firms in areas with poor local economies. In addition, we find that older CEOs respond less actively to the public governance caused by anti-corruption regulations. This paper offers clear policy implications for business ethics by indicating that public governance provides external monitoring of corporate decisions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics Commissions: Town Meetings with a “Blue, Blue Ribbon”Susan Cartier Poland (bio)Town meetings are characteristic of New England. In theory, a quorum of registered voters in a small municipality meets annually to decide local public policy. In fact, special interests and the town bureaucracy control the meeting.Like a town meeting, a commission (or committee or council) comes into being, whether on an ad hoc or permanent basis, to (...) direct a government function. Bioethics commissions specialize in one area: the intersection of public policy with developments, either real or anticipated, in the basic and applied sciences.That specialization of commissions carries over into the selection of the members. More often than not commission members are appointed on the basis of expertise in a specific area. Although some commissions are still made up entirely of one kind of expert, usually medical, the majority of these government bodies seek breadth between the fields of law, religion, ethics, and science (including medicine and the social sciences).In the words of Mrs. Rigenbach, the law clerk to Chief Judge Carl B. Rubin of the United States District Court for the Southern District of Ohio, selection of persons “knowledgeable in the field” constitutes a “blue, blue ribbon” jury. In contrast, a “blue ribbon” jury is composed of those persons having “the greatest amount of formal education” (In re Richardson-Merrill, Inc. (Bendectin litigation), 624 Federal Supplement 1212 at 1217 (1985)). The problem with persons knowledgeable in the field is that their minds may have already been made up. For a jury, this is a disaster; for a bioethics commission, this directs and shapes the research, investigation, and discussion, or, in short, it makes for more efficient decision making.For this Scope Note, the definition of commission begins with the Bioethicsline description of its index term “advisory committees” as committees or commissions set up to advise government bodies on public policy. Furthermore, a commission [End Page 91] (or committee) receives government funding and support in exchange for its expertise in research, investigation, reporting, and recommendations.Six functions served by bioethics commissions have been clearly and succinctly described by LeRoy Walters (Commissions and Bioethics. Journal of Medicine and Philosophy 14 (4): 363–68, August 1989). The functions are: (1) to legitimize action; (2) to delay action or resolution; (3) to identify duplication; (4) to be representative; (5) to do research and find facts; and (6) to provide education and support (pp. 364–65). Since 1989, however, another government function has moved to the forefront. Instead of remaining within the legislative arena, government commissions serve the judiciary as well, in cases involving complex and technical questions. The now defunct Law Reform Commission of Canada recognized this use when it included in its annual reports a section on its “Influence on Law Reform through Judicial Decisions.”In mid-1997, the United States Supreme Court in its consolidated cases on assisted suicide used extensively the writings from a state commission, the New York State Task Force on Life and the Law, to support its rationale. Not only did the Court make use of the Task Force’s work, but in so doing the Court extended the efforts of the commission beyond its jurisdiction of New York into another jurisdiction on the opposite coast, Washington state. Furthermore, although the commission was chartered by one state, through the federal court system, its influence became national.Outside the U.S., the United Nations recently adopted its first bioethics text on the ethics of genetic research, and Canada is reworking its human research guidelines into a single set of guidelines that will apply to research in both the natural sciences and the social sciences.This Scope Note attempts to compile for the researcher and the reference librarian those commissions, existing and defunct, that have addressed bioethics issues. Only one other such attempt is known to the author, an Office of Technology Assessment [OTA] Background Paper, Biomedical Ethics in U.S. Public Policy (1993). Due to space limitations, not all publications could be listed; the selections included represent the range of topics from a particular group or the more frequently cited sources. Future updates of this compilation are planned, so please notify the... (shrink)

The case describes the developments of an ethics code observed in the local government of Suffolk County, New York, USA. In Suffolk County, there is now a dedicated Board of Ethics Agency (“Board”) within the local government to ensure that business operations and government operations run as ethically compliant as possible. This Board was created in 2012 in order to follow compliance with a law that established a replacement for the Ethics Commission (previously existing (...) within Suffolk County) because this Ethics Commission had been involved in a serious controversy. The former County Executive, Steve Levy, was found guilty of compromising the “integrity of an ethics commission”. Suffolk County government prescribed various measures in order to ensure that the citizens of Suffolk County were protected from business ethical violations. The Board also preemptively created laws that discouraged businesses from acting unethically. (shrink)

In the forty‐year history of U.S. bioethics commissions, these government‐sanctioned forums have often demonstrated their power to address pressing problems and to enable policy change. For example, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, established in 1974, left a legacy of reports that were translated into regulations and had an enormous practical impact. And the 1982 report Splicing Life, by the President's Commission for the Study of Ethical Problems in Medicine and (...) Biomedical and Behavioral Research, became the basis for the National Institutes of Health's Recombinant DNA Advisory Committee as well as for the Food and Drug Administration's developing “Points to Consider” when contemplating the introduction of recombinant DNA into human beings. Some efforts of bioethics commissions, however, are not tightly connected to policy change or to outcomes directly linked to a specific report. While direct policy impact is indeed a useful metric for government bioethics commissions, it is not their only legitimate utility. For instance, bioethics commissions can also be incubators for deliberation on a hot topic, giving policy‐makers time to think through options while the political heat has some time to dissipate. Or a bioethics commission may stake out a position that enables a politician to take action while not necessarily following its recommendations. (shrink)

Presidential commissions come and go by design, and it is reasonable to wonder about the impact of their recommendations. I have been involved in the work of two presidential commissions: as a member of the Advisory Committee on Human Radiation Experiments (from 1994 to 1995) and as senior consultant to the National Bioethics Advisory Commission (from 1999 to 2000) for its report on multinational research. I continue to reflect on and look for the impact of both these (...) class='Hi'>commissions.ACHRE's charter included the review of experiments with ionizing radiation sponsored or conducted by the United States government since the 1940s. The committee was also charged with investigating specific intentional releases of radiation into the environment. ACHRE had a somewhat unique difficulty built into its work: the need to make retrospective ethical judgments. With the National Bioethics Advisory Commission, my main role as senior consultant consisted of writing chapters of the report on multinational research for the commissioners’ approval. A more important concern for me as a hired consultant was how to maintain intellectual and moral integrity. Unlike when writing scholarly papers, where I can express my own views, when I was drafting text for a presidential commission, the commissioners’ views took precedence over my own when we disagreed. I wondered, how much could I comply with the commissioners’ positions without compromising my own integrity? (shrink)

The aim of this article is to analyse the Report on good corporate governance (Olivencia Report) from an ethical point of view. This report was drawn up by a group of experts at the request of the National Commission of the Spanish Stock Exchange Commission (Comisión Nacional del Mercado de Valores), in winter 1998, and began to be implemented over late 1998.This paper is the result of several sessions of discussions with businessmen and managers about the role that can be (...) played by the Olivencia Report, its virtues and weaknesses. (shrink)

Details goverment, private, and international response to the policy recommendations of the National Bioethics Advisory Commission.

Ethics advisory groups, in various forms, have existed for at least 50 years in the United States and other countries. In science and biomedicine, four principal types of committees can be distinguished: policy-making and/or advisory committees, health professional association committees, health care ethics committees, and research ethics committees. Overall, these bodies have been of use to governments, policy makers, health care professionals, and the public in considering ‘what is ethical’ and ‘what is unethical’ in areas such as (...) research involving humans or animals or environmental questions such as whether to use genetically modified crops. This paper concentrates on a particular and... (shrink)

Since the mid-1980s, internal corporate investigations have become commonplace in the U. S., with an upsurge occurring as a result of the corporate scandals of 2001-02 involving Adelphi Communications Corporation, Enron, Merck & Company, Riggs Bank, and other companies accused of financial malfeasance. After an introduction, this article first presents the U. S. public policy framework (as implemented through the U. S. Sentencing Commission, the U. S. Department of Justice, and the Securities and Exchange Commission) encouraging the use of corporate (...) internal investigations and self-reporting of these results to federal authorities; second, evaluates this framework, identifying the public policy issues inhibiting companies from using corporate internal investigations and self-reporting significant results; third, proposes a policy incentive regime which attempts to ameliorate these outstanding issues; and fourth, offer policy recommendations and suggestions for further research on this topic, including increasing the maximum deduction in the Organizational Sentencing Guidelines Culpability Score available to a firm for development of an Effective Compliance and Ethics Program (from 3 to 5 points), and self-reporting the results of an internal investigation (from 5 to 7 points); evaluating the effectiveness of these enhancements in legal incentives over a period of 5-7 years after implementation; instituting a formal federal government effort to educate the American business community on the corporate reputation (and financial) benefits of an effective compliance program; and protecting attorney-client privilege and work product protection, through legislative action, to encourage company executives and directors to utilize independent, outside attorneys to conduct fair, comprehensive, and impartial internal investigations. (shrink)

The Joint Research Centre (JRC) is the European Commission’s in-house science and knowledge service, employing a substantial staff of scientists devoted to conducting research to provide independent scientific advice for EU policy. Focussed on various research areas aligned with EU priorities, the JRC excels in delivering scientific evidence for policymaking and has published numerous science-for-policy reports and scientific articles. Drawing on a scientific integrity statement, surveys among JRC’s research staff, and thematic discussions with JRC’s research leaders, the JRC has developed (...) a comprehensive Scientific Integrity and Research Ethics (SIRE) framework, including instruments, procedures, and guidelines to ensure high standards and independence in its research. Key components of the SIRE framework include a Scientific Integrity Officer, an Editorial Review Board, a Research Ethics Board, and guidelines for responsible conduct of research. This article provides an overview of the JRC’s SIRE framework and how it was developed, emphasising the importance of maintaining independence, integrity, and ethics in scientific research that supports EU policy. The article also discusses potential gaps in the framework and where additional efforts may be needed, comparing with the recent U.S. National Science and Technology Council report on Protecting the Integrity of Government Science. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The National Commission on AIDSDonald S. Goldman (bio) and Jeff Stryker (bio)A decade after the first cases were recognized in the United States, AIDS continues to vex policymakers and fascinate the public. It has been said that AIDS acts as a prism, refracting a spectrum of controversial topics. For bioethicists, these topics include: equity in the allocation of resources for treatment and research; forgoing life-sustaining care and proxy decision (...) making; informed consent in the context of HIV testing and screening; the ethical duties of health care workers to provide care for persons with HIV disease; and competing obligations of health care professionals to patients and to third parties who may be put at risk.The Role of CommissionsIf AIDS is the quintessential case study for bioethicists, it is a potential quagmire for politicians. The association of HIV disease with drug use and sexual behavior makes it a topic that all but the most courageous (or the most homophobic) politicians shy away from. A frequent political response is to form a commission.Alexander Capron, who was executive director of the President's Commission for the Study of Ethical Problems in Medicine, has described some roles commissions play: a watchdog, overseeing the work of particular government agencies; a crucible, providing a means for "publicly hammering out conclusions on controversial issues when consensus, both in the public and in the relevant disciplines, is not yet apparent"; and "a lightning rod for public concern—or viewed less charitably, dumping ground for an issue that is too difficult for the ordinary political process to handle" (Capron 1983, p. 9).Nearly every state has created a gubernatorial-level task force or commission on AIDS. The National Commission on AIDS was established under the Health Omnibus Program Extension (HOPE) Act of 1988, which was signed by President Reagan on November 4, 1988. The official charter of the commission was approved August 2, 1989 and its original two-year term was extended for a third year. The mission statement crafted by the commission to reflect its Congressional mandate reads: [End Page 339]The National Commission on Acquired Immune Deficiency Syndrome is an independent body of 15 members created to advise the President and Congress. The Commission seeks to build a broad public understanding on the magnitude, scope and urgency of the HIV/AIDS epidemic; provide and inspire leadership at all levels of both the public and private sectors; empower individuals and communities; and advocate for effective, cooperative and non-discriminatory resources required for prevention, comprehensive care, and the research necessary to halt the epidemic.As the mission statement implies, the National Commission on AIDS has viewed itself from the outset not only as a crucible for policy analysis, but also as a forum for those affected by HIV disease. In site visits and hearings the commissioners have met with hundreds of people living with HIV disease, and with caregivers on the front lines. This odyssey has taken the commission on visits to homeless shelters in New York City; to "shooting galleries" where intravenous drug users congregate in Seattle; to Native American communities in four states; to private homes in rural Georgia; and to hospitals, HIV antibody testing centers, drug treatment clinics, and hemophilia treatment centers throughout the nation. It quickly became clear during the commission's travels that HIV disease cannot be understood outside the context of the racism, homophobia, poverty and unemployment that provide the medium that fosters its spread. It also became apparent that issues of HIV prevention, care and treatment, and clinical research are inextricably intertwined and must be dealt with as such.Early InitiativesUnder the leadership of Chairperson June Osborn and Vice-chairperson David Rogers, the commission decided that the problems it saw in its first few meetings were too urgent to await a full-length annual report. Hence the commission entered the fray with a series of brief interim reports on particular aspects of AIDS. These reports enabled the commission to draw attention to urgent problems of limitations in access to health care and to underscore the plight of people with HIV disease who might otherwise garner little media attention, such as prisoners and drug users (National Commission... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Private Bioethics Forums:Counterpoint to Government BodiesCynthia B. Cohen (bio) and Elizabeth Leibold McCloskey (bio)Ethical issues associated with reproductive technologies quickly gain public attention. The front pages of newspapers have featured stories about grandmothers giving birth to their own grandchildren, couples "renting" wombs from surrogates, and researchers prepared to transplant fetal ovaries into women unable to produce viable eggs. With each new and bolder foray into reproductive realms, the (...) question of whether to set limits on the use of such technologies surfaces. An ancillary debate inevitably ensues about the proper forum for discussing and deciding such limits. The recent announcement of human embryo splitting or cloning research is no exception to this pattern. Articles in both the popular press and academic circles in the wake of the reported research contain lamentations about the absence of a national ethics body that could address the ethical issues raised by the cloning experiment. This research also breathed new life into congressional calls to create a government bioethics commission.1At times, it appears that the substantive questions raised by a procedure like cloning are subsumed under the debate about whether this ethics group or that should be convened to study the matter. But the forum in which options are discussed is as crucial to the development of sound ethical thought and public policy as are the conclusions themselves. Thus, we address the question of whether a private, as opposed to a public, bioethics body provides a distinctively useful forum for reaching an understanding of issues such as cloning that have significant ethical and public policy implications.A 1993 Office of Technology Assessment report, in which the authors suggest that a new federal bioethics commission might be useful, has helped to frame recent discussions about the value of government-sponsored bioethics bodies (Office of Technology Assessment 1993). To most people, the question of whether a national forum for bioethics is needed is synonymous with the question of whether a new federal body should be convened. Yet the existence of the National Advisory Board on Ethics in Reproduction (NABER) suggests that the scope of the question should be broadened. [End Page 283]NABER was born in 1992, in part as a response to an Institute of Medicine report on infertility. That document endorsed the formation of a nongovernment body to develop guidelines for assisted reproductive measures and fetal research in the event that a government body was not forthcoming (Institute of Medicine 1989). NABER, which was founded by the American College of Obstetricians and Gynecologists and the American Fertility Society, now functions wholly independently of those groups and is supported by private foundations including the Ford, Greenwall, and Josiah Macy, Jr., Foundations and the Walter and Elise Haas Fund. NABER has issued a report on ethical issues related to the use of fetal tissue (Cohen and Jonsen 1993), is about to publish a report and background papers on oocyte donation, and presents a report on human cloning in this issue of the Kennedy Institute of Ethics Journal. In addition, it has developed a protocol for NABER review of research proposals from federal agencies subject to federal guidelines on the use of human subjects in research.Thus, in function and form, NABER was envisioned as a substitute for a government body, and it now functions in a manner similar to several types of government bioethics groups. Like the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission) and the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (President's Commission), NABER functions primarily through the publication of reports intended for a broad audience of practitioners, patients, policymakers, and the general public. Just as the Ethics Advisory Board of the late 1970s examined ethical issues related to specific protocols or types of research as they arose, NABER's purposes include scrutinizing the ethics of various research efforts in the reproductive area.NABER also parallels past government bodies in form. Like these groups, NABER is a multidisciplinary board that meets regularly and is supplemented by consultants and staff who provide research and writing for the board. Its members are nationally recognized in... (shrink)

As has become tradition, executive directors of United States’ presidential bioethics committees offer reflections about their experience shortly after the orderly shutdown of the commission staff. After the records are filed according to government records regulations; after all the staff members, who are hired into temporary positions that must be renewed every two years, have secured permanent employment; after preparations are made to ensure that the next commission staff (should there be one) has a budget and standard operating procedures (...) in order to begin its work in a timely manner; after the lights are turned out for the last time, the executive director makes the final climb up the stairs into the sunlight and reflects on the whirlwind. There is much about my work with the Presidential Commission for the Study of Bioethical Issues that deserves comment, but one aspect of the commission that has been especially valuable to me is its work to educate the nation on bioethical issues. This is, moreover, a contribution in which the commission staff was central, and it is one that, as an ethics educator myself, I will cherish deeply. (shrink)

Like the National Commission and the President's Commission, the Advisory Committee on Human Radiation Experiments was formed to carry out specific ethical tasks. Yet the committee also had an “openness” mission, a charge to investigate allegations that the U.S. government secretly exposed Americans to environmental releases of radiation. Eighteen months later—and after sixteen public meetings, more than 200 interviews, and the review of about 400,000 documents—the committee delivered a 925‐page report to the president.

As the only nation in the western world without a national health insurance program, the United States faces ongoing issues of access and fairness in health care coverage. The Clinton administration tried and failed to address the problem of universal coverage. Since then we have focused on the narrower, but nonetheless real, issues of fairness and equity in the benefits package provided in insurance plans. The LORAN Commission spent two years trying to devise agreed-upon principles to govern such issues. The (...) lesson learned was the same as that of the Ethics Force study: there was no possibility of getting agreement, let alone consensus, among the participants on how to decide what should be a covered benefit. There were, however, two generally agreed upon principles that emerged regarding health care: “Every individual should be treated alike,” and “When it comes to health, cost cannot be a consideration.” That formula translated into providing everyone with everything. The only certain outcome from such a policy would be fiscal insolvency and ultimately bankruptcy. (shrink)

The European Union is strategically committed to the development of nanotechnology and its industrial exploitation. However, nanotechnology also has the potential to disrupt human health and the environment. The EU claims to be committed to the safe and responsible development of nanotechnology. In this sense, the EU has become the first governing body in the world to develop nanospecific regulations, largely due to legislative action taken by the European Parliament, which has compensated for the European Commission’s reluctance to develop special (...) regulations for nanomaterials. Nevertheless, divergences aside, political bodies in the EU assume that nanotechnology development is controllable and take for granted that both the massive industrial use of nanomaterials and a high level of environmental and health protection are compatible. However, experiences such as the European controversy over agri-food biotechnology, which somewhat delegitimized the regulatory authority of the EU over technological safety and acceptability, arguably show that controllability assumptions are contestable on the grounds of alternative socio-economic and cultural preferences and values. Recently developed inclusive governance models on safety and innovation, such as “Responsible Research and Innovation”, widely claim that a diversity of considerations and issues are integrated into R&D processes. Even so, the possibility of more radically alternative constitutions of socio-technical safety seems to be seriously limited by the current ideology of innovation and economic imperatives of the global, knowledge-based, capitalist economy. (shrink)

Foundations of medical ethics and law -- Professionalism and medical ethics -- The doctor, the patient, and society -- Ethics and law at the beginning and end of life -- Healthcare commissioning and resource allocation -- Introduction to sociology and disease -- Experience of health and illness -- Organization of health care provision in the UK -- Inequalities in health and health care provision -- Epidemiology and public health -- Clinical governance.

The Australian Royal Commission into Aged Care Quality and Safety acknowledged understaffing and substandard care in residential aged care and home care services, and recommendations were made that that the Australian Government should promote assistive technology within aged care. Robotic care assistants can provide care and companionship for the elderly—both in their own homes and within health and aged care institutions. Although more research is required into their use, studies indicate benefits, including enabling the elderly to live independently at (...) home, assistance with medication and monitoring of safety. Nevertheless, there are inherent ethical challenges in the use of robots as carers, including loss of privacy, unwarranted restrictions on autonomy, lack of dignity, deception, and the exacerbation of loneliness. Ethics by design can counter these issues in development of robotics and clinical ethics committees have been put forward as a way of dealing with the ethical use of robotic care in healthcare institutions. In this paper I outline the ethical challenges of robotic care assistants and how these may be mediated in their design and use. (shrink)

ABSTRACTDebate about the TRC has become necessary in South Africa today, 20 years since the final Report was handed over to government on 29 October 1998. Assessment of its efficacy and longer-term value is being undertaken, unfortunately, within an environment of intense disillusionment about the promise of constitutional democracy. This paper sets out the environment in which the TRC was established in 1996, its legal and constitutional frameworks, its achievements for creating a climate of reconciliation, for granting amnesty to (...) perpetrators of human rights violations, and for setting a reparations framework. South Africans are conscious of grinding poverty and inequality, pervasive racism, and unfulfilled aspirations of the democratic settlement of 1994. What value, then was the TRC? This paper attempts a fair assessment, seeks to be honest about its grandiose claims, and undertakes a philosophical, political and ethical analysis of its achievements. Drawing on many studies on the TRC it seeks to chart a more rational course than some, noting that circumstances in Africa are such that the TRC is being revisited, The Gambia, for example, being the latest country that has introduced the TRC. Others may follow suit: Zimbabwe, the Democratic Republic of Congo, Burundi, to name a few. (shrink)

The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research published in March of 1983 its Report, Securing Access to Health Care: The Ethical Implications of Differences in the Availability of Health Services . Concluding that there are "ethical obligations" on behalf of society which are balanced by individual obligations, the Report provides an ethical framework for ensuring "ultimate responsibility" of the Federal government to arrange for equitable access to health and to a (...) fair share of cost. In doing so the Report neither makes justice nor beneficence the prime moral principle in public health care, it rather calls for a common sense approach in "approximating adequacy". But how to define equality without creating uniformity in a society rich in its diversity, including attitudes towards health? Keywords: justice, beneficence, right to health care, equality, distribution CiteULike Connotea Del.icio.us What's this? (shrink)

In Citizens United v. Federal Election Commission , the US Supreme Court sharply curtailed the ability of the state to limit political speech by for-profit corporations. This new legal situation elevates the question of corporate political involvement: in what manner and to what extent is it ethical for for-profit corporations to participate in the political process in a liberal democratic society? Using Scanlon’s version of contractualism, I argue for a number of substantive and procedural constraints on the political activities of (...) businesses. Central to this contractualist analysis is an identification of the self-governance-based interests of individuals that are affected by corporate political activity and a method for judging the various assignments of social rights, duties and roles according to how they collectively meet those interests. Together, these two features make this contractualist approach distinctive and allow it to generate substantive ethical results. (shrink)

The policies of the European Union concerning the development of biofuels can be termed a lock-in. Biofuels were initially hailed as a green, sustainability technology. However evidence to the contrary quickly emerged. The European Commission proposed to alter its policies to accommodate for these effects but met with fierce resistance from a considerable number of member states who have an economic interest in these first generation biofuels. In this paper I argue that such a lock-in might have been avoided if (...) an experimental approach to governance had been adopted. Existing approaches such as anticipation and niche management either do not reduce uncertainty sufficiently or fail to explicitly address conflicts between values motivating political and economic support for new technologies. In this paper, I suggest to apply an experimental framework to the development of sustainable biobased technologies. Such an approach builds on insights from adaptive management and transition management in that it has the stimulation of learning effects at its core. I argue that these learning effects should occur on the actual impacts of new technologies, on the institutionalisation of new technologies and most specifically on the norms and values that underly policies supporting new technologies. This approach can be relevant for other emerging technologies. (shrink)

In the last decade, the UK Government has attempted to implement improved processes and procedures in modelling and analysis in response to the Laidlaw report of 2012 and the Macpherson review of 2013. The Laidlaw report was commissioned after failings during the Intercity West Coast Rail (ICWC) Franchise procurement exercise by the Department for Transport (DfT) that led to a legal challenge of the analytical models used within the exercise. The Macpherson review looked into the quality assurance of (...) class='Hi'>Government analytical models in the context of the experience with the Intercity West Coast franchise competition. This paper examines what progress has been made in the 8 years since the Laidlaw report in model building and best practise in government and proposes several recommendations for ways forward. This paper also discusses the Lords Science and Technology Committees of June 2020 that analysed the failings in the modelling of COVID. Despite going on to influence policy, many of the same issues raised within the Laidlaw and Macpherson Reports were also present in the Lords Science and Technology Committee enquiry. We examine the technical and organisational challenges to progress in this area and make recommendations for a way forward. (shrink)

Introduction -- Historical perspectives of medical ethics -- The medical ethics Renaissance: a brief assessment -- Risk disclosure/'informed consent' -- Consent, control and minors: Gillick and beyond -- Sterilisation/best interests: legislation intervenes -- The end of life: total abrogation -- Medical ethics in government-commissioned reports -- Conclusion.

In lieu of an abstract, here is a brief excerpt of the content:Fallout from Government-Sponsored Radiation ResearchCarol Mason Spicer (bio)On December 28, 1993, Energy Secretary Hazel R. O'Leary publicly appealed to both the executive and legislative branches of the United States Government to consider compensation for individuals who were harmed by their exposure to ionizing radiation while enrolled in government-sponsored studies conducted between 1940 and the early 1970s.1 The call for compensation was issued three weeks after Secretary (...) O'Leary disclosed that radiation experiments involving humans, sometimes without their consent, had occurred under the auspices of the Atomic Energy Commission (AEC), a forerunner of the Department of Energy (DOE). Secretary O'Leary directed her department to investigate the nature and extent of the experiments, report on their medical and ethical acceptability, and locate the research subjects or their families.Background to the Federal Advisory CommitteeDespite the fact that the existence of many government-sponsored radiation experiments was not a secret—much of the research was reported at the time in scientific journals, and in 1986, Representative Edward J. Markey (D-MA) conducted congressional hearings on such radiation research—Secretary O'Leary's disclosure of the AEC experiments and her call for compensation made the experiments common knowledge and sparked a swift and complex governmental response involving both the executive and legislative branches.It is curious that the "radiation experiments" have garnered so much attention now, since they were virtually ignored in the wake of the 1986 hearings. Secretary O'Leary's disclosure of the radiation studies grew out of a general reassessment of secrecy in government. In April 1993, the Clinton administration set out to review the system of government secrecy that evolved during the Cold War, and in May 1993, DOE began reviewing and declassifying files pertaining to nuclear weapons research. When Dan Reicher, a top aide to Secretary O'Leary, informed her in November of the impending publication of an Albuquerque Tribune investigative report (Welsome 1993) on an experiment conducted between 1945 and 1947 in which 18 subjects were injected with plutonium, [End Page 147] the topic of questionable research involving the exposure of human subjects to radiation was added to the DOE list of information to be disclosed. At the time, it was thought to be but one small part of a massive quantity of DOE information to be made public.As part of its effort to investigate the radiation experiments, DOE established a toll-free telephone hot line for individuals who thought they might have been the subjects of radiation exposure experiments. The hot line, originally staffed by three people to handle the anticipated few dozen calls per day, received more than 2,000 calls in the first week. By early January the hot line was flooded with 6,000 to 10,000 calls daily, and its staff had increased more than ten-fold. Although many of the calls were deemed not to be candidates for further investigation, the extent of the radiation-related experiments, sponsored not only by AEC, but also by the military and other government departments and agencies, took officials by surprise.On December 30, the Department of Defense, the Department of Veterans Affairs, and the National Aeronautics and Space Administration all announced that they were initiating thorough reviews of their files to determine the extent and nature of any radiation experiments conducted under their auspices.2 In January, the CIA and the Department of Health and Human Services, including the National Institutes of Health, followed suit.The White House publicly entered the arena in late December announcing that it would hold a meeting on January 3, 1994, to help coordinate the government's investigative effort. At the same time, Senator Edward M. Kennedy (D-MA) called for a mid-January congressional hearing to investigate experiments conducted between 1946 and 1956 in which mentally retarded boys at the Fernald State School in Massachusetts were fed radioactive iron supplements or milk containing radioactive calcium to enable researchers to trace the absorption of those nutrients. Senator Kennedy's hearing, conducted by the Subcommittee on Health of the Senate Committee on Labor and Human Resources, was the first of a number of congressional hearings held earlier this year to investigate the... (shrink)

PurposeThis paper aims to demonstrate the relevance of worldviews of the global south to debates of artificial intelligence, enhancing the human rights debate on artificial intelligence (AI) and critically reviewing the paper of UNESCO Commission on the Ethics of Scientific Knowledge and Technology (COMEST) that preceded the drafting of the UNESCO guidelines on AI. Different value systems may lead to different choices in programming and application of AI. Programming languages may acerbate existing biases as a people’s worldview is captured (...) in its language. What are the implications for AI when seen from a collective ontology? Ubuntu (I am a person through other persons) starts from collective morals rather than individual ethics.Design/methodology/approachLiterature overview on the African philosophy of Ubuntu as applied to artificial intelligence. Application of it to the United Nations Educational, Scientific and Cultural Organisation (UNESCO) debates on establishing guidelines to the ethics of artificial intelligence.FindingsMetaphysically, Ubuntu and its conception of social personhood (attained during one’s life) largely rejects transhumanism. When confronted with economic choices, Ubuntu favors sharing above competition and thus an anticapitalist logic of equitable distribution of AI benefits, humaneness and nonexploitation. When confronted with issues of privacy, Ubuntu emphasizes transparency to group members, rather than individual privacy, yet it calls for stronger (group privacy) protection. In democratic terms, it promotes consensus decision-making over representative democracy. Certain applications of AI may be more controversial in Africa than in other parts of the world, like care for the elderly, that deserve the utmost respect and attention, and which builds moral personhood. At the same time, AI may be helpful, as care from the home and community is encouraged from an Ubuntu perspective. The report on AI and ethics of the UNESCO World COMEST formulated principles as input, which are analyzed from the African ontological point of view. COMEST departs from “universal” concepts of individual human rights, sustainability and good governance which are not necessarily fully compatible with relatedness, including future and past generations. Next to rules based approaches, which may hamper diversity, bottom-up approaches are needed with intercultural deep learning algorithms.Research limitations/implicationsThere is very few existing literature on AI and Ubuntu. Therefore, this paper is of an explorative nature.Practical implicationsThe ethics of Ubuntu offers unique vantage points in looking at the organization of society and economics today, which are also relevant for development of AI, especially in its tenet of relatedness rather than individuality (and practical use of AI for individuals), taking responsibility for society as a whole (such as analyzing the benefit of AI for all strata of society), and embodying true inclusiveness. Whether looking at top-down guidelines for the development and implementation of AI or the bottom-up ethical learning process of AI (deep learning), ethics of the Global South can have an important role to play to combat global individualist tendencies and inequity, likely reinforced by AI. This warrants far more research.Social implicationsApplications of AI in Africa are not contextualized, do not address the most pressing needs of the African continent, lead to cybersecurity issues and also do not incorporate African ethics. UNESCO’s work in this regard is important but expert inputs are largely centered around Western “universal” principles and Organisation for Economic Cooperation and Development and EU precedence. African ethics have, so far, a small role to play in global ethics and philosophy and therefore risk to be overlooked in the discussion on AI and ethics. This is why the consultation process of UNESCO on ethics of AI was of paramount importance. However, it does not automatically lead to consultation of African philosophers or sages, as many are educated in Western (ized) education systems. See further details under practical implications.Originality/valueThis is a new area of research in which little work has been done so far. This paper offers the opportunity to widen the debate on AI and ethics beyond the conventional discourse, involving multiple worldviews, of which Ubuntu is just one. (shrink)

This article describes how ethical guidelines have been applied while interviewing psychiatric patients who were recovering from mental illness, especially from psychosis, to allow nurses to understand these patients’ experiences. Because psychiatric patients are vulnerable, their participation in research involves ethical dilemmas, such as voluntary consent, legal capacity to consent, freedom of choice, and sufficient knowledge and comprehension. The first part of this article describes the most important ethical guidelines concerning human research. These have been published by different organizations, departments, (...) committees and commissions for the purpose of protecting human rights and dignity whenever research participants are vulnerable persons or their capacity to consent is limited. At present, however, no special regulations govern research involving adults who have been diagnosed with a condition characterized by mental impairment. Furthermore, a relatively small body of research has documented the effects of various disorders on decision-making capacity per se. One basic moral and policy question is whether these individuals should ever be involved in research. The second part of this article concentrates on how the investigator made sure that participating patients had understood their role in this particular piece of nursing research. During the interviews the investigator noticed that some ethical dilemmas required further study and debate because of the lack of consensus on the proposed regulatory provisions on research involving institutionalized persons and their ability to make an informed and voluntary decision. (shrink)

In response to the obesity epidemic, much discussion in the public health and child advocacy communities has centered on restricting food and beverage marketing practices directed at children. A common retort to appeals for government regulation is that such advertising and marketing constitutes protected commercial speech under the First Amendment. This perception has allowed the industry to function largely unregulated since the Federal Trade Commission 's foray into the topic, termed KidVid, was terminated by an act of Congress in (...) 1981. The FTC has since focused on self-regulation as a potential solution to such concerns. However, this method of control has proven ineffective to protect children, and has led to growing recognition that federal regulation may be necessary.Since KidVid, the evidence has only mounted that children are uniquely vulnerable to the effects of advertising. Over the same time period, the exposition of commercial speech jurisprudence has plateaued, as the Supreme Court has not decided a pure commercial speech case since 2002. (shrink)

The purpose of this paper is to examine the effect of corporate governance practices of small cap companies have had on their financial performances. Previous studies have mainly examined governance practices of larger corporations. This analysis focuses on the governance variables that have been highlighted by the New Zealand Securities Commission governance principles and guidelines and also on the governance variables that are supported in the literature as providing an appropriate structure for the firm in the environment in which it (...) operates. The data for 71 small cap companies listed in New Zealand over a five-year period from 2001 to 2005 was analysed. Pooled data, OLS and 2SLS regression techniques were used and Tobin's Q, ROA and OPINC were used as the dependent variables. The evidence does support the hypothesis that the existence of board independence and audit committee has enhanced firm financial performance, as measured by Tobin's Q. (shrink)

Following the trend of sharing, and associating being on-line with being 'on-life', many people are now demanding the ownership and control of their data across all processing phases, including the erasure of their presence on the web. In Europe, recent proposals for regulation include an explicit 'Right to be Forgotten'; this right stated in the European Commission Proposal for Regulation COM 2011/12 does not emerge without controversy. It is being criticised on several grounds, including clashing with other rights, such as (...) freedom of expression, as well as setting the terrain for censorship. Besides the purely legal aspects of the proposed provisions, the chapters of this volume discuss how those legal provisions correspond in practice to worldviews and how individual and collective memory must be governed. They look into the deeper consequences of such provisions to construction of identity, culture and community formation, and how such a right affects how, what and why individuals, groups and societies remember and forget. (shrink)

This article describes how ethical guidelines have been applied while interviewing psychiatric patients who were recovering from mental illness, especially from psychosis, to allow nurses to understand these patients’ experiences. Because psychiatric patients are vulnerable, their participation in research involves ethical dilemmas, such as voluntary consent, legal capacity to consent, freedom of choice, and sufficient knowledge and comprehension. The first part of this article describes the most important ethical guidelines concerning human research. These have been published by different organizations, departments, (...) committees and commissions for the purpose of protecting human rights and dignity whenever research participants are vulnerable persons or their capacity to consent is limited. At present, however, no special regulations govern research involving adults who have been diagnosed with a condition characterized by mental impairment. Furthermore, a relatively small body of research has documented the effects of various disorders (e.g. psychiatric conditions) on decision-making capacity per se. One basic moral and policy question is whether these individuals should ever be involved in research. The second part of this article concentrates on how the investigator made sure that participating patients had understood their role in this particular piece of nursing research. During the interviews the investigator noticed that some ethical dilemmas required further study and debate because of the lack of consensus on the proposed regulatory provisions on research involving institutionalized persons and their ability to make an informed and voluntary decision. (shrink)

Recent events in Western Australia culminating in the Royal Commission into Commercial Activities of Government and Other Matters 1992, and the subsequent publication of the Report, highlighted the fact that the commercial activities of the State Government in Western Australia had been in disarray for some time. However, in spite of some early interest in the outcomes of the Report, the general reaction by the public was largely one of disinterest. This paper traces some of the events which (...) took place after the main hearings. A number of leading citizens felt that some action was warranted. In brief, a series of lectures on different apects of business ethics were planned and given to business students at Curtin Business School. This paper highlights some of the observations made during this series of lectures. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Egg Takes Flight: The Once and Future Life of the National Bioethics Advisory Commission*Alexander Morgan Capron (bio)Attempting to describe the National Bioethics Advisory Commission (NBAC) is comparable to the surreal feat performed by the artist in a famous painting by René Magritte. The artist (Magritte himself) sits with his back to the viewer, a palette in his left hand. The brush in his right hand is raised to (...) a canvas, blank except for a bird in flight that he is in the process of painting. The artist is looking to his left at a tabletop, bare except for a single, plain egg.Having held its second formal meeting in mid-January, NBAC is certainly still embryonic, its future mysterious within its shell. Yet answers to four major questions that will determine not just what kind of bird the Commission turns out to be but the heights to which it will fly should be evident by April or May 1997. First, will the White House take the sort of interest in NBAC that is needed if it is to succeed? Second, will the Commission’s term be extended beyond October 1997—and will the decision come early enough to allow it to start soon on projects that will take more than a single year to complete? Third, will the Commission take a broad view of the issues it addresses, reexamining widely accepted assumptions and going back to basic premises, or will it respond primarily in bureaucratic terms, guided by its charter’s focus on improving the policies and practices of federal departments and agencies? Fourth, will the Commission move beyond its initially mandated topics—the rights and welfare of human research subjects and the management and use of genetic information—and become what its name promises, the nation’s advisory body on the full range of bioethical issues that arise in the organization and management of health services and research?The Origins of the Egg: NBAC’s PredecessorsThe creation of a national bioethics commission has been demanded for years, at the least since its most recent predecessor, the Biomedical Ethics [End Page 63] Advisory Committee (BEAC) finally expired in 1990. BEAC’s statutory authority lapsed after the hapless committee had spent several years itself like an in vitro embryo in a vat of liquid nitrogen. BEAC’s opponents in Congress froze its appropriation and forbad it to meet until the Biomedical Ethics Board of six senators and six representatives to which it was supposed to report resolved the chaos resulting from the Board members’ ideological differences and personal distrust; this never occurred, and the Board proved unable even to choose its chairman. 1 BEAC, which met only twice, had laid preliminary plans to study the issues raised by the new genetics, but the politics of abortion—which had greatly complicated and slowed the Board’s naming of the BEAC members—was strong enough to interfere even with the topic of genetics, on which the difference among committee members actually gave no sign of dividing on pro-life/pro-choice grounds.The disappearance of BEAC left the nation without a mechanism for “public bioethics,” and several efforts were undertaken in the early 1990s to generate a new commission that could carry on in the tradition of the two previous, successful bioethics commissions. (The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research operated under a Congressional mandate in the Department of Health, Education, and Welfare from 1974 to 1978, and the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, which had been authorized by Congress in 1978, actually operated as an independent body with government-wide purview from January 1980 to March 1983.) The Institute of Medicine established a committee to assess the mechanisms available not only to the federal government but also to states, professional bodies, and the public for deliberating about and resolving ethical issues stemming from developments in biomedicine (Bulger, Bobby, and Fineberg 1995). In September 1992, Senators Mark O. Hatfield (R-OR), Edward M. Kennedy (D-MA), and Dennis DeConcini (D-AZ) requested that the Office of Technology Assessment (OTA) evaluate the... (shrink)