October 2, 2022

Bioethics commission sets out game plan for creating consensus

Learning from experience of UK in brushing aside controversy

Rapid innovation in the wake of the development of the CRISPR gene editing technology has not caught the US Presidential Commission for the Study of Bioethical Issues napping. Armed with this tool, scientists will be eager to conduct many ethically contentious experiments with government funding — and the Commission seems keen to facilitate this.

So, in the waning days of the Obama administration, the Commission has issued a report about decision-making in an age of bioethical change. The commission is merely an advisory body which reports to the White House and can be reconstituted or dissolved by the next President. However, its recommendations will no doubt influence policy, especially if Mrs Clinton wins in November.

Rather than dealing with a specific issue, the report, Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology, discusses how to reach a consensus on controversial issues when the broader public really doesn’t understand all the implications of policy. In the United States this has led to acrimonious debates conducted on the front pages of newspapers and on prime-time TV on issues like the death of Terri Schiavo, embryonic stem cell research, the assisted suicide of Brittany Maynard, or Planned Parenthood’s sale of foetal tissue.

Finding a way to reach a decision on such issues without Sturm und Drang is the ultimate purpose of the report. The model it proposes is “democratic deliberation” backed up by ethics education. “Democratic” does not mean that the decision-making takes place in Congress, but that it embodies qualities like respect, compromise, reason-giving, and constructive public engagement.

Ethics education is supposed to be life-long and universal, from toddlers to seasoned bioethicists:

Schools from pre-kindergarten to professional training programs can and should incorporate ethics education into their curricula to help build the ethics literacy that will enable us to reason through complex bioethical problems we all will face. Ethics education can raise the population’s ethics and scientific literacy and can help prepare everyone for the difficult conversations and decisions that bioethics presents.

The model for the Commission’s proposal comes from the United Kingdom, where the national fertility authority successfully staged a 13-month campaign to persuade Britons that mitochondrial donation was ethical and necessary. It partnered with a government-funded media office for promoting science and organises deliberative workshops, open consultation meetings, a representative survey, patient focus groups, and an open consultation questionnaire. The result was an easy win in Parliament, despite an outcry from opponents over the creation of three-parent embryos.

Whether “democratic deliberation” will work across the Atlantic in a more diverse and polarised society is hard to judge. But the Commission feels that it is the best way to break deadlocks in science policy:

It provides a morally and practically defensible way for addressing hyperpartisan gridlock. It also promotes mutual respect rather than fueling the sharp polarization and heightened differences that make consensus and legitimate outcomes nearly impossible in our current context. 

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