August 12, 2022

If Trump moves on bioethics, what kind of commission should he create?

There are at least two different schools of thought: consensus commissions and non-consensus commissions

Today is October 14. Two hundred and sixty-seven days have passed since President Trump was inaugurated. And the United States still has no bioethics commission. Is that a problem in a year when CRISPR has generated controversy after controversy? A series of articles in the Hastings Center Report addressed this problem a few months ago.

Alexander Capron, a former president of the International Association of Bioethics, believes that a new commission should be created, but not necessarily a carbon copy of its predecessors, the first of which was created by the Nixon Administration in 1974.

Capron insists that a commission should try to achieve a “consensus”, the model for all previous commissions apart from the one created by George W. Bush. “A commission's only true power—the power of persuasion—is stronger with unanimity,” he writes. Its most valuable work is hammering out a consensus when none currently exists.

He also suggests that a commission should be created by Congress and appointed by the President, giving both the executive and the legislative branch a stake in its outcomes. The deliberations of a commission are meant to result in changes and these links will give it more authority.

A very different view was taken by Rebecca Dresser, who served on the President's Council on Bioethics under President Bush, which promoted discussion rather than consensus. “Although the search for consensus may be the most suitable approach for policy activities,” she writes, “it can lead to a bland and anemic version of bioethics.”

After her experience on the firing line, she regards herself as battle-hardened because bioethics sometimes became “fodder for partisan political debates”.

She raised some interesting questions about the bioethics establishment in the wake of her experience:

I learned that some people won't like it if you deviate from “the Great Bioethics Compromise.” This is the term Jonathan Moreno uses to describe the prevailing approach to United States’ oversight of science and medicine, which is to “[k]eep a close eye on scientific innovation for its societal implications, apply the brakes now and then as needed through regulations or guidelines or just the glare of public discussion, and let the bioethicists be the ones to analyze how all this is going.” Those comfortable with the Great Bioethics Compromise were vocal critics of a politically diverse Council that dared to depart from the status quo.

Her suggestion for the next commission – if one is ever appointed – are to be more inclusive, welcoming new voices, including “members with a range of backgrounds and political views” and people with practical knowledge of some of the issues under consideration. 

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