The blog of the Presidential Commission for the Study of Bioethical Issues

Bioethics Commission’s New Recommendations Bolster Ethics Education

The Bioethics Commission has encouraged and supported bioethics education throughout its projects and activities. Our educational materials, related to our reports, are tailored reach a variety of audiences. As the Bioethics Commission nears the end of its tenure, the capstone report Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology ties together these educational efforts. Among its eight recommendations, Bioethics for Every Generation included three that focus on improving bioethics education going forward.

First, early ethics education should build a foundation of ethical reasoning, literacy, and character formation. A solid basis in ethics will help children grapple with ethical choices far beyond the traditional classroom, such as how to be loyal to a friend or when, if ever, to break a promise. Those who develop curricula for ethics education should use evidence about childhood and adolescent moral development to inform their instruction, selecting questions and topics that are age-appropriate.

Second, in secondary school and higher education, bioethics education should become more targeted, and prepare students for particular ethical challenges that arise in health, science, technology, and engineering. Professionals should explore ethical questions alongside the technical dimensions of their fields, as critical reasoning skills and moral sensitivity help professionals grapple with the distinct ethical dimensions of their work.

Third, teachers and educational administrators need support, including professional development, to provide effective bioethics ethics education. Such efforts are likely to encounter understandable, but surmountable, obstacles. Among these include a hesitancy to engage students in questions of values, especially in matters that are likely to produce disagreement. Professional development can prepare instructors to overcome such obstacles. For example, training can prepare teachers to enlist support and address concerns of administrators and parents and demonstrate how ethics education is rooted in respect, does not seek to indoctrinate students, and cultivates critical thinking.

To assist educators in understanding the intersection of bioethics education and deliberation, Bioethics for Every Generation has an accompanying suite of educational materials, including deliberative scenarios that provide teachers and students with information on how to model deliberation in the classroom. All Bioethics Commission educational materials are free and available at www.bioethics.gov/education. The Bioethics Commission encourages feedback on its materials at education@bioethics.gov.

Bioethics for Every Generation and all other Bioethics Commission reports are free and available at www.bioethics.gov.

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Democratic Deliberation in Bioethics for Every Generation

On May 12, 2016 the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) issued its tenth report Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology. In the first section, the report addresses how a pluralistic, democratic society can make policy decisions about complex topics in the realm of bioethics—which involves deeply held values regarding health, bodies, identities, and life and death—using democratic deliberation.

In an era in which complex topics often become mired in polarized debate, the Bioethics Commission’s recommendations for democratic deliberation provide a method for constructive public engagement. Democratic deliberation, characterized by mutual respect and reason-giving, offers a way to find acceptable solutions to complex policy challenges in bioethics. During its tenure, the Bioethics Commission has demonstrated the effectiveness of democratic deliberation by using this method to analyze and make policy recommendations about a variety of challenging bioethical topics.

Three of the eight recommendations that the Bioethics Commission made in Bioethics for Every Generation are about democratic deliberation. First, the Commission recommended that stakeholders in the democratic process inform bioethics policy decisions with democratic deliberation. Examples of stakeholders include government officials, health plans, researchers, and members of the public who are trying to set policies about health, science, and technology with important ethical dimensions. Democratic deliberation can promote understanding, mutual respect, and greater legitimacy for the resulting policy outcomes, even when the issues under discussion seem intractable at the outset.

Second, the Bioethics Commission recommended that organizers of deliberative activities conduct deliberative activities in ways conducive to mutual respect and reason-giving among participants in accordance with best practices. Reason-giving, a central tenet of deliberative practice, entails providing reasons that are accessible to all parties and using facts that are acknowledged by others. In addition, the Commission recommended that organizers design the deliberations to influence policy decisions. For example, if organizers anticipate a policy decision on a topic, they could convene deliberations about that topic and present the results to inform involved policymakers. Empirical research on deliberative activities should guide organizers as they design further parameters and principles of deliberative activities.

Third, the Bioethics Commission recommended that scholars and organizers of democratic deliberation conduct additional research on the effectiveness of deliberative methods to further the practical contribution of deliberation in bioethics. Empirical research serves as an evidence base on which to ground deliberative activities. Further research that evaluates different deliberative processes and outcomes will strengthen this foundation. Such research will require careful consideration of what constitutes success.

These three recommendations work to strengthen the value, process, and empirical foundations of democratic deliberation. Together, they encapsulate the Bioethics Commission’s commitment to democratic deliberation as the most effective way to solve complex problems in bioethics.

Bioethics for Every Generation and all other Bioethics Commission reports are free and available at www.bioethics.gov.

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Bioethics Commission Recommends Deliberation and Education to Facilitate Civic Engagement with Pressing Bioethical Concerns

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) recently released Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology . In Bioethics for Every Generation, the Bioethics Commission addresses how bioethics education and democratic deliberation are mutually reinforcing functions that create a virtuous circle that leads to productive civic engagement.

Educators and policymakers should implement bioethics education and deliberative activities to promote values essential to an engaged and civic-minded population. Through its focus on engagement with values and analytical reasoning, ethics education prepares members of communities to discuss not only their individual perspectives and values, but also those of others in the community. In turn, engagement with topics and issues that affect a community can lead to a better understanding of our own values. Civic involvement helps us focus on the kinds of communities we want to create, and on our own ability to contribute through collaborative problem solving. Ethics education and democratic deliberation are mutually reinforcing—in other words, ethics education prepares us to deliberate, and deliberation helps us clarify values and develop a way forward. In this report, the Bioethics Commission recommends that educators and organizers of deliberative activities use deliberation and education when engaging with the ethical dimensions of developments in health, science, and technology.

The Bioethics Commission outlines several examples of how deliberation can enhance education, including various deliberative classroom activities. Additionally, the Commission highlights the Intercollegiate Ethics Bowl, which teaches college students how to engage in ethical reasoning by deliberating in teams about specific cases, including topics in bioethics.

The Bioethics Commission also addresses the important role bioethics advisory commissions play in supporting public bioethics education and engaging in deliberation. Specifically, the Bioethics Commission recommends that future bodies continue to explore, reimagine, and reinvigorate their role in education and democracy, and that they encourage discourse and civic involvement in developing health, science, and technology policy.

This Bioethics Commission has implemented deliberative practices, and made significant contributions to bioethics education, including the development of educational tools that range in scope and format, are intended for many audiences, and are available for free on Bioethics.gov .

 

Bioethics for Every Generation and all other Bioethics Commission reports are free and available at Bioethics.gov .

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New Bioethics Commission Report Lays Out Roadmap for Tackling Tough Ethical Questions

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) today released, Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology. This tenth report sets forth a series of recommendations for how to tackle the most pressing ethical questions that confront our nation, and ensure everyone in our society is equipped to address ethical dilemmas that arise in everyday life.

The report marks the culmination of the Bioethics Commission’s work over the last eight years and draws on its experience using democratic deliberation to advise the President on complicated ethical issues in health, science, and technology.

The field of bioethics is often called upon to resolve seemingly intractable ethical conflicts and challenges. This Bioethics Commission has tackled challenges that face us all as individuals, professionals, family members, and members of society in an increasingly interconnected world.

To help national advisory bodies as well as smaller, community-level organizations such as schools, churches, hospitals, and universities, approach issues that have no clear right or wrong answer, the Bioethics Commission has outlined five key steps in the process of democratic deliberation:

  1. Begin with an open question and consider distinct points of view
  2. Time the deliberation for maximum impact
  3. Invite input from experts and the public
  4. Foster open discussion and debate
  5. Develop detailed, actionable recommendations

Emphasizing the important role that education plays–across the lifespan–in preparing individuals with the skills they need to navigate complex challenges, the Bioethics Commission calls on educators, from primary school through professional training and beyond, to incorporate ethics education into their curricula.

The report highlights educational programs and classroom activities from across the country and abroad, such as The Ethics Bowl, that teach students how to share their views and engage in thoughtful and respectful deliberation of a solution. The Bioethics Commission also provides recommendations to ensure teachers are trained to effectively deliver ethics education.

As the Bioethics Commission looks to the future and considers the role of national bioethics advisory bodies, it underscores the important functions of supporting public bioethics education and engaging in deliberation, and their symbiotic relationship. Deliberation and ethics education work together: education is required for informed deliberation about complex bioethical issues, and deliberation results in a deeper understanding of ethical dimensions of difficult problems.

Read full report:

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Roundtable Discussion: Bioethics Advisory Bodies Past, Present, and Future

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) closed its reflections on the impact of national bioethics advisory bodies with a roundtable discussion involving Commission members and the day’s presenters.

Amy Gutmann, Ph.D., Chair of the Bioethics Commission, began the session by asking each panelist to articulate an important takeaway from the previous discussions about what the future holds for bioethics advisory bodies. She invited panelists and members to reflect upon what they would recommend to the next bioethics commission, in terms of either topic selection or structure/function.

Highlights from the discussion include:

Jason L. Schwartz, Ph.D., M.B.E., Assistant Professor of Health Policy and the History of Medicine at Yale University School of Public Health, talked about continuity between commissions, and how retaining their names might ensure a smoother transition and better continuity between administrations.

Nandini Kumar M.B.B.S., D.C.P., M.H.SC., Dr. TMA Pai Endowment Chair at Manipal University in India, emphasized the importance of including a member fluent in issues of international research, especially taking place in developing countries.

Tom L. Beauchamp, Ph.D., Professor of Philosophy and Senior Research Scholar at Georgetown University’s Kennedy Institute of Ethics, discussed the role of philosophy and philosophers in the conversations of bioethics advisory bodies.

Ruth Faden, Ph.D., M.P.H., Andreas C. Dracopoulos Director and Philip Franklin Wagley Professor at Johns Hopkins Berman Institute of Bioethics stressed that human rights and health should be emphasized by future bioethics commissions, as opposed to emerging technologies. She also referred to accountability and the importance of signaling independence and authority, helping to ensure that the government responds to recommendations by commissions.

Manuel Ruiz De Chávez, M.D., M.S., F.R.C.P. President of the Mexico National Commission of Bioethics (CONBIOÉTICA) focused on the importance of international cooperation between bioethics bodies.

Patricia King, J.D., Carmack Waterhouse Professor of Law, Medicine, Ethics, and Public Policy at Georgetown Law said applied ethicists play a critical role in the discussions at this level, and emphasized the importance of passing on some of the institutional knowledge gained by this Bioethics Commission to the next one.

The next meeting of the Bioethics Commission, which continues this discussion, is scheduled for August 31 in Philadelphia, PA. For details, go to www.bioethics.gov.

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Additional Reflections on National Bioethics Advisory Bodies

The Bioethics Commission continued its discussion on the impact of bioethics advisory bodies, looking to the past to inform future efforts to address social and ethical dimensions of health, science, and technology policy.

In the second panel of the day, the Bioethics Commission heard from a variety of speakers considering the past, present, and future impact of such groups. Presenters included Tom L. Beauchamp, Professor of Philosophy at the Georgetown University Kennedy Institute of Ethics and Ruth Faden, Director of Johns Hopkins Berman Institute of Bioethics. In addition, the commission heard from Manuel Ruiz de Chávez, President of the Mexico National Commission of Bioethics (CONBIOÉTICA) and Patricia King, Professor of Law, Medicine, Ethics, and Public Policy at Georgetown Law.

Beauchamp shared insights gleaned from his time on the staff of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission) where he contributed to the delineation of foundational principles for research ethics in the Belmont Report. He discussed the enduring impact of the Belmont Report both in the United States and abroad, while acknowledging its limitations and reflecting on what national bioethics bodies should focus on in the future.

Faden spoke of her experience as chair of the President’s Advisory Committee on Human Radiation Experiments (ACHRE). She described ACHRE’s charge and the nature of the issue that it was facing under the Clinton administration. Faden emphasized the power that a presidential commission has, serving as a “public pulpit to make a tremendous difference.”

Ruiz de Chávez talked about the importance of promoting the message of bioethics to the public, and the role that national bodies can serve in fulfilling that mission. He discussed the importance of an interdisciplinary commission and staff to advise executive, legislative, and judicial branches of government.

King reflected on her experience to two U.S. bioethics committees, as a member of the National Commission and ACHRE. She discussed what made the National Commission successful, including the fact that the federal government was required to respond to each of their recommendations, even if they did not take them up, and the fact that they convened at least once a month for over four years. She also discussed some of the features of the commission that she felt could have been improved, including a lack of sufficient disciplinary diversity, and what the members learned from the challenges that they faced during their tenure.

Stay tuned as panelists from the morning’s session return for a roundtable discussion with the Bioethics Commission.

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Reflections on National Bioethics Advisory Bodies

At today’s meeting, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) reflected on its own tenure and that of other bioethics advisory bodies.

In the first panel session of the day, the Bioethics Commission heard from a series of speakers reflecting on the past, present, and future impact of national bioethics advisory bodies. Presenters included Jason Schwartz, Assistant Professor of Health Policy and History of Medicine at Yale University; James Childress, University Professor and John Allen Hollingsworth Professor of Ethics at University of Virginia; Michael Gazzaniga, Director of SAGE Center for the Study of Mind and UC-Santa Barbara; and Nandini Kumar, former Deputy Director of the Indian Council of Medical Research.

Jason Schwartz has written widely on the history of national bioethics advisory bodies, decision making in public policy, and the structure and function of scientific expert advice to government. He addressed the impact of previous national bioethics commissions, highlighting the unique contributions that the current model for acquiring advice on bioethical issues can offer. He noted that bioethics commissions can serve an agenda setting role, identifying pressing issues of the day and bringing them to the fore. For more on this history, including links to previous commissions’ reports, click here.

Childress served as a consultant to the National Bioethics Advisory Commission (NBAC), which outlined ethical principles governing research involving human participants. He was also a member of other bioethics advisory bodies including the Recombinant DNA Advisory Committee and the Biomedical Ethics Advisory Committee. He observed that part of the overall impact of NBAC was to contribute to a public conversation about bioethics. NBAC’s work stimulated public discourse, informed public policy in the United States and abroad, and generated significant media interest in topics in bioethics.

Gazzaniga recalled his time as a member of the President’s Council on Bioethics under President George W. Bush from 2001 to 2009. He noted, “there should always be a bioethics council advising the President,” despite the sometimes controversial nature of the topics that the President’s Council took on. “People change their minds as a result of the public discourse,” he said, emphasizing the important function of diverse bioethics advisory bodies deliberating in public to bring values and facts to light.

Kumar previously collaborated with the Bioethics Commission as a member of the international panel that informed their report Moral Science. She discussed her time as a member of the Indian Council of Medical Research (ICMR) and contemporary bioethical issues arising in India. She stressed the contribution of the ICMR in helping to revise guidelines on many topics in bioethics in India, including informed consent, biobanking, and other important issues.

Following the four presentations, the Bioethics Commission engaged in a lively discussion with the panelists about the topics, structure, and function of Bioethics Commissions and looked towards the future, offering opinions on the best model going forward.

Stay tuned for more of this discussion, continuing in Session 2 at 12:30pm.

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Bioethics Commission Meeting 25: Live from Washington, DC

Welcome to Washington, DC for the 25th public meeting of the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission). The Bioethics Commission’s meeting is today, May 3, 2016, from 9 a.m. to 3:15 p.m. ET.

Chair Dr. Amy Gutmann opened up the meeting by summarizing the Bioethics Commission’s forthcoming report focusing on key aspects of their own efforts—on deliberation and education in bioethics. Deliberation is a process that has informed the Bioethics Commission’s practices, including respectfully engaging different viewpoints and striving toward consensus recommendations with transparent and accountable justification. The Bioethics Commission has previously made numerous recommendations to support bioethics education, and developed its own materials to address this need. The new report builds on these efforts, offering new recommendations for advancing bioethics deliberation and education.

At today’s meeting, the Bioethics Commission will begin its discussion of the impact of bioethics advisory bodies past, present, and future. The Bioethics Commission welcomes a variety of esteemed speakers from past U.S and other national bioethics advisory bodies. Panelists will shed light on previous bioethics advisory committees, and how these set the stage for the future of national-level bioethics bodies.

For the full agenda of today’s meeting, click here.

You can follow the proceedings of the Bioethics Commission’s meetings here at this blog, and on the live webcast at the Bioethics Commission’s website. All transcripts and webcasts will be archived and available following the meeting.

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Using the Bioethics Commission’s Meeting to Educate About Democratic Deliberation

In the Bioethics Commission’s upcoming work focusing on deliberation and education, the Bioethics Commission describes the principles inherent in successful democratic deliberations. These principles include maintaining mutual respect and providing clear reasons for a position with the goal of arriving at a shared solution.

The Bioethics Commission puts these principles into practice in their own deliberations conducted at public meetings. Since July 2010, the Bioethics Commission has conducted 23 meetings across the country during which they have deliberated about topics and reached agreement on recommendations that are published in their nine reports.

Dr. Rachel Fink, professor of biological sciences at Mount Holyoke College in Massachusetts, brought eight of her students to Washington, DC to observe the Bioethics Commission deliberation in action on November 17, 2015. For many of the students, this provided their first opportunity to observe democratic deliberation firsthand—an opportunity that many of the students found educational.

As one student observed:

Each commissioner had started out in a specific profession and had knowledge in certain subjects, yet they all sat together diplomatically, accepting, critiquing, and refining each other’s ideas and points.

A second student reflected:

I thought the meeting would be a heated debate about an issue of their choice with strong opponents to each side. I expected it would take them awhile, maybe even a few meetings, to agree on a position, and even then the decision wouldn’t be perfect. However, I was incredibly impressed with how well each panelist presented themselves in speech and in logic supporting their individual perspectives, taking into account a number of pros and cons, and how easily they were able to agree with a level head.

Observing democratic deliberation in practice, such as the deliberations carried out by the Bioethics Commission, can serve to educate future deliberators about the merits of the practice and foster appreciation for all that can be achieved through deliberation. In fact, one student noted that the deliberations:

[L]eft an impact on me because I have never had an interest in pursuing politics or policy as I assumed the fields were more cutthroat, more about how the individual can get ahead without thinking about how their decisions affect others. However, after … observing how composed and productive the commission was in a few short hours, I am hoping to someday consider using my advanced degree in science to benefit the community from a political standpoint.

Source: Student reflections provided by Dr. Rachel Fink

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New Educational Module from the Bioethics Commission on Research Design in Ethics and Ebola

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has released a new educational module on research design in the context of a public health emergency. The module integrates material from the Bioethics Commission’s report Ethics and Ebola: Public Health Planning and Response (Ethics and Ebola).

This module serves as a guide for instructors to help students understand key ethical challenges that might arise when conducting clinical research during public health emergencies. The module identifies ethical considerations of various approaches to clinical research during public health emergencies, including randomized controlled trials.

The Research Design in Ethics and Ebola module provides background information on randomized controlled trials and considers the differences between vaccine and treatment trials, the interpretation of what constitutes “best available” supportive care, the necessity of research to be responsive to the host and affected communities, and the importance of designing trials that yield scientifically valid results. Through discussion questions, scenarios, exercises, and illustrative and timely examples, the module guides instructors to help students reflect on ethically relevant concerns that arise in designing research during a public health emergency.

The Bioethics Commission’s topic-based educational modules are grounded in contemporary ethical questions addressed by the Commission and are designed to provide instructors with foundational information, ethical analysis, discussion questions, problem-based learning scenarios, exercises, and additional resources to support ethics education and the integration of bioethical analysis into coursework across disciplines.

All Bioethics Commission educational materials are free and available at www.bioethics.gov/education. The Bioethics Commission encourages feedback on its materials at education@bioethics.gov.

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This is a space for the members and staff of the Presidential Commission for the Study of Bioethical Issues to communicate with the public about the work of the commission and to discuss important issues in bioethics.

Learn more about the Presidential Commission for the Study of Bioethical Issues.

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