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Presidential Commission on Bioethics lays out roadmap for tackling tough ethical questions

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WASHINGTON, D.C. – In a new report, the Presidential Commission for the Study of Bioethical Issues sets forth a series of recommendations for how to tackle the most pressing ethical questions that confront our society, and ensure every one of us is better equipped to address the ethical dilemmas that arise in everyday life.

As our nation weighs the risks and rewards of breakthrough technologies and scientific advances, from neuroscience research to whole genome sequencing and synthetic biology, the report, Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology, provides practical guidance for implementing deliberation as a method to help overcome gridlock and advance solutions to complex and contentious bioethical issues.

"In our sharply polarized world, it is increasingly important that we engage in respectful discussion around these morally thorny and divisive issues, and work to find common ground and a way forward together," said Amy Gutmann, Ph.D., Bioethics Commission Chair. "Bioethics involves matters of life and death, as well as deeply held values. They are not problems that we can solve in 140 characters. Tackling these questions requires careful and reasoned deliberation."

Throughout its tenure, the Bioethics Commission has used a process of democratic deliberation to develop recommendations and formulate advice on complicated ethical challenges in health, science, and technology. Drawing on this experience, the Bioethics Commission has outlined five practical steps to help other 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. Key steps in the process of democratic deliberation include:

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

With a process of democratic deliberation in place, the Bioethics Commission believes organizations at all levels will be better equipped to answer ethical questions on a timely basis and, anticipating the future, proactively chart a path forward.

Recognizing that people need the skills and know-how to engage in these difficult conversations and decisions — both as individuals and as members of their communities — the Bioethics Commission's report calls on educators, from primary school through professional training and beyond, to incorporate ethics education into their curricula.

In doing so, it emphasizes the importance of ethics education across the lifespan: When children are young and beginning school, they can begin to grasp such general ethical concepts as right and wrong. As students focus their interests and begin work or professional training, education in ethics can and should become more specific. Currently, there are no national requirements for ethics education in schools.

"If we don't teach ethics in schools, we'll miss an opportunity to prepare people for the bioethical issues they'll face in life, whether those are medical decisions on behalf of a loved one who is incapacitated, or getting tested for a genetic disorder that runs in the family," said Dr. James W. Wagner, Commission Vice Chair and President of Emory University. "Everyone needs these skills of careful consideration and reflection – not just those who plan to be doctors, nurses, clinicians or scientists."

In its report, the Bioethics Commission 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 to find a solution. The Bioethics Commission also provides recommendations to ensure teachers are trained to effectively deliver ethics education. The report emphasizes that deliberation and education can work together, reinforcing one another to create a more democratic and just society.

Bioethics for Every Generation is the Bioethics Commission's tenth report. The Commission seeks to identify and promote policies and practices that ensure that scientific research, health care delivery, and technological innovation are conducted by the United States in a socially and ethically responsible manner. The Commission is an independent, deliberative panel of thoughtful experts that advises the President and the Administration, and, in so doing, educates the nation on bioethical issues.

To date the Commission has:

  • Advised the White House on the ethical dimensions of new technologies, including synthetic biology;
  • Completed an independent historical overview and ethical analysis of the U.S. Public Health Service STD experiments in Guatemala in the 1940s;
  • Assessed the adequacy of U.S. rules to protect human participants in research domestically and abroad;
  • Examined the pressing privacy concerns raised by the emergence and increasing use of whole genome sequencing;
  • Conducted a thorough review of the ethical considerations of conducting clinical trials of medical countermeasures with children, including the ethical considerations involved in conducting a pre-and post-event study of anthrax vaccine adsorbed for post-exposure prophylaxis for children;
  • Offered ethical analysis and recommendations for clinicians, researchers, and direct-to-consumer testing companies on how to manage the increasingly common issue of incidental and secondary findings;
  • Deliberated the ethical dimensions associated with the conduct and implications of neuroscience research; and
  • Reviewed the ethical considerations and implications of U.S. public health emergency response in the context of the 2014-15 western African Ebola epidemic.

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