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President's Bioethics Panel Off to a Controversial Start

By Martha Frase-Blunt
Special to the AAMC Reporter

Leon R. Kass, M.D.

Leon R. Kass, M.D., Chair, President's Council on Bioethics, Addie Clark Harding Professor in the Committee on Social Thought and the College at the University of Chicago, and Hertog Fellow, American Enterprise Institute. (Photo Courtesy of: University of Chicago News Office)

Last August, when President Bush agreed to allow limited federal funding for stem cell research on existing cell lines only, he also vowed to form a bioethics advisory panel to consider the scientific and ethical aspects of this research. That pledge bore fruit late last year when his executive order created the 17-member President's Council on Bioethics.

Meeting five to six times a year over two years, the council will consider a range of bioethical matters connected with specific biomedical and technological activities such as embryo and stem cell research, assisted reproduction, cloning, uses of knowledge and techniques derived from human genetics or the neurosciences, and end-of-life issues. The council may also study broader ethical and social issues, such as the protection of human participants in research and the appropriate uses of biomedical technologies.

According to the White House, "The President has assembled a diverse group of individuals to address these matters, who will bring a variety of perspectives to these challenging issues. Council members have been chosen not only for their specialized knowledge, but also for their thoughtfulness and their devotion to serious ethical inquiry."

But ever since the panel membership was made public in January, just one day before the group's first meeting, research institutions and advocacy groups have raised concerns about the council's makeup. Particularly vexing to them is the absence of panelists representing patient advocacy groups.

"The council has some diversity, but it is all in the academic arena," says Sean Tipton, a spokesperson from the American Society for Reproductive Medicine - a Council of Academic Societies (CAS) member society and an organization closely engaged in current bioethical issues. "The group would have a different flavor if it included people who stood to benefit more quickly from the research in question."

Many scientists and research advocates were also dismayed by what they perceive as a partisan cast to the panel, and particularly by the appointment of Leon R. Kass, M.D., as chair. Dr. Kass is known for sharing the president's vocal opposition to somatic cell nuclear transfer (therapeutic cloning), and his position on stem cell research is not well documented. Tipton points out that the council's original purpose "was to provide a nonpartisan think tank - that was lost when the panel was stacked with Bush bioethicists." He added that "The NBAC wasn't a stacked panel," referring to the National Bioethics Advisory Commission, whose Clinton-era charter expired in October. "I don't think [the council] is in existence to say the president's policies are mistaken."

"Dr. Kass has promised the council will transcend politics and uphold its mission to study these issues," asserts Michael Manganiello, director of Government Relations for the Christopher Reeve Paralysis Foundation and president of the Coalition for the Advancement of Medical Research. "But it is imperative that the therapeutic needs of 100 million Americans living with diseases and life-threatening conditions, who could possibly benefit from embryonic stem cell research and somatic cell nuclear transfer, are considered in these discussions."

On the plus side, says Tipton, "There is a tremendous amount of intellectual firepower on the panel. I am optimistic that their work will illuminate the critical issues of the day, and this will especially benefit ethics committees and institutional review boards at academic medical centers."

Tipton is more circumspect about the council's ability to directly impact policy, however: "The main role of ethics panels convened in the past has been to educate a variety of people on the issues. What we'll get is a very good bibliography - not a primer on an ethical system for human embryo research."

Panel member Daniel Foster, M.D., chair of Internal Medicine at the University of Texas-Southwestern Medical School, agreed that the council's deliberations will have "no immediate impact on academic medical centers. The initial charge from the president was to examine the ethical and other issues involved in cloning, whether for reproduction (baby-making) or for the recovery of embryonic stem cells (research/therapeutic cloning). The major research medical centers will be ultimately affected by the decision on research/ therapeutic cloning in the sense that they will be able to do it or not able to do it."

Dr. Foster, reporting back from the first of the council's sessions, nevertheless was "impressed by the intellectual power of the members. I expected that from resumes and reputations, but when you saw it in action you couldn't help but say this is really a smart group of people."

The first two meetings, in January and February in Washington, "were extremely professional and utterly dignified," he reported. "Every position was thoroughly heard, and there was no posturing or grandstanding. It was impressively mature, and there was never an angry rebuttal or argument." He added that "The four scientists interacted well with the non-scientists and vice versa, and I think it fair to say we all learned from each other." Dr. Kass earned Dr. Foster's praise for his demonstrated evenhandedness: "He leaned over backwards to ensure that all members participated and that all sides were heard. I felt a sense of pride in the country that it could be represented in this fashion by such a diverse group."

Members of the President's Council on Bioethics

Elizabeth Blackburn, Ph.D. Professor, Department of Biochemistry and Biophysics, University of California, San Francisco, and former president of the American Society for Cell Biology.

Stephen Carter, J.D. William Nelson Cromwell Professor of Law, Yale Law School.

Rebecca Dresser, J.D., M.S. Daniel Noyes Kirby Professor of Law, Washington University School of Law.

Daniel Foster, M.D. Donald W. Seldin Distinguished Chair in Internal Medicine and Chairman of the Department of Internal Medicine, University of Texas Southwestern Medical School.

Francis Fukuyama, Ph.D. Bernard Schwartz Professor of International Political Economy, Paul H. Nitze School of Advanced International Studies of Johns Hopkins University.

Robert P. George, J.D., D. Phil. McCormick Professor of Jurisprudence, Princeton University, and Director of the James Madison Program in American Ideals and Institutions.

Alfonso Gomez-Lobo, Ph.D. Ryan Family Professor of Metaphysics and Moral Philosophy, Georgetown University.

Mary Ann Glendon, J.D., L.L.M. Learned Hand Professor of Law, Harvard University.

William B. Hurlbut, M.D. Consulting Professor in Human Biology, Stanford University.

Charles Krauthammer, M.D. National Columnist, the Washington Post.

William F. May, Ph.D. Cary M. Maguire Professor of Ethics Emeritus, Southern Methodist University.

Paul McHugh, M.D. Henry Phipps Professor of Psychiatry and Director of the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, and Psychiatrist-in-Chief of the Johns Hopkins Hospital.

Gilbert Meilaender, Ph.D. Richard & Phyllis Duesenberg Professor of Chris-tian Ethics at Valparaiso University.

Janet D. Rowley, M.D., D.Sc. Blum-Riese Distinguished Service Professor of Medicine, Molecular Genetics and Cell Biology, and Human Genetics, Pritzker School of Medicine, University of Chicago.

Michael J. Sandel, Ph.D. Professor of Government, Harvard University.

James Q. Wilson, Ph.D. The James A. Collins Professor of Management and Public Policy Emeritus at the University of California, Los Angeles.