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Presidential Commission for the Study of Bioethical Issues Publishes Capstone Report

The Presidential Commission for the Study of Bioethical Issues (the Commission) published its capstone report, Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology, in May 2016. [1]

The report presents two complementary practices to guide decision-making about ethical policies and practices that take into account the perspectives of experts and the general public: democratic deliberation and ethics education. The Commission recommends using these tools to mutually reinforce each other and to inform the work of future bioethics advisory bodies. 

The report presents 8 recommendations:

  • Guide bioethics policy decisions with democratic deliberation;
  • Conduct deliberative activities in ways conducive to mutual respect and reason-giving among participants in accordance with best practices;
  • To further the practical contribution of deliberation to bioethics, conduct additional research on the effectiveness of deliberative methods;
  • Implement foundational broad-based ethics education at all levels;
  • Develop bioethics education and training for professionals;
  • Support opportunities for teacher training in bioethics education;
  • Foster mutual reinforcement of deliberation and ethics education;
  • Encourage future bioethics commissions to further their deliberative and educational roles.

The first part of the report describes the value and use of democratic deliberation in bioethics, and the steps to facilitate a democratic deliberation process, and recommends further research into the efficacy of deliberative methods. The second part of the report advises on implementing general ethics education at all stages of education, developing topic-specific ethics education for graduate students and professionals, and enhancing teacher training for bioethics education.

The Commission has integrated these approaches in its own work over the last eight years by following a democratic deliberation process for each of its reports and producing corresponding educational materials on issues including the Ebola virus and genome sequencing.

The report explains the tenets of democratic deliberation, a method of decision making in which participants with diverse backgrounds and expertise debate a question of common concern, “justifying their arguments with reasons and treating one another with mutual respect.” While discussion develops understanding, democratic deliberation organizes discussion to reach a collective understanding of “a shared policy or course of action in response to a particular question of the form, ‘What should we do about this?’” [2]

According to the Commission, topics in health, science, technology policy are “particularly well-suited to the process of democratic deliberation. They are often unsettled, become contentious, have public impact, and need public guidance to chart a path forward.” [3] Principles of respect, compromise, and constructive public engagement are at the center of the deliberation process. For this reason, the report states that “especially in a climate of polarization and distrust regarding government and public officials” deliberation is “an essential tool for building constructive policy and practices.” [4]

The authors particularly emphasize revisability as an integral characteristic of ethical decisions, “because bioethics often involves emerging technologies that, along with our understanding of them, are likely to evolve rapidly.” [5] In light of this, the report emphasizes the need for continued revision of ethical standards.

The title of the report is inspired by a quote from the pragmatist philosopher John Dewey: “Democracy has to be born anew every generation, and education is its midwife.” [6] The Commission sees ethics education as relevant and essential for all generations--from elementary school students to professionals--and bioethical policies as challenges in need of continual revision. By combining education and deliberation in a “virtuous circle,” the report recommends that future bioethics commissions facilitate civic engagement and involvement, and bioethical standards be continuously revisited to “create a more democratic and just society” for every generation. [7]

An Executive Order extended the Commission until September 30, 2017. The next meeting of the Bioethics Commission will take place in Philadelphia, PA on August 31.

[1] Presidential Commission for the Study of Bioethical Issues (PCSBI), (2016, May). Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology. Washington DC: PCSBI,
[2] Ibid., p. 22.
[3] Ibid.
[4] Ibid., p. 15.
[5] Ibid., p. 27.
[6] Ibid., p. 14.
[7] Ibid., p. 2.