Final Report (all chapters)

contributing factor is strategic behavior. Each interest group might be willing to make political
concessions if it did not believe that its political opponents would interpret their willingness to
compromise as a sign of weakness that could in turn lead to additional demands. This is a classic
“slippery slope” argument whose importance has been documented in many political settings. 15
Our discussion has shown that in the area of reproductive medicine and biomedical research,
political distortions are significant. How to respond to these failures is a tricky question. The
theory of public choice in this case has little to offer; its main recommendation, to ensure that all
views are being heard, both does not apply to the present situation and is operationally empty. It
does not apply because all organized interest groups are already participating in the political
arena. It is operationally empty because the general public, as such, cannot simply be organized
into yet another interest group. How then could political failures and distortions in the area of
reproductive medicine and biomedical research be corrected? In the remainder of this chapter,
we discuss this question in some depth. We explore first what may be described as the
professionalization of bioethical dilemmas. We find that this approach should be rejected in
favor of a much broader process of decision-making. We then examine the role of administrative
options such as notice-and-comment as a means to broaden public input. We also assess the
experience made by federal agencies such as the EPA and the Department of Energy (DOE) in
their efforts to involve the general public in highly controversial policy decisions. We conclude
that while these initiatives have taught us a great deal about the pitfalls of efforts to involve the
public, none provides a template for implementing a process of public consultation that meets
our requirements.
10.2 A Problematic Start: The Professionalization of Ethical Dilemmas
It may be argued that parliaments were created at a time when political decisions were
relatively simple choices and did not require an understanding of scientific facts or an
appreciation of ethical questions. In this view, parliaments are not suitable institutions for sorting
out some of the deepest questions afflicting modern liberal democracies. What is needed is an
institutional setting in which competent and experienced individuals are given an opportunity to
untangle modern ethical intricacies in a deliberate fashion free of nefarious political influences.
Bioethics commissions can be described as a rough approximation of this ideal. According to
this view, the members of these commissions, typically a mix of scientists, ethicists, theologians,
and occasionally senior politicians, are in the best position to examine in a dispassionate way
contemporary bioethical dilemmas and propose broadly acceptable answers.
Most industrialized countries have created ethics advisory panels, but none of them has
given these bodies actual legislative powers. Britain is the only instance where a parliament,
distrusting its own inclinations, has created a regulatory body, the HFEA, designed to be largely
insulated from mundane political influences; but the role played by bioethicists in this body is
15
Volokh, "The Mechanisms of the Slippery Slope."
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