Human Dignity and Bioethics

30 | F. Daniel Davis
organ transplantation, newborn screening, neuroethics, psychopharmacology
and children, the determination of death, aging and end
of life care, and nanotechnology. 31 And the President’s Council has
both formed and pursued this varied, wide-ranging agenda in complete
freedom from any external constraint or pressure—including
constraint or pressure from any quarter of the executive branch, including
the White House.
The direct link between the deliberations of the National Commission,
on the one hand, and policymaking at the federal level, on
the other, demanded that the Commission seek and develop among
its members a consensus: only agreement on the form and content of
its findings and recommendations could provide a firm foundation
for federal law and regulations in human subjects research. The U.S.
Congress needed clear, unequivocal guidance, especially in addressing
difficult, emergent questions about clinical research involving specific
populations that are, by definition, vulnerable: fetuses, children, the
mentally infirm, and prisoners. And as an ethical framework for all
federally funded research involving human subjects, the U.S. Congress
sought, as well, a set of norms distinguished, in part, by broad
acceptance and endorsement, not only by the members of the National
Commission but also by the American public. Although several
reports by the President’s Council do include recommendations
for policymaking (or recommendations with clear implications for
policymaking), its inquiries have not been structured or conducted
with the overriding aim of agreement among its members; instead, in
the words of President Bush’s executive order, “the Council shall be
guided by the need to articulate fully the complex and often competing
moral positions on any given issue…and may therefore choose
to proceed by offering a variety of views on a particular issue, rather
than attempt to reach a single consensus position.”
This particular contrast between the National Commission and
the President’s Council is not simply one of procedures and aims,
for it offers a revealing window on striking differences between their
respective historical contexts. The U.S. Congress established the National
Commission in 1974, at a time of profound social change
ignited by the civil rights and women’s movements and one year after
the U.S. Supreme Court’s historic and, in the years since, increasingly
divisive decision in Roe v. Wade. The ideological tensions generated