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Society's Choices: Social and Ethical Decision Making in Biomedicine
effect of an ethics body, factors such as the authority of the appointing body, the esteem in which its members are held by society, the adequacy of the staff and resources available, and the impact of previous products issued by the group, in addition to the criteria outlined in Chapter 5, may be influential.
Applying the Yardstick
Although the criteria for success cannot be reduced to a checklist, the committee members believe that-with the appropriate scholarly analysis-general agreement on the success of public ethics bodies often can be obtained.
As noted in Chapter 4, the Ethics Advisory Board, established in 1978 by the Secretary of DHEW as a permanent advisory body, met frequently for two years and produced four documents, marking a degree of success. However, the EAB was disbanded in 1980 and the recommendations of its principal report were never acted upon by DHHS. Moreover, since DHHS regulations require that all research involving human in vitro fertilization or embryo transfer be reviewed by such a board, work in this area has virtually ceased. Disbanding the EAB might be considered a success by individuals who wish to block controversial research. The committee disagrees and considers the demise of the EAB to have left unmet a critical need for bioethical deliberation and decision making. Without the EAB, the country has had no officially constituted group of national scope to provide analysis and advice on ethically and socially controversial biomedical research protocols or guidance to the research community. Human in vitro fertilization has nevertheless become a standard accepted form of medical practice, but without what many would consider sufficient scientific, social, and ethical underpinnings to optimize clinical practice (IOM, 1989; OTA, 1988).
The HFTTRP, also described in Chapter 4, was convened in 1988 by the NIH and concluded that the use of human fetal tissue in transplantation research was acceptable public policy if certain guidelines were in place (Childress, 1991). Although the panel's report lies within the range of an international consensus (Walters, 1988), the Reagan and Bush administrations did not accept the panel's recommendations and the moratorium on the funding of research using fetal tissue from induced abortions remained in effect until rescinded by the Clinton administration in 1993. Some analysts believe that the continuation of the moratorium stemmed from the report's failure to make clear how persons holding radically different views about abortion could nonetheless agree that use of fetal tissue from induced abortion could be acceptable public policy under specific conditions (King, 1991).