A second group of committee members believed that a single national commission with a broad mandate was preferable if sufficient time and funding were available to hire staff and commission background papers to encompass all of the appropriate expertise needed. In this case, commission members could be generalists, and background papers and staff research would play a far more critical role than in a commission with a thematic mandate.

Sponsorship. National commissions could be appointed by the president or Congress. Wherever located, each national commission should operate autonomously.

Both the perception and reality of independence are important to the credibility of a commission's recommendations. In spite of appointment by the president or Congress, a national commission needs insulation from short-term political interests at the same time as it needs strong ties to affected or vulnerable groups, consumers, and public interest groups.

Membership. Each national commission should have a diverse membership in order to represent the points of view of all those concerned with or affected by the social and ethical issues to be considered. The composition of the body should enhance the qualities of impartiality.

Public media coverage can help to educate the public about the deliberations of a national commission. Public meetings can also facilitate broad public involvement.

Public Access. To the extent possible, a national commission should deliberate in public. The committee recognizes that if such public deliberation is not possible, means need to be found to gain input from all persons and groups with interests in the deliberations. A national commission must reach out to segments of the population whose voices are less regularly heard.

Commissions at all levels should take specific steps to assure that the results of their deliberations are made accessible to the public. In addition to the use of newspaper and radio, thought needs to be given to how newer methods of information transmission (e.g., electronic means) might be utilized to communicate commission conclusions.

Advisory Role. A national commission should provide advice not only to its authorizing body but to all concerned parties, including the biomedical community; federal, state, and local governmental bodies; and the public.

Action-Forcing Powers. Although a national commission should be advisory, its recommendations should be published, and relevant federal agencies should be required to respond to the recommendations within



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