Although Morris Abram's appointment by the President unquestionably carried enormous prestige, it was understood that the appointment was a reflection of President Carter's gratitude for Abram's role in Carter's election. Abram's most pertinent experiences were as a patient who had received experimental treatments for a potentially fatal disease. Although this was valuable on certain topics (particularly those addressed in the report Making Health Care Decisions), Abram was essentially an informed layperson on most of the issues addressed by the commission. Perhaps in recognition of this, he selected a staff director, Alexander Capron, who was a nationally recognized expert on legal and ethical issues in medicine and science and who had published books and articles on many of the topics that were taken up by the commission. Abram worked closely with Capron for guidance about how the commission should address the issues on its agenda and was relatively distant from both the staff and other members of the commission. Capron, in turn, hired a strong staff made up primarily of professionals who had made career commitments (in law, philosophy, sociology, and medicine) to the issues on the commission's agenda. Individually and as a group, the President's Commission's staff probably had stronger professional credentials than did the commission itself.

So, the National Commission's staff was dominated by career governmental employees for whom the staff role was already familiar. The President's Commission staff was dominated by people from outside of government who identified primarily with their fields of professional activity and disciplinary work. As was evident in my survey in 1993, they continue to evaluate the President's Commission's reports primarily in terms of its scholarly quality. The National Commission was clearly more interested in finding a set of recommendations that they could agree upon than in laying out a rigorous line of reasoning regarding how they got there.


What does it mean when the National Commission and the President's Commission are said to have been successful? And how and why did this success vary across their various reports? I approached these questions by using objective measures of influence as well as seeking the views of former members and staff of the two commissions. For each commission, the major variable across reports was the topics themselves.6 I sought lessons about the success of these two commissions by seeking to understand the differences in impact from report to report.

Two methods were used. The first involved searches of on-line databases (Nexis, Lexis, and Medline) for citations to the reports of each commission. The second involved a survey of former members and staffers of the two commissions to obtain their assessments of their work and of differ-

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