4.  

For example, both Senator Kennedy and Senator Buckley, who had reached a key legislative compromise involving fetal research-creating a moratorium pending recommendations from the Commission-had visible hands in the selection of commission members, and the chair of the President's Commission was owed a large political debt by President Carter. Political connections undoubtedly had a role in other members' appointments; the least subtle instances occurred when President Reagan made several appointments to the President's Commission after the terms of several Carter-appointed commissioners expired.

5.  

The major examples were the National Commission's study of the Institutional Review Board system and the President's Commission's extensive survey research project of the public and physicians to provide documentation for its report Making Health Care Decisions.

6.  

This statement requires some qualification, since there was some turnover of commissioners and staff, especially in the instance of the President's Commission. Moreover, since staff members tended to concentrate on certain reports and since the interest and commitment of individual commissioners varied across topics, it could be argued that in a sense the commission and staff both varied from topic to topic or report to report. Yet, for both commissions, there was one staff director and one chairman and substantially the same set of commissioners and staffers throughout the commission's life.

7.  

Federal Register citations should be interpreted with caution because the same action may appear numerous times. Moreover, a report may be cited more than once without final regulatory action ever taking place.

8.  

In legislation to indemnify vaccine manufacturers so that they would produce the swine flu vaccine, Congress required the Centers for Disease Control to consult with the National Commission regarding the issue of informed consent; the commission met with CDC officials and sent them a letter with recommendations. The consultation (though not the commission's letter) was cited in several lawsuits alleging injuries from the swine flu vaccine.

9.  

Rust v. Sullivan; Cruzan v. Missouri Department of Health; Bowen v. American Hospital Association.

10.  

In the view of some, this was also a problem with the report on the institutionalized mentally infirm.

11.  

A methodological point arose with regard to responses of staffers of the President's Commission, many of whom devoted much or all of their effort to particular topics and who had little or no involvement with other topics. Unlike staffers of the National Commission, who generally attended all parts of all meetings, many President's Commission staffers went to commission meetings (or parts of meetings) only when their particular topic was on the agenda. As a result, President's Commission staffers had more difficulty assessing the process and outcome of the whole group of reports than did National Commission staffers.

12.  

Perhaps the best example of timing was the coincidental release of the report on Definition of Death on the same day that an anti-abortion Constitutional amendment that would define the beginning of human life was introduced on Capitol Hill. The juxtaposition was too delicious to be ignored by the media and led to a Nightline appearance that night by the executive director and a member of the Commission, as well as other news coverage.

13.  

I first heard a similar formulation from David Goslin regarding projects at the National Research Council.

14.  

Adequate resources are also a requisite, but this was not an issue in either of these cases.



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