AMA Resolutions

Subject:  Establishing a Permanent National Bioethics Advisory Commission

Whereas, The National Bioethics Advisory Commission (NBAC) was created in 1995 by Presidential Executive Order; and

Whereas, The NBAC’s mission is to "provide advice and make recommendations to the National Science and Technology Council and to other appropriate government entities regarding the following matters:

1. The appropriateness of departmental, agency, or other government programs, policies, assignments, missions, guidelines, and regulations as they relate to bioethical issues arising from research on human biology and behavior; and
2. Applications, including the clinical applications, of that research"; and

Whereas, The NBAC has been extended in two-year increments, with a current end-date of October 3, 2001; and

Whereas, Major bioethical issues, including, but not limited to, the ethical preferability of various health care delivery systems for the United States, the ethical ramifications of various balances of health care funding (prevention vs. treatment, individually-oriented vs. public health oriented, large investments in end of life or other QALY-neutral care), the ethical ramifications of various balances of research funding (prevention vs. treatment, rare vs. common diseases), remain to be addressed by a national ethics advisory body; and

Whereas, There are issues that we do not yet know about—such as the ethical implications of the use of gene therapy, xenotransplantation, and fetal surgery, which are emerging therapeutic technologies that raise both public health and ethical issues— that justify consideration by a long-term, permanent body with a national mandate and responsibility; therefore be it

Resolved, That the American Medical Association and its constituent organizations endorse the creation of a permanent national bioethics commission, charged with a similar mission to that of the current National Bioethics Advisory Commission as well as with making recommendations on the many emerging bioethical issues resulting from new technologies and research; and be it further

RESOLVED, That the AMA send letters to the President and to Congress recommending the creation of this permanent and appropriately funded commission, whose findings would be major determinants of federal policy, and requesting that the current NBAC be assigned the duty of recommending the mission statement and scope of issues for the new commission.

H-140.999 Our AMA and Bioethics

Our AMA requests official representation on any federal advisory committee or commission dealing with ethical issues of interest to medicine. (Res. 39, I-78; Reaffirmed: CLRPD Rep. C, A-89; Reaffirmed: Sunset Report, I-99)

Our AMA: (1) encourages strong public support of federal funding for research involving human pluripotent stem cells (PSC); and (2) supports the recommendations of the National Bioethics Advisory Commission (NBAC) report, Ethical Issues in Human Stem Cell Research, September 1999. (CSA Rep. 15, I-99)

(1) Private organizations and academic institutions should jointly develop a means to continue and enhance broadly based study and discussion of ethical and societal issues in biomedical research. (2) The federal government should provide the resources to support new initiatives within the National Institutes of Health for the funding of research studies in bioethics. Existing federal programs that fund bioethical research studies should be preserved. Private foundations should be encouraged to provide resources to support research studies in bioethics. (3) A uniform set of federal regulations governing research with human subjects, based on the core regulations of the Department of Health and Human Services (as revised in 1985), should be adopted by all federal agencies. Uniformity should not preclude additions to Department regulations that do not conflict with the core regulations or that enhance the protection of research subjects. (4) Associations of regional institutional review boards (IRBs) should be formed to enhance IRB performance through the development of educational site visits and local workshops. (5) Each institution should have a system both for monitoring the conduct of biomedical research and for investigating and reporting allegations of research misconduct. (6) All investigators involved in research projects should be responsible for the clear articulation and enforcement of standards that ensure the integrity of scientific data and conclusions. Regardless of whether the research project is a result of individual or collaborative efforts, investigators should thoroughly understand the data and conclusions in research publications and studies. (7) As part of their formal training in research investigation, graduate, medical and postdoctoral students should be instructed on the importance of adhering to the ethical and scientific requirements in research conduct and in the reporting of research results. (BOT Rep. NN, A-87; Reaffirmed: Sunset Report, I-97)