Public deliberation is vital to navigating ethical challenges in recent developments in biomedical technologies and health care in the US, argue Bioethics Commission chair, Amy Gutmann, and vice chair, James W. Wagner.
Democratic deliberation is one of five guiding principles in an ethical framework identified by the Presidential Commission for the Study of Bioethical Issues, the national advisory panel on social and ethical responsibility in research. Addressing a controversial advancement in synthetic biology, the Commission engaged citizens and experts in open public deliberations to achieve consensus on the following guiding principles:
- public beneficence;
- responsible stewardship;
- intellectual freedom and responsibility;
- justice and fairness; and,
- democratic deliberation.
Gutman and Wagner’s Reflections on Democratic Deliberation in Bioethics assigns an essential role for democratic deliberation in addressing technically and morally complex health and bioethics problems. The steering of principle and practice by deliberation marks an historic shift from the previous commission, represented in the capstone report ‘Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology’.
The authors acknowledge disagreement as an unavoidable – and important – aspect of dealing with bioethical questions. Democratic deliberation not only offers a productive framework for addressing diverse and polarised views, they find, it also recognizes the value of dissent as an aid to decision-making. They highlight the role of deliberation in issues where ‘sound-bite democracy’ contributed ‘heat and fear’ rather than ‘light and understanding’.
Distinguishing deliberation from debate, the authors illustrate how their deliberative approach produced ethically defensible solutions and promoted understanding between opposed positions. They confront the notion of deliberation as a lofty but impractical ideal by pointing out the dangers of the alternative, which neglects reason, facts and principles. The latter they exemplified by the fear-based, ethically indefensible ideas propagated during the Ebola outbreak.
Amy Gutmann is President of the University of Pennsylvania, Christopher H. Browne Distinguished Professor of Political Science in the School of Arts and Sciences, and Professor of Communication in the Annenberg School for Communication. James W. Wagner served as President of Emory University.