An opinion piece: The consensus conference

Abstract

I N SPRING 1989, the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA), through the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), added nursing to its consensus development programs by organizing a 3-day meeting to prepare a consensus statement on the minimum knowledge, scientific information, training, skills, and attitudes that baccalaureate nursing graduates need in the prevention, diagnosis, treatment, and management of the use and abuse of alcohol and other drugs (AODA). Comparable consensus statements in the area have been developed for physicians, including general internal medicine faculty and residents, medical students, family medicine faculty, pediatricians, emergency physicians, obstetricians and gynecologists, and psychiatrists. At issue is the question of the influence of consensus conferences and the resultant statements that are published (West, Maxwell, Noble, & Solomon, 1984). The ADAMHA is separate from the National Institutes of Health (NIH) (Fig 1). However, the NIH has had a Consensus Development Program since 1977, which has provided consensus statements on the safety and efficacy of more than 80 medical technologies. Fogle (1990) reports that critics believe there is little evidence that consensus statements have had much effect on medical practice or on the public. As a result, a special committee of the National Academy of Sciences’ Institute of Medicine (IOM) was organized to evaluate the consensus program’s structure and operation. Among the special committee’s 30 or so recommendations are proposals that topical suggestions be solicited from both inside and outside the government; that the issues considered be broadened to incorporate economic, social, and ethical aspects