Bioethical Policymaking for Advanced Medical Technologies: Institutional Characteristics and Citizen Participation in Eight OECD Countries1

Abstract

AbstractOrganizational characteristics of public institutions, councils, committees, and panels for bioethical deliberations were examined in eight OECD countries, that is, the United Kingdom, Germany, France, the Netherlands, Denmark, the United States, Canada, and Japan. Their jurisdiction, membership composition, modes of agenda setting, and appraisal systems were examined, as was their utilization of public involvement measures. Questionnaire surveys and structured interviews were conducted with representatives of parliamentary offices, ministries, and other institutions for ethical deliberations, both public and private, in the eight countries. Confirmation of survey results was made by close follow‐up communications. Since the early 1980s, all the countries studied have established public institutions for policy deliberation on bioethical issues. While legislatures, for example, Parliament, sometimes convene special commissions or expert panels on an ad hoc basis, most of the permanent institutions are affiliated with ministries of health, science, or technology. The composition of core panel members was quite similar across institutions as well as among countries, generally composed of 10 to 15 experts. Many institutions have experimented with some forms of public involvement measures, although public involvement is not routinely incorporated in the policy process, except in Denmark, the Netherlands, and Canada. The study describes the current public institutions and their practices for bioethical policy deliberations. Exchange of experience and knowledge among the institutions is advisable to improve their performance.