Respect for the RAC.

Abstract

Eliot Marshall (News & Comment, [17 May, p. 945][1]) writes that “in proposing to do away with RAC [the Recombinant DNA Advisory Committee],” National Institutes of Health (NIH) Director Harold Varmus “is following the recommendations of two expert advisory groups he commissioned last year.” But at least one of those committees, the Ad Hoc Review Committee, recommended that Varmus not do away with the RAC. After recommending that the RAC should avoid duplicating case-by-case review of every clinical gene transfer protocol, the executive summary of the Ad Hoc Review Committee's report states ([1][2], p. 648) > Review of protocols by the RAC in an open public forum should continue in several areas of concern in which a particular protocol or new technology represents a significant departure from familiar practices. Marshall also writes that the advisory groups suggested that NIH should treat “gene therapy no differently from other types of biomedical research.” Most observers in this arena agree that research involving the modification of somatic cells to cure disease is in principle no different from other sorts of biomedical research. But the Ad Hoc Committee makes it clear that there are enormously controversial extensions of that research now on the horizon. Among these extensions are the “modification of the germ line [and] the use of gene transfer for enhancement purposes” ([1][2], p. 648). Given those possible extensions, the Ad Hoc Review Committee found ([1][2], p. 648) that > gene therapy differs in major ways from other clinical technologies in use or under development and is, therefore, deserving of continued public scrutiny. The article reports that Varmus hopes that in the place of the RAC he can “appoint a small group of experts to meet several times a year to advise NIH on gene therapy” and that “NIH [will] sponsor regular public workshops” to examine the more controversial applications of new genetic technologies. But at least three features of the RAC make it an indispensable public institution. First, the RAC has a 20-year history. Because the group has worked through many complex ethical questions over time, it does not have to reinvent the ethical wheel each time it faces another protocol. Public workshops of the sort mentioned by Varmus would not have the benefit of such ongoing reflection. Second, the RAC's members are from both scientific and lay communities. Small groups of experts of the sort mentioned by Varmus risk losing touch with the ethical concerns of the people who pay for their research. Third, the RAC has built a reputation for thoughtfulness and independence. That reputation did not come easily. It was built in the face of skepticism about the ability of an NIH-appointed committee to independently evaluate proposals submitted by members from the NIH community. Given the controversial extensions of genetic research now on the horizon, it is in the interest of the public—and ultimately NIH—that there is a group which enjoys such history, diversity, and respect. 1. 1.[↵][3] Ad Hoc Review Committee, Recombinant DNA Advisory Committee, Executive Summary of Findings and Recommendations (National Institutes of Health, Bethesda, MD, 1995). [1]: /lookup/doi/10.1126/science.272.5264.945a [2]: #ref-1 [3]: #xref-ref-1-1 View reference 1. in text