More on Politics and Bioethics
March 16th, 2005Posted by: Roger Pielke, Jr.
Last week we made the case that the development and promotion of a “legislative agenda” by Leon Kass, the chair of the President’s Council on Bioethics, meant that he was (mis)using his role as the Council’s chair to advocate a special interest agenda.
“If Kass wants to be a political advocate, then he should resign his position of the Bioethics Council and join one of the many conservative advocacy groups that are truly independent of the Bioethics Council. If he wants to serve as an honest broker to the nation as chair of the Bioethics Council, then he should recognize that this means deferring his desire to serve as a political advocate advancing special interests. But he does have to choose, because he can’t do both.”
This week the Washington Post reports that Representative Diana DeGette (D-CO) has asked the Inspector general of HHS to investigate Kass’ actions,
“… At issue is whether Kass acted inappropriately by helping to lead an effort to craft a legislative “agenda” for Congress that would place new restrictions on embryo research and other areas of reproductive science. In the letter, Rep. Diana DeGette (D-Colo.) expressed concern that Kass may have misrepresented his private views as those of the council and that the council’s resources may have been used in the effort. The effort brings “a cloud of suspicion” on the bioethics council, she wrote. Kass said he has been very clear with people that his work for the new “bioethics agenda” for Congress — still in its early stages — is independent of his work for the council. “No council resources or council time was used,” he said yesterday. The inspector general typically takes two weeks to decide whether to take on a congressional request, a spokeswoman said.”
Kass’ legislative agenda is available here from the American Journal of Bioethics Editors Blog, who write,
“…It contains the grand plan for all sorts of bans and restrictions of science to be enacted by the U.S. Congress, and has been unabashedly promoted by Kass – who says that he is not acting as Presidential Council Chair during his lobbying efforts. The agenda is sweeping, conservative, and odd enough that it has angered Republicans in Congress more than Democrats; the latter are beside themselves with joy at watching the right wing rip the Kass document to shreds for being too liberal. Democrats should not be too giddy – much of what is here could be pushed through the executive branch and left to the courts and states to reject.”
The AJB Editors Blog weighed in with a perspective on Kass’ actions similar to that expressed here:
“It isn’t that it is a surprising announcement, and the incredible gall of it requires no comment, but what is amazing to most … is how stupid a political move this is for the PCB. This morning, Gladys White put it best on MCW-Bioethics: “I have an old-fashioned idea. That idea is that chairs of Presidential bioethics councils/commissions should, once appointed, go about their business with as much objectivity and neutrality as they can muster in order to facilitate the work of the council and ultimately to serve the American people. I have this idea because in years past it has been the case that chairing these councils or commissions has been viewed as a distinct honor and well worth the price of setting aside personal views at least for the duration of the group’s work… Directly lobbying Congress in a role “that is independent of the role bioethics chair” accompanied by a group which “has no name,” is unprecedented, unwise and in my view, unacceptable for the chair of a bioethics commission. I don’t see how one person can function as a hard-headed lobbyist at one moment and as a neutral objective, bioethics chair at the next. I don’t think that this latest development bodes well for the work of the current council or for the future of independent bioethics analysis in the U.S. and I am very sorry to see it.””
And Iain Murray writing at Tech Central Station expresses similar sentiments,
“[Kass’] recent decision to draft a political strategy aimed at achieving certain policy goals renders his position as an honest broker on the issue untenable… The merits of Dr. Kass’s preferred policies are irrelevant here. The problem is that by hitching his star to a particular set of policies he has breached the trust set in him by the President, whose executive order creating the council asked it to “explore specific ethical and policy questions related to these developments; [and] to provide a forum for a national discussion of bioethical issues.” At the very least, by sheer virtue of his position, his favored policies are more likely to get a hearing than those of other well-qualified bioethicists who do not have the authority of such an office …Such a prospect would seriously undermine in the principle of “procedural justice” — the right of all sides of a political argument to be heard without fear or favor.”
I have yet to see anyone actually defend Kass’ actions in similar venues, though I’d welcome pointers. I’d also welcome comments and input on Rep. Degette’s letter to HHS IG (does anyone have a copy?) and the legal basis for her complaints. Of course, my objections, and those cited above, go far beyond any possible legal impropriety to the very core of what it means to serve on a government advisory committee and the inevitable trade offs between serving as an honest broker and political advocate.
March 16th, 2005 at 4:21 pm
I replied to your original post taking exception with your characterization of Dr. Kass’ actions as exceptional for members of government advisory committees, especially chairmen. I asserted that policy advocacy is the norm and not the exception for advisory committees. I offered the testable hypothesis that this is always true and invited empirical refutation, suggesting that “[t]he most persuasive evidence would be an advisory committee that recommended policies contrary to the interests of its members”. If my hypothesis is false this should be easy.
My post did not constitute a “defense” of Kass’ actions, which you seem to be seeking today. Nevertheless, I am disappointed to see that you have simply ignored the arguments in my earlier reply.
Are you hosting a dialogue or conducting a monologue?
March 16th, 2005 at 5:50 pm
Richard-
Thanks for your comment. I don’t respond to every comment we get, and since you would like a response I’m glad that you asked. You are correct that many advisory committees are in the business of advcoacy and we’ve pointed to many over the past year in this space. But it is equally true that many advisory committees don’t recommend a single course of action, they recommend a range of policies and not each policy within this range is consistent with one another or serves the same interests. The advice put forward by OTA was a good example of this approach. Also, many advisory committees are comprised in such a way so that there is no single recommendation that in in the interests of every member. Recent FDA advisory committee action on painkillers shows that this is the case. As I suggested in a Washington Post op-ed in January, the issue is not whether politics is inter-mixed with the advisory process, it is. The real question is how we comprise them with expertise and put that expertise to work.
March 17th, 2005 at 11:05 am
OTA was not an advisory group, and hence is irrelevant to the comparison with Prof. Kass. OTA was a congressional service office with a professional staff. Their charge was to provide Members with (largely) neutral information and alternatives. The Congressional Research Service, the Congressional Budget Office, and the Government Accountability Office have similar charges, but they also are known to bend a bit to accommodate their clients. (See, e.g., my comment http://sciencepolicy.colorado.edu/prometheus/archives/science_policy_general/000372cherry_picking_cba.html to your post on GAO’s report criticizing EPA’s regulatory impact analysis of mercury control options.)
Unlike CBO and GAO, however, OTA did not have a permanent statutory mission to help insulate it from politically charged client demands. Hence it is history; its demise is evidence supporting my thesis that “advisory” bodies are generally expected to promote the policy preferences of their creators, not to think independently.
The “Resource Management Offices” (i.e., the “budget side”) of OMB are similar to GAO and CBO insofar as White House politics (by whichever party controls it) is attenuated by explicit statutory responsibilities. RMO professional staff no doubt would like more insulation. OMB’s Office of Information and Regulatory Affairs (OIRA) is situated a bit more precariously. OIRA is a “statutory office” within OMB charged with administering the Paperwork Reduction Act and a few stray statutory dogs and cats. But it also performs centralized regulatory oversight pursuant to presidential executive orders (initially Executive order 12,291 [Reagan; 1981] and most recently Executive order 12,866 [Clinton; 1993]) that prescribe a particular presidential vision for how subordinate Executive branch departments and agencies are expected to perform regulatory analysis and make regulatory decisions. (The Bush [43] administration operates under the Clinton EO.) OIRA’s professional staff is highly skilled at performing neutral analysis and illuminating the range of potential impacts across alternative actions, and they are far more neutral than the agencies they oversee. However, the degree of White House interest in neutral analysis is not always as vibrant as its interest in advancing specific regulatory policy outcomes (also independent of which party controls it).
If creators of advisory committees (and similar institutions) genuinely wanted neutral scientific and/or analytical information compiled by honest brokers, they would automatically exclude from committee membership any person representing a stakeholder interest or who held strong policy views on the subject. When “advisory” committees explicitly include stakeholder representatives or scientists with strong policy views, the creator’s objective is either to kick the can down the road to avoid having to make a decision or to get the contesting parties to cut a political deal under the guise of “science”.
March 17th, 2005 at 11:19 pm
Hi Richard.
In your last posting you mentioned, “If creators of advisory committees (and similar institutions) genuinely wanted neutral scientific and/or analytical information compiled by honest brokers, they would automatically exclude from committee membership any person representing a stakeholder interest or who held strong policy views on the subject.”
I get the impression that you believe there is no ‘grey area’ in terms of our expectations for advisory committee member behavior. On the one hand we can choose honest brokers or people who lack any interest in the outcome. Or we can accept the fact that advisory committees are obviously political, adn that we should not view the Kass afair with such a critical eye.
Unfortunately you’ve oversimplified the issue.
First, I would argue that it would be virtually impossible to find anyone who is truly ‘neutral’ and one person’s honest broker is another’s shill. We all bring our values to whatever decision we make, so the sooner we accept that fact the better off we’ll be.
Second, strong value preferences and the development of ’sound’ policy alternatives are not mutually exclusive concepts. Take for example the US Commission on Ocean Policy which recently published its findings. Membership on the commission includes people who represent several special interest groups (e.g. offshore oil drilling, oil supply industry, shipping industry, the environment, etc.) and yet the commission produced a report suggesting numerous policy alternatives that seem to put forward the common interest as opposed to any single special interest.
Perhaps ‘pursuit of the common interest’ is one metric we can use in evaluating advisory committee and committee membership process. In this case, the US Commission on Ocean Policy may be a good model. Kass, on the other hand, insisted on promoting his own special interest at the expense of the PCB’s repuation and credibility.
Time to vote Kass off the island.
March 18th, 2005 at 7:27 am
Elizabeth, I very much appreciate your reply. It takes two to dialogue.
I am not familiar with the example you mention but look forward to examining it in detail. What I write below should not be misunderstood as a criticism of the Ocean Commission’s work; for all I know they produced a terrific report.
The structure of an advisory committee matters for understanding its purpose, and hence, understanding whether the committee was created to offer (more or less) neutral policy alternatives or to promote a pre-determined policy.
Looking at the Commission’s website I note that it was statutorily bi-partisan and inter-branch in composition, and that the Commission itself selected its chairman:
“The Commission is composed of 16 members. The House and Senate Majority each nominate 8 people, and the President appoints 4 from each list. The House and Senate Minority each nominate 4 people, and the President appoints 2 from each list. The President independently appoints 4 people.
“The Commission selects the Chair who is responsible for supervising staff and the expenditure of funds.”
See http://www.oceancommission.gov/documents/oceanact.html.
This design is often chosen when the objective is a political consensus at the policy development stage. It is also a popular structure when the Legislature is institutionally at odds with the Executive. (12 of the 16 members represented Congress.) However, this structure is fundamentally different from that of the President’s Council on Bioethics (PCB). According to Executive order 13,237 establishing the Council:
“The Council shall be composed of not more than 18 members appointed by the President from among individuals who are not officers or employees of the Federal Government. The Council shall include members drawn from the fields of science and medicine, law and government, philosophy and theology, and other areas of the humanities and social sciences.
“The President shall designate a member of the Council to serve as Chairperson.”
See http://www.bioethics.gov/reports/executive.html.
This is a presidential advisory commission, and its members are accountable solely to the president. Diverse policy views could in fact characterize the PCB membership, but diversity in the selection criteria is limited to disciplinary training and professional experience. Diluting authority for member selection is the most common means of trying to achieve policy diversity, but it is unrealistic to expect presidents to abdicate this authority. If Congress wants more diverse policy advice, it knows how to legislate a new advisory committee structured a la the Oceans Committee. Of course, the more politically sensitive the issue is to the president, the more he will resist a structure like the Oceans Committee in which Congress controls three-fourths of the membership.
In addition, it appears to me that the PCB’s mission included elements of advocacy. Sec. 2(c) says:
“The Council shall strive to develop a deep and comprehensive understanding of the issues that it considers. In pursuit of this goal, the Council shall be guided by the need to articulate fully the complex and often competing moral positions on any given issue, rather than by an overriding concern to find consensus. The Council may therefore choose to proceed by offering a variety of views on a particular issue, rather than attempt to reach a single consensus position.”
Consensus would have been fine but it was definitely not the overriding objective. Also, sec. 2(f) sets forth criteria for setting priorities, and includes “the urgency and gravity of the particular issue” and “the need for policy guidance and public education on the particular issue.” In Washington-speak, “public education” is synonymous with advocacy.
In my previous comments I did not intend to suggest that all advisory committees are the same, or that they are somehow monochromatic. Rather, I sought to point out that they are often very different, and that evaluating their performance (including matters touching on alleged conflicts of interest) requires respectful attention to how they are different.
Advisory committees that are created to advance specific policies should be expected to engage in policy advocacy. If the creator of an advisory committee really wants policy-neutral analysis of alternatives and does not want policy advocacy, membership should be limited to persons who do not bring with them strong policy views. Moreover, the charge to the committee must be tightly drawn to exclude policy advocacy from the committee’s responsibilities.
I do not disagree with those who say the public exposure of Dr. Kass’ advocacy has damaged the PCB’s credibility as a neutral honest broker of competing alternatives. The perception of neutrality is, after all, critical for public credibility even if neutrality was ancillary to the committee’s mission.
What I disagreed with is the notion that there is something unusual about advisory committee members (and chairmen) behaving as advocates. I suggested that this happens all the time, and worried a bit that Dr. Kass might be held to a higher standard because he has “conservative” policy views than other advisory committee chairmen who hold “liberal” views.
March 18th, 2005 at 8:01 am
Richard-
Thanks for this clarification. Reading your last two paragraphs suggests to me that we are pretty much in agreement on this topic. We are not singling out Kass because of his politics. If you take a look through our archives you will find that we have made a very similar argument about the role of the chair of the Intergrovernmental Panel on Climate Change.