Promises and Pitfalls of Using National Bioethics Commissions as an Institution to Facilitate Deliberative Democracy— Lessons from the Policy Making of Human Embryonic Stem Cell Research

國家生命倫理委員會作為促進審議民主機制的願景與隱憂--人類胚胎幹細胞研究政策決定之啟示

鮮有其他科學發展如晚近人類胚胎研究般引起偌大爭議,世界各國決策前多為此諮詢不同型態的國家生命倫理委員會。本文所謂的「國家生命倫理委員會」係指提供政府生命倫理相關決策意見的委員會,諸如美國「總統生命倫理委員會」、德國「國家倫理委員會」,以及英國「人類基因委員會」。本文認為這類「國家生命倫理委員會」是實現理想決策、促進審議民主的有效建制。然而,有鑑於此類議題的高度政治敏感性,以及委員會受操控的危險性,制度設計上必須預防可能的風險。因此,參考全球生命倫理委員會的實務經驗,尤其是幹細胞的研究決策過程,本文力求嚴格檢驗「國家級委員會」在促成審議民主的機制量能,並為達成該目標提出具體的制度建議。首先,此類委員會必須「小而美」以求充分論辯,亦須兼顧多元性以反應各種社會觀點。我們認為若經過適當建制,國家生命倫理委員會的意見能事實上要求決策者在作成不同決定時提供更充足的論理基礎。藉此,能提高「生命政治」決策過程中倫理考量與說理的強度,並促成審議民主理想的實現。

Rarely has any scientific development stirred more public controversies than recent researches that make use of human embryos to harvest stem cells or clone another person. Facing these issues, policy-makers worldwide have been seeking counsels from national bioethics commissions of all varieties. By national bioethics commissions," this paper refers to commissions set up to advise government policy-makers on bioethics-related public policy, such as U.S. President's Council on Bioethics, National Ethics Council of Germany, and Human Genetic Commission of the United Kingdom.This article sees these national bioethics commissions as an opportunity to serve as an institution that can help realize the ideal condition for policy-making advocated in theories of deliberative democracy. Nevertheless, given the highly political nature of the issues, and national commissions' vulnerability to be manipulated, there are also good reasons to be wary of its pitfalls. Hence, by drawing in experiences of bioethics commissions worldwide, particularly their recommendation for stem cell research, this article seeks to provide a critical examination of national commission's ability to facilitate deliberative democracy and make concrete institutional suggestion as to how it can achieve it. With a size small enough to allow deliberative debate, yet pluralistic enough to reflect possible societal viewpoints, we argue that if properly structured, national bioethics commissions' opinions can set a de facto burden of reasoning for public policy makers should they seek to decide otherwise. This in turn would create a pressure for sound moral reasoning in a policy area that tends to be infused with bio-politics and hence realize the ideal of deliberative democracy.