President's bioethics panel gets new leadership, direction

In what could mark a notable change in direction for President Bush's Council on Bioethics, Leon Kass, MD, PhD, stepped down from his post as chair of the panel Oct. 1 after four years of steering the group toward conservative positions on issues ranging from human embryonic stem cell research to age retardation.

Dr. Kass's replacement is Edmund Pellegrino, MD, professor emeritus at Georgetown University's Center for Clinical Medical Ethics, in Washington, D.C., and widely recognized as a founder of bioethics.

Dr. Pellegrino, 85, said in a statement that he plans to focus on issues such as access to health care and end-of-life care.

The founding editor of the Journal of Medicine and Philosophy, Dr. Pellegrino opposes all embryonic stem cell research, but has long been primarily interested in clinical ethics, whereas Dr. Kass's focus was the ethical implications of biomedical advances.

"It would benefit the country if the council turned itself toward topics closer to ground," said Jonathon D. Moreno, PhD, director of the University of Virginia's Center for Biomedical Ethics. "A lot will depend on what kind of stamp Ed decides to put on the council in the next few years."

Dr. Kass, a philosophy professor at the University of Chicago, had tired of his unpaid tour of duty as chair of the 18-member council and wanted to engage in other pursuits, according to a council spokeswoman. He will continue to serve as a council member.

Though Dr. Kass, who was not taking interview requests, did not achieve what he wanted legislatively, some say his work with the council had an impact.

"The bad news is he was able to slow down a lot of things that might have happened," said Ronald Bailey, author of Liberation Biology: The Moral and Scientific Case for the Biotech Revolution. "He has managed to create uncertainty on what will happen with stem cells, and that will slow down research. Even for private funding, what kind of investment can you make if you think they might outlaw it in the next month or so?"

Dr. Moreno said Dr. Kass achieved his goal of getting the public to consider the ethical dimensions of new biotechnologies.

"Presidents' advisory councils don't always do this, but they can and do get a public conversation going," he said. "That's a strength of what Leon did. He got people talking about biotech issues."

Council's focus likely to shift

Bush appointed Dr. Kass to chair the newly created President's Council on Bioethics in November 2001, just months after Bush limited federally funded stem cell research to a small number of existing stem cell lines. The AMA supports federal funding for stem cell research and therapeutic cloning but opposes reproductive cloning.

From the start, stem cell research and liberal bioethicists heavily criticized Dr. Kass. They said he stacked the council with like-minded conservatives. In February 2004, Bush removed two of the seven council members who voted against a complete ban on cloning research, though Dr. Kass denied their departures had anything to do with their views.

Perhaps most egregious in the eyes of his critics was Dr. Kass's attempt to lobby the Congress after Bush's re-election. Dr. Kass distributed a memo touting his "bioethics agenda for the second term," which included a complete ban on human cloning and many reproductive biotechnologies. A bill banning both reproductive and research cloning has passed the House but stalled in the Senate.

"We need to be careful in the future that people who run government forums on ethical issues do not appear to also be lobbying for a political position," said Glenn McGee, PhD, editor-in-chief of the American Journal of Bioethics.

"I just don't think you can be the chair of the President's Bioethics Council and then go up to Congress and say, 'Oh, by the way, this is just my opinion.' The impression it gives is that the entire council is being used as a political instrument," he said.

That perception should be wiped away with Dr. Pellegrino's appointment, Dr. McGee said.

"As long as Dr. Pellegrino has the latitude to make appointments to the council," he said, "they can do great stuff."