MEDICAL ETHICS: THE RIGHT TO SURVIVAL, 1974 う HEARING BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE NINETY-THIRD CONGRESS SECOND SESSION ON EXAMINATION OF THE MORAL AND ETHICAL PROBLEMS Printed for the use of the Committee on Labor and Public Welfare 41-017 U.S. GOVERNMENT PRINTING OFFICE WASHINGTON: 1974 COMMITTEE ON LABOR AND PUBLIC WELFARE HARRISON A. WILLIAMS, JR., New Jersey, Chairman JENNINGS RANDOLPH, West Virginia JACOB K. JAVITS, New York J. GLENN BEALL, JR., Maryland MARIO T. NOTO, Staff Director ROBERT E. NAGLE, General Counsel ROY H. MILLENSON, Minority Staff Director SUBCOMMITTEE ON HEALTH EDWARD M. KENNEDY, Massachusetts, Chairman HARRISON A. WILLIAMS, JR.. New Jersey GAYLORD NELSON, Wisconsin RICHARD S. SCHWEIKER, Pennsylvania ROBERT T. STAFFORD, Vermont LEROY G. GOLDMAN, Professional Staff Member Duff, Raymond S., M.D., associate professor of pediatrics, Yale University School of Medicine; accompanied by Lewis B. Sheiner, M.D., Human Experimentation Committee, University of California at San Francisco; Robert E. Cooke, M.D., vice chancellor for health sciences, University of Wisconsin at Madison, chairman, scientific advisory board, Joseph P. Kennedy, Jr. Foundation, and Warren T. Reich, senior research scholar, Center for Bioethics, Kennedy Institute, Georgetown University, Wash- Duff, Raymond S., M.D., associate professor of pediatrics, Yale University School of Medicine; accompanied by Lewis B. Sheiner, M.D., Human Experimentation Committee, University of California at San Francisco; Robert E. Cooke, M.D., vice chancellor for health sciences, University of Wisconsin at Madison, chairman, scientific advisory board, Joseph P. Kennedy, Jr. Foundation, and Warren T. Reich, senior research scholar, Center for Bioethics, Institute, Georgetown University, Washington, Cooke, Robert E., M.D., vice chancellor for health sciences, University of Wisconsin at Madison, chairman, scientific advisory board, Joseph P. Kennedy, Jr. Foundation, prepared statement_-_ Reich, Warren T., senior research scholar, Center for Bioethics, Kennedy Institute, Georgetown University, Washington, D.C., prepared statement Sheiner, Lewis B., M.D., Human Experimentation Committee, University MEDICAL ETHICS: THE RIGHT TO SURVIVAL, 1974 TUESDAY, JUNE 11, 1974 U.S. SENATE, SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE, Washington, D.C. The subcommittee convened at 11 a.m., in room 4232 Dirksen Building, Senator Edward M. Kennedy, chairman of the subcommittee, presiding. Present: Senator Kennedy. Committee staff members present: LeRoy G. Goldman, professional staff member; and Jay B. Cutler, minority counsel. Senator KENNEDY. The subcommittee will come to order. I apologize to the witnesses here this morning for starting at 11. The Senate came in early, and we are going to have a series of votes on the floor. Hopefully they will not start for about an hour and a half. The Judiciary Committee is considering extremely controversial copyright legislation which all of our friends in the broadcasting industry are vitally interested in. There will be votes during the course of the morning, so unfortunately I will have to take a short recess at that time. I apologize for that. It is a terrible way to have to run the hearing but we will just do the best we can. Last week Senate and House conferees reached agreement on a landmark piece of health legislation-the Protection of Human Subjects Act. That act will result in the establishment of a National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. To be composed of 11 members representing a wide range of disciplines medicine, law, theology, ethics, philosophy, sociology-and many more-the Commission will identify the basic ethical principles which should underlie the conduct of research involving human subjects. It will then recommend guidelines and policies to the Secretary to assure that all experiments are designed with the protection and safety of its human subjects as the first consideration. The Commission, and the permanent National Advisory Committee which will follow it, will study the perplexing moral and ethical dilemmas that have been created by the dramatic advances in biomedical technology. Issues like psychosurgery, fetal research, research on prisoners, children and the mentally infirm will be subjects of careful scrutiry and deliberation. These issues will be debated, hopefully, in an atmosphere of reason and scholarship. They will be and should be, debated outside of the political arena. The Commission will also give guidance and assistance to individual research institutions grappling with particularly complex ethical |