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Thursday, February 15, 2007

Welcome and Introduction


DR. PELLEGRINO:  Good morning.  Well, despite the inclement weather, you've all arrived very, very much on time and we all appreciate it.

Welcome to the twenty-eighth meeting of the President's Council on Bioethics.  My first task always is to recognize our Designated Federal Official, Dan Davis, Executive Director of the Council, and his presence gives our meeting a governmental sanction, which we need.

As you can see, we have a very, very full agenda this time and much to accomplish.  We hope, our hope is to bring to conclusion, if possible, and some sense of closure of our inquiry into the organ transplantation issue we've been looking at over the past several months.  We need to come to some degree of closure on the range of policy questions and a number of other issues.

Now with the aid of setting the stage for today's session, the staff has prepared a series of papers, four papers, one for each of today's major sessions.  These papers were intentionally brief and succinct, designed to advance our discussion without leaving anything of what we had discussed previously behind or excluded, but trying to bring us in focus for each of those papers.

The first paper does not do justice, nor was it intended to do so, to all the ways we have touched on the meaning of the body which is so fundamental in our consideration of something like organ transplantation where we interfere with the integrity of the body for reasons which some feel are quite debatable and others are justifiable.  But all the papers are intended to get a discussion going and bringing discussion to each of those papers to some sense of closure.  I keep using that word closure because we have been at this topic for a long time.

We're going to begin with a discussion of the body.  There are no policy questions that are in play here, but it's important that we begin with a philosophical exchange on the meanings of the body.  This has not often been addressed by people who have prepared reports on organ transplantation.  And so it provides us a philosophical foundation for some of the ethical issues and pronouncements we might make.

We're then going to move on to allocation of organs, a very important practical consideration.  We've had discussions about allocation in this group before, but we need to be a little more focused today and we will do so with respect to three questions that we'd like to look at particularly:  the role that geography should play; age is a second issue; and then the question of calculations of net benefit in allocation.

Our third session is going to focus on proposals spawned by the aim of caring for the living donor and for the transplant recipients, the participants in the activity itself. 

And on the fourth and final session, we'll focus on the shortage of organs and on three policy issues.  On the ethics of pair donation and list donation, donation after controlled cardiac death and organ sales, a topic which engaged us toward the ending of our last meeting.

My hope is that in these sessions we will proceed to some sort of — and come to closure, be responsive to the concerns raised at the last meeting by the Council, and especially the need for a focused debate on some of the more contemporary ethical and policy questions of these ethical issues in contemporary medicine.

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