Department of Anesthesiology and Critical Care Medicine, Kantonsspital Münsterlingen, Spitalcampus 1, 8596 Münsterlingen, Switzerland.
Health Ethics and Governance Unit, World Health Organization, Geneva, Switzerland.
Bull World Health Organ. 2021 Feb 1;99(2):138-147. doi: 10.2471/BLT.19.243907. Epub 2020 Nov 30.
To assess the current state of national ethics committees and the challenges they face.
We surveyed national ethics committees between 30 January and 21 February 2018.
In total, representatives of 87 of 146 national ethics committees (59.6%) participated. The 84 countries covered were in all World Bank income categories and all World Health Organization regions. Many national ethics committees lack resources and face challenges in several domains, like independence, funding or efficacy. Only 40.2% (35/87) of committees expressed no concerns about independence. Almost a quarter (21/87) of committees did not make any ethics recommendations to their governments in 2017, and the median number of reports, opinions or recommendations issued was only two per committee Seventy-two (82.7%) national ethics committees included a philosopher or a bioethicist.
National ethics (or bioethics) committees provide recommendations and guidance to governments and the public, thereby ensuring that public policies are informed by ethical concerns. Although the task is seemingly straightforward, implementation reveals numerous difficulties. Particularly in times of great uncertainty, such as during the current coronavirus disease 2019 pandemic, governments would be well advised to base their actions not only on technical considerations but also on the ethical guidance provided by a national ethics committee. We found that, if the advice of national ethics committees is to matter, they must be legally mandated, independent, diverse in membership, transparent and sufficiently funded to be effective and visible.
评估国家伦理委员会的现状及其面临的挑战。
我们于 2018 年 1 月 30 日至 2 月 21 日期间对国家伦理委员会进行了调查。
共有 146 个国家伦理委员会中的 87 个（59.6%）代表参与了调查。涵盖的 84 个国家属于世界银行所有收入类别和世界卫生组织所有区域。许多国家伦理委员会资源匮乏，并在独立性、资金或效力等多个领域面临挑战。仅有 40.2%（35/87）的委员会表示对独立性没有担忧。2017 年，近四分之一（21/87）的委员会未向政府提出任何伦理建议，每个委员会发布的报告、意见或建议中位数仅为两份。72（82.7%）个国家伦理委员会有哲学家或生物伦理学家。
国家伦理（或生物伦理）委员会向政府和公众提供建议和指导，从而确保公共政策能够考虑到伦理问题。尽管这项任务看似简单，但在实施过程中却存在诸多困难。特别是在当前 2019 冠状病毒病大流行等充满不确定性的时期，各国政府最好不仅基于技术考虑，还基于国家伦理委员会提供的伦理指导来制定自己的行动方案。我们发现，如果要让国家伦理委员会的建议发挥作用，就必须赋予其法律地位、保持独立性、成员构成多样化、保持透明并获得充足资金，以确保其有效和可见。
