Daniel Callahan commented that what he felt was a surprising lack of disagreement with Hans Jonas' position on freedom of inquiry represented "a major historical revolution, which ought not to go unnoticed." Some discussants disagreed with Callahan's assessment, arguing that much of the disagreement had not surfaced during the discussion. There did seem to be agreement that the question of freedom of inquiry needed further study. Morison felt "the discussion should be followed up by some smaller standing group, because the issues are very difficult... I don't think (it) has been discussed fully even among experts, and it certainly isn't understood by the public or by me or by many other people. I would like to see us really worry about that

one."

Harold Edgar questioned the ability of any group to identify areas of research that may be potentially too dangerous to pursue. He suggested that "it would be good for a small group to work through a couple of case studies to see whether it is a realistic expectation that the funding process can be utilized to stop things."

Some participants expressed a degree of uncertainty about what the Senators who asked for the meeting expected this group to produce. André Hellegers said he thought the Senators were looking for "a group of scientists to advise them. However, I do not think there is uniformity among the scientists that they would want any such thing,” he said.

There was also some feeling that legislators should be specifically warned about the complexities of the issues and the need to refrain from precipitous action. Said Belding Scribner, "I would stress that the theme of our response to the Senators should be one of real concern, a willingness to look into the problem and to try to define it better, but to ask for some time." Daniel Callahan agreed: "I get a strong sense that there is enthusiasm for legislation on the part of the senatorial staff, a feeling that they've got to take some action. My own very strong feeling is a word of caution: don't always rush to legislation."

APPENDIXES

APPENDIX 1

REMARKS OF U.S. SENATOR JACOB K. JAVITS (R-NY) BEFORE THE CONFERENCE ON BIOMEDICAL RESEARCH AND THE PUBLIC, AIRLIE HOUSE, WARRENTON, VA., APRIL 2, 1976

BIOMEDICAL RESEARCH AND THE PUBLIC: THE CHALLENGE OF
ACCOUNTABILITY

I am pleased to have the opportunity to listen-and to learn from you-the distinguished members of the biomedical research community, ethicists, lawyers, journalists, citizens-and to share with you my perspectives with respect to our mutual problems, challenges and opportunities.

I congratulate Dr. Gaylin and Dr. Robbins for their successful efforts in organizing this conference, and in so eloquently articulating the complexity of the major social policy issues before us.

The very title of this conference-Biomedical Research and the Public-underlines the central concern of us all, namely: the challenge of public accountability.

The achievements of modern medicine are indeed impressive and awe-inspiring:

We have seen surgeons renew life by transplanting a heart or a kidney from one human being to another.

We have seen scientists begin to unravel the mysteries of the process and dynamic of the transmission of genetic information and characteristics.

We have seen breakthroughs in the treatment of some forms of cancer, which provides new life to previously doomed victims of this killer disease.

We all can agree that the responsibility for the ethical and moral dilemma-who shall live and who shall die?-can not be the social judgment of scientists only.

When Dr. Gaylin testified before the Senate Health Subcommittee, he underlined the paradox that the very success of biomedical research has put it into the public domain. He noted the irony that arises when those who control the essentials for survival in a democracy-and biomedicine is such an essential become the servants of that society, and not its masters. There are few villains and few heroes; rather, as Dr. Gaylin wisely stated "Arrogance and ignorance are the only enemies." I believe we must address our considered, collective efforts to three general, though overlapping areas. The first is the pursuit of new knowledge to improve our understanding of basic disease processes in order to prevent them, and the related questions of whether and to what extent such research can or should be planned.

Second, we must examine the ethical, procedural and technical problems with respect to the appropriate means of testing and validat