Changing tactics to embed ethics in decision-making

This month, we will launch a new five-year strategy for the Nuffield Council on Bioethics (NCOB). A strategy that is purposefully ambitious and shaped to deliver tangible, real-world impact.

We believe most of us are motivated to do what we consider to be the ‘right’ thing and that being ethically aware can in part, help us get closer to making decisions so we all benefit.

To date, the NCOB has prioritised our focus on scientific and medical advancements – assessing them for their ethical implications and advising decision-makers on how to best balance different interests involved. For more than thirty years, this has been an effective way of working. We have confronted some of the most complex and controversial issues facing society, bringing clarity and mapping practical ways through seemingly intractable ethical dilemmas. Indeed, our work in areas ranging from assisted reproduction to farmed animal genome editing has shifted public understanding and led to lasting policy change in the UK.

However, a lot has changed in the past three decades including the pace of developments and an even greater awareness of the social and ethical issues they raise. The COVID-19 pandemic exacerbated social concerns we were already grappling with, such as health inequalities and showed, the need for guidance to be discussed and agreed upon much faster. It also highlighted the difficulties we face when needing to develop policies based upon fast emerging data and insights. All this has introduced new expectations for how, as a society, we deal with developments in biomedicine and health and in making ethics matter.

Developments in biomedicine play a part in tackling some of the most pressing health and wider societal issues in the world today. Yet, in doing so they will often raise profound ethical challenges that require independent, rigorous and multi-disciplined deliberation. So, how can the NCOB continue to deliver this reliable counsel in a rapidly evolving landscape, and when expectations are higher than ever?

We have surveyed the landscape, consulted across sectors and networks, and agreed that if we are to succeed in putting ethics at the centre of decisions about biomedicine and health, we are going to have to refresh the way we work.

First, we must better anticipate disruptive developments and technologies. Second, we need to become more comfortable within and capable of influencing faster decision-making. Third, we should provide policymakers with the tools they need to front-load ethics into their work and solution finding. And last, we ought to better convene and align our bioethics sector so that together our voices are stronger and louder than when alone.

Underpinning all of this is a recognition that for the NCOB’s work to continue to be impactful, we need to prioritise our attention and resources on providing key decision-makers with the information they need to embed ethics in their work. We must challenge ourselves to maintain our rigorous, multidisciplinary approach whilst giving decision makers information at the time they need it and in a format they find most helpful. We will diversify our outputs, tailoring them to the requirements of the topic, the change we want to make and the audience we are seeking to inform or influence – we will start with the question in mind. This will mean our ask of decision-makers will be much easier to see, as will whether they heed our advice or not.

It would be fair to say that this year’s General Election throws a lot of uncertainty into the mix and longer-term decisions will likely be kicked into the long grass. However, that doesn’t mean we can take our foot off the gas. We have an archive of work that can and should be used to guide solution-finding for today’s knotty issues. And we must keep our eyes on the horizon so we can gather the insights needed to better shape the agendas of those who keep or gain control. We hope our new programme of work will do exactly that.

We are approaching the next five years with a good deal of energy and commitment. We have a great team around us, a highly engaged bioethics sector to work with and a clear target to aim for. If we get this right, we believe our new ways of working will not only serve to further raise the awareness of and debate about ethics, but they will also make the practice a fundamental consideration in any policymaking decision, both across the UK and internationally.