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France’s vision for setting ethical health policy

Laure-Anais Zultak

France is setting a new standard for engaging the wider public in thorny issues related to health and science policy like extending medically-assisted procreation to gay couples, legalising voluntary egg freezing and the ethical use of genetic testing and gene editing.

France launched a National Forum on Bioethics on Monday 12 February. No, don’t turn away just yet, this has much broader and exciting implications than laboratory science and impenetrable ethics.

The Forum will tackle some of our more polarising social policy and moral dilemmas of our time, which have been thrust to the top of the national debate by technical innovation and shifting ethical values.

Issues such as extending medically-assisted procreation to gay couples, legalising voluntary egg freezing and surrogate pregnancies and the ethical use of genetic testing and gene editing will all be under the spotlight. Against a backdrop of global suspicion of experts and the rise of armchair activism, it represents an opportunity to actively engage the population at large, and particularly young people, in developing complex and controversial legislation.

This National Forum – Etats généraux de la bioéthique – is part of the revision of the 2011 bioethics law. This law is reviewed every seven years to keep up with medical innovations and societal change and the issues to be debated include exciting and potentially life-altering innovations that are already available in some other countries.

But the extent to which French society is willing to embrace this is precisely what the Forum is aiming to establish. It seeks to capture the opinions of ‘ordinary people’ – with an emphasis on young people – on complex and controversial issues.

It is not intended as a mere opinion poll – the moral and ethical issues at stake go beyond simply testing the national point of view. Instead, the Forum will involve a series of public debates throughout the country.

France is a highly-centralised state, but the consultation will be conducted at regional level, reflecting the ambition to go beyond the usual experts who crowd the hallways of Parisian science institutes.

 

Traditionally, the nations' young adults have made their frustrations on social policy felt through protests and online petitions, but they have not yet voiced an opinion on these issues. For the first time, French law-makers will bring the the debate directly to them.

There has been growing scepticism toward expert opinion, and the Forum is making an effort to integrate and engage wider public opinion in the law-making process. This open and inclusive process should – in theory – give the new laws more legitimacy when they are finally implemented.

Most importantly, the Forum will focus on engaging young people in this national debate. Traditionally, the nations’ young adults have made their frustrations on social policy felt through protests and online petitions, but they have not yet voiced an opinion on these issues. For the first time, French law-makers will bring the the debate directly to them.

A large number of National Bioethics Forum events are due to take place in universities and high schools. This is not just a pragmatic decision about suitable venues, this is a deliberate step to include those whose lives stand to be most directly impacted.

Ultimately, the Forum is an exciting model of public engagement for complex technical and ethical policy issues that cannot be fully solved with a simple yes or no answer.

In recent months we have seen biological innovations such as ‘three-person babies’ and lab-grown human eggs continuing to push back the limits of what is medically possible. The proactive public engagement approach that this Forum represents could point the way for regulators in other countries – such as the Human Fertilisation and Embryology Authority (HFEA) here in the UK – as they consider the best means of overcoming difficult ethical concerns.