Mapping the debate on the role of national ethics councils in democratic reasoning. A narrative literature review.

Developments in science and society are moving fast. Emerging technologies give rise to ethical questions about manipulability of life and the ethical limits of biomedical science. To foster legitimate and justified policymaking on bio-ethical issues, governments seek expert guidance from bioethics advisory bodies such as national ethics councils. This raises questions about how they fulfil their advisory role within the democratic context. In what way can national ethics councils best contribute to democratic reasoning and decision-making regarding complex bioethics issues? We performed a narrative review of academic literature that concerns the role and legitimacy of national ethics councils. We searched literature databases PubMed, Embase, Scopus, Web of Science and Google Scholar. The goal was to identify key themes that emerge as common threads across the literature. We identified five themes. We examined the discussions on the conceptualization of advice and the forms deemed appropriate for a national ethics council in relation to democratic decision-making, on the role of consensus, on the dimensions of expertise and council composition, on the dual tasks of formulating policy advice and stimulating public debate, and on the normative frameworks underpinning the work of national ethics councils. Our results indicate that in the context of complex policy issues, national ethics councils can make important contributions to democratic reasoning, though this involvement is shaped by several underlying dynamics. This narrative review urges national ethics councils to increase (self-) awareness as well as transparency about how they interpret their role within the democratic system.