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207 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 minimal risk in nonpotentially beneficial research. DR. EMANUEL: Wait a second. As I read the chart on page 150 it says -- DR. CASSELL: That is minimal risk. DR. KRAMER: Where are you? DR. EMANUEL: It says minimal risk. MR. CAPRON: No, no, minimal has an X in it. DR. CHILDRESS: The X is there. No, no, that is -- DR. EMANUEL: X means that is minimal risk, right? DR. CASSELL: It just means the unknown. MR. CAPRON: No, there is no -- we have not specified the requirements where it is minimal risk. DR. CHILDRESS: That is right. MR. CAPRON: Greater than minimal risk on people who are not going to get any benefit. DR. CHILDRESS: See that is very important because -- MR. CAPRON: And we know this kind of research has gone on and we are disturbed by this type of research. DR. CHILDRESS: And, see, that is a -- I am assuming that you are -- so I am assuming that you were building it into the -- would that lead you to state your
208 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 views differently now that we are clear about what we mean here because we are limiting this to greater than minimal risk nonpotentially beneficial research? DR. EMANUEL: Well, I think there are two separate things. One -- sorry, I misinterpreted the chart. I apologize. I did not interpret -- MR. CAPRON: It is a fault of the chart. It is easy -- DR. CHILDRESS: Instead of X put -- DR. EMANUEL: It is my fault. I was -- I understand the -- let me separate it. I understand the motivation in this category of greater than minimal risk or no potential benefit to want higher levels of protections. I still object or still find the idea of trying to use advance directives -- not going to reach the objective. What I heard from Alex and what I hear around the table is we share the concern. We need protections for people. The question is whether this answers that concern and whether this is the procedure that is going to answer that concern. My sense, again importing some information from other areas, is it is not going to. Two things in response to Alex. First, I agree end of life may not be a perfect analogy here. On the
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NATIONAL BIOETHICS ADVISORY COMMISS
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I N D E X Welcome 1 Report from the
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