A French Perspective on Hospital Ethics Committees

The growth of bioethics and ethics committees in France is very different from that in the United States and elsewhere.1 In our country, ethics committees emerged in the 1980s as the result of two movements, a political movement with the creation of a permanent Comite Consultatif National d’Ethique (CCNE) (National Ethics Committee) and a professional movement, with the development of local ethics committees. The CCNE, created in 1983 by the French President, was given the mission “to express its opinion on moral issues raised by research in the fields of biology, medicine and health, whether these issues concerned individuals, social groups or society as a whole.” Between 1983 and 1993, one third of CCNE opinions concerned medically assisted procreation and the embryo, one third concerned research on human beings, and one third concerned genetics.2 At the same time, ethics committees were formed in teaching hospitals in response to the requirements of international scientific journals for better control of research protocols. After several years of debate on the role of these committees, the French Parliament voted the so-called Huriet-Serusclat law in 1988, which defined the framework of research. It created Comites Consultatifs pour la Protection des Personnes dans la Recherche Biomedicale (Institutional Review Boards), CCPPRB now called CPP. Following the application of this law at the beginning of the 1990s, almost all of the old local committees disappeared and were replaced by the new CCPPRB. It is important to stress several characteristics of bioethics and ethics committees development in France. First is the prominent place in the birth of French bioethics devoted to problems of research and biology, particularly medically assisted procreation and genetics. Although the creation of the CCNE can be interpreted as a denial of the role of the official representative body of the French Medical Association (Conseil de l’Ordre des Medecins), it was not,