CHAIRMAN KASS:  Good morning.  Welcome to this, the 19th meeting of the President's Council on Bioethics.

I would like to recognize the presence of Yuval Levin, who is the designated federal officer, in whose presence this is a legally-constituted meeting.

Before coming to the program, I, with some sadness, have to announce that Dick Roblin, who is our Scientific Director, will be stepping down from that position at the end of this calendar year, a position that he has filled with consummate skill, grace, and devotion for the three years of the Council's existence.

When I was first appointed to this position, Dick, who was an old friend of now over 40 years from our graduate student days, expressed a willingness to interrupt his career plans for a year and to give me and us one year of service as the Scientific Director.  That one year has grown to three, involving heroic commuting, two daily 90-minute commutes from Frederick, and he has given all of us, and me in particular, the benefit of his extraordinary probity and judgment, his dependable penchant for care and precision, and his insistence that all of our work conform to the highest standards of scientific and other sorts of reasoning and evidence.  All parts of our reports, but especially the scientific parts, have benefitted immensely from his knowledge and critical acumen.

The only saving note of this is I'm happy to add that Dick has agreed to continue as a senior consultant on scientific matters to the staff, cutting down to a day or so a week.

Dick, all of us on the Council applaud your work and are deeply grateful for your outstanding service.

(Applause.)

This meeting is devoted to three subjects of ongoing interest to the Council:  ethical and social issues of an aging society, the regulation of the uses of biotechnology, and, with a novel twist, embryonic stem cell research.  The topics will come in that order.

Members will recognize these remarks from the Chairman's letter, but I would like to put them on the record.  After the last meeting in discussions with members of the Council, we identified at least three pieces of this aging and dementia topic that were ripe for possible Council reporting and recommendations.

First of all, an overview of the looming "crisis" in long-term care, to be presented in humanistic as well as medical and economic terms.

Second, an evaluation and critique of the growing reliance on advance directives as the primary means of dealing with critical decisions in the care of people incapable of making their own decisions.

And, third, a consideration of possible substantive ethical guidelines for deciding how vigorously to intervene medically in patients with advanced dementia.

These topics grow out of things that we have heard here beginning in April.