The construction and spread of global models: worldwide synchronisation and the rise of national bioethics committees Open Access

Cultural approaches to national policymaking have made considerable headway in exploring the truly interdependent nature of decision-making (e.g. Simmons, Dobbin, & Garrett, 2008). In contrast to micro-cultural perspectives that emphasise the locally driven, idiosyncratic nature of national policies, a macro-cultural approach draws attention to the wider institutional environment within which national states are embedded (Meyer, Boli, Thomas, & Ramirez, 1997). Considerable empirical evidence in this line of scholarship shows that policy reforms made elsewhere have a great impact on decision-making in any country (Alasuutari & Qadir, 2014b). Yet we still need more knowledge about how precisely global models influence the politics of national policymaking and how national policy reforms, in turn, have an effect on the formation of global models. In this paper, we approach these macro-cultural questions by focusing on the two-way relation of formation and worldwide spread of policy models, underscoring how policy models are formulated as they travel through the world polity.

Interdependent policymaking is mostly operationalised in research as the diffusion of global policy models through the global system (Drori, Meyer, Ramirez, & Schofer, 2003; Meyer et al., 1997). Indeed, nation states across the world often enact administrative apparatuses of policymaking guided by worldwide models. Examples range from central bank independence (Maman & Rosenhek, 2014) to ministries of science and technology (Jang, 2003) and human rights institutions (Koo & Ramirez, 2009). Nation states also formulate remarkably similar policies and appear to reform existing policies in surprisingly similar ways (e.g. Dobbin, Simmons, & Garrett, 2007; Frank, Hironaka, & Schofer, 2000). Sociological institutionalism has been quite successful to explain such policy isomorphism, i.e. patterns of increasing formal similarity when it comes to trajectories of worldwide policy change. In particular, world society theory explains policy isomorphism by drawing attention to the fact that nation states are members of a single, stateless world polity, and whose actors are guided by common cultural ‘scripts’ (Meyer, 2009; Meyer et al., 1997; Thomas, 2009). The typical research strategy is to begin from a recognisable pattern of adoptions of a policy innovation among nation states and then ask for an explanation for this pattern.

In their critique of realist notions of more or less hermetically sealed nation states, such studies on diffusion have greatly enhanced our understanding of how policies travel across the world. However, they tend to overlook the actual processes by which a global policy model is created or tuned, and often underplay significant policy differences amongst nation states by emphasising overarching world cultural scripts. This is mostly because the research design traces the top-down diffusion of a policy model, and therefore begins with the assumption that the model's construction precedes its diffusion. The diffusing model itself is assumed to be relatively stable through the spreading process. Researchers then often assess the deviation of one policy model from another, or the ‘original’, with explanations ranging from variations in implementation capacities to ‘decoupling’.

Although this is a natural assumption, it is obvious that it is an idealisation to assume that a model is first constructed and then diffused (in more or less the same form). Some traditions, such as policy transfer research (Acharya, 2004; Cook, 2008; Dolowitz & Marsh, 2000), ‘domestication’ (Alasuutari & Qadir, 2014b), ‘hybridisation’ (Nederveen Pieterse, 1995) and ‘creolisation’ (Hannerz, 1987), have indeed emphasised how models adapt to suit the local context. However, these approaches, too, have lacked effective emphasis on the bi-directional nature of construction and spread of models (Drori, Höllerer, & Walgenbach, 2014). Most of the attention in this tradition has been on individual national contexts and decision-making. We thus need to know much more about how recognisable policy models become global in spread, as well as whether and how they change in the process of spreading back and forth through the world polity.

This paper aims to address these gaps by suggesting an alternative operationalisation for the principle of interdependent policymaking. Rather than beginning with an assumption of a single, stable policy model diffusing (or adapting) through the world polity, we propose to view the process of construction and spread of a model as a series of policy moves made by national states. The world polity can be thought of as a synchronised system, in which national states keep an eye out on each others’ moves and, often, match them (Alasuutari, 2014). In the process, a global policy model emerges as an on-going construction and theorisation that spreads as it forms. We aim to show how the lens of policy synchronisation helps make better sense of this bidirectional process of formation and spread of policy models than diffusion of a single model.

To do this we study the processes of construction and worldwide spread of National Bioethics Committees (NBCs). The NBC is a prime example of a model created and codified in parallel with the process of its spreading. Most scholarship relates this spread to an ‘ethical turn’, referring to the fact that over recent decades ethics has become the predominant discourse in governance of biotechnology, health care and life sciences (Bogner & Menz, 2010; Gottweis, 2008). That is not to argue whether policymaking has become more ethical where it was previously unethical; what is certain is that an ethics discourse is more explicitly present in today's policymaking. Policy issues involving biotechnology and biomedical interventions are inevitably framed in terms of ethics, as for instance in the case of the UK vote on ‘three-parent babies’ in early 2015. The global proliferation of NBCs is a highly tangible facet of the ethical turn. These organisations evaluate policies or emerging technologies from the standpoint of ethics, educate scientists on ethics-related aspects of research, raise public discussion of ethics issues and advise policymakers on ethically problematic issues arising from legislative needs that emerge from developments in biomedical science and technology. Almost all industrialised countries have now established committees of this sort, and developing countries, in increasing numbers, are in the process of creating such bodies.

By tracing the process through which the NBC has evolved into its present universally applicable form, our analysis points out that the NBC has been increasingly codified as a global model while it spreads. In this way, the paper diverges from diffusion studies and illustrates how policy moves made by synchronised national states results in a shifting yet spreading global policy model.

Neoinstitutionalist world society theory has discerned that individual nation states consistently make reforms in surprisingly similar fashion (e.g. Frank et al., 2000; Meyer, Ramirez, & Soysal, 1992). Countries often appear to be conforming to global models in their policymaking even when models in question do not fit to the country, or when there are no apparent functional needs for making such reforms. Given significant differences in conditions and resources of nation states, and the fact that there is no world government telling nation states what to do, such isomorphism has been a puzzle. World society theory (Meyer, 2009; Meyer et al., 1997) has successfully accounted for this by drawing attention to the similar constitution of nation states in a stateless world polity. From this viewpoint, it is world culture that causes nation states to conform to common models, not by enforcing but by working through universalised assumptions and shared cultural scripts characterising the various aspects of social reality. National policy actors are, therefore, far less agentic and rational in their choices, and far more guided by the world cultural scripts that largely constitute them as actors in the first place (Meyer, 2010).

In this research tradition, policy models are seen as diffusing through the world polity. Thus, Strang and Meyer (1993) argued that the social construction of actor identities and the theorisation of the diffusing models and adopters impose conditions for the successful diffusion of any socially meaningful object. The process of diffusion is portrayed by this account as beginning with the invention of a model, typically via theoretical abstraction, followed by diffusion that accelerates when enacting the model becomes an ‘institutional imperative’ (Strang & Meyer, 1993, p. 495) among potential adopters. Operationalising the spread of global models as diffusion has meant that the variables and causal mechanisms explaining successful diffusion have been at the centre of attention. The literature on world society theory certainly expresses awareness of the bidirectional nature of the relationship between spreading and formation of global models (Drori et al., 2014). However, the processes by which global models are created have not been the focus of research. Empirical studies of diffusion of specific policies or organisations, for example, typically ignore these issues because the research design traces the ‘top-down’ diffusion of a model, or its adaptation by policymakers around the world. Critics of diffusion focus on how local policy models are translated (Czarniawska & Sevón, 1996), localised (Acharya, 2004) or domesticated (Alasuutari & Qadir, 2014b) versions of the global model. However, they too tend to overlook the simultaneity in construction and spread of models that is a feature of many actual policies.

In order to retain focus on the worldwide phenomenon of a global policy model, and yet preserve insights into local adaptations, we build on emerging studies about policy synchronisation (Alasuutari, 2014, 2015). To do so, we first need to unpack the commonly held singularity of ‘a’ policy model. In world society theory and empirical studies informed by it, there is great variation in what a ‘model’ really is. In the context of world society theory, the term is used to signify principles and ideas at a high level of abstraction, such as citizenship, equality, rationalised justice and socio-economic development (Meyer et al., 1997, pp. 145, 148). Actors from individuals to organisations subscribe to scripted ‘models’ of actorhood (Meyer, 2010). Furthermore, the entirety of material reality is ontologically organised in globally diffusing models, of which medical models of the human body are an example (Meyer et al., 1997, p. 148). Yet not all models that diffuse are as grandiose: some are more like ‘travelling ideas’ (Czarniawska & Sevón, 1996), from health as a social concern (Inoue & Drori, 2006) to all kinds of fashions that ceaselessly travel between organisations (Drori et al., 2014). There are also models with very practice-oriented content, such as ‘the global model of a chess club’ (Lechner & Boli, 2005, p. 13). All kinds of policies, practices and standards spread (e.g. Meyer et al., 1997, pp. 146–48), as do bureaucratic structures such as government ministries (Jang, 2003).

In this paper, we propose separating the term ‘model’ into two ontological levels. The first is a level of ‘principles’, or ‘scripts’, such as rationalised organisation. The second is a practice-oriented level of codified organisational forms. The first may, indeed, diffuse as a single, identifiable principle through the world polity, and be more or less tightly coupled in different contexts with practices. However, the second level of actual codified organisational form is not so stable and, as we show below, continually forms while spreading. What actually spreads is not a single, identifiable organisational format, but an evolving codification that moves back and forth through the world polity.

The world polity itself is tightly integrated, especially since the 1940s (Meyer et al., 1997; Strang & Meyer, 1993). National states are not only criss-crossed by intergovernmental and international nongovernmental organisations, but also themselves keep an eye out on each others’ moves and match them, although not necessarily by copying or even adapting whole policies. The stateless world polity is by now so well synchronised that national policymakers routinely justify individual reforms by referring to what others are doing or have not yet done (Alasuutari, 2014; Alasuutari & Qadir, 2014a). In this sense, it is more appropriate to think of successions of policy moves being made by national states in particular policy areas, than of diffusion of singular policy models. Each move sparks a response by other states, although not by all states in all cases and not always by emulating a complete policy. But the common scripts of world culture that constitute each state as a member of the world polity mean that most states end up making similar policy moves, turning in similar ways, as for instance in the case of the ethical turn in policymaking since the 1970s.

The boundary between academic bioethics and policy-advising expertise has been drawn by calling the latter ‘official’ (Jasanoff, 2007, p. 173) or ‘public’ (Kelly, 2003) bioethics. Here we choose to use the concept of political bioethics (Felt & Wynne, 2007, p. 46), because of its emphasis on the political element that institutionalised ethics discourse has acquired in contemporary policymaking (even though ‘technical’ discourse might often obscure its political nature). The two modes may be mutually reinforcing: academic bioethics is legitimated by being ‘policy-relevant’, while political bioethics is legitimated by its relationship to an academic tradition.

What developments, then, have led to the ethical turn? Numerous studies, extending from the history of bioethics (e.g. Jonsen, 1998) to sociological research on science and governance (Fox & Swazey, 2008, p. 25; Jasanoff, 2007, p. 174), begin the story with the Nuremberg Trials, held in 1945–1947, wherein 23 doctors, among others, were convicted of war crimes. Disclosures of experimentation on humans and other horrors committed by Nazi doctors garnered worldwide repugnance and deflated the reputation of the medical profession. The trials produced the Nuremberg Code, issued in 1947, a set of 10 principles describing conditions that must be fulfilled before human medical experimentation is justified. In the following year, the World Medical Association adopted the Declaration of Geneva, a modern version of the Hippocratic Oath, to renew confidence in doctors and medical science. In 1964, both the Code of Nuremberg and the Declaration of Geneva were incorporated into the Declaration of Helsinki, a set of ethics principles for medical research adopted by the World Medical Association. Ever since its announcement, the Declaration of Helsinki has served as a basis for all important self-regulation measures of the medical profession.

Increasing self-regulation and new formulations of professional ethics clearly codified and strengthened medical ethics, as professional ethics for use by doctors; however, ethics questions related to biomedical science were here to stay, and means of evaluating practices in medical research and health care were needed. Novel technologies and new forms of knowledge emerged, especially with the rise of genetic research and molecular biology, which the field of traditional medical ethics was not fully equipped to face. Bioethics was developed to address these new problems. The scope of this new field was broader than that of medical ethics, which is often thought of as no more than professional ethics for doctors’ practice in clinical settings. Bioethics was not merely institutionalised as a novel academic field; it soon came to form a promising enterprise among policy advisers in many countries.¹

Critics have pointed out that bioethics expertise can be employed to shield the commercial interests of biotechnology companies from closer scrutiny and criticism (Elliott, 2004). Bureaucratised bioethics may provide much needed ethical clearance, especially for commercial actors in pharmaceuticals (Rose, 2007, pp. 30, 256). From national policymakers’ perspective, bioethics advisory bodies can be seen as ‘soft infrastructure’ for promoting biotechnology, as they work as a mechanism to guarantee the good image of national biomedical research in global markets (Reubi, 2010, p. 153). Other critics note that the diversity of positions in society on ethics may be suppressed through the use of bioethics to legitimate certain policies regulating bioscientific advances (Galloux et al., 2002, p. 146). The technical and theoretical language of bioethics is also disconnected from patient experience, and does not respond to the anxieties felt by individuals (Evans, 2006). Many note that technocratic means of control and the bureaucratic authority of expert advisers are extended to reaches of human life that would better be left as the realm of politicians and the people themselves. Perhaps paradoxically, literally vital issues associated with human life from zygote to terminal treatment are depoliticised through ethicisation.

As a whole, earlier studies have explained the emergence of bodies of ethical policy advice in mainly functional terms, as a solution to the legitimacy problems triggered by the develop­ment of the biosciences (e.g. Kelly, 2003; Salter & Salter, 2007). These narratives provide reasonable explanations for the prominent position that ethics has attained in policymaking in the areas of biotechnology, health care and life sciences. Taken together, they may yield a plausible conception of the diverse political rationales behind the establishment of NBCs in any given country and also of the potential consequences of this development. However, it is unlikely that the functional explanation – establishing an NBC as a response to legitimacy problems – can be applied to all cases. In many countries, such as Singapore (Reubi, 2010, p. 153) and Finland (Syväterä & Alasuutari, 2013, p. 38), the establishing of NBC was not preceded by remarkable conflicts, scandals or public outcry surrounding biotechnology. The functional accounts mostly ignore the rise of political bioethics as a global phenomenon.² Somehow national policymakers almost everywhere in the world quickly considered it necessary to institute a new kind of advisory body, specifically labelled as ethical.

To trace the formation of the NBC as a global model we draw on empirical evidence from two data sets. The first data set consists of information about when and where NBCs have been established. Since there is no complete list of NBCs and their dates of formation, the information was gathered from numerous sources. The full list of NBCs and their years of establishment, along with the sources of this information, are specified in Supplemental Data 1. The second data set consists of texts that represent the discourse of political bioethics. We searched for all naturally occurring data that sheds light on the formation of the NBC as a global model. From the initial mass of documents we selected key documents for close reading on the basis of their being authoritative or illustrative in their way of describing and legitimating NBCs. Many of these documents are published by UNESCO and its International Bioethics Committee, the European Commission and its Expert Group on Science and Governance or other organisations (including the WHO and individual NBCs), and some are scholarly papers (many of them authored by individuals active in some of the above-mentioned organisations). The documents also include project descriptions, experts’ reports, working papers, strategy papers, guides, memoranda, declarations, newsletters and brochures. We do not consider the documents we have analysed to be mere containers of information – they are also ‘active agents’ (Prior, 2003), in the sense that they themselves have had an important role in constructing NBCs and the networks of actors formed around them.³ Our methodological approach has been inspired by forms of neoinstitutionalist analysis that emphasise the role of ideas and discourse in explaining the dynamics of policy change (Alasuutari, 2015; Schmidt, 2008).

The NBC model has been increasingly formalised and codified in parallel with its spread. By tracing this development, we have identified four key shifts in the global rise of political bioethics. The first took place with the NBC appearing as simply a category of organisations of a specific kind. In the second shift, the paradigmatic model of the NBC was constructed. With the third shift, the activities and modes of work of the existing NBCs were networked with each other. The fourth shift led the international organisations in the field to redefine the NBC while they strove to assist nation states in establishing NBCs.

In speaking about ‘shifts’, we do not refer to four discrete events. Rather, each turn in the path is a shift from earlier conceptions towards a more universalistic understanding of the NBC. Accordingly, they are not total breaks; each shift adds a new layer to earlier conceptions.

The international trend of establishing NBCs started before ‘NBC’ appeared as a category used to describe the bodies in question. The first of the committees that are now known as NBCs were established in the 1970s (1974 in the US and 1977 in Slovenia) and the early 1980s (1983 in France and 1985 in Sweden). The category was coined a while later, with Australia's National Bioethics Consultative Council and Italy's Comitato Nazionale Italiano di Bioetica, both established in 1988, being the first national-level bodies whose names actually included the word ‘bioethics’. The word has been part of the name of most NBCs established since then. The entrenchment of a specific category, or institutional identity, of ‘NBC’ strengthened the global trend in line with which most nation states suddenly wanted to establish an NBC.

The first use of the category appears in an article about comparative law in relation to modern birth technologies, published in the mid-1980s (Knoppers, 1985, p. 11), where the French Comité Consultatif National d’Ethique pour les sciences de la vie et de la santé (CCNE) is referred to by this term in a footnote. Then 1988 in the British Medical Journal reports about a conference on ethics in reproductive medicine, where ‘the foreign visitors found it peculiar that no national bioethics committee had been established’ in the UK (Gillon, 1988, pp. 1212–1213). Since then, the use of the term ‘NBC’ has increased rapidly: Google Scholar found only about 10 hits for work published before 1990 that feature the term ‘NBC’. The number of hits exceeded 100 for works published in 2000 or earlier, 1000 for publications issued in 2010 or earlier and 2000 for works published by 2014.⁴ The increased presence of the term in published texts speaks to the stabilisation of this particular label in reference to or description of certain kinds of bodies.

Bioethics in general gained prominence first in the US, where the earliest academic institutes of bioethics were established in the late 1960s (Jasanoff, 2007, p. 176). From there, academic attention to bioethics spread all over the world in the following decades, most forcefully in the 1980s and the 1990s (Fox & Swazey, 2008). The origins of bioethics in the policy-advising realm too, in the form of national-level committees, can be traced to the US. Rothman (1991), writing about the history of bioethics in the US, mentions that back in 1968 a bill had been introduced to create an advisory body on bioethics issues, to assess ‘the ethical, legal, social, and political implications of biomedical advances’ (Rothman 1991, p. 169). The idea behind this body was similar to that of most NBCs today: a national committee was to be set up comprising not only doctors but also lay representatives with various backgrounds and diverse viewpoints. The bill was not passed, largely on account of fierce opposition by leading figures of the medical profession, who fought for their monopoly of authority in the regulation of biomedical practices.

The idea of establishing such a body resurfaced a few years later; this time Congress passed the act. Thereby, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was established in 1974. The growth of support for founding a commission had occurred because of scandals coming to attention in the US between 1968 and 1974 when cases of experimentation on humans in biomedical research were disclosed (Jonsen, 1998). In the interpretation of Rothman (1991), an important consequence of the establishment of this first national-level body for bioethics policy advice was that the medical profession lost its monopoly on ethics-related decision-making on medical issues in the US.

Successive bodies followed that first US commission, leading to the present Presidential Commission for the Study of Bioethical Issues (established in 2009). The composition of NBCs in the US has been more explicitly politically grounded than that of NBCs in most other countries. They have received their mandate from either the President in office at the time or Congress and, therefore, have been regularly assembled and disbanded. The National Bioethics Advisory Commission (set up in 1996 and dissolved in 2001) recognises that the US was a forerunner in the development of ethical policy advice:

Nevertheless, the US later lost its leading position by disbanding the bodies and being unable to create a permanent commission. The report bemoans the fact that the US has, for years at that point, ‘stood virtually alone among industrialised nations in not having established a permanent standing commission to address evolving bioethical issues’ (National Bioethics Advisory Commission, 1998, p. 3). It was recognised already in 1993 in the US that other countries were following France's model in the development of NBCs:

The idea that national, multidisciplinary expert bodies could help on public policy issues that include complex ethical questions related to biotechnology and life sciences thus first emerged in the US. The context for the innovation was the general rise of social regulation in US policymaking in the 1970s. The decade saw the rise of many scientific advisory committees in several policy fields (Jasanoff, 1994). The bodies of ethics policy advice were initially identified as belonging to this broad group of scientific policy-advice bodies. Before the NBC as a category was even coined, a similar idea was also enacted in some other countries (Slovenia, France, Sweden). However, the appearance of the NBC as a category involved a theorisation of ethics advisory bodies as a distinct form of policy advice. This theorisation created an entirely new field of expert policy advice. From then on they were not primarily compared to other national science advisory bodies, but to their counterparts in other countries. From NBCs being something to think about in regard to ethical policymaking, they became something through which to think about ethical policymaking.

Though the US had established an NBC early on, it would be France that became commonly known as giving birth to the world's first NBC (e.g. Bouësseau, Reis, & Ho, 2011; Maio, 2004). Theirs has become a paradigmatic model for NBCs, serving as a standard to which other countries’ ethics bodies are often compared. The French model of the NBC has become a well-known and valued brand and thus facilitated the spread of NBCs around the world. While the US national ethics committees established earlier are acknowledged, it is usually emphasised that the first permanent NBC was set up in France (e.g. Fuchs, 2005).

The creation of the CCNE, in 1983 by a decree of President Mitterrand, was politically motivated but also advocated for by the scientific community (Fox & Swazey, 2008). Academic and public discussion on issues of medically assisted reproduction (e.g. in vitro fertilisation) in the early 1980s precipitated the establishment of the CCNE (Rabinow, 1999). Indeed, the first issues discussed by the committee were related to reproduction, but, in contrast to the US, where these debates have usually been linked to political struggles over abortion, the French committee articulated the issues more broadly through ‘universal ethical principles, especially those relevant to defending the ‘dignity’ of the ‘human person’ (Rabinow, 1999, p. 72). Most of its members are appointed on the basis of expertise and interest in ethics; many are selected from the research sector and some are appointed by the President of the Republic. A brochure published in English by the CCNE when it celebrated its 25th anniversary illustrates how the committee identified itself as the original NBC and a model for other countries:

Indeed, many NBCs have utilised the CCNE as a model. The formal structure and the scope of its activities have been followed in many countries that have set up an NBC. The French version has, in fact, become ordinarily employed as the paradigmatic example of the NBC. For instance, in a Finnish parliamentary debate, preceding the establishment of an NBC in Finland, the French model was referred to in a reverential tone, as though a symbol of a modern and civilised nation (Syväterä & Alasuutari, 2013).

Slovenia is another case in point. It is interesting for the fact that Slovenia's National Medical Ethics Committee (or Komisija Republike Slovenije za medicinsko etiko), a permanent body active since 1977, was founded six years before France set up its committee. However, according to Fuchs (2005, p. 48), only some ‘representatives of central and eastern European bioethics’ claim that it was the first in the world:

The example of Slovenia shows how successfully the NBC of France has been branded; only after its tasks were redefined in 1995 to follow the French model more closely did the existing Slovenian national ethics body become classified as belonging to the group of NBCs. Compared to the paradigmatic model of NBC, the Slovenian committee had up to that point had an overly practical focus, with the emphasis in its work being on reviewing research protocols (ten Have, Dikenou, & Feinholz, 2011, p. 386).

The construction of the originality of the French NBC has had an important role in the evolution of the NBC as a global model. The French model has become routinely utilised as something in relation to which other versions can be viewed.

During this ongoing process of construction as a uniform model, NBCs have become organised internationally and networked with each other. The biennial Global Summit of National Bioethics Commissions, supported by the World Health Organization (WHO) and held for the first time in 1996 in San Francisco, is a good example of this development. The aims of the Global Summit and the measures intended for achieving them are expounded in the Tokyo Communiqué (Global Summit of National Bioethics Commissions, 1998), which was signed at the second summit in the series, held in Tokyo in 1998. The summit aspires to promote ‘enlightenment on bioethics around the world’ and ‘increase the know-how of national commissions in dealing with difficult issues’ through concrete practices such as assembling and circulating a list of topics to facilitate co-ordination of national bodies’ activities. After the 2010 summit, members of WHO and host Singapore's Bioethics Advisory Committee claimed that ‘[s]ummits have proven to be a valuable instrument [ … ] to facilitate collaboration between national ethics committees’ (Bouësseau et al., 2011, p. 156).

In Europe, even more intensive and explicit aspirations have arisen in relation to the goal of synchronising the field and the modes of activities of NBCs. Ethical policy advice became institutionalised in the European policy arena when the Group of Advisers on the Ethical Implications of Biotechnology was established, in 1991. It was replaced six years later by the European Group on Ethics in Science and New Technologies. Earlier studies (Galloux et al., 2002, p. 140; Jasanoff, 2007, p. 89) have emphasised that the institutionalisation of ethics in Europe has been a political move by the European Commission and the European Parliament, responding to public concerns surrounding developments in biotechnology, concerns that have been characterised by the European policymakers as conflicts over values.

The European Group on Ethics has proved to have had a far-reaching influence on the governance of biotechnology in the European Union (Mohr, Busby, Hervey, & Dingwall, 2012). Its purpose has, accordingly, been seen mainly as to legitimate politically contested policies and ensure increasing commercialisation of biotechnology, in this way improving the competitive position of the EU in emerging bio-economic markets (Plomer, 2008). The European Commission's (2002) Life Sciences and Biotechnology – a Strategy for Europe indeed supports such an interpretation. The strategy urges reinforcement of the networking between and within the European Group on Ethics and European NBCs because the committees are seen as useful in increasing public acceptance for the development of the life sciences and biotechnology:

Being helpful in crafting legislation and in other everyday policymaking is not considered the only purpose of the European Group on Ethics. Instead, it considers itself to have a much more important mission in searching for common European values and building a common ethical identity for Europe (European Commission, 2010). The foundation for the legitimacy of the European Group on Ethics seems to lie in the fact that it seeks to identify values shared by European citizens or ensure that the various ethics-related positions held by Europe's citizenry are taken into account in science and technology policymaking. Information-sharing through networking with NBCs is seen as a key to success in this respect. This turn towards a focus on ethics in EU policymaking is officially explained in terms of aspirations to redefine the EU as a community of values instead of viewing it as a mere trade community (European Commission, 2010, p. 1).

It is important to note that the search for a common ethical identity entails, in practice, redefinition of NBCs. In the European context their purpose is no longer only ‘national’ (to advise national governments and raise public discussion); now they actually participate in the Europe-wide coordination of the scope and field of policy-relevant ethical advice. The work of NBCs produces material for the European Group on Ethics to use in its opinions for the European Community, and, simultaneously, NBCs use the opinions produced by the European Group on Ethics when they craft their own positions. To organise this flow efficiently, the European NBCs have been networked together through the Forum of National Ethics Councils, organised by the European Commission, which has regular joint sessions with the European Group on Ethics. This process certainly contributes to the harmonisation of official ethical opinions and standards, but one could argue that it is not so obvious that it has very much to do with the ‘harmonisation of ethical values’ as held by citizens or with creating ‘the European ethical consensus’ – though both are held to be highly desirable in EU policymaking (see Ozoliņa, Mitcham, & Stilgoe, 2009, pp. 29–30). International networks and bodies that have a representative from each nation state with an NBC have contributed to the forming of the self-evident ‘truth’ that each nation state must have an NBC.

The third shift in theorisation of the NBC model produced rules for appropriate scope and modes of action. NBCs around the world were networked which each other and their representatives were organised into new bodies for political bioethics. These organisations set out to standardise the work of NBCs by sharing best practices and identifying ethical problems relevant for all NBCs. After the emergence of the NBC as a category, the French model soon became a typical or even original representative of the model. The generic model became theorised through the French model. It came to represent a kind of ideal type of NBC: a prestigious, permanent, multidisciplinary and consultative body with no decision-making mandate but that issues opinions to be used in national policymaking, and which is independent but established by law. This paradigmatic model was utilised to exclude bodies that do not resemble it enough.

There has always been space for difference between NBCs established in different countries. Nevertheless, when NBCs are compared with each other, comparisons take place within frames set by the paradigmatic model. For instance, the French model standardised the idea that members must have some expertise and interest in ethics, and must represent different fields of research, stakeholder groups and religions. This has been adopted in most other countries. However, while the French NBC includes five members representing the ‘the main philosophical and spiritual families’,⁵ NBCs in some other countries do not include any religious representation, or only a representative of one religion. In any country establishing an NBC, discussion over membership typically also activates debate over whether or not to include religious representatives. So the change brought by this shift is that after the formation of a paradigmatic model it has scarcely been possible to establish an NBC without relating its membership to these, now naturalised, member categories.

International organisations also encourage and provide assistance to nation states to establish such bodies. UNESCO, in particular, has been active in producing instruments for the development of global ethical standards for science (Pavone, 2007). UNESCO and its International Bioethics Committee have been actively encouraging developing countries to establish NBCs since about 2005. They came to define the NBC as a universally relevant (rather than nation-specific) policy instrument, thus constructing the model as transferable.

In 1991, it was decided that UNESCO would have a role in developing global bioethics (Sass, 1991). UNESCO's interest in bioethics can be traced back to the 1980s, when it organised conferences at which the ethics implications of the Human Genome Project were given attention. In 2002, the ethics of science and technology were listed among UNESCO's main priorities. Soon after, in 2003, the UNESCO General Conference declared it necessary to formulate universal standards of bioethics, so the International Bioethics Committee began work to draft the Universal Declaration on Bioethics and Human Rights (Berlinguer, 2004). ten Have (2006, p. 334), the director of UNESCO's Division of Ethics of Science and Technology from 2003 to 2010, explains that prioritising bioethics among UNESCO activities is a reflection of global concerns over the ethical acceptability of scientific and technological progress. Indeed, UNESCO has taken the lead in pursuing shared standards and principles for technological development. This has taken the form of assisting nation states to establish NBCs, providing guides and training members of NBCs around the world, helping nation states to organise education in ethics, and issuing several declarations on bioethics.

Two global-level bodies established by UNESCO – the International Bioethics Committee, founded in 1993, and the Intergovernmental Bioethics Committee, established in 1998 – have been especially important. While the former is made up of independent experts in various fields of science, the latter is composed of UNESCO member state representatives. The purpose of the Intergovernmental Bioethics Committee is to examine the recommendations given by the International Bioethics Committee and issue opinions on them in accordance with the aim of ensuring a solid link between the policymaking of member states and bioethical policy advice.

Mindful of the purpose of promoting shared norms, values and global standards for the regulation of the life sciences and biotechnology, UNESCO has produced three declarations on bioethics, most ambitiously the Universal Declaration on Bioethics and Human Rights (UNESCO, 2006b). In its wake, UNESCO also produced a precise definition for NBC (UNESCO, 2005, pp. 9, 22). The declaration states that NBCs should be established by all UNESCO member states. At the time of its issuing, practically all industrialised countries had already established such a committee, so the call obviously was directed to developing countries. UNESCO initiated the Assisting Bioethics Committees project (UNESCO, 2008), aiming to support states in the establishment of NBCs. In practice, much of its focus has been on Africa, most of whose countries have lacked an NBC. The project has facilitated the model's adoption via, for example, publication of a series of guides for policymakers and members of committees, along with the arrangement of courses for actors in target countries (ten Have et al., 2011). The guides supply a practical checklist of steps necessary for enacting the NBC (UNESCO, 2005), instructions as to work methods for existing NBCs (UNESCO, 2006a) and material that aids in preparation of training for the committee's members (UNESCO, 2007). Through activities such as these, UNESCO has contributed to making the NBC a universally applicable policy model.

In a sense, UNESCO and other international organisations promoting the establishment of NBCs around the world are ‘teachers of norms’ (Finnemore, 1993). This suggests that an international norm has evolved according to which responsible nation states must establish specific organisations to supply ethical policy advice on issues related to developments in medical science and technology. The motivation of UNESCO in helping nation states to establish NBCs is that only through the mediating role of ethical policy advisers can the principles of the declarations be expected to be incorporated into national laws and policies (ten Have et al., 2011).

UNESCO has indeed been successful in furthering the spread of the NBC. In 2013, the organisation listed 17 countries that established an NBC with its support, and nearly as many in which the process was in progress with its assistance (UNESCO, 2013). It is important to note that UNESCO's capacity to spread the model of the NBC to developing countries is not coercive in nature, since the measures described above have an effect only if national policymakers become convinced that enacting the proposed model is consistent with national interests. Thus, UNESCO tries to create a common understanding that a need exists for having an NBC in all countries. It is, in the end, the nation states’ policymakers who decide whether they will enact the model or not.

This shift has contributed to development of the NBC into a global policy model in two important ways. First, the fact that only representatives of NBCs are invited to certain international meetings reaffirms the self-evidence of the idea that every nation state should have this kind of body. Second, international organisations have had an important role in standardising the NBC, such that now a clear blueprint is available for latecomers.

The fourth shift in theorising the NBC model changed it so that it has become constructed as global in two senses: it has become understood as an instrument of global change and it has become universally applicable. The NBC is now theorised as an important aspect of reinforcing human rights on a global scale. This is evident in the Universal Declarations on bioethics issued by UNESCO where the bioethics policy advice is explicitly presented as having a role in the realisation of human rights especially in the developing countries. The NBC model was also turned by international organisations (especially by UNESCO) into a model that is easily adopted by any country. ‘Step by step guides’ for establishing and education of NBCs were published. Thus, this shift has been a decisive turn in accelerating the spread of the model into developing countries. Through this shift, the model was constructed as if it was a fundamental part of policymaking in any country.

In this paper, we traced the development of the NBC into a global policy model. We showed how the NBC has become a global standard, such that its enactment by nation states appears to be nearly an institutional imperative. In breaking down the singular conception of a policy ‘model’ into two ontological components – abstract principles and concrete formats or institutions – the paper identified four shifts along the way by which the NBC become constructed as a global model. In these shifts, the spread of the model throughout the world became possible. The first shift, the creation of the NBC as a category, was an obvious condition for the emergence of the model. The important finding in this connection was that members of this category existed before the emergence of the category per se. In this sense, ‘theorisation’ of the model followed the first phase of spreading. With the second shift, the NBC was further standardised as a model. The way in which the NBC was organised in France came to be commonly considered the paradigmatic model for other countries either to follow or to diverge from; for instance, the case of Slovenia shows that, to be deemed a genuine NBC, an organisation had to resemble the French model closely enough. The paradigmatic model also became widely associated with the image of a civilised, modern and efficient way to govern development in the life sciences.

With both the first and the second shift, individual ‘theorists’, such as researchers, had an important role in stabilising the new category. With the two following shifts, the NBCs already created became organised into international networks. These networks and international organisations became key actors in further modification, standardisation and codification of the model. The third shift entailed purposeful activities aimed at the development of a uniform model, including sharing best practices and defining a similar set of problems in the countries in which the model had already been adopted. The fourth shift – consultation by international organisations – strengthened the institutional imperative of the NBC, with intergovernmental organisations promoting the establishment of NBCs. The motivation of UNESCO and many other international promoters of the model stems from the idea that NBCs might function as carriers of many (world cultural) principles and norms – for example, of those encompassed in the Universal Declaration on Bioethics and Human Rights. Indeed, the global proliferation of NBCs can be seen as reflecting more abstract ‘world models’ (Meyer et al., 1997, p. 145) such as human rights, individualism and rational governance. These principles and purposes are made explicit in the self-description of any of these committees just as much as in the political discourse wherein their establishment was justified. The analysis showed how the NBC model has become more codified over time.

Thus, the case illustrates that while local enactments are translations of a global model, what is considered to be a global model is also constantly redefined. The dynamics of interdependent policymaking cannot be fully grasped if the adoption of a model is seen as the endpoint of the process. Global policy models are not as stable as diffusion studies often describe them to be or as the idea of script-enactment in world society theory might suggest. Instead, as the case of the NBC demonstrates, numerous actors employ a variety of measures – such as codifying, defining, branding and networking – as they strive to stabilise the models. In the process, locally enacted models are modified but are also used as material in the construction of uniform global models. Although we have shown that at the institutional level the NBC has become a largely standardised format of policy advice, we do not argue that actual NBCs – enactments of the global model – have all become similar. There certainly are many differences between the practices, self-images and political roles of NBCs in different countries. This is, first of all, a consequence of huge differences in regards to the financial and human resources of NBCs: even if the highly esteemed NBC of France serves as a model to be emulated for several other organisations, it is quite clear that most NBCs, working with scarce resources, cannot achieve similar results. On the other hand, features of national political cultures contributing to differences between enacted versions of the global model of NBC could be pointed out in future studies. These features are embodied, for example, in different compositions of NBCs: what scientific disciplines, or which religions, if any, are presented. Establishing an NBC has, indeed, triggered struggles over representation in many countries, e.g. in Austria (Bogner & Menz, 2005, pp. 25–26), Finland (Syväterä & Alasuutari, 2014, pp. 167–171) and Germany (Sperling, 2013, pp. 37–41).

Our analysis of the four shifts shows that new layers of theorisation and codification are added to the policy model of the NBC as it spreads through the world polity. In each shift, nation states looked across their borders to see what others were doing, which was enabled by the fact that democratic polities are so similarly structured and constituted by such similar scripts of what a nation state should look like. Depending on when a state adopted the model, it drew on the level of formalisation in that shift of the global process. A crucial element in each shift is the conception of the NBC as an ever-more universally applicable model. To argue that other global policy models than the one studied here typically evolve through a similar set of ‘shifts’ would need more empirical research. It is not immediately clear whether the same pattern is generally applicable for other policy models and whether precisely the same shifts may be exported to other cases, although we hypothesise that the first two shifts might be generic as far as state institutions are concerned.

In any case, the parallel codification and spread of the NBC as a policy model is quite a general phenomenon: many policy models change as they spread through the world polity, sometimes back to ‘early adopters’ as in the case of the Slovenian NBC. We therefore suggest that ‘diffusion’ – evoking the image of single particles spreading through a fluid – is not the most appropriate term to describe the emergence of such global policy models. Instead, the image of the world polity as a synchronised system better captures the parallel spread and formation of a global model. In this image, the actors engaged in national politics and policymaking utilise globally available culturally constructed models. This takes place in a stateless world polity that comprises national states keeping an eye on each other's moves, using those moves to justify their own, possibly by amending them to ‘suit local requirements’. They also draw on a relevant, theorised global model, as it exists at the time. As a result, such policies and even institutions in a state bear at least a ‘family resemblance’ to those in other states at any given time, although each model is quite ‘unique’ and the system as a whole is never static but always in motion. Although states enact the same forms of global models in a manner that makes them seem like a school of fish, constantly adjusting their moves to each other, they never become one single fish (Alasuutari & Qadir, 2014c, p. 2). Thus, the lens of synchronisation may advance our understanding of world cultural conditions of national politics and policy change.

Coming back to the idea of a policy model, we hasten to add here that this does not affect world polity theory's point about the diffusion of abstract principles, or ‘cultural scripts’, such as ‘rights’ or ‘ethical care’. But when it comes to precise, codified, institutional models, the concept of diffusion cannot accommodate the evident fluidity in the world polity. The macro-cultural concept of synchronised policy moves by nation states in the world polity promises to offer us more nuanced insight into the travels of policies.

We are grateful to Pertti Alasuutari, members of the Tampere Research Group for Cultural and Political Sociology, and two anonymous reviewers for their valuable comments.

No potential conflict of interest was reported by the authors.

Supplemental data for this article can be accessed at doi:10.1080/23254823.2016.1147370