Aside from the health impact, the quality of SE programmes and their implementation also deserve attention and should be evaluated. To be applicable to HSE, the evaluation criteria need to cover more than the typical public health aspects. Since they do not register long-term and multi-component characteristics, evaluation methods such as randomised controlled trials are not sufficiently suitable for HSE. The evaluation design should rely on a number of different information sources from mixed methods that are complemented and triangulated to build a plausible case for the effectiveness of SE in general and HSE in particular.

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Bioethical and bio-political questions are increasingly tackled by committees, councils, and other advisory boards that work on different and often interrelated levels. Research ethics committees work on an institutional or clinical level; local advisory boards deal with biomedical topics on the level of particular political regions; national and international political advisory boards try to answer questions about morally problematic political decisions in medical research and practice. In accordance with the increasing number and importance of committees, the quality of their work and their functional status are being subjected to more and more scrutiny. Besides overall criticism regarding the quality of their work, particular committees giving political advice are often suspected of being incompatible with democratic values, such as respect for affected parties, representation of diverse values and transparency in the decision-making processes. Based on the example of the German National Ethics Council, whose inauguration caused a still ongoing debate on the aims and scopes of committees in general, this paper discusses: (1) the requirements of modern democratic societies in dealing with complex scientific-technical problems; (2) the composition and organisation of committees working as political advisory boards; and (3) the appointment procedures and roles of laymen and experts, and here in particular of ethicists, who may legitimately be taken on by a committee. I will argue that bioethics committees do not necessarily endanger democratic values, but can considerably improve their realisation in democratic decision-making procedures--if, and only if, they do not act as substitutes for parliamentarian processes, but help prepare parliamentarian processes to be organised as rationally as possible.

Recent developments in the neurosciences, such as functional magnetic resonance imaging, have greatly broadened our understanding of the human brain, its structure and functions. Along with this deepened understanding, new kinds of psychoactive substances and techniques of brain surgery, neuro-bionic artificial limbs and cellular implants, have been developed which offer new and potentially valuable ways to treat psychological disorders and to restore diminished sensory and motor capacities.Such developments are already proving important for a wide variety of formerly untreatable conditions, ranging from severe forms of depression, through uncontrollable abnormal movements in patients suffering from Parkinson's disease, to deafness. Yet, however promising these new results seem from a medical point of view, we should not lose sight of the fact that the brain is the seat of our capacity to act autonomously, and thus the seat of what we naturally regard as the very centre of our nature as human beings. These new areas of research, therefore, certainly hold out the promise of great benefits but they also give rise to serious concerns and to disturbing challenges to our perception of ourselves as autonomously acting persons.A particular fear raised by these new techniques is that they will be used not only to cure but also to enhance psychic and physical capacities in an excessive and undesirable manner. Some argue that current developments might lead to a new ''breed'' of technologically enhanced man-machine hybrids. These people are concerned that new psychoactive substances and neuro-bionic limbs and implants are already leading to the medicalisation of an increasingly wide range of different aspects of our lives.These concerns are made the more pertinent by the fact that there is often no clear consensus on whether or not a condition is to be regarded as an illness