For Engineering and Science
Anonymous
Commentary On
"A Young Woman's Struggle for Peace" may be read on two levels. First, it is a case of an individual's personal moral dilemma. Ann must weigh her duties as a student and her desire to become a researcher in light of the wisdom of her developing conscience. Regardless of the basis of her dilemma, the realm of professional ethics includes resolution of conflicts that may arise between personal convictions and professional activities. Questions 1-7 are roughly contained within this framework. I have outlined approaches to these questions in some detail.
Ann's dilemma does not exist in a vacuum, but necessarily rests upon more fundamental issues. The second reading of this case, therefore, addresses the basis of Ann's dilemma, primarily by questioning the ethics of developing military technology and the related notion of the just war. These underlying matters lie beyond the immediate scope of professional ethics, for they appeal to more basic philosophies. Dismissal of such questions, however, silences discussion of the very issues that give rise to practical problems and consequently squanders the wisdom that can be gleaned from earnest deliberation. Progress in professional ethics, therefore, requires consideration of basic questions, even if consensus cannot be reached. In this spirit, Questions 8-13 investigate broad issues that surround Ann's situation. I make no attempt to answer them systematically. I sincerely hope the reader finds these questions engaging, and that they will inspire thought and dialogue that will inform the consciences of engineers and scientists as they choose to participate in various research activities.
Discussion Questions
1. Characterize Ann's dilemma. Is it a conflict of interest or a personal moral dilemma? Depending on Ann's course of action, does Doe have a conflict of interest? (See Question 7.)
The purpose here is to distinguish between a personal moral dilemma and a professional conflict of interest.
Clearly, Ann has a personal moral dilemma. If she has a conflict of interest, then it is necessary to identify vested interests and show them to be in opposition. "Interests," in the professional sense, correspond to duties associated with employment, contractual obligations or financial interests.
It is not clear that Ann has any interests in this sense. Perhaps she has duties as a student, but as yet they are not directly related to her research. Ann's conscience is not regarded as an interest. Therefore, this case does not present a conflict of interest. As a point of reference, Harris, Pritchard, and Rabins note that a person's objection to developing military technology is regarded as a personal moral dilemma.
As for Doe, he clearly does have duties to his students and to agencies that fund his research. He could conceivably have a conflict of interest if Ann begins to work on the Air Force project and later determines that she cannot continue the work.
2. Does Ann's dilemma change if she is Jewish? Muslim? Buddhist? Hindu? Humanist? If so, how?
The purpose here is to acknowledge that Ann's dilemma is not dependent on her Christianity, but could arise in a variety of faiths and belief systems. Adherents of particular belief systems are encouraged to consider this case from their own perspectives.
3. Identify Ann's goals and purpose as she matures and progresses. To what extent do Ann and Doe perceive differently the relevant applications, goals, or purposes of the research?
Here the reader is asked to critically consider the basis of the attitudes of Ann and Doe. Ann's intellect and conscience are both developing. Initially, her goals are based on her zeal for science and her desire to become a scientist. While she attaches some sense of purpose to her scientific work (sustainable energy), the science is an end in itself. Later, as a result of her budding understanding of nonviolence, she begins to attach greater importance to the military application of the science rather than the science itself. We can only conjecture how her views will develop in the future.
The text does not elaborate on Doe's character. One possibility is that he has not considered ethical issues surrounding the application of science and is therefore oblivious. He may be happy simply to conduct research irrespective of its source of funding. On the other hand, he may have thought very critically about such issues, and perhaps is even a devout Christian who supports a notion of just war. In this case, he may have determined that the research he is conducting is acceptable, and even necessary. Either way, he does not appear to consider that Ann may be sensitive to issues beyond rote science.
4. Does Ann have responsibilities to know and understand the applications of her work? How might these responsibilities depend upon the stage of her education or career?
Professional ethics asserts that each person, as part of his or her professional duty, is called to act as a moral agent. That means that professionals must be sensitive to ethical concerns in their working environments and must be able to make informed judgments to solve or prevent ethical problems. In this light, two basic questions emerge concerning Ann's situation:
- Does the domain of moral agency include the objectives and premises of professional activities?
- As a graduate student, is Ann a professional, and thereby required to act as a moral agent?
A reasonable answer to the first question is "yes." Moral agency is not confined to the ethics of conduct within a profession, such as conventions of authorship, confidentiality, data reporting, informed consent, etc. Vigilant moral agents may legitimately question the basic objectives and premises of their professions. Imagine that a new version of the Tuskegee study is devised to study untreated HIV. Perhaps the study is scientifically sound and provides for informed consent of the participants. Surely a clinician would be justified in questioning the premise of the study if he or she felt that it targets poor people who cannot afford treatment.
However, not all ethical problems are necessarily problems in the professional sense. In Ann's case, one basis of analysis rests on understanding the ambient system of law. One may presume that Ann is working in a nation whose constitution authorizes the power to declare war, and in which subsequent laws have provided for the systemic development of military technology. Therefore, Ann's potential objection to military research per se is not an issue of professional ethics, but is rather a personal moral dilemma. (Of course, this case could be modified to examine the specific nature of the research and analyzed with reference to additional criteria, such as international law and conventions of warfare. In some instances, Ann could object to certain types of military research on professional grounds.)
Regarding the second question, Ann is a junior student and is clearly not a professional. She is not expected to master any of the dimensions of her work, whether they are research techniques, mathematical skills, or ethical reasoning. Furthermore, just as beginning students enter with varied technical skills, they enter with different backgrounds in ethics. While loose ethical standards can be expected of all students (in the general area of academic integrity), it is my own experience that beginning and even advanced students lack a full conception of moral agency. Given this climate, I contend that Ann is not responsible for understanding or affirming the wider applications of her thesis work at its outset.
The assertion that a graduate student is free from the full obligation of moral agency is perhaps less than satisfactory. The argument that relieved Ann from considering the applications of her thesis work rested not on philosophy, but rather on an estimation of the current norms among graduate students. As ethics education is implemented at the undergraduate level, these norms will change. Students will become more responsible for acting as moral agents before they become full professionals.
5. Is Doe obligated to reveal the applications of the research to his advisees and the corresponding funding agencies? Does he have a responsibility to be aware of ethical concerns that others may have about his work, even if he does not share those concerns?
This question is a companion to Question 4. Doe is clearly a professional and therefore has the duty to act as a moral agent in the course of his work, including research, teaching, and advising. Based on the arguments given in Question 4, Doe is clearly responsible for understanding and affirming the applications of his research.
As an adviser, Doe has the duty to help his students become aware of information that is pertinent to their career development, in order that they will learn to think independently and make informed decisions. Therefore, he must be prepared to engage his students in both technical and ethical matters. In particular, Doe is obliged to discuss with them the applications and funding of his research, for the following reasons:
- In Question 4, the argument is made that moral agency includes the possibility of questioning the basic purpose or premises of one's work. Doe cannot assume that his students are unconcerned about the applications of their research. Reticence on their part may be due to their fear of raising sensitive issues. He must actively create an environment in which his students have the freedom to investigate their ethical concerns. To this end, he has a responsibility to be reasonably aware of ethical matters that students might raise, even in cases in which he personally disagrees.
- Even if his students do not have ethical concerns about the applications of their research, Doe must raise their consciousness to include these concerns as part of their ethical thinking. As professionals, they will be asked to devote their time and energy toward achieving certain goals in accordance with the norms of their fields. As students prepare for professional service, they must realize that they are not merely developing technical skills to qualify for employment; they are actively choosing how they wish to participate in society, a choice for which they will ultimately bear responsibility. I submit that ethics education must reveal the interests and objectives of the various professions in order that students may make informed, deliberate career choices.
- The solicitation of research funding requires justification of the proposed work. Doe should discuss with his students the current interests and trends in their fields and which agencies are likely to provide support. That is especially important for students who decide to pursue research careers.
Special Note. I contend that researchers in engineering and science have a special obligation to consider the motivations and applications of their work. In his essay Target Equals City, Thomas Merton argues that during warfare in which new technologies are applied, ethical principles shift very quickly, and yield to "practical dictates."
6. How is the funding agency related to the application of the research? Does Ann's dilemma change if
- she pursues the same basic research with funding from NSF or DOE?
- she pursues research that has no direct military application but is funded by the Air Force?
This is a line-drawing problem.
- It is unlikely that the NSF or DOE would be funding research specifically for the purpose of designing a new weapons system. However, Ann may still wish to determine whether the research has clear military applications.
- The Air Force and other military branches do fund basic research that is not directly related to weapons systems and in fact may be far from technological development. Ann must consider whether she is an accomplice to the development of weaponry even if she is not directly involved.
7. Consider the extent to which Ann and Doe have entered into a contractual relationship (written, verbal, implicit). It may help to draw upon your own experience as a student or faculty member.
- Is Ann bound by this contract if she discovers information that contradicts the initial premises of the contract? Is she obligated to reveal her own attitudes, which may conflict with her research?
- What risks does Ann take if she voices her objections? What risks does she take if she decides to change her research course?
- Does Doe have responsibilities to Ann if Ann determines that she cannot participate in the research, given its intended purpose?
This situation may vary according to institution and individual faculty-student relationships.
- Ann has not yet begun any research. If she is certain of her convictions, now is the time to raise them. This strategy is in the best interests of her credibility as well as Doe's research program. A stickier situation occurs if she realizes her dilemma in the midst of her research, or if she is uncertain of her convictions at the beginning of her research. That could happen if she is not certain of her convictions at the beginning of her research. In such a case, she is advised to raise the issue and seek a mutually acceptable arrangement with Doe.
- Ann may at least perceive a risk that she will be labeled "uncooperative" if she changes her research course based on a nontechnical issue. Depending on the availability of other research projects in her department, it is conceivable that she risks working in an area that interests her less. In the long term, she may risk losing employment opportunities in research if her objections are perceived to conflict with general conventions of research in her field.
- Doe has a right to sponsor research that may not meet Ann's approval, and may reasonably determine that she cannot work in his lab. However, his duty as a mentor requires him to respect Ann's convictions and at least try to find common ground. Perhaps he can find an alternative source of funding or help to establish a position for her with another faculty member.
While Doe may have to reveal information about Ann's convictions as he helps her find a satisfactory position, it is ultimately Ann's responsibility to report her convictions to her associates as they are relevant. It would be unethical for Doe to discuss Ann's moral convictions with colleagues indiscriminately. His faithfulness to this duty will help to prevent some of Ann's fears from being realized.
For Further Thought and Investigation
The following questions are very broad and may serve as the basis of discussion in a range of settings, including academic, professional, and religious. I have only a couple of comments here.
11. University teaching, especially at the graduate level, is influenced by faculty research. Research is typically funded by external organizations that have their own agendas (corporations, government agencies, nonprofit institutions).
- To what extent is the relationship between basic research and research sponsorship discussed in teaching settings? In research settings?
- To what extent do the values and interests of the research sponsors bias the teaching of basic science? Are students aware of these biases? Is objectivity compromised?
- What can be done within the educational system to convey to students the need to understand the applications and implications of science and technology? Can social responsibility be "taught?"
I believe that these questions are centrally important in modern education and apply to issues beyond military technology. Another example to consider is the relationship between genetic engineering and large agricultural corporations that produce food.
13. The medical profession is generally agreed that the advancement of knowledge -- even with the intent of extending and enhancing life -- is unethical if research deliberately compromises human life or health. Guidelines to govern research on human subjects emphasize protection of the individual. This philosophy may be generalized as follows: It is unethical to enhance the life or lifestyle of certain individuals at the expense of the basic health, will, or dignity of other individuals.
Consider now that civilian technology (transportation systems, computers, etc.) has historically been developed as a result of military endeavors. Given the generalization stated above,
- Is it ethical to choose to develop civilian technology in tandem with military technology, especially weapons technology?
- It it ethical to commit certain acts of violence with the intention of ensuring the safety of others?
- Why might medical research be especially concerned with the welfare of the individual at the potential risk of the general population? Why might these factors not apply to warfare?
- Medical practitioners and researchers generally have face-to-face contact with individual patients and subjects. The encounter with a person's face is very compelling and naturally engenders feelings of love and respect. Nonviolent objectors and just war theorists alike can agree that modern methods of warfare -- bombing civil infrastructure form a distance -- remove the face of the victim from the vision of the attacker. It is much easier to lose love and respect for one's fellows when they are referred to as "collateral damage," and not as "Bushra" or "Vicktor." To use force from a distance is to reject the elements of just ware theory that argue fo the restriction of force to protect innocent civilians.
Commentary On
Case Point 1: The Instructor's Grading Decision
Case Point 2: The Committee and Its Decision
Case Point 3: The Dean's Involvement
Case Point 4: The Adviser's Involvement
This commentary is organized by a general discussion of the entire case followed by several Case Points. In addition to the outlined case points, many other points are raised by this case. They are left to the reader for further discussion.
General Discussion
Based on the facts of the case, it is evident that at least one person -- either Josh or Robert -- is guilty of cheating on the examination. It is possible that Josh and Robert conspired to cheat, and that they simply reacted very differently to being caught. Given these basic facts, this case appears to be a straightforward instance of cheating, deserving complete investigation and disciplinary action according to university policy.
The situation is made significantly more complex by the decision of the course instructor to punish both students equally for cheating. This issue is discussed in Case Point 1. When the instructor's decision is appealed, the college dean chooses to resolve the conflict by appointing a committee to investigate the incident. The selection of committee members and the committee's decision are easily criticized and discussed in Case Point 2.
The dean then arranges to have informal, "off-the-record" meetings with each of the participants. In these meetings, the dean appears to have conveyed different impressions to the parties concerning his under-the-table plan to resolve the situation. Case Point 3 addresses the dean's behavior. The dean plans to have Zilch dissuade Josh from completing his degree, while remaining neutral toward Robert in his degree progress. The issues facing Zilch, with particular regard to the dean's requests, are discussed in Case Point 4.
Finally, we learn that Josh leaves the university without his intended degree. It is noted that the dean's long-range intentions are fulfilled with the adjustment of Robert's transcript. It would appear that Josh was the immediate victim of the injustice demonstrated by this case, but Zilch is not unscathed during the process, as pointed out in Case Point 4. While the instructor can be criticized for his initial decision, it would appear that at least the dean and one faculty member were united behind the decision. Finally, the dean, who consistently made ethically questionable decisions, is allowed to continue unchallenged in his role at the university.
Case Point 1: The Instructor's Grading Decision
The instructor must determine grades for Josh's and Robert's examination. Her options can be summarized as follows: 1) defer the grading decision pending more information or further counsel; 2) assign grades that selectively punish one student; 3) assign grades that punish both students to varying degrees; 4) assign grades that punish neither student. Each option is discussed below. The reader is encouraged to explore other options available to the instructor.
Option 1: Defer the grading decision pending more information or further counsel.
Referring the decision and seeking counsel is reasonable, especially given the nature of the infraction and potential consequences, which could include Josh's and Robert's expulsion from the university. However, this course of action may allow others to criticize Zilch's ability to function as a professional and to manage difficult classroom issues. The faculty might conclude that she is incompetent. She would be wise to move beyond such self-involved concerns and to seek justice for Josh and Robert and the other students in the class.
Option 2: Assign grades that selectively punish one student.
Selectively punishing one student in the absence of convincing evidence would be an unjustified, immoral decision. Not only would it be unacceptable to the students, it would be an abuse of the instructor's power.
Option 3: Assign grades that punish both students to varying degrees.
This action considers both Josh and Robert to be guilty, even in the absence of evidence of conspiracy. This form of justice is in contrast to that revered in the United States where innocence is presumed until guilt is established. Ideally, the enforcement of ethical and legal standards in academia should parallel those of society. The instructor chose this course of action, which is inconsistent with the system of justice in the United States. For this reason, this option is not the preferred course of action.
Option 4: Assign grades that punish neither student.
In the face of an obvious ethical infraction failing to locate a "smoking gun" and issuing suitable discipline is less than satisfying. Additionally, disciplining neither student may send the inappropriate message that cheating is permissible and/or is not a punishable offense. This action may leave the instructor feeling that she is unable to administer justice in the classroom. Despite these considerations, the prevailing system of justice in our society allows innocence to prevail until guilt is proven. Therefore, by societal standards, this is an acceptable course of action.
Summary:
Deferring the decision for further evaluation and/or punishing neither student (Options 1 and 4) are the two most ethically defensible options available to the instructor. The reader is encouraged to evaluate other alternatives. The instructor's decision to punish both students adds significant complexity to an already difficult situation. By deciding to award each student the minimum passing grade for the course, the instructor potentially eliminates both students' ability to successfully compete for future fellowships and awards. The decision may even place both students on academic probation in their department.
Case Point 2: The Committee and Its Decision
The dean assembles a faculty committee to review Robert's appeal. Unfortunately, the dean does not exhibit good judgment in the selection of committee members, as both the dean and the other faculty member are colleagues and presumably friends with Bell and Zilch. With these relationships in mind, it is difficult to conceive that the committee is sufficiently disinterested to discern and administer justice. On one hand, they could overturn Bell's autonomous decision, perhaps introducing new conflicts among the faculty. Alternatively, if they determined guilt and voted to expel one or both of the students, Zilch would lose a student just before her tenure review. As the committee has many obvious conflicts of interest, the dean would have been wiser to choose committee members completely removed from the situation, perhaps even selecting faculty members who had no interaction whatsoever with Bell and Zilch. It would be preferable to have a faculty committee of peers, rather than including a dean who may exert undue political influence. As the dispute is a straightforward cheating issue and not a technical grading detail specific to the field, even selecting committee members outside the academic discipline would have been reasonable.
The committee's alternatives are similar to those described in Case Point 1. Given the decision that the committee actually made, it would appear that they, like the instructor, failed to grasp the ethical consequences of their actions. Perhaps the conflicts of interest facing the committee overrode any desire to overturn or alter the instructor's decision. Zilch is dissatisfied with the committee's decision, but she is probably not interested in developing new conflicts with the dean and department faculty prior to her tenure review.
The committee's decision to informally share its unsubstantiated opinions with Bell and Zilch introduces issues of confidentiality and hierarchical compromise. This type of behavior raises suspicions of a "good ol' boy" network that makes decisions independent of the outcome of formal proceedings. Furthermore, with compromise of confidentiality, Zilch may be rightfully suspicious that any disclosed information may eventually be manipulated to her detriment. Zilch may somberly realize that her dissent could lead the dean to conclude that she is not a team player, thereby jeopardizing her future in the department, even though she had no involvement with the cheating episode whatsoever.
Case Point 3: The Dean's Involvement
The dean demonstrates questionable insight and judgment in the selection of the review committee members, as noted. In his meetings with the students and Zilch, the dean administers a unilaterally determined version of justice. The dean's actions can be strongly criticized on many grounds. Not only does the dean disregard the discovered facts in the case and arrange these informal "off-the-record" meetings about very serious matters, the dean selects Josh to become the scapegoat and attempts to manipulate Zilch to remove him from her research group. Zilch is placed in a compromising position by the dean's abuse of power. If she rejects the dean's plan, the dean may make an unfavorable tenure decision in her case. Following the dean's plan would be participating in an unethical course of action that may violate her integrity. It would also leave Zilch with one less student for her research efforts and a potential black mark on her tenure review report.
The dean's willingness to alter Robert's official student record suggests other, undisclosed unethical activities. What might the dean do to Zilch if she failed to cooperate? Clearly the dean's decisions and activities are very questionable.
Case Point 4: The Adviser's Involvement
Zilch is an innocent and very vulnerable bystander in this case. She is not involved in the cheating episode, but both of the accused students are her students. As Josh's and Robert's adviser, she is obligated to provide nonpreferential moral support and institutional information to each student. Aside from the events described in the case, her personal considerations must include the integrity of one or both of the students involved with this case. Could her students extend this behavior to research data and future publications?
Zilch clearly does not agree that punishing both students for cheating is appropriate, perhaps a suggestion of the "innocent until proven guilty" paradigm. She expresses this opinion to the review committee. Openly disagreeing with the dean on this issue may be difficult for Zilch, given her tenure review later in the year, yet she disagrees in a manner that does not draw undue attention to herself.
Her role as an adviser changes when the dean actively recruits her involvement in an unofficial plan to remove Josh from the graduate program. As discussed above, the dean's action is ethically inappropriate, as Zilch should have been permitted to continue to be an impartial adviser to both students while they continued to study at the university. The dean's actions dramatically increase the stakes for Zilch, as she cannot passively disagree with the grading decision any longer. Practically speaking, the dean politically forces Zilch to take a stand, either for or against his decisions. Zilch certainly realizes the gravity of the situation and the ethical standards of the dean at this point. She hears the dean's plan, but does nothing to discourage Josh to leave. However, the case does not indicate that Zilch encourages Josh to remain in the program. Ultimately the dean's plan is realized, and Zilch is a passive participant in the master plot.
In this case, Zilch is the only person who is aware of the dean's intentions to alter Robert's student records. What moral obligation does she have to report this compromise in ethics, and at what price? The dean's plan probably could have been averted completely by challenging his actions and/or publicly disclosing his plans. This course certainly would have been detrimental to Zilch's tenure and, by extension, to all of her students, including Josh and Robert. Zilch could await a tenure decision, and then reveal the dean's actions. By that time, however, Zilch would definitely be implicated as a co-conspirator with the dean, and Robert's academic career would again be scrutinized - and all of this after Josh has already left the program. Zilch's least painful course may be silence. The reader is encouraged to discuss Zilch's moral responsibilities in the context of this case.
Commentary On
Sherry's Obligation as Academic Counselor
Sherry's Obligation as Researcher
Contribution Research may make to knowledge vs. cost to the research participant
Are there alternative research designs?
Who has the final ethical responsibility?
This case raises concerns about a researcher's ethical obligations to her research and research participants, and how those obligations can conflict with her responsibilities and obligations toward her employer and clients.
Sherry's primary responsibility is working with students who are experiencing academic difficulty, particularly those on academic probation. These students on probation are facing academic dismissal from college if they do not improve their grades in the current or following term. As she works with these students, she decides that they would probably benefit by taking a course on effective study skills. Because of the large number of students experiencing academic troubles, Sherry feels this strategy will be the most efficient use of her time, providing the students with increased contact with her -- ten hours per term as opposed to 45-60 minutes per term.
Sherry is also in graduate school with only her research thesis left to complete her Master of Science degree. She sees this course on study skills for academically troubled students as an interesting research thesis.
At this point, the tension between Sherry's role as a professional and her role as a researcher becomes apparent. Sherry must consider her responsibilities and obligations to her employer and her moral responsibility for the effect of her work with the students. Yet Sherry as researcher must consider the ethical obligation she has to conduct the best research she possibly can.
Sherry's Obligation as Academic Counselor
Sherry may argue that she has a moral obligation to fulfill the responsibility given her by her employer to help students experiencing academic difficulty improve their grades. That means that she will help students to learn skills that could enable them to improve their academic standing. As she has explored the research literature conducted in traditional college settings that focused on low academically achieving students, she finds that positive results have been observed when those students learn appropriate study skills.
Even though students at this technical college are drawn from a different population than those who attend traditional colleges, Sherry believes that her students would probably benefit as much, if not more, from learning successful study skills. Perhaps because of her review of the research literature, she finds study skills to be the most successful factor in helping students improve their academic standing.
Given Sherry's feeling of responsibility (to her employer and to the students) to help the students improve their grades, it is understandable that she would feel an ethical obligation to provide these students the opportunity to learn successful study skills, increasing their chances of getting off academic probation and eventually earning their college degrees.
Sherry's Obligation as Researcher
Sherry could argue that it is "the initial ethical obligation of psychologists to conduct the best research of which they are capable."
Sherry could agree with her thesis committee's position, allowing for a control group whose members receive no intervention. She has an ethical responsibility to conduct her research in the most rigorous and scientific manner possible. Certainly for the research Sherry is proposing, a control group would be the most sound experimental design, and the knowledge that could be gained from this research might be used to benefit an even greater number of students in academic trouble.
However, Sherry decided before consulting her thesis committee that her research design would not include a control group. She made this decision based on the results she found in her literature search, which indicated that the study skills intervention produced improvement in most students' GPAs in traditional college settings. Her concern about the possible negative effect for students who would not receive the study skills intervention led her to believe that priority must be given to the research participants' welfare rather than the best research design.
Contribution research made to knowledge vs. cost to the research participant
Three principles have been proposed for ethical research involving human participants.
Respect for persons. Respect for persons incorporates at least two ethical convictions: first, that individuals should be treated as autonomous agents, and second, that persons with diminished autonomy are entitled to protection.
Beneficence. Researchers treat persons in an ethical manner not only by protecting them from harm, but also by making efforts to secure their well-being. Beneficence here is understood in a strong sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: 1) do no harm and 2) maximize possible benefits and minimize possible harms.
The principle of beneficence assumes that investigators will carefully think through the implications of their research. This principle means that the research should provide participants with maximum benefits while risks are minimized. Clearly the students who receive the study skills training have a greater possibility of receiving maximum benefits and minimal risks, if any (based on the research literature).
The benefits and risks for students in a proposed control group need to be examined carefully. The risks to the students in the control group may appear to be minimal. If the research shows no benefit to the experimental group, the students in the control group would not have invested their time in a useless course. If the results of the study are positive, they can participate in the study skills course after the end of the study. However, as stated in the case, these students are on academic probation and are in danger of being dismissed at the end of the current academic term if their GPAs do not improve. It is important to understand what success in college might mean to these students. As the first persons in their families to attend college, their families have high expectations for them. Failing at this technical college could have a profound impact on their dignity and self-esteem.
The best possible scenario is that they will have one more term to improve their grades to avoid being dismissed from school. Some of the students in the control group would not have the opportunity to participate during the next term because they would already have been dismissed from school due to academic ineligibility. Those students who had two terms to raise their GPA might had a better chance to do so if they had received the study skills training prior to the term in which they might be dismissed.
Justice. The principle of justice centers on "who ought to receive the benefits of research and bear its burdens."
Thus, Sherry must consider that "the general ethical question always is whether a negative effect upon the dignity and welfare of the participants is warranted by the importance of the research. . . [and that]. . . in weighing the pros and cons of conducting research that raises ethical questions, priority must be given to the research participant's welfare and dignity."
Are there alternative research designs?
Sherry could explore other research designs and methodologies that will allow her to conduct sound research and still fulfill her ethical obligations to her students. One possibility would be to use students who do not volunteer to participate in the study skills course as control group participants. The difficulty with this design is that the very act of not volunteering could be an indication that those students so different from the students who volunteer that one could not compare the results. Another design methodology might be for Sherry to take half the students who volunteer for the study skills course and meet with them for the same amount of time as students who take the course, but not work with them on study skills. This design could provide valuable insight as to whether it is the study skills that students are learning that enable them to achieve better grades, or whether it is simply contact and attention from someone who is concerned with their academic progress.
Who has the final ethical responsibility?
According to the APA,
Whether a proposed research project is ethically acceptable. . . is a matter on which the individual investigator is obliged to come to a considered judgment without abdicating this responsibility on the grounds of current practice, regulatory considerations, or judgments by others. . . . The investigator. . . must accept the final ethical responsibility for deciding whether or how to proceed. . . . The teacher or research supervisor should respect the moral judgment of students and assistants. If students or assistants feel a moral reluctance to carry out a research procedure, the supervisor should not pressure them to perform the procedure, even though it seems completely acceptable.
Ibid., pp. 19, 21, 30.
Sherry has the sole ethical responsibility for deciding whether and how to proceed. She cannot abdicate her responsibility to her thesis committee. Even though they might disagree with Sherry's decision, her committee members must not pressure her to go against what she feels are her moral obligations to her students and her employer.
Commentary On
This case touches on several points in research ethics. The points may be clear to a reader who can look at the entire picture over the course of a few minutes, but it is written to try to get the reader to look at the various steps as they may have happened -- over the course of a few weeks. The characters in the story had to deal with the issues far more slowly than one sees them while reading the case. Further, the individual steps from decision to decision are relatively small, and they may have appeared even more innocuous when addressed over a long period of time. The "slippery slope" concept is very relevant when dealing with the training of graduate students in ethical conduct in research, since the graduate years are those where they make s their first choices on where to stand in their professions.
The case is meant to address proper supervision of students, proper review of data and conclusions, ownership of data, honesty in reporting, and honesty in reporting. Jessica was included in order to provide a revelation of conflicting data and is not intended to be a significant part of the case at all. However, the case could become more complex if Roger were to act vindictively and grade her poorly based on his own biases.
The first direct question in the case asks whether any mistakes had been made before Jessica's arrival at the lab. The point addressed by this question is actually directed more toward the behavior of Hare and the committee. From the background it is clear that Hare did not take an active role in guiding Roger's development of the histochemical techniques and was not able to provide expert advice or critique regarding the results. This fact has relevance to Roger's possible misinterpretation of data. It also has relevance to the rest of the case as it gives an indication of Hare's approach to the education of students.
Roger's first relevant decision occurred when he decided not to report the conflicting results to Hare or Jessica. It could be argued that this decision was perfectly reasonable since these were only the first results produced by a novice researcher. However, Roger made an executive decision regarding data that was not his sole property. Perhaps it would have been more proper for him to mention to Jessica and Hare, even in passing, the possible relevance of what Jessica had found.
Roger's next actions were a mixture. It was good, scientifically and ethically, for him to follow up on Jessica's results. His decision to put her on a different project could go either way -- it really depends on his motivation, and the case is not clear on that point. Roger made another important decision when he completed the follow up experiments that confirmed Jessica's initial findings. The case made it clear that he did not relate his finding to anyone. In fact, he accepted thanks and praise for his monitoring of Jessica's progress and for keeping the lab "on track." It is now clear that Roger, whether it was his intent from the outset or not, is manipulating data and hiding results from the lab director.
Certain aspects of this entire situation may have been averted had Hare and the committee taken a more active role in Roger's training and guidance. This case clearly addresses issues of honest handling of data and of disclosure, touching on the ownership of data and the responsible use of laboratory resources and showing that Roger has responsibilities that go beyond his own interests. The case also demonstrates how small decisions can eventually create a situation that one would clearly have avoided were that situation one of the initial choices.
Commentary On
On the surface, this case appears to focus on a problem involving data presentation. However, if we look more closely, we can see that the disagreement between a major professor and his graduate student over how the master's project information will be shared with the general community stems from a more basic problem: poor communication.
This case addresses fundamental aspects of a student-mentor relationship. What is the mentor's academic responsibility to the student, and what is the student's role in this breakdown in communication?
It is not uncommon for large universities such as the one described in this case to be immense bureaucracies, filled with mounds of paperwork, extremely busy and overscheduled faculty, and students who find themselves thrown into a system fundamentally different from their undergraduate education. The questions posed after Part 1 direct the reader to consider the department's and faculty's obligations for new graduate student orientation. Additional questions concerning the student's role in this information exchange are equally important. After all, this is the student's education. Moreover, faculty generally view graduate students as highly responsible and self-motivated adults. However, the student may not ask the appropriate questions to garner information if he cannot anticipate the problem. In other words, an inexperienced individual such as a new master's student may not have the background to foresee potential difficulties.
It appears that the department and Dr. Lee should routinely provide written materials outlining departmental mores to all new incoming students. Perhaps the materials could also emphasize general expectations for both parties and the importance of a continuous dialogue between mentor and student.
In Part 2, we find that the graduate student spends an inordinate amount of time on his master's thesis. When he finally finishes, he faces a disagreement with his mentor over the publication format of his research. There are several considerations here. 1) Who has the right to determine publication format; who has ownership of data? 2) How should the conflict be handled? Should a third party be brought in to mediate? 3) Does the department have a responsibility to assure that a graduate student makes timely progress and does an appropriate amount of work for his project?
Again, it seems that the department and faculty committee should address questions of ownership and appropriate size of projects at the onset of the student's research. It would also seem reasonable for the department to provide a system for the mediation of student/mentor conflicts.
Part 3 finds the student retaining ownership of his research, but damaging his relationship with his mentor. Changes in how information is presented with the advent of the internet pose new questions. Standard methods of citation, publication, and so on, are in the process of being established. However, questions of ownership and conflict resolution methods could be addressed prior to the formation of a dispute. If a conflict develops in spite of such preventive measures, it may be necessary to bring in a third party to mediate. With the help of mediation, a win-win solution might be found that would satisfy both parties. By refusing to reconsider his position, the student in this case may have lost his best avenue for professional advice and recommendations.
In other words, he won the battle only to lose the war.
Commentary On
When someone hears or reads about research on nonhuman animals and potential ethical problems with that research, the research typically has biomedical applications. This type of research uses non human animals as models for human beings, in experiments with new products or techniques. Ethical arguments against this research have generally fallen under two major views: a utilitarian view or a deontological (rights-based) view. From the utilitarian viewpoint, the question hinges on whether the study organism has the capacity for suffering; if so, we need to take that suffering into account.
From the rights-based viewpoint, the question of suffering is not the central criterion for evaluating our decisions about non human animal research. For this view, the major problem with non human animal research is that we are using living, sentient individuals as resources, as means to our ends.
But what if the research does not have a direct, immediate application to our own species? What if, instead, we are interested in understanding the basic ecological and evolutionary processes that govern the living world? One field of research taking this approach and using nonhuman animals as research subjects, is the field of animal behavior. Ethologists, comparative psychologists, and behavioral ecologists study the behavioral patterns of nonhuman animals and humans in both captive settings and in the organisms' natural settings. The goals of the research are to understand the behaviors animals use to feed, reproduce, communicate, and avoid predation -- how these behaviors develop, the mechanisms by which they are elicited, what functions they serve, and how they evolved in the species. Indeed, for those of us concerned about the use of nonhuman animals in research, a solid understanding of the ethology and natural history of the species is fundamental to know what might be painful to an animal or what is an abnormal environmental context or stimulus for a species. To arrive at this understanding, research with nonhuman animals is necessary. While mathematical modeling, computer simulations, and strictly observational data often serve as the foundation for generating predictions about behavior, experimental studies involving manipulations are often necessary to test the predictions.
How does one decide whether a given ethological experiment with non humans should be done -- whether it would be ethically justifiable? A decision model proposed by Bateson
An important extension of this decision cube would take into account what might be called a conservation criterion.
"The Gladiator Sparrow" case touches on many of these issues. The research is designed to reveal basic principles and processes of behavioral development -- the benefit that might accrue from the research may have no direct application to human welfare whatsoever. Then again, understanding socialization processes during development that lead to certain behaviors being displayed in a nonhuman animal species may be of some significance to our understanding of human behavior. With basic research like the study described in the case, one simply cannot know beforehand the practical results that might be obtained. The questions raised in the case touch on our notions of whether some groups of animal species may be more or less preferable as study organisms in behavioral research and how this decision might relate to utilitarian or rights-based views. They also relate to the fact that with behavioral research, the questions asked and the design of research are often inseparable from the ethical issues confronting the research. However, the remainder of this commentary will focus on one of the most fundamental issues in this case -- studying aggression in a captive group of animals.
In this case, the behavior in question is aggressive behavior, and a study of aggression in and of itself brings many of these ethical issues to the forefront. Perhaps the most central issue in this case is that, by definition, research on aggression will involve pain and suffering for some of the animals. Further, the study of aggression in a captive setting raises the stakes. Although a captive setting allows for increased experimental control and for extremely detailed observations of behavior and its development, in this case it also exacerbates the problem of animal pain. In a captive setting, an individual being attacked by another cannot escape the interaction by leaving the area, as might be the case in the species' natural setting. This concern has led some authors to view any captive study of natural behaviors like aggression, infanticide, or predation -- or any field study with manipulations to increase the likelihood of these events -- to be ethically problematic.
In her discussion of ethical problems with studies of predation or aggression, Huntingford argued that the conflict between the pain involved in the experiment and the likely information acquired by doing the experiment will come out in favor of doing the experiment to the extent that six criteria are met:
- The theoretical importance of the study is critically evaluated by several researchers, including researchers outside the particular field of aggression and predation studies.
- The behavior of the subjects in the experiment is recorded in extreme detail.
- Care is taken not to replicate unnecessarily experiments with the particular species or question; collaborative research with other workers in the field or of that species should be pursued.
- Data are collected from natural (unmanipulated, noncaptive) settings as much as possible.
- Models rather than live predators/aggressors are used whenever possible.
- Aggression and other potentially dangerous or painful encounters are kept to a minimum and to as short a duration as possible.
F. A. Huntingford, "Some Ethical Issues Raised by Studies of Predation and Aggression," Animal Behaviour 32 (1984): 210-215.
It is informative to look at the case of The Gladiator Sparrow in light of Huntingford's six criteria (as well as those of Bateson, Cuthill, and Driscoll and Bateson, discussed above).
- We can assume that the Institutional Animal Care and Use Committee (IACUC) of Clarisse's university comprises several scientists and at least one community member and that her study passed the IACUC's criteria for theoretical importance. On the other hand, given the nature of studies of aggression or predation, it may be important for researchers such as Clarisse and her adviser to go beyond the IACUC and request commentary on the research question and design from several researchers in and outside the particular field.
- We can perhaps assume, given the information in the case, that Clarisse has analyzed behavioral interactions of her birds in great detail. This information may be particularly relevant to the question of unnecessary pain and suffering of birds in her future work. If Clarisse has collected dozens of dependent behavioral measures in her work, she may be able to find antecedents of aggression in the behavioral repertoires of the birds that allow her reliably to predict aggressive and potentially harmful behaviors. Thus, in future studies, she may be able to stage encounters using one of these antecedent behaviors as her measure of aggressive interaction.
- This criterion is an area where Clarisse probably did not prepare sufficiently in establishing her research design. It also points to a weakness of present IACUC protocol applications. These applications typically ask for a Web-based literature search for related studies and for alternatives to research with nonhuman animals. Most Web-based literature searches only go back for the last two decades or so, however, which means that older studies may go unnoticed by some researchers. That could be particularly damaging in a field like animal behavior, where a great deal of very detailed natural history studies of species may be several decades old. In this case study, Clarisse did not contact Drs. Cabral and Marable, and she may not have been aware of their earlier work until well into her study. Clarisse should have known these researchers' work better than she apparently did, and should have contacted them before initiating her study. Knowing she might encounter extreme amounts of aggression among the birds, she may have been better able to minimize losses in her study.
- Had Clarisse herself had first-hand knowledge of and data on aggression in the wild with the particular population of Gladiator sparrow she would study, she may have been more ready to deal with the level of aggression that would occur in her birds. On the other hand, if she were studying a population whose behavioral interactions had been studied thoroughly by other researchers, it may not be necessary for her to spend a year or more observing the behavior of the birds in the natural setting.
- It is difficult to tell from the case study whether the use of models rather than live birds might have been possible in Clarisse's study. If she plans to carry out more manipulated and experimental tests of aggression and/or responses to aggression in the future, however, it may be possible to use stuffed models of the sparrows in aggressive postures or playbacks of aggressive vocalizations, rather than using real birds to test subjects' behavior.
- This point is similar to the discussion brought up in Criterion 2. If Clarisse were able to know with a high reliability that a given behavior "A" of a bird virtually always led to fighting and harm to another bird, she may be able to use behavior "A" as her measure of aggression, and stop any interactions between two birds after that behavior is displayed by one of the birds.
To summarize, Clarisse seems to have done a fair amount of preparation for her research, and she has met the expectations and concerns of her IACUC in developing her study. On the other hand, given the nature of her research project, she perhaps should have prepared more thoroughly. Had she known the extent of the aggression she would observe (and from the case it seems likely she could and should have known this), she could have been ready for what she would encounter with the birds. She could have set up testing situations, or in general could have been better prepared, to minimize the losses in her study as well as the amount of pain suffered by the birds, while still collecting the data required to answer her research questions.
Commentary On
Recent advances in human genetic research have made it easier to identify mutations responsible for rare genetic disorders like BCK. The availability of families like those in Community Z are important for the characterization of these gene defects in order to predict and immediately treat future cases. The main purpose of this case is to stimulate discussion of researchers' moral and ethical responsibility to culturally distinct and/or indigenous populations who engage in population-specific genetic studies in return for improved health care.
The case presents several ethical dilemmas. Although clear-cut answers are not obvious, the research team must make a decision. They must consider all interested parties, including individual community members, the community as a whole, the research team, and, indirectly, the integrity of the research team's institution.
The first issue is whether to screen unmarried couples or individuals even though the elders do not recommend it. In some cultures, the concept of persons as individuals may differ from other societies' definition. Whether the choice of unmarried couples to go against their elders' wishes to be screened is wise, depends on that community member. Certainly, if the research team decides to test unmarried couples who desire screening, it may affect the researchers' relationship with the community elders. This decision could also impact these individuals' decisions to marry -- or never to marry for fear of having an affected infant. However, if the couples are not allowed to be screened until married and it is determined that they are both carriers, knowledge that they have been identified as carriers may have a negative effect on the marriage. In addition, each child they may conceive has a 1 in 4 chance of having BCK. In light of these facts, screening unmarried couples may be best. Because of the high incidence of BCK in this community, it is far better to screen the unmarried couples who desire carrier testing than to deny them.
Another issue raised by this case is respect for the community as a whole by honoring the recommendation of the elders. In the interest of maintaining their relationship with the elders, the research team should provide further education about BCK to the elders and the community, with the hope that the elders will either 1) allow unmarried couples to be screened or 2) arrange for married couples to receive genetic counseling if tests show that both partners are gene carriers.
References
- M. W. Foster, D. Bernsten, and T. H. Carter, "A Model Agreement for Genetic Research in Socially Identifiable Populations," American Journal of Human Genetics 63 (1998): 696-702.
- L. O. Gostin, "Informed Consent, Cultural Sensitivity, and Respect for Persons," Journal of the American Medical Association 274 (10, 1995): 844-845.
This case raises several important dilemmas that confront clinical scientists who conduct research with individuals who have mental disorders. A dilemma can be defined as a situation in which rights or obligations of interested parties are in conflict. In this case, the interested parties include Miriana, Duncan, Duncan's advisers and others who may require the use of the data, health care workers involved in Miriana's care, and the agencies and Internal Review Boards of the hospital, university and funding source. Whichever course of action Duncan chooses, consequences will ensue for each of these parties. For this reason, Duncan must consider both participant protection and methodological factors as he seeks to resolve his dilemma.
In deciding upon an appropriate course of action, Duncan could take solace in the fact that the IRBs of the hospital, university, and granting agency have approved the research protocol, including the consent procedure. Or can he? There is a potential conflict of interest inherent in approval of research protocols by the granting agency, in that the agency has a vested interest in the success of the research project.
Informed Consent
Informed consent is at the core of Duncan's dilemma, and in particular, informed consent with individuals who may exhibit impaired capacity to fulfill the requirements of informed consent. Informed consent becomes a dilemma in this case because of the potential conflict between the rights and interests of the research participant and those of the individuals who have a stake in the outcome of the research. The Belmont Report described three elements of informed consent: information, comprehension, and voluntariness.
When Duncan initially reviewed the consent form with Miriana, he asked her whether she understood each component of the study, including the component that she was to complete today, and she stated that she did. This procedure is described as relatively intensive. Yet, at least one study has demonstrated that, in some cases, objective assessments of schizophrenia patients' comprehension of informed consent are discrepant with the patients' self-report of understanding.
The capacity of patients with mental disorders to engage in decision making related to participation in research and treatment has been the subject of increased attention and debate. Current conceptualizations of decision-making capacity have evolved from operational definitions of legal competence and generally include four standards for determining whether individuals have the capacity to make autonomous decisions. These standards are: 1) the ability to express a choice, 2) the ability to understand relevant information, 3) the ability to appreciate the situation and its likely consequences, and 4) the ability to manipulate information rationally or to reason.
As noted in the case, schizophrenia is a disorder that can affect multiple areas of cognitive functioning. In one investigation of the four decision-making standards, one-fourth to one-third of patients with schizophrenia exhibited impaired understanding, reasoning, or appreciation. The investigators reported a significantly lower percentage of healthy comparison participants, patients with depression, and patients with angina who exhibited impairment in these capacities.
Duncan wonders whether the controversy over informed consent is relevant to his situation with Miriana, because she may not have schizophrenia. Although it may be true that much of the current controversy concerns patients with schizophrenia, and that they are at a greater risk of impairment, Miriana's diagnosis would appear to be irrelevant. In the individual case, the diagnosis in and of itself cannot indicate whether decision-making capacity is impaired. (Indeed Grisso and Appelbaum suggest that as many as 75 percent of patients with schizophrenia are unimpaired in at least one of these capacities.
Rather, the relevant question is whether the individual prospective research participant has sufficient decision-making capacity to engage in the consent process. Indeed, there has been considerable discussion regarding whether the decision-making capacity of all prospective research participants should be evaluated, regardless of psychiatric status. Some commentators suggest that the capacity of all hospitalized psychotic patients, whether or not they have schizophrenia, should be evaluated, but concede that this practice might lead to an overestimation of incapacity among such patients.
However, one aspect of Duncan's problem is that he did not initially employ, and does not seem to have at his disposal, an effective means of identifying impairments in Miriana's decision-making capacity as they relate to informed consent. Duncan appears to have unwittingly contributed to the development of this dilemma by not reminding her that he was from the research project when he approached her today. At this point, Duncan could review the informed consent form with Miriana and obtain consent again, using the approved protocol. Such re-consent procedures have been suggested in cases in which experimentation occurs over an extended period of time.
A further problem arises when one must rely on the subjective judgments of a participant's capacity by researchers who have a potential conflict of interest between the need to gather data and the need to protect their human subjects.
In determining criteria for acceptable levels of capacity, the American Psychiatric Association guidelines state "As a general rule, the less favorable the risk/benefit ratio of participation in a research project, especially as the absolute level of risk increases, the higher the level of capacity that should be required."
If Duncan were able to use such an instrument, and if he determined that Miriana evidenced a level of impairment in decision-making capacities that was not acceptable, given the risks in the study, he could discontinue with Miriana for the day, running the risk that she will be discharged, and approach her again tomorrow. If she were discharged, or if she still exhibited impairment, the data he has already collected apparently would be unusable. But, even if a research participant such as Miriana demonstrated impaired capacity when assessed objectively, should she necessarily be ineligible for participation? As Appelbaum points out, "Impairments exist on a spectrum and some degree of dysfunction is not incompatible with competent decision-making."
Such questions frequently have been explored from the armchair; more recently, several investigators have begun to address these issues as empirical questions. In one investigation, Wirshing et al. designed a consent procedure that involved an explanation of the study protocol, brief survey, re-explanation of information pertaining to missed items, and a re-testing. In their sample, schizophrenia patients obtained a median score of 80 percent on the first testing; 37 percent of the remaining individuals required three or more trials to answer all items correctly.
Despite such promising results, there are potential drawbacks to the use of assessment tools to evaluate capacity. Results may be influenced by other factors including performance anxiety, psychometric properties of the instrument, and current context.
If educational efforts and objective testing are not successful in eliciting a satisfactory level of decision-making capacity, then state laws may allow an alternative individual to consent for the patient. The American Psychological Association's guidelines stipulate,"For persons who are legally incapable of giving informed consent, psychologists nevertheless 1) provide an appropriate explanation, 2) obtain the participant's assent, and 3) obtain appropriate permission from a legally authorized person, if such substitute is permitted by law."
Keeping in mind these issues, including the facts that Duncan does not appear to have a readily available means of assessing Miriana's current decision-making capacity and that she does not have a legally authorized representative, there may be no way in which Duncan can "set things straight with Miriana" and continue with the interview. Instead, the most appropriate course of action is likely to be to terminate Miriana's participation, despite the risk of being unable to use her data. The loss of one patient's data is a small price to pay if it spurs Duncan and his advisers to design an approach to address these important issues that would better accommodate the conflicting demands of protection of participants and research outcome.
Confidentiality
A second major issue raised by the case concerns the confidentiality of diagnoses obtained during the course of the patient's participation. While Duncan does not specifically face this dilemma in his interactions with Miriana, it is an important point that is worthy of consideration by researchers who investigate mental disorders,
In this case, the primary question is whether researchers should promise confidentiality as it pertains to diagnosis when that diagnosis might conflict with that of the hospital. The interested parties are the same as those involved with informed consent, but the interests of hospital staff may be more directly involved in this context. Here, confidentiality and methodological rigor may be on the "same side" of the dilemma, and may conflict with beneficence regarding the patient's care. That is, research participants typically are promised that their results and the information they provide will be confidential, but that could not be promised if there were an agreement that the diagnosis would be shared.
From a methodological standpoint, it could be argued that it is to the researchers' advantage to ensure confidentiality, because it increases the chances that the information given by the patient will be accurate. Some patients may attempt to downplay or deny their symptoms to the hospital staff if they feel that full disclosure will prolong their stay in the hospital or lead them to be transferred to a state hospital. If confidentiality were not ensured, patients may not be motivated to be as truthful, which may compromise the diagnosis and results of the research. Indeed, Nowell and Spruill conducted an investigation of the reporting of symptoms by college students as a function of the level of confidentiality assured; they reported that participants who were promised complete confidentiality were more willing to disclose information about certain kinds of symptoms depending on their nature and severity.
Inaccurate information can compromise data in other ways. For example, the patients may be asked to be completely truthful about the last time they used drugs and cigarettes. These substances can affect performance on many tasks and it is vital to interpretation of some forms of data that these variables are known. Thus, the integrity of the information, and therefore the accuracy of results, could be compromised in some cases if complete confidentiality is not ensured. In addition, many patients with schizophrenia exhibit suspicion, and some of these patients have adversarial relationships with their health care teams. Sometimes, patients may choose to participate only because they know that the study is not formally affiliated with the system of which they are so wary. These patients are sometimes the most seriously ill and the most difficult to recruit, but it can be very important to obtain their data. Without assurance of independence from the hospital, it might be difficult to obtain their participation.
The research team is not obligated to inform the hospital staff of a new diagnosis or other information relevant to the patient's status (e.g., use of drugs and alcohol). Yet, through their rigorous procedure, the research staff may obtain a more reliable and accurate diagnosis that, if shared, could benefit patients like Miriana.
However, in addition to researchers' potential concerns regarding integrity of information, there could be other ramifications if research diagnoses were disclosed to the hospital staff. The first issue relates to the importance of safeguarding the voluntariness of the patient's consent. Consent forms include the statement that the relationship with the hospital will not be affected by the patient's participation in the research; this provision is intended in part to minimize the possibility that a patient will feel pressured to participate. The Belmont Report states, "Unjustifiable pressures usually occur when persons in positions of authority or commanding influence -- especially where possible sanctions are involved -- urge a course of action for a subject."
One way of addressing this concern would be to allow participants or their legally authorized representatives to determine whether the research diagnosis is shared with the staff. However, this alternative too would raise important questions. Would patients choose to share the diagnosis with the staff only if they "liked" the research team's diagnosis? If they didn't "like" it and didn't want it shared, what responsibilities would the research team have? If patients had to decide at the beginning of the study whether the research team's diagnosis would be shared regardless of the outcome, might some of those electing to share the diagnosis purposefully manipulate the information given to the research team?
Further questions are raised by uncertainty about the way in which discrepant diagnoses would be handled by hospital staff. Not all practitioners would agree that the diagnosis achieved through use of a semi-structured interview leads to a more valid diagnosis. In addition, a prevailing hierarchy in many hospitals ranks psychiatrists higher than psychologists in certain areas of expertise, and psychiatrists frequently have administrative superiority over psychologists. Thus, it is possible that the psychiatric staff would choose not to accept the diagnoses provided by a psychologist- staffed research team. How far would the research team be obligated to go if a psychiatrist insisted on one diagnosis and the research team another? In this situation, what responsibilities would the researchers have to the patients? Would the researchers be required to inform patients or their legally authorized representatives about the discrepant diagnosis? How could patients or representatives ensure that the research diagnosis was taken into consideration? Could this practice lead to legal ramifications for the hospital? What if the hospital diagnosed and treated a patient for bipolar illness, but the research diagnosis was schizophrenia? The patient or family could see legitimate grounds for a suit against the hospital for misdiagnosis and treatment. To avoid this problem, would the hospital pressure the research team to reconsider the diagnosis in discrepant cases? How would that affect patient care, the ability to conduct research, and the results of the investigation? Would some level of irreconcilable differences affect hospitals' willingness to allow research? How might that affect the progress of knowledge about the etiology and treatment of disorders like schizophrenia?
In order to weigh the costs and benefits of compromising voluntariness by disclosing diagnoses and contending with the ensuing issues, it is important to consider the likelihood of benefits to the patients from sharing diagnoses with the hospital staff. An important point is that psychiatric treatment is not currently so specific that well-supported and distinct treatments exist for specific psychotic disorders. For example, most treatment of patients with psychotic disorders includes antipsychotic medications regardless of the specific disorder. Thus, in studies that include patients with different types of psychotic disorders, such as Duncan's, all participants may already be receiving similar treatments and the actual diagnosis may be irrelevant. Although this fact perhaps begs the major question, and will likely change as treatments become more refined, it raises questions about the extent to which psychiatric patients would actually benefit from disclosure of their diagnoses.
Just as researchers have begun to empirically address issues surrounding consent, the issues surrounding confidentiality of diagnoses could be framed as empirical questions. To determine the scope of the problem, studies could be designed that would quantify the frequency with which hospital and research diagnoses are discrepant. These investigations could include whether the prescribed medications varied as a function of the patient's diagnosis, to address the relevance of conflicting diagnoses. By posing hypothetical cases to hospital staff, investigators could examine the ways in which staff members are likely to handle discrepant information. Such empirical studies are likely to contribute to a better understanding of the extent of the problem and potentially lead to modifications in confidentiality agreements where they are warranted. As Bonnie states, "Current controversies regarding research with cognitively impaired subjects should be seen, in historical context, as a reminder of unfinished business."
Commentary On
This case shows that ethical issues arise even when none of the parties involved commit obvious ethical violations.
It might be tempting to confine the study of ethics to situations in which one or more of the parties involved has committed some obvious violation of ethical principles. Once this stance is taken, many make secondary the study of ethics on the grounds that "the people I deal with on an everyday basis are reasonably ethical." This case reminds us that the study of ethics is important nevertheless, and should always be at the forefront of our thought process.
In this case, Huge and Ivy are confronted with ethical dilemmas even though both parties have operated in a manner that, at least at first glance, seems ethical. After all, both parties want to see the new MRI technique succeed, and neither party is hindering the progress of the other. This case also reinforces the fact that ethics plays an important role in fundamental science, despite the fact that its experiments are rarely conceived with a practical application in mind. Furthermore, it may remind us that the study of ethics doesn't always ask us to choose between a '"right" and "wrong" answer. This fact can be troubling to some scientists, and it is worth discussion.
It is also instructive to note that this case never focuses on one individual. Often our case studies revolve around interactions between individuals, which can lull us into believing that these are the only ethical situations that we need to look out for. One might argue that behaving ethically does not just involve doing what is right for one's own situation, but also involves understanding how ethical decisions are dealt with between groups.
We must be willing to approach ethics with forethought. It is not sufficient to just wait for a situation to present itself and then "behave ethically." Ethical behavior must involve understanding (or at the bare minimum, attempting to understand) what ethical decisions might lie ahead. In the end, the reader may note that the downfall of the parties involved in this case is not that they took an unethical step along the way, but rather that they failed to consider the ethics of their research before they began.
Question 1
The first topic this question is likely to raise is how a moral obligation to society differs from what is legally right (i.e., patent law). Too often, the two are deemed to be identical. Although one could argue that both parties have a moral obligation to society to mass produce the new technique, one cannot argue that the most efficient manner for either party to do so would necessarily be legal. Furthermore, this question is a good way to get students to think about the ultimate purpose of science. Is the ultimate goal of science to search for truth, to better society or to do something else? What do you do when the search for truth conflicts with bettering society?
Question 2
One interesting way to approach this question might be to ask. "Why do we call the funding we get for experiments 'grants'?" The word "grant" carries a connotation of "free money"; however, most would argue that grant recipients have some sort of responsibility to the entity that funded the research. At the vary least, scientists have the obligation to show that the money was spent wisely. If they fail to do so, they will not receive any more grants and will no longer be able to practice science.
Question 3
This is an especially interesting topic for scientists whose livelihoods depend on ideas that do not or have yet to bear practical applications. Many scientists' careers are based on developing abstract, entirely theoretical notions. Occasionally, these abstract theories will yield an application (either directly or indirectly) that is highly profitable. Some examples include the CD player, the internet and quantum computing. This question asks the reader how to maximize public gain from scientific applications without squashing a valuable reservoir of talent that could produce new, applicable science.
Question 4
This question requires readers to look beyond the ethical questions presented to them and instead examine how their choices place others in a situation where there is an ethical decision to be made. In other words, is it good enough to behave in a way that passes the ethical decision on to another party?
Question 5
This question asks readers to weigh the pursuit of truth, utilitarianism and patent law all at once. This discussion can be especially rich because many, if not most, of the ethical decisions that we must make require deciding between choices, all of which have good intentions. It is important to remember that the study of ethics is not only important when trying to decide between right and wrong, but also when deciding between two "right" options.
Question 6
At this point, the reader may ask about the four universities that did not emerge as players in this case study. After all, at least six universities contributed to the pool of basic science research that Huge and Ivy applied to new MRI techniques. What do Technological University, Private University, Popular University and Selective University deserve?
Commentary On
This case provides a framework for discussion about affirmative action, graduate education and graduate research. Indirectly, the case raises questions about the responsibilities of university research in society and issues surrounding student-mentor relationships. It is intended to open up communication on a topic that is rarely discussed in technical research and thought to pertain only to "policy."
Affirmative action in graduate education is important because science and the generation of knowledge are embedded in a larger context of values, norms and priorities. Historians have recognized that the growth of knowledge in science cannot be understood simply as a mastery of nature through the use of a set of tools. Rather, the interests and priorities of science are structured by circumstances in society. As scientists, we should be able to reflect on our work and determine how it relates to a broader context. The debate over affirmative action is only one aspect of the complex interaction between science and society.
In using this case for instruction, it could be useful to assign the characters to different students/participants and have them develop arguments in support of their positions. Such a role-playing exercise could unveil additional issues of importance to the case. It also allows students to determine what "ought to be done" for a given situation as well as the compelling pressures for not following through.
The commentary is organized in three sections. First, the parties involved are identified and a discussion of their roles and responsibilities is provided. Second, four points of conflict are presented. These topics will bound the discussion. (The reader must realize that the topic of affirmative action is controversial and quite broad.) Finally, the third section contains additional questions for discussion.
Parties Roles, and Responsibilities
Each of the multiple parties involved in the case provides a different perspective on the issues at stake and the points of conflict. The essence of the case is the student member's participation on the admissions committee and his or her role on it.
The faculty members, as agents of the university and as implementors of the admissions policy, are the second group involved. Each committee member -- the student and the faculty -- is expected to "ensure a fair and transparent admissions process." These terms are vague for the student serving on the committee, not to mention the faculty members, who might have personal interests to promote. The third group consists of the two students under consideration for admission (and the fellowship). These individuals embodied in the university are a micro-representation of a public education system that has specific goals and objectives.
As a public university, the school has a public mission to fulfill. That mission could be to provide quality education to the state's population, or to develop a strong research agenda that supports the state's or the nation's priorities. In achieving their missions, institutions as complex as schools often find contradictions in the implementation of policies. For example, is academic excellence exclusive of racial diversity under the current historical context? As with many hierarchical institutions, Major State University is supporting a controversial policy by having language written in a vague way. Vague policy directives, however, are not surprising. The school might be attempting to avoid future lawsuits, or has simply delegated to departmental administrators the nuts and bolts of policy implementation. This vagueness of the school's intent resembles many real-life situations.
In addition to the responsibilities of each group, it is important to focus on how accountability is distributed among the actors. Accountability is important because it helps determine how individuals view their responsibilities and the need to act upon them. The faculty members are accountable to other faculty members, to the university at large and, in an indirect way, to the society. Accountability of the student on the committee is less clear, however. The student may be accountable to other current students, to future students or to the faculty members on the committee.
Points of Conflict
A first point of conflict is the appropriateness of student participation in a program's admission decisions. Student representation is often justified by appealing to a democratic and consensus-based character of decision making where stakeholders are heard and have some influence on committee decisions. Although valuable for the student body, the appropriateness of this approach in admissions decisions is difficult to ascertain. Regardless of the ethical implications of student involvement in admission decisions, the information that a given student was admitted primarily because of the availability of funds earmarked for a racial (or gender) category should remain confidential, not accessible to students. The perils of information leaks are considerable. It is surprising that neither the faculty nor the student raised any questions about the appropriateness of the student's participation before the committee's activities began.
This case raises further questions about the relationship between faculty members and students (which differs from the one-to-one student-mentor relationships discussed in other cases). Should students be limited to their research and academic activities? Is their involvement in program decision making worth the perils it brings?
A second point of conflict arises from the decision itself. For this discussion, it is important to consider some of the most common arguments favoring affirmative action. Affirmative action is often promoted in the interest of compensating for past situations deemed wrong. It is cited as a challenge to a historian by insisting on a contextual analysis of issues. Current inequalities and institutional practices, it is argued, are linked to earlier periods. There is a presumption that racism (or gender bias) has contributed to contemporary manifestations of group advantage and disadvantage, resulting in differences in income, education and rates of incarceration, among others. The United States, like many other countries in this hemisphere, was born of different forms of violent colonization, with slavery being critical to a national economy. For some, the mere memory of this often overlooked past justifies the need for affirmative action. It could be argued that these types of harms spill over from person to person in the form of stereotypes. The net result of this hypothesized cultural contagion is that future members of society inherit the cumulative effects of macro- and micro-level discrimination before they are ever in a position to experience a specific and identifiable harm that many consider a prerequisite to reparation, the concept cited by Professor Harris. Other rationales for affirmative action include compensating for current bias, redistributing resources vital to survival, democratic participation in society, preventing social disintegration or bestowing charity.
It would appear that a key element of the discussion is that Lambert was born and presumably educated in Kenya, while Rodney grew up in the United States. This difference would make Rodney more qualified to receive the fellowship even though merit and qualifications for admission have not been discussed yet. It could be argued that Kenya's precarious economy, due to colonialism, qualify Rodney for the fellowship. A third point of friction arises from the potential conflict of interest faced by the faculty members. For example, Professor Belman is not yet tenured. For her, quality research (and the means to achieve it) might be a decisive factor for her professional career. However, Professor Belman might find racial or gender diversity in the workplace valuable and hence encounter a definite conflict. Similarly, Professor Harris argued against Lambert's admission based on the notion of restoration. Is it because he firmly believes in affirmative action or because Rodney has expressed interest in working with him?
From the text, it is not clear what motivates each faculty member to make the statements presented. The alternatives outlined above are plausible and point to definite conflicts of interest. One could think of similar situations in admissions processes where conflict of interest is not as clear, and yet it exists. For example, what should be done when a highly qualified student expresses interest in working in a field where research money is scarce, but it is clear to the faculty that his abilities would be in suited to other, more promising areas of research.
A fourth point of conflict is the flexibility of standards in determining the admission of either or both of the students. As presented, the case is ambiguous about Lambert's qualifications for entering the program, but the case presents Rodney as less qualified than Lambert. Should the admission decision be based solely on academic standards or merit? How can letters of recommendation be comparable if they come from different countries or areas of study? The word "merit" is often used to illustrate one aspect of affirmative action, but how does one define merit in this context? While the general implication is that merit refers to standardized test scores, these determinants are more accurate reflections of the socioeconomic status of the parents. Defenders of affirmative action policies focus on the importance of having a healthy skepticism toward claims of neutrality, objectivity and color blindness, and meritocracy. These claims appear to be central to an ideology of an equal opportunity that presents race as an immutable devoid of social meaning and tells an historical, abstracted story of racial inequality. But is affirmative action the answer?
The fifth point of conflict takes the discussion back to the role of graduate education in society, and more specifically, in a public university. Should graduate education focus on individual success or on the advancement of knowledge and science? What is socially responsible education? Are the advancement of science and social responsibility mutually exclusive? As stated in the opening paragraph of this commentary, these questions are difficult to answer because they are embedded in the social and political milieu of the educational system. Awareness, discussion of the issues and tolerance surface as catalysts for understanding what is ethical and desirable for society.
Additional Discussion
There is enough ambiguity in the case to allow the construction of other scenarios for further discussion. For example, both applicants are males. Do the issues discussed here apply to gender discrimination? Would the case be different if the Kenyan applicant were a woman?
What if Professor Belman, motivated by her tenure worries, said that she would not accept responsibility for the tutelage of either student and pushed other faculty to state whether they would mentor them? Where do one's role as a leading researcher, one's responsibility as a mentor to the students and one's obligation to society begin and end?
A common feeling among minority students in graduate (and undergraduate) school is that other students view them only as a result of affirmative action policies, thereby discrediting individual merit. In a society that appears to value merit over other personal aspects, is this concern legitimate? Can schools address this concern? How?
Cornell West states that, "if racial and gender discrimination could be abated through the good will and meritorious judgement of those in power, affirmative action would be unnecessary." (West, 1993, p. 65) Can discrimination be effectively reduced with affirmative action policies? Are other policies more effective? How would they affect graduate research?
References and Further Reading
- Ansley, Fran "Affirmative Action: Diversity of Opinions - Classifying Race, Racializing Class," 68 University of Colorado Law Review (Fall 1997): 1001-33.
- Edley, Christopher Jr. Not all Black and White: Affirmative Action, Race, and American Values. New York: Hill and Wang, 1996.
- Gordon, Robert W. and Margaret Jane Radin, eds. Words that Wound. Boulder: Westview Press, 1993.
- West, Cornell. Race Matters. Boston: Beacon Press, 1993.
Commentary On
The object of this case is to raise the related issues of the value of scientific information and the role played by agents of dissemination, such as journals. Scientists be aware of these issues early in their careers so that they may appropriately wield the power they have over their own products and better achieve their goals (whatever they may be). Established scientists may be interested in the issues raised by this case because they are in a position to act, making decisions about journal management that can establish a fair and effective mechanism of information dissemination.
1. Should the board even care whether S&T goes under? If the journal does fold, is anyone harmed? Why might the board be concerned with the "value" of the research it publishes?
Of course the board should care whether S&T goes under. Most academic societies have one fundamental purpose: to disseminate information to interested parties, usually via a journal and a meeting. If the journal folds, much of the purpose for ASST's existence goes with it, and ASST is fairly likely to collapse, as investigators establish stronger ties to the remaining journals that publish in their fields. A more interesting question is whether anyone else should care. There are people who may be harmed if the journal folds. Some, such as the employed staff of the journal are harmed for reasons other than disruption of the scientific enterprise. Others are harmed by the intellectual loss that would be created if S&T folds - for example, stuffologists and thingographers who are interested in how their own work ties in with work being done in the sister discipline. Scientists in other fields may be interested in having a consolidated location with the best stuff and things in it. The scientific establishment as a whole would be harmed by the loss of S&T, because it is a unique resource, deliberately trying to bridge two fields, a valuable contribution as science becomes more and more fractionated.
In one sense, the board is concerned with the value of the research it publishes because it seeks to retain the current prestige and status of ASST and the journal. At the top of its fields, the board would probably like to stay there. So it will try to publish the most influential, controversial, clever, insightful, well-executed research available. However, that is not what Naylor means by value. Naylor's argument is about the monetary (commercial) value of publicly published information. In this case, Naylor is referring to the commercial demand created by readers who want the information primarily, though not exclusively, for the scientific process (as opposed to those who primarily want to apply the information). In theory, the more valuable the information, the more that can be charged for a copy of the publication. ASST's position of manipulating the subscription price based on concerns other than demand, means that they probably need not be concerned with maximizing monetary value. (Monetary value may be correlated, however, with scientific value, which ASST does seek to maximize. Maximization of monetary value then becomes an indirect result, if ASST can maximize scientific value.)
2. How valid is Dr. Naylor's assertion? Can one legitimately treat research results as a marketable product? Are there values in academic publishing that make it substantively different from the rest of the publishing world?
Naylor's position grows out of the idea that scientific information is a product of creative labor, and, as with any other product of labor, the laborer should be justly compensated. Naylor thinks that the prestige/stature/recognition that accrues to authors in S&T is inadequate, or that there must be some component of monetary compensation. Naylor, as ASST President, clearly holds the respect of his colleagues and can probably give a reasonable assessment of the stature gained by authors in S&T. This stature may or may not be adequate reward for the amount of effort that goes into a publication. One cannot conclude that the compensation is adequate based on the fact that people continue to submit papers for publication, because S&T, as the top journal, offers the best compensation available (and the best may still be inadequate). The board might be able to make this determination by polling the membership.
Naylor's assertion that page charges devalue information is true, but only with respect to the monetary value of the information. If the authors believe themselves to be adequately compensated with stature, or if they are altruistic, the monetary devaluation probably matters little.
3. Who should be responsible for paying for the dissemination of research results? Who is the "consumer" of the journal? Does it even matter who pays as long as the information gets out?
Several parties are interested in having the results of research disseminated, including the researchers, the researchers' institutions, other researchers who might use the information, the agencies that funded the research and parties outside the academic community (such as policy wonks and venture capitalists). In the simplest situation, a product will have one producer (who becomes the seller) and one consumer (who becomes the buyer). Scientific information is much more problematic, because several different entities are involved in its production, and the same entities can be the consumers.
The primary consumer of the journal is the reader; and thus subscriptions (or individual copy charges) should be the primary mechanism for funding journals. Structured this way, all entities that may consume the scientific information will share in the costs of producing it. It may be feared that this arrangement will price journals so high that no one can afford them. However, that outcome is impossible, because the publisher needs subscribers to stay afloat. Under this system, if a journal cannot survive, then it really is not terribly useful to the scientific community. Note that that does not mean that S&T is not useful; rather, it points to the problems created by trying to artificially suppress subscription prices.
Some may argue that it is acceptable to charge the authors for the privilege of publishing their work. In this approach, the journal is selling a forum to authors. This interpretation is plausible, but it is basically a cycle of buying prestige: Prestigious publications justify grant funding, which is then used to purchase prestige and justify more funding. I doubt if any journals have descended to the point where they charge different rates for papers of varying quality, but if they did, they would need to indicate the charge to maintain the cachet of the journal's name. That seems unlikely, but many journals already charge different subscribers different rates, based on factors much more arbitrary than quality.
Who pays for dissemination affects the method and place a researcher decides to publish his work (although it isn't the exclusive determinant); it also affects the way a reader finds the work and the costs incurred in so doing. The value to the researcher of the work going out must be balanced with the value to the reader. If the system of paying for dissemination does not approximate this balance, then either the flow of information will be inhibited, or the consumer will be swamped by overload. Because the value ratio will vary, it is likely that having a mixture of information dissemination practices will be most efficient.
4. Does the value of the journal vary by whether it is published electronically or in hard-copy? What if many other related journals are moving toward electronic access?
This issue is large enough to deserve a whole discussion on its own. However, here we are mainly interested in whether it allows us to dodge the ethical dilemma created in deciding who should pay for research dissemination. If the cost is low enough to be negligible for all parties, then functionally the issue becomes moot.
Briefly, electronic publication, or at least electronic access, enhances the value of a journal. It will increase the accessibility of the journal to readers, both in ease of access and speed. Rolling publication of papers becomes a possibility. A unique advantage is the search capability afforded to electronic text, which, if well done, will mitigate the possible information overload that could be created. If many other journals become electronic, and S&T does not, S&T will probably lose stature due to its relative inaccessibility.
5. How do different journals' publishing practices affect the flow of information in science? Can they affect the functioning of the scientific community? What responsibilities do journals have in the scientific enterprise?
This is the critical issue raised by the case, and Questions 1-4 have merely been leading up to it. By now, discussion participants should have touched on these questions, if not explored them in depth. However, some may be slightly lost unless it is made clear to them that the issue rests on the assumption that efficient flow of information is crucial to the ability of scientific investigation to explain phenomena. Efficiency is not rapidity - papers could come out much more rapidly if they were neither edited, reviewed nor revised. This change would substantially hamper readers' ability to distill what is useful to them, a problem that generates as many complaints as does the current speed of the publication process. There appears to be a trade-off between speed and utility, and the functioning of science depends, in part, on journals seeking to maintain an appropriate balance between the two.
6. Are there any ethical issues involved in attempting to manipulate the value of a scientific publication by means other than the quality of the papers published?
This issue is unrelated to the major issues of the case, but several reviewers were uncomfortable with the notion that a journal would use "dirty tricks" to manipulate its perceived value. One thing to remember is that this approach is possible only when the system used to rate journals is flawed. Using those flaws to leverage the true value of a journal isn't necessarily unethical; perhaps it is the flawed evaluation system that needs revision. Another consideration is that the approaches S&T uses to inflate its value may simply be catalysts of a positive feedback because perceptions of high quality will attract a broader and better class of manuscripts.
Commentary On
This case is based on real studies that were conducted in Vancouver and Montreal (Bruneau et al., 1997; Strathdee et al., 1997a, b; Archibald et al., 1998). When researchers found that needle exchange did not reduce the spread of HIV among their subjects, congressional leaders in the United States and conservative Christian groups like the Family Research Council demanded an end to NEPs. (E.g., Maginnis [1998a] specifically cites the Bruneau et al. [1997] and Strathdee et al. [1997a] studies.) Though some may find the reference to "religious extremists" biased and even inflammatory, it reflects the political environment in which needle exchange and needle exchange research take place. (See Maginnis, 1996a-c, 1997a-d, 1998a-c for Family Research Council articles on the topic.) Relevant policy research necessarily hits on such hot-button issues.
Dr. Lang and the real-world researchers on whom this case is based are indeed needle exchange advocates (Bruneau and Schechter, 1998b), but it is up to the reader to decide if whether theirs is a well-researched, rational, professional opinion or the view of passionate activists. It is important to address the issue of bias in research head on. What are the limits to the objectivity of science? Relevant to the issue of needle exchange and HIV/AIDS in particular is the role that social injustice plays in disease, which is increasingly recognized by the public health and medical communities. How researchers deal with bias varies across and even within fields.
Is bias something to be minimized, avoided and downplayed, or is it something to be named in order to contextualize the work and help others understand it? Is it possible to be a competent, well-read researcher on such a hot-button issue and not have an opinion on the efficacy of NEPs? Does having no opinion in this environment reflect a kind of bias against the existing research? How confident is Dr. Lang in her explanation of confounding variables in her study? What if she is wrong? What if needle exchange really does increase HIV through some as yet unknown mechanism? What is her responsibility as a scientist to report her results as she finds them, and where is the line between experienced interpretation of results and unfounded argument?
What are researchers' obligations in the process of policy making and politics? In the Montreal and Vancouver studies, the misrepresentation of results in the public arena was so significant that the studies' authors published an op-ed piece in the New York Times about the distortion of their findings by American policy advocates, politicians and journalists. (Bruneau and Schechter, 1998a) Local government in Canada responded to the studies by expanding needle exchanges and adding other health services for injection drug users. In the United States, however, the Clinton administration upheld the federal ban on funding for needle exchanges, which had a chilling effect on many less established local needle exchanges. (Freedberg, 1998; Neal, 1998).
One might ask if Dr. Lang is obliged to be similarly active in communicating her results in the political sphere; while Bruneau and Schechter responded only after damage had been done, Dr. Lang anticipates the misrepresentation of her results and has the option to act preventively. Where does Dr. Lang's role as a researcher meet the ethical responsibilities of journalists reporting on science and health policy issues or the responsibilities of policy advocates and public servants to accurately represent research findings?
This case raises further questions about the social consequences of scholarly research and the responsibilities of researchers to various communities with which they interact. What should be done when these interests and responsibilities conflict? On the one hand, Dr. Lang's finding that needle exchange did not aid HIV prevention could result in the shutdown of the exchange and any future research she had planned there. On the other hand, she is under pressure from her funders to publish, and findings that so blatantly contradict the dominant belief in her field could be her ticket to fame or notoriety, depending on whether she is right.
One might explore the possible alternatives Dr. Lang faces in her choice to publish. She might, for example, choose to present her results in the best light possible, perhaps falsifying or omitting some of her data. She might delay publication, wanting to collect more data that might alter her findings. What are the implications of these decisions for each party involved in and affected by the research?
The nature of Dr. Lang's relationship with the NEP's activists and clients is a key issue. There is a strong possibility that the trust the exchange had established with clients would be eroded by articles in the paper against needle exchange that used Dr. Lang's findings for support. To what extent are the needle exchange activists and clients partners in research? What kind of role would they ideally play in such a project?
Because injection drug users have so little access to health care, needle exchange can be their only bridge to health care services (including, in many cases, drug treatment). Might access to certain forms of medical care such as free HIV testing serve as a coercive inducement to participation in research? How might Dr. Lang address the concerns of some community members who view needle exchange as part of a racist effort to bolster the influx of drugs to poor, African-American communities? What are the ethical issues involved in a research project that monitors the spread of HIV through the voluntary use and refusal of needles? For example, what follow-up care should be planned for those who do contract HIV during the course of the study? With a disease like HIV for which effective treatment is not an option in poor communities, what is the researcher's responsibility to disseminate information about HIV prevention? Does this responsibility compromise the "objectivity" of the study? How can such a conflict be resolved?
Perhaps Dr. Lang's situation could have been avoided entirely with a more appropriate research design. Discussions of this case may include brainstorming about what kinds of designs might have eliminated or minimized the flaw in Dr. Lang's work. Could she have foreseen this problem? What should scientists do when they make such mistakes?
References
- Archibald, C. P., M. Ofner, S. A. Strathdee, D. M. Patrick, D. Sutherland, M. L. Rekart, M. T. Schechter and M. V. O'Shaughnessy. "Factors Associated with Frequent Needle Exchange Program Attendance in Injection Drug Users in Vancouver, Canada." Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 17 (2, 1998): 160-66.
- Bruneau, J., F. Lamothe, E. Franco, N. Lachance, M. Desy, J. Soto and J. Vincelette. "High Rates of HIV Infection among Injection Drug Users Participating in Needle Exchange Programs in Montreal: Results of a Cohort Study." American Journal of Epidemiology 146 (12, 1997): 994-1002.
- Bruneau, J., and M. T. Schechter. "The Politics of Needles and AIDS." New York Times, April 8, 1998. (1998a)
- Bruneau, J., and M. T. Schechter. "Needle Exchange Programs Do Work" Chicago Tribune, April 23, 1998; Sec. 1, p.22, col. 3. (1998b)
- Freedberg, L. "White House Needle Swap Surprise: A Refusal to Lift Ban on Program Funding." San Francisco Chronicle, April 21, 1998, Sec. A, p.1, col. 5.
- Maginnis, R.L. "Will Exchanging Needles Save America's Future?" Insight, Family Research Council, May 1996.
- Maginnis, R.L. "Government Should Not Encourage Newest Heroin Epidemic," Perspective, Family Research Council, September 1996.
- Maginnis, R.L. "'Harm Reduction' an Alternative to the Drug War?" Insight, Family Research Council, October 1996.)
- Maginnis, R.L. "An Update: Free Needles for Junkies?" Insight, Family Research Council, June 1997
- Maginnis, R.L. "Swiss Heroin Giveaways, Media, and National Security," Insight, Family Research Council, July 1997.
- Maginnis, R.L. "America Assesses Needle Exchange Programs," Special Publication, Family Research Council, August 1997. http://www.frc.org/get.cfm?i=BL041. (1997c)
- Maginnis, R.L. "Voters Reject Free Needles for Addicts," Article, Reporter-News.com, October 1997. http://www.texnews.com/opinion97/con090897.html. (1997d)
- Maginnis, R.L. "Religious Voters Assess Drug Policy." In Focus, Family Research Council, March 1998
- Maginnis, R.L. "1998 Update: Free Needles and Politics," Insight, Family Research Council, March 1998.
- Maginnis, R.L. "Needle Exchanges are Bad Medicine," At the Podium, Family Research Council, June, 1998
- Neal, T. M. "Drug Policy Chief is Facing Some New Foes; McCaffrey's Tactics on Needle Exchange Program Prompt Anger Among Advocates." Washington Post, May 18, 1998, Sec. A, p. 15, col. 1.
- Strathdee, S. A., D. M. Patrick, S. L. Currie, P. G. Cornelisse, M. L. Rekart, J. S. Montaner, M. T. Schechter, and M. V. O'Shaughnessy. "Needle Exchange is Not Enough: Lessons from the Vancouver Injecting Drug Use Study." AIDS 11 (8, 1997a): F59-65.
- Strathdee, S. A., D. M. Patrick, C. P. Archibald, M. Ofner, P. G. Cornelisse, M. L. Rekart, M. T. Schechter, and M. V. O'Shaughnessy. "Social Determinants Predict Needle-sharing Behaviour among Injection Drug Users in Vancouver, Canada." Addiction, 92 (10, 1997b): 1339-47.
Commentary On
One of the major issues in this case is separating what is legally required of the researcher from his/her ethical responsibility as a scientist working with human subjects. Sometimes the law offers incomplete answers to ethical questions that may arise in research involving vulnerable populations. (Fisher, 1997) The goal of science is to discover truth through controlled experiments, but the researcher also has an ethical duty to protect participants' welfare, In some instances these goals appear to conflict. (Fisher, 1993)
In HIV/AIDS research, many laws have been enacted as a response to litigation. Science and research, in trying to keep up with the rapid increase of this relatively new epidemic, have leapt ahead of the legal guidelines. Current federal regulations and professional ethics codes should be revised to accommodate new concerns in this field. In the meantime, scientists should take great care to implement and design ethical procedures that take a proactive stance regarding the impact of the research on individuals. They should adopt a relational ethical perspective, which involves dialogue between participants and researchers. This approach allows the investigator to reflect on participants' needs and concerns in the research context and serves as a guide to researchers in understanding their own boundaries, competencies and obligations. (Fisher, 1997)
It is important for research scientists to identify and evaluate the risks and benefits of research before they begin a study. An important factor in determining the benefit of research is whether the study has scientific merit. In order for research to be scientifically valid, it must produce reliable information. (Fisher, 1996) Many researchers promise confidentiality to ensure that participants feel comfortable enough to give accurate information. In many instances, confidentiality is integral to ensuring participant cooperation.
John made several mistakes in the design of his research. As a psychologist, he is required to be knowledgeable about the population with whom he is working. He should have consulted with others who have conducted similar research and with HIV+ patients themselves. If he had used the experience of the investigators and the perspectives of prospective participants as a resource, John would have realized that it was highly likely that a participant would report having unprotected sex. John should have developed a protocol that would deal with all of the possible consequences of data revealed by the research.
Informed consent procedures are designed to protect participants by ensuring that their decision to participate is informed and voluntary. According to Federal Policy 46.116, informed consent forms must include:
- A statement that the study involves research, explanation of the purpose and duration of the research, and a description of the procedures.
- A description of any foreseeable risks or discomfort.
- A description of potential benefits to the participant or others.
- Disclosure of alternative procedures or treatments that may be advantageous to the subject.
- A description of the extent and limits of confidentiality
- For research involving more than minimal risk, information regarding compensation and availability and nature of treatment if injury occurs
- A statement describing the voluntary nature of the research, the right to refuse participation or withdraw participation at any time without penalty.
John's protocol complies with most of the informed consent requirements, but he fails to detail the extent and limits of confidentiality. His informed consent form should have stated that information indicating that a participant is having unprotected sex with a partner who is unaware of the participant's HIV status would lead to disclosure. This clause would have given participants the information needed to make an informed decision about participating in the study. John also could have added the option of helping participants disclose their HIV status to their partners.
In general, the scientific community needs to be more sensitive to misleading or inadequate informed consent protocols, especially when working with vulnerable populations. Individuals in need of services or monetary compensation are at greater risk of coercion to participate in research. Participants must be given all the facts regarding a study in order to make an informed decision regarding participation.
Researchers are aware that if individuals are told that their actions will be disclosed if they report harming another person, some may either refuse to participate or withhold that information. The possibility of disclosure is likely to bias the sample and does not allow the researcher to gain an accurate understanding of the behavior in question.
Does the "good" accomplished by warning a third party about potential HIV risk outweigh the "good" that can be gained from a large subject pool whose members provide honest answers? Does the benefit of gaining a better understanding of a phenomenon outweigh the cost of potentially violating a participant's right to privacy in order to protect an individual outside the scope of the research?
Who is John responsible to -- himself, the participant, the participant's boyfriend, the HIV community, society at large, or the obligation to increase the body of scientific knowledge? Are these categories mutually exclusive? The answers depend on the scientific community's concerted efforts to address these ethical concerns. A balance between a consideration for the welfare of others and a scientist's obligation to ensure the validity of research findings is an important goal for investigators as we head into the twenty-first century.
References
- American Psychological Association. "Ethical Principles of Psychologists and Code of Conduct." American Psychologist 47 (1992): 1597-1611.
- Fisher, C. "Integrating Science and Ethics in Research with High Risk Children and Youth." SRCD Social Policy Report 7 (1993): 1-27.
- Fisher, C., K. Hoagwood and P. Jensen. Casebook on Ethical Issues in Research with Children and Adolescents with Mental Disorders. In K. Hoagwood, P. Jensen and C. Fisher, eds. Ethical Issues in Mental Health Research with Children and Adolescents. New Jersey: Lawrence Erlbaum Associates, 1996.
- Fisher, C (1997). "A Relational Perspective on Ethics in Science Decision Making for Research with Vulnerable Populations." IRB 19 (5, 1997): 1-4. Contracted paper for the National Bioethics Advisory Commission.
- Office for Protection from Research Risks (OPRR), Department of Health and Human Services, National Institutes of Health. Protecting Human Research Subjects: Institutional Review Board Guidelines. Washington, D.C.: U. S. Government Printing Office, 1993.
Commentary On
Question 1
The researchers have carefully considered the risks and benefits of the study. If a death from anaphylactic shock were likely to occur, there would be little moral justification for the research. This research poses a very low initial risk to the children: 1 in 1 million.
There are several aspects of the research that the investigators can address. First is the issue of respect, which would include informing the parents and children of the potential risk and requesting informed consent. In addition, the researchers will try to maximize the benefit to the participants by dropping the nonsymptomatic control group because these children have much less to gain from participating than children who have respiratory symptoms. Only symptomatic children, who would have more to gain from the skin testing, will be recruited.
If one child enrolled in the study developed anaphylactic shock, the consequences could be devastating - the death of the child; the loss to family and friends; anger and fear in the community directed at the researchers, the school administration and the public health department. A child's death would also affect the research policies of the school administration and the public health department. It is likely that more conservative policies would be adopted, which would limit the ability to identify disease in at-risk subpopulations and implement measures to reduce disease.
The researchers should take several steps to prevent a death from anaphylactic shock. First, they should have trained staff who know what to do immediately if a child begins to go into shock. Second, they can conduct the research in a medical clinic with quick access to medical expertise if the emergency epinephrine does not work. With these measures in place, the researchers will have maximized the benefits to the participants and minimized the risks.
Question 2
In the Tuskegee research, investigators deceived members of the African-American community and enrolled them in a study to follow the natural history of untreated syphilis. These men were allowed to remain untreated for syphilis for forty years, from the 1930s to the 1970s, even though treatment became available in the 1940s with the dissemination of penicillin. With the legacy of the Tuskegee experiment, the African-American community has had much less trust in governmental institutions and outside investigators conducting research in their community.
Issues of respect, beneficence and justice do not change; they are universal principles in our society. However, we as researchers can learn from the past. Clearly the Tuskegee study violated the three tenets published in the Belmont Report. People who participate in research are entitled to respect, beneficence and justice.
Little respect was shown for the African-American men who participated in the Tuskegee experiment. They were treated like children or experimental lab animals; they did not give informed consent; crucial information about the experiment was withheld from them. Nor was there much concern for the welfare of participants in the 40-year duration of the experiment.
The participants did not obtain any benefits from taking part in the study. Although the men received a few free meals and palliative treatment for some of their symptoms, these were of negligible benefit compared to the harm they experienced as the disease progressed to advanced stages. Nor were they told they had syphilis. The men did not benefit from being under medical surveillance. In fact, they were placed at higher risk from procedures such as lumbar punctures to test for neural syphilis. Justice was not served by research conducted at the expense of a subpopulation of African-American men to obtain information designed to benefit the entire U.S. population. Moreover, there were no clear benefits to the population of all syphilitics.
Researchers in today's environment can ensure that they take the Belmont Report's tenets into account when planning and conducting research. In the asthma study, parents and children who are invited to participate in the study receive a clear explanation of the risks and benefits that would be incurred with participation. The informed consent forms are written in easily understood language with little jargon. Moreover, only children who seem to be at risk of asthma or wheezing are invited to participate because they are the children most likely to benefit from the study. They will learn what potential allergens they are allergic to, as well as receiving information on how to reduce their exposure or deal with asthma. They will also be enrolled in the medical clinic and have better access to care for their wheezing symptoms. In addition, all participants will receive the plastic bed covers and cockroach traps.
In considering the tenet of justice, the question stated in the Belmont Report is, "Who ought to receive the benefits of research and bear its burdens?" In the case of the asthma research, the intervention is low cost, specifically targeted for families with little money or time to spend. Thus, the subjects are being systematically selected for reasons directly related to the problem being studied rather than their easy availability or their manipulability. (National Commission,1979) Moreover, these subjects are recruited from a pool of children who were found to have wheezing symptoms, so they would benefit greatly from a reduction in allergen levels.
References
- Jones, James H. Bad Blood: Tuskegee Syphilis Experiment, 2nd edition. New York: Free Press, 1993.
- The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. "The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects." OPRR Reports, April 18, 1979.
Commentary On
Questions 1-3
The objective of this case study is to invoke discourse on two issues: 1) a possible conflict of interest between mentor and student and 2) the dissemination of information within academia.
Common reasons for attending a research conference are to learn what the competition is focusing on and to assess the progress of their research. This valuable information is used to avoid being "scooped" and to gain technical knowledge that can provide a "leg-up" on the competitors. What Dr. Smith has done is not too unfamiliar to a graduate student attending his or her first conference and something seemingly taken for granted by more senior students and, unfortunately, researchers.
But by what authority does Dr. Smith act? Often, such actions are taken under the pretense that they are in the student's best interest (i.e., so Lisa won't be "scooped" and can publish). It is very easy for a mentor to become increasingly occupied with the success of the lab, as judged by size and amount of funding. This focus can easily lead to the belief that the success of the lab justifies actions that are believed to better chances of success. In other words, the end (i.e., promotion for Dr. Smith and publications for Lisa) justifies the means (i.e., instructing a student to compromise her relationship with a friend and to withhold knowledge from the scientific community).
But doesn't the position of a mentor entail fostering personal growth and the teaching of students? Does this responsibility include teaching students that publishing supersedes friendships and the sharing of information with peers? The situation is further complicated by the fact that this information involves Lisa's thesis project, and Dr. Smith has a significant influence over when and if she will complete her degree. In most cases, a successful graduate career is based on the number of published articles. The bibliography, along with a letter of recommendation from the mentor, will greatly influence a graduate student's career. Should a person's thesis be based on published data? If the student is "scooped," should that damage the student's ability to graduate? Is Dr. Smith acting in Lisa's best interest, or is he thinking about his ability to get future funding? How much influence should a mentor have on when and if a student should graduate?
Steve is Lisa's peer, and collaborations are often based on previous relationships. Is it possible that by withholding information, Lisa is jeopardizing her future potential to set up fruitful collaborations?
Question 4
The quest for research funding has created a highly competitive environment where advantages are sought and adamantly held. In addition, because of the duration of most grants, many scientists plan no further than three to five years ahead, thus masking the long-term consequences for the scientific community of withholding information. These actions serve to impede the overall advancement of science. In addition to generating data, the ability to conceal possible advantages is now a determinants of success, and this situation jeopardizes the advancement of knowledge as a whole. Taken together, these issues are possible conflicts of interest.
Isn't Dr. Smith's responsibility to his student and the scientific community greater than that to his lab? Dr. Smith assumes that his actions offer no ill effects but simply are part of today's cutthroat research environment. In truth, his actions serve to propagate unhealthy practices that only hinder scientific progress.
Commentary On
The main goal of this case is to stimulate discussion of activities that fall into the category of questionable research practices. The National Academy of Sciences states:
Questionable research practices are actions that violate traditional values of the research enterprise and that may be detrimental to the research process. . . . Questionable research practices include activities such as the following: Failing to retain significant research data for a reasonable period; Maintaining inadequate research records, especially for results that are published or relied on by others; . . . Inadequately supervising research subordinates or exploiting them. (National Academy of Science 1992, 1-16)
While questionable research practices do not endanger the research process as critically as outright scientific misconduct, they do erode the integrity of the scientific institution as a whole.
Part 1 of this case attempts to present a scenario that is difficult to interpret definitively as a questionable research practice. Rather than a blatant statement of scientific misconduct, the reader is presented with a suspicion of inappropriate behavior. The intent is to mimic potential real-life situations where, quite frequently, there is no initial concrete evidence to support the decisions that must be made by the parties involved. Additionally, this case attempts to establish an environment where there is intense pressure on graduate students to produce publishable results quickly. This type of pressure is often encountered in labs conducting biomedical research, and it arises not only from the principal investigator, but from the graduate students themselves.
In this case, several factors contribute to the stressful environment in Dr. Larson's lab. For example, it is stated that neither Peter nor Sally had managed to publish a paper, which caused them both to worry about obtaining postdoctoral positions. It is also stated that other labs were attempting to develop the same knockout mouse. Dr. Larson's assertion that Peter and Sally have the chance to publish in Nature only adds to the pressure. In such an environment, even normally careful researchers can be tempted to cut corners, and thus engage in inappropriate scientific conduct.
Questions 1-3
These questions focus on the decisions Peter must make. Although he has no solid evidence that Sally has done anything inappropriate, his suspicions are aroused by their phone conversation in which Sally states that her data deviate from the previous trend observed, the fact that she disposed of remaining cells so that their identity could not be determined in an unbiased manner, and the absence of sufficient documentation in her lab notebook. There is no evidence that Sally has falsified data, which would constitute scientific misconduct. However, Sally's work behavior does fall into the category of questionable research practice.
Peter should first attempt to initiate better communication with his potential co-author by asking her to review her data with him, not accusing her of wrongdoing. If this conversation does not alleviate his suspicions, he should approach Dr. Larson with his concerns. As first author of the manuscript, Peter is ultimately responsible for its entire content. It is imperative that he feel confident in the data. The scientific process relies upon the publication of unbiased data generated via sound experimental designs.
Question 4
As a contributing author, Sally has a responsibility to maintain her lab notebook in such a way that her experimental procedures and raw data are easily located and identified. She is responsible for retaining any raw data or samples until the lab is reasonably confident that they are no longer needed. She also has a responsibility to honestly communicate any procedural problems to her co-authors. In situations where multiple researchers contribute to a final manuscript, each must be able to assume the honesty of the others and the unbiased nature of their results. There are many situations in which it is almost impossible to identify data that have been obtained in error or altered on purpose. In Sally's defense, she could well have the raw data in another notebook, and she may have thrown out the remaining cells by mistake, but her behavior raises suspicions about her scientific conduct.
Question 5
Dr. Larson's actions contributed to the problem in several ways. First, although it may be a reality that other labs are competing to produce the same results, he should attempt to set an example as a mentor in which strict adherence to careful lab practices is of utmost importance. His statement that Peter and Sally may be able to publish in Nature if they beat the competition went a long way toward establishing a stressful working environment, where inappropriate conduct is more likely to occur. Secondly, he tells Sally that she will be included on Peter's paper only if her results are informative. That may well encourage Sally to falsify data to produce the desired results. A better approach would have been to tell Sally that her efforts would be rewarded with a second author status, even if the results were not what was predicted. As Sally's research adviser, Dr. Larson should be stressing that honesty in science is required and expected of his students. After all, "Graduate school is the place to learn that one does not publish research results and conclusions until one is certain of their accuracy." (Sigma Xi, 1994, 6)
Thus, even Dr. Larson's behavior could be classified as a questionable research practice in that his supervision of his students was inadequate. He appeared more interested in the results than in the methods used to obtain them.
Part 2 introduces more evidence that Sally had actually engaged in scientific misconduct. Although Peter does not find concrete evidence that her graphed data was falsified, circumstantial evidence is gained from the results of the competing labs. At this point, after his paper has already been published, the best course of action would be first to discuss his concerns with Dr. Larson (whose reputation is also at stake). After that, it may be possible for Peter to repeat key experiments done by Sally. If that indicates that the initial published results were in error, the best course of action would be for Dr. Larson and Peter to notify Sally and then submit a retraction or correction to the journal.
References
- National Academy of Sciences. Responsible Science: Ensuring the Integrity of the Research Process. Washington, D. C.: National Academy Press, 1992, pp. 1-16.
- Sigma Xi, The Scientific Research Society. Honor in Science. Sigma Xi, Research Triangle Park, N.C.: Sigma XI, 1994.
Commentary On
This case addresses the issues of mentor responsibility to the student as well as a scientist's right to maintain scientific freedom. Julie is faced with a dilemma that could have been avoided had her mentor played by the books and presented her with the contract before she began her research project. But even then, she would have had to decide whether to abide by ABC's unwritten agreement. However, now that she is placed in this difficult situation, all the parties involved are at risk of losing.
If she refuses to sign the contract, Julie stands to lose all the research work she has put in so far toward obtaining her degree, unless she can find another funding source. As she has nearly completed her data analysis, this loss could be substantial. She also stands to lose the support of her mentor, Dr. Angstrom. By creating friction with ABC, Julie could fall from favor with Dr. Angstrom, which could jeopardize the amount of knowledge she could gain from working with him, as well as the contacts that he could make for her when she begins looking for a job.
Dr. Angstrom and possibly other researchers at the university stand to lose a close relationship with a funder, ABC. If Julie and ABC are not able to work out their differences, this incident could create distrust or negative feelings toward the university from ABC's perspective. That could in turn result in ABC granting fewer contracts to the university.
Dr. Angstrom may find it necessary to take sides since he was the primary contact person between ABC and Julie. By siding with Julie, he may lose a significant source of funding. By siding with ABC, he may lose the respect of a graduate student. If Julie decides to make this incident public, he may lose respect within the university as well.
ABC stands to lose significant profits and reputation if its drug is proven less cost effective than competitors and Julie publishes these results. If ABC agrees to allow Julie to publish regardless of the results, the company runs the risk of funding a project that may severely damage them financially.
ABC may hold Joni responsible for this damage, and her job and reputation are also at stake.
Based on federal guidelines, Julie's academic freedom is legally protected from clauses such as the one presented by ABC. (Kodish 1996) However, the situation becomes difficult when she realizes that the way in which she decides to deal with ABC at this point could affect not only her professional career, but that of her mentor as well.
It appears that Julie's dilemma is not uncommon, given the increasingly closer relationships between academia and industry. (Blumenthal 1996) A potential conflict of interest exists in this situation because the way that Julie writes up her results is likely to be influenced by a secondary interest -- that of ABC. While Joni was not asking Julie to falsify the data or distort the results of the data analysis, she was implying that ABC would like Julie to provide more discussion of the positive results for ABC's drug. Julie could easily refuse to do so and still be protected by law -- she would not have to worry about losing the funding for her particular project. However, as a student of Dr. Angstrom's, Julie represents him as well, especially since she obtained this contract through his relationship with ABC. If Julie breaks the informal agreement made with ABC, it would appear to ABC that Dr. Angstrom has broken the informal agreement as well, since he oversees Julie's research project. His relationship with ABC could be forever tarnished by Julie's actions.
Julie could go along with the informal agreement, but that response would raise the issues of academic freedom and conflict of interest. Can Julie truly abide by the agreement without a loss of freedom?
A conflict of interest clearly exists, yet there is a fine line as to the extent of conflict and its ramifications. What could happen if her study were taken out of context due to a "skewed" manuscript? One possibility is that within a hospital drug formulary, ABC's drug could be chosen over a cheaper, equally effective AIDS treatment, and significantly higher drug costs would result in fewer people having access to the drug. In the most extreme case, death might occur earlier due to inadequate treatment because a patient could not afford the medication.
Another option for Julie is to explain her reservations to Dr. Angstrom and ask him for advice. This course of action could solve all her problems or make a decision even more difficult, depending on how Dr. Angstrom handles her request for advice. If Dr. Angstrom truly finds nothing ethically wrong with writing manuscripts in conjunction with ABC, it is likely that he would not understand Julie's concern, and he would suggest she sign the contract and agree with the informal agreement. Since he himself has had a similar relationship with ABC, that is the most likely case. However, if she is able to convince him that she has a conflict of interest, a possible course of action for Dr. Angstrom would be to help her to find an alternate source of funding for the project that is nearly completed.
If Julie were to perform a quick analysis of the data before making any further decisions, she may be solving her own immediate problem, but she would not really be addressing the ethical issue that she is facing. Throughout her whole career it is likely that she will be confronted with similar conflicts of interest, and it may be more appropriate to set a precedent in how she will carry herself in these future situations. Also, she must consider whether it is fair to future graduate students of Dr. Angstrom to be placed in the same situation, when she could have addressed the issue and perhaps come up with a solution.
Julie could always refuse to sign the contract with full knowledge that by doing so, she alienates herself from ABC and possibly from Dr. Angstrom as well. A more immediate concern would be how she would obtain funding for her project. If no funding is available, she faces the possibility of developing a completely new project for which she could obtain funding. If her relationship with Dr. Angstrom is tarnished because of this incident, finding a new funding source may prove to be difficult.
It is important in this case that the ramifications of all possible actions are explored and weighed individually. Consequences of Julie's actions affect not only herself, but the careers of others as well, and this consideration should weigh on her decision.
References
- Blumenthal, D. "Ethics Issues in Academic-Industry Relationships in the Life Sciences: The Continuing Debate." Academic Medicine 71 (12, December 1996): 1291-1296.
- Kodish E., T. Murray and P. Whitehouse. "Conflict of Industry in University-Industry Research Relationships: Realties, Politics and Values [Comment]." Academic Medicine 71 (12, December 1996): 1287-1290.
Commentary On
This case revolves around an interdepartmental and cross-disciplinary research discussion group dynamic found at many medical schools and medical research centers. The situation allows for the discussion of several issues depending on the audience and the time available for discussion. The most obvious ethical concern is that Dr. Kent presented data that originated from another lab without the consent of that lab chief (Dr. Barry). However, additional, more subtle secondary issues can also be addressed. The overall message from this case study is the need to establish defined roles involving dissemination and control of data in a research discussion group or joint lab meeting environment. The perspectives of each person involved in the case (i.e., Dr. Barry, John, Dr. Kent and Jim, who represents the greater scientific community) are discussed below.
Dr Barry has a responsibility to John to ensure that he receives proper credit for his work, particularly since, as a graduate student, John will be significantly affected if he and Dr. Barry are scooped by competitors. More importantly, however, she has a responsibility to be sure John understands what defines appropriate scientific practice. If she does not address Dr. Kent's unethical behavior, John might get the message that Dr. Kent's actions are acceptable in the scientific community.
Dr. Barry must also consider that, as a junior faculty member, she is under a great deal of pressure to publish multiple articles in first-rate journals and to actively pursue extramural funding. If John's findings are reproducible, then she must weigh her responsibilities to her own development as a scientist and tenure-seeking faculty member with her responsibilities as John's mentor. A consulting and/or collaborative connection with a major pharmaceutical company would no doubt be a lucrative relationship. However, she must determine the impact of such a decision on John and the other students and post-doctoral fellows for whose training she is currently responsible. An additional aspect of establishing an association with the pharmaceutical company who approached Dr. Kent is that she would be strengthening her ties with Dr. Kent. Considering his previous unethical behavior, aligning herself with Dr. Kent is probably not a prudent choice. Moreover, she does not know how John's replicate experiments will turn out. If they do not reflect Dr. Kent's presentation results, then the pharmaceutical company will probably rescind its offer to collaborate and Dr. Barry will be left with a tainted reputation. These are important discussion points for students, but can also be elaborated on by faculty.
While it is justified to condemn Dr. Kent for his actions, it is also possible to use him as an example of the enormous pressure under which medical school faculty function. This is another opportunity to bring faculty into the discussion for comments on how to deal with such temptations. As the Director of the Breast Cancer Center, Dr. Kent is under more pressure than most to be a productive physician-scientist. He probably has substantial clinical duties in addition to his research activities. Since his lab has not been particularly productive in the past few months, it is possible that he simply made a bad decision in presenting Johns findings. However, Dr. Kent's culpability is compounded by his apparent fabrication of data. At the discussion group meeting, John clearly presented his findings as preliminary with one set of replicates (three mice per treatment group); however, Dr. Kent presented the results of multiple experiments in a bar graph format. Either Dr. Kent miraculously replicated the experiments in a matter of weeks, or he fabricated the replicate data. Unfortunately, the former is most likely as in vivo experiments often require months to complete. This point is not explicitly stated in the case study, and it offers an opportunity to play out scenarios for discussion (i.e., have participants consider what would changes if Kent did nor did not fabricate the data). A more subtle point is that Kent is trained as a physician, not a scientist; that might have a dramatic effect on Kent's perspective. Physicians often have different notions regarding the communal use of data within a research group. This point might also generate discussion on the scope research ethics training at the institutional level (i.e., all persons engaged in research activities would benefit from such training, not just graduate students). Physicians are not likely to be as sensitive to the competitive nature of science as a basic science faculty members might be. Moreover, MDs and MD/PhDs are more likely to receive funding for clinically relevant research grants; Kent may not be aware of the intense competition for new or younger PhDs in the basic sciences to obtain and sustain funding. Second, Kent probably has never trained a graduate student and is not familiar with the role of a mentor in graduate student research training. Thus, he might be ignorant of the value of John's work to his future as an independent scientist. Finally, physicians are often more concerned with expediting the flow of information, particularly novel, efficacious therapeutics from the bench to the bedside. Dr. Kent's comments to Dr. Barry are an attempt to stimulate this line of discussion. Participants can debate the pros and cons of such motivations.
Another perspective to consider is that of John. This case places John in a precarious position. He must trust Dr. Barry to represent his interests with Dr. Kent and to assert her (and his) right to control the dissemination of the data. Dr. Kent's premature presentation has left John in the position of having to publish these data as soon as possible, ideally before any competing labs can perform similar experiments. A point of discussion revolved around the consequences of John's project turning into a collaboration with the pharmaceutical company. This possibility leads to a host of issues including publication rights and sources of research dollars among others. Each of these topics can be integrated into the case study depending on the time allotted for discussion and the audience.
Jim represents the greater scientific community and researchers in the breast cancer field in particular. Clearly, other breast cancer investigators have a vested interest in obtaining data and information like John's research. The practice and advancement of science depend upon the publication and dissemination of new results. However, if Kent fabricated a portion of the results he presented, then Jim and the rest of the scientific community cannot depend on the research to guide their own. For the greater community of researchers, it is more useful to have complete sets of data with valid results and conclusions that might not be very interesting than to have incomplete or invalid sets of data with erroneous conclusions that appear more exciting. In the latter case, investigators will waste time, energy and resources following up an artifact.
Taking all these perspectives and issues into consideration, Dr. Barry has a few options for a plan of action. As a junior faculty member she is in rather dangerous territory. However, since Dr. Kent does not hold an appointment in her department, he has no tangible control over her professional future at the university (i.e., tenure decision, etc.). Barry will first need to solicit the opinion and support of other members of the Breast Cancer Group. Her next move should be to contact her department chairperson and discuss the incident. This way she may be able to gain support from other faculty who are on more even ground with Kent (tenured full professors). Next, or alternatively, depending on the relationship with her chair, she should report the matter to the Office of Research or the Office of Research Integrity. This is an excellent opportunity to discuss the appropriate institutional policies and procedures regarding issues like scientific misconduct and whistle blowing. As a last resort, Barry can also contact the International Breast Cancer Meeting organizing committee or society directly. However, before taking such action with an organization outside the university it is best to go through the proper institutional channels. The organizing committee and/or society could then be contacted in an official statement from the university. This way Dr. Barry would not need to be mentioned specifically. This anonymity might be important as she could be discriminated against in future dealings with the International Breast Cancer organization.
The onus rests with Dr Barry; she is confronted with a number of dilemmas and has a variety of responsibilities. Dr. Kent's actions are clearly unacceptable and highlight what can happen when ground rules for control of data are not established in a group meeting or joint lab meeting setting. It is important to include options that will help to avoid such situations. One choice is to refuse to participate in discussion groups. That is not a very realistic option since much can be learned in such meetings. A better option is for Kent to confer with Barry regarding his upcoming presentation and ask for her permission to mention the findings. Perhaps the two of them could develop a more traditional collaboration on the project. Finally, this case highlights the need for the development of clear guidelines for the discussion group's operation (i.e, Kent's role in handling dissemination of findings) before the first research presentations. This way each investigator is aware of the ground rules for the group and situations like the one described can be avoided.
Part 1
The objective of this case was to create a situation where two aspects of being a successful and ethical scientist come into conflict. In this case, maintaining reviewer confidentiality challenges the scientist's ability to honor her responsibilities as a mentor. In an ideal situation, this case will engender a discussion of both the importance of reviewer confidentiality and the specifics of being a responsible mentor. It may also help the discussants to think about situations where they will be forced to juggle the various aspects of a scientific career. These situations may push the ethical scientist to look for solutions that may not be obvious at first.
Question 1. This question brings up the inherent conflict of the skilled reviewer. A scientist who is knowledgeable and prominent within a particular field will often be working on questions related to the work being reviewed. The individuals most qualified to review a paper will also be those who stand to gain or lose the most from the information it contains. A discussion focusing on this question should address the fact that there are no universal criteria detailing the situations in which it is acceptable to review a paper. It is almost entirely up to the individual reviewers to decide whether they will be able to maintain objectivity or whether reviewing the paper will present a conflict of interest. How do those reading this case think they would make a decision like this? Can any absolute criteria or considerations be identified?
Question 2. This question addresses the heart of the conflict. If Dr. Ethicos suggests that Sarah add GFX to the cells, she will be acting on information received in confidence. Furthermore, her suggestion will open a can of worms if Sarah ever wants to publish her results, especially if the original reviewed paper remains unpublished. Essentially, Dr. Ethicos and Sarah would be claiming credit for an idea that belonged on some level to someone else.
That brings up another very tricky question that often causes problems in scientific research: Who (if anyone) owns an idea? The discussion of this question could focus on who would be affected by Dr. Ethicos' decision and how would they be affected. Clearly in the short term Sarah (and Dr. Ethicos by extension) would probably benefit from the suggestion to add GFX, or at the very least they certainly would not be harmed. However, Dr. Spacely could certainly be harmed by Dr. Ethicos' decision. The scientific community itself could be harmed if there were a general perception that reviewer confidentiality was not being honored.
This scenario has the added complication that Dr. Ethicos wouldn't be proposing that Sarah analyze the interaction between GFX and survivin (which was the essence of the reviewed paper) but simply that she use GFX as a tool to help with her cultures. Even though Dr. Ethicos would only be mentioning the idea to Sarah in the hopes of getting her cultures up and running, without intending for Sarah to focus on the GFX-survivin interaction itself, this is still starting down a slippery slope. The questions of where ideas come from and whether or not the origin of ideas can be regulated are additional powerful, subtle and tricky questions that the discussants may or may not wish to take up.
Question 3. The discussion of this question should bring up the mentoring side of the conflict: that it would be better to tell Sarah ASAP, but it should also bring up the reviewer side of the conflict: If Dr. Ethicos is going to remain an ideally ethical reviewer, she should wait until the paper is published or the information is made public at a conference or a talk or something of that nature. In some ways, this is a lose-lose situation. No matter how long Dr. Ethicos decides to wait, someone ends up losing out.
Question 4 simply serves to add even more weight to the scale on the side of mentor responsibilities without decreasing Dr. Ethicos' reviewer responsibilities. This question is designed to show how frustrating and tricky a situation like this could be. If the discussion is confined to the conflict itself, the discussants may find they have hit a wall. At first glance there seems to be no ideal ethical solution.
Question 5 throws another red herring of sorts into the discussion. One could see how easy it would be for Dr. Ethicos to convince herself that no real harm would be done by mentioning GFX to Sarah and that the information contained in the paper she reviewed will get out into the public domain somehow or another. However, essentially this rationalization does nothing to address the inherent conflict. Even if some other reviewer or individual had indeed broken reviewer confidentiality, that should have no bearing on Dr. Ethicos' ethical decision. To quote a useful cliché: Two wrongs don't make a right.
It is possible that the discussion will break down at some point. Some of the group may feel that reviewer confidentiality should really take precedence in this case, while others might feel mentor responsibilities should predominate. This case is designed in some ways to lead to this type of standoff.
However, at some point during the discussion a successful resolution to this dilemma might be brought forward with the realization that it is in fact possible to break reviewer confidentiality in special cases and reveal oneself to the author of the reviewed publication (ideally with the blessing of the journal editor). If Dr. Ethicos revealed herself to Dr. Spacely and explained her desire to assist Sarah in a way that should not harm Dr. Spacely's research, a satisfactory solution might be achieved.
This type of solution would preserve the inherent tenet of reviewer confidentiality, which is essential to a functional peer review system in any field, scientific or otherwise. It would also be an example of exemplary mentor responsibility, where a scientist is willing to expend extra time and energy to help further the prospects of her student while still remaining an admirable role model for that student. Lastly, this situation emphasizes the value of what might be considered lateral thinking. Ethical situations are complex and often require creative solutions that may not be immediately obvious to those facing the ethical dilemma. In some ways practice, in the form of the discussion of hypothetical situations, is the only way to try to prepare oneself to handle the inevitable ethical conflicts that will arise.
It is possible that the discussants may arrive at this solution early in the discussion before they have seen the zero sum game nature of the original conflict. The discussion leader might then want to introduce the question of what to do if Dr. Spacely refuses to allow Dr. Ethicos to mention the GFX to Sarah, which brings the discussion back to the initial problem.
Commentary On
This case study is intended to highlight the differences between "advisers" and "mentors" and to show the positive effects a good mentor can have on a graduate student. Because mentoring can be construed differently across disciplines, clarification is needed. In academic settings, the term "mentor" is often simultaneously associated with the term "faculty adviser." In this case, however, the research adviser and mentor are not only two different people, but also come from different disciplines.
The Committee on Science, Engineering, and Public Policy stated that "A fundamental difference between mentoring and advising is [that mentoring is] more than advising; mentoring is a personal, as well as, professional relationship." (Committee on Science, Engineering, and Public Policy, 1997, 1) Positive mentoring requires effort from both parties involved. A motivated graduate student helps the process of mentoring along, while the professor feels that she in not wasting anyone's time. Unfortunately, there is no optimal formula for positive mentoring. Each situation is complex, with many different factors entering the formula. Mentoring can differ on the basis of discipline, personality type, gender, ethnicity, knowledge of subject matter, and status of graduate student and professor.
The original concept of mentoring is an ancient one. Homer describes the first mentor as the "wise and trusted counselor" who is left in charge of Odysseus' household during his travels. Athena acted as the mentor and became the guardian and teacher of Telemachus, the son of Odysseus. In the context of today's higher education, mentoring has many different facets. A mentor's primary responsibility is to help a graduate student and to take an interest the student's professional development. This responsibility requires patience, trust, effective communication, good role modeling and understanding from both parties involved. It also requires that both the professor and graduate student fully understand the ethics of research and abide by federal and institutional regulations and guidelines.
Swazey and Anderson suggest that a good mentor be skilled in interpersonal relationships and genuinely interested in the mentee's professional development. In addition, they suggest that the mentor be involved in teaching effective communication skills to the mentee. It is not surprising that research has shown that both faculty and graduate students consider mentoring relationships rare. (Friedman 1987)
An adviser, by contrast, performs more narrow or technical functions such as "informal advising about degree requirements, periodic monitoring of an advisee's research work and progress toward his/her degree" (Swazey and Anderson 1996, 6). In addition, the adviser usually serves as the principal investigator and/or laboratory director for the graduate student's project. In this capacity, the adviser instructs the graduate student on design, methodology, literature review, proposal and other aspects of the dissertation research.
This case study demonstrates the differences between adviser and mentor by suggesting that the two need not be the same person, or even come from the same discipline. Simpson's egregious ethical mistake undermines his position as adviser. Simpson's behavior effectively demonstrates the term "toxic mentoring" coined by Swazey and Anderson (1996). They cite four types of undesirable or "toxic" mentors: "avoiders" - mentors who are neither available nor accessible; "dumpers" - mentors who force novices into new roles and let them "sink or swim"; "blockers"- mentors who continually refuse requests, withhold information, take over projects, or supervise too closely; and "destroyers or criticizers" - mentors who focus on inadequacies. (From Darling 1986, quoted in Mateo et al. 1991, 76)
Although this case study raises several issues, such as whistle blowing and the vulnerable position of being both an advisee and employee, it is important to underscore the differences between the mentor/mentee and adviser/advisee relationship as it may affect the ethical environment for both faculty member and student. Effective communication is paramount in both relationships. Interestingly, a recent survey of graduate students at one university reported that just over half of all graduate students surveyed (52%, with 40% agreeing and 12% strongly agreeing) believe that communication between faculty and graduate students is satisfactory. While that result is gratifying, the survey raises questions about why 48% found communication between graduate students and faculty unsatisfactory.
A positive mentoring relationship can be an important asset to the graduate school process. If properly mentored, graduate students can expect to grow academically, professionally and personally and develop the skills necessary to become mentors themselves in the future. The mentor/mentee relationship cannot be ignored in higher education and should not be confused with the adviser/advisee relationship.
References
- Adams, Howard G. Mentoring: An Essential Factor in the Doctoral Process for Minority Students. Notre Dame: National Consortium for Graduate Degrees for Minorities in Engineering and Sciences, Inc. (GEM), 1992.
- Burke, Ronald J., Carol A. McKeen and Catherine S. McKenna. "Sex Differences and Cross-Sex Effects on Mentoring: Some Preliminary Data." Psychological Reports 67 (1990): 1011- 1023.
- Burke, Ronald J., Catherine S. McKenna and Carol A. McKeen. "How Do Mentorships Differ From Typical Supervisory Relationships?" Psychological Reports 68 (1991): 459-466.
- Bushardt, Stephen C., Cherie Fretwell and B. J. Holdnak. "The Mentor/Protégé Relationship: A Biological Perspective." Human Relations 44 (No. 6, 1991): 619-639.
- Carden, Ann D. "Mentoring and Adult Career Development: The Evolution of a Theory." The Counseling Psychologist 18 (No. 2, April 1990): 275-299.
- Committee on Science, Engineering, and Public Policy. Adviser, Teacher, Role Model, Friend: On Being a Mentor to Students in Science and Engineering. Washington, D. C.: National Academy Press, 1997.
- Darling, L. A. "What to do About Toxic Mentors." Nurse Educator 11 (No. 2, 1986): 29-30.
- Edlind, Elaine P., and Patricia A. Haensly. "Gifts of Mentorship." Gifted Child Quarterly 29 (No. 2, Spring 1985): 55-60.
- Friedman, N. Mentors and Supervisors. IIE Research Report No. 14. New York: Institute of International Education, 1987.
- Gilbert, Lucia Albino, and Karen M. Rossman. "Gender and the Mentoring Process for Women: Implications for Professional Development." Professional Psychology: Research and Practice 23 (No. 3, 1992): 233-238.
- LaPidus, Jules B., and Barbara Mishkin. "Values and Ethics in the Graduate Education of Scientists." In William W. May, ed. Ethics and Higher Education. American Council on Education. New York: Macmillan Publishing Company, 1990
- Mateo, M. A.; K. T. Kirchoff and M. G. Schira. "Research Skill Development." In M. A. Mateo and K. T. Kirchoff. Conducting and Using Nursing Research in the Clinical Setting. Baltimore: Williams and Wilkins, 1991.
- Newby, Timothy J., and Ashlyn Heide. "The Value of Mentoring." Performance Improvement Quarterly 5 (No. 4. 1992): 2-15.
- Noe, Raymond A. "An Investigation of the Determinants of Successful Assigned Mentoring Relationships." Personnel Psychology Research Student and Supervisor: An Approach to Good Supervisory Practice. Washington, D.C.: Council of Graduate Schools, 1990.
- Pimple, Kenneth D. "General Issues in Teaching Research Ethics." In Robin Levin Penslar, ed. Research Ethics: Cases and Materials. Bloomington: Indiana University Press, 1995.
- Roberst, Priscilla, and Peter M. Newton. "Levinsonian Studies of Women's Adult Development." Psychology and Aging 2 (No. 2, 1987): 54-163.
- Schockett, Melanie R., and Marilyn Haring-Hidore. "Factor Analytic Support for Psychosocial and Vocational Mentoring Functions." Psychological Reports 57 (1985): 627-630.
- Swazey, Judith P., and Melissa S. Anderson. "Mentors, Advisers, and Role Models in Graduate and Professional Education." Washington, D. C.: Association of Academic Health Centers, 1996.
- Wigand, Rolf T., and Franklin S. Boster. "Mentoring, Social Interaction and Commitment: An Empirical Analysis of a Mentoring Program." Communications 16 (1991): 14-31.
