The Name of the School
Introduction
Some people argue that to make important advances in clinical and scientific research, sometimes, ethical considerations have to be disregarded. In research, ethical issues are generally thought of as the set of rules that distinguish right from wrong. Ethics can take the form of a generalized rule of thumb, such as the “golden rule,” which says that you should not do to others what you would not like done to yourself; or, ethics can be codes of professional conduct, such as the Hippocratic Oath, which says “First of all, do no harm.” Researchers are usually legally bound to some ethical principles; for example, researchers conducting clinical trials on pharmaceutical drugs are required to make a full disclosure of the possible side effects of the drug to the study's volunteers (Beecher, 1996).
Important to the concept of ethics in research, especially medicinal research, is the idea of informed consent. Informed consent is a process in which a researcher ensures that participants in clinical trials understand what will happen during the trial, including all of the risks (Diener & Crandall, 1978). Informed consent helps study subjects decide whether participation in clinical trials is right for them.
Informed consent must be obtained from the study participant before proceeding with the investigation. The American Psychiatric Association's code of ethics establishes several rules for the obtainment of informed consent (Faden, Beauchamp, & King, 1986). For instance, a researcher cannot perform a psychological experiment on volunteers using deception, unless there is a valid reason to use deception, and the research cannot be successfully conducted without it. In addition, the risk of physical or emotional distress and discomfort must never be concealed. In a study on sleep deprivation in which participants are asked to stay awake for a long period of time, the participants must be informed of the physical risks, rather coerced into participation. Finally, if deception is used during the psychological experiment, it must be revealed to the test volunteers as soon as possible; for example, as soon as the experiment is concluded, volunteers should be informed of the deceptive practices used on them. These ideas have been around for decades, but they have only recently been applied in practice (Faden et al., 1986).
Though most societies chose to enforce moral and ethical standards through judicious application of the law, ethics and laws are distinct from each other. An action may be legal, but not ethical or moral; conversely, there are actions that may be illegal, but that are not necessarily immoral or unethical (Beecher, 1996). For example, it is not illegal for a man or woman to cheat on their spouse, but there are many who would consider cheating unethical. On the other hand, it may not be unethical for a doctor to prescribe a patient medication derived from cannabis to treat their psychological or physical pain; however, medical marijuana remains illegal in most states.
Ethical norms across different disciplines help individuals organize their activities in a coordinated manner and to promote public trust in the discipline. Ethics can also be thought of as a method or procedure that informs us how to act, providing a framework for analyzing social problems and issues (Diener & Crandall, 1978). For example, the problem of global warming can be considered from an environmental, political, economic, or ethical perspective. An economist might be concerned about the costs of reducing the impact of global warming versus the cost of allowing global warming to go unchecked. An environmental ethicist, on the other hand, might be chiefly concerned with the damage to the aquatic and terrestrial ecosystems that make up the diversity of life on our planet.
Ethical standards govern the conduct of research in medicine, engineering, law, and business. Ethical standards enhance and expedite the goals of research. For example, the ethical standards of almost any institution or organization condemn the act of plagiarizing the works of others. In both academic and professional contexts, plagiarism is thought to be highly unethical, and it is also often illegal. Plagiarism is bad for many reasons, and one of these reasons is that it hinders scientific ambition and progress. Plagiarism impedes collaborative learning, silences debate, and prevents ideas from moving forward (Beecher, 1996). Therefore, having a standard of ethics that denounces plagiarism and fraud helps propel the goals of research forward.
Another example that demonstrates how ethics supports the goals of research is seen in how ethical principles promote values of collaboration, accountability, mutual respect, and fairness. Research often requires the participation and cooperation of members across multiple disciplines, and ethical standards instruct the members of different groups on how to interact constructively with each other (Diener & Crandall, 1978).
Ethical standards not only protect the integrity of the research, they protect the people on whom the research is conducted. It prevents harm to those who volunteer their bodies and minds to the service of scientific advancement. By requiring informed consent to be given before proceeding with an experiment or survey, the volunteers are protected from coercion or deception.
A system of ethics is not only beneficial to the collection of data on scientific, clinical, and other types of research; it is imperative to its success. Research conducted without a mind to ethics will only be of questionable value. Therefore, ethical considerations should never be neglected when research is conducted.
Kantian Ethics
Kant's theory of ethics follows what is called a deontological moral theory (Paton, 1971). According to deontology, a person's moral character is described by his or her adherence to a rule or set of rules. Deontological ethics are also known as obligation-based ethics, because they assert that rules bind people to their duty.
Kant believed that the moral requirements of ethical conduct relied on what he called the “categorical imperative (Paton, 1971).” Kant's categorical imperative provides a framework for evaluating the morality of our actions. The categorical imperative asks us to ask ourselves: if I made this action a universal law (as in, if everyone could do what I'm thinking of doing right now), what would be the consequences of that?
For example, according to Kant's categorical imperative, a person who wishes to commit murder should first ask themselves whether it would be permissible for everyone to commit murder. Since it would obviously be extremely detrimental to society if everyone committed murder with impunity, the categorical imperative tells us that the individual should not commit murder. In fact, the categorical imperative commands us not to commit murder, as an imperative is a command to action.
In another scenario, a person may debate whether they should donate money to a homeless shelter. Kant's categorical imperative asks us to consider what would happen if everybody began contributing to homeless shelters. Would this have a deleterious or an advantageous effect on society? In fact, if everyone donated to homeless shelters, we as a society would benefit from a world in which there was less homelessness and poverty. In this case, the categorical imperative commands us to fulfill our moral duty by giving to homeless shelters.
In the context of research, Kant's theories of morality and ethics tell us two things. First, a research strategy can be considered moral or ethical if it adheres to a strict set of rules and guidelines. Research conducted without any consideration given to the foundational rules laid out by society is ethically and morally suspect. Secondly, when determining whether a research strategy is ethical or not, researchers should ask themselves what the consequences would be if everyone in society decided to act in a similar way. If the effect of such an action taken on a widespread scale would be good for society as a whole, then the researchers are duty-bound to perform that action. Conversely, if the action would have deleterious effects if taken on a widespread scale, then the researchers are duty-bound not to perform the action.
BPS Code of Ethics
According to the British Psychological Society, a rigorous code of ethics should be present in all aspects of a researcher's decision making process. In the 2009 guide published by the Ethics Committee of BPS, it is stated that “thinking about ethics should pervade all professional activitiy (p. 6).” Before researchers set out on their work, they should consider the ethical implications of their study within the context of legal and professional frameworks.
The BPS suggests that researchers should identify the key issues of their work and assess their ethical impact. Specifically, they should determine the parameters of the investigation; whether there is research evidence already available that will be relevant; which legal guidelines exist; what are the recommendations of their peers; and whether the Health Professions Council or other related governmental bodies can provide guidance. Thus, BPS proposes a legal and social framework through which to examine the ethical components of a research undertaking (The British Psychological Society, 2009).
The Tuskegee Syphilis Experiment
When it comes to the importance of ethics in clinical and scientific research, history is perhaps the best teacher. Between 1932 and 1972, the United States Public Health Service conducted human experimentation on rural African-American men in Alabama (Thomas & Quinn, 1991). The men were suffering from untreated syphilis, and the researchers were studying the disease's natural progression through each of its stages.
At no point in the forty year duration of the Tuskegee Syphilis Experiment were the study participants informed that they had syphilis; none of the 400 initial enrollees who had contracted syphilis before the study were aware they had the disease, and may not have even known what syphilis was. Nor were any of the afflicted individuals treated for syphilis at any time, as this would have conflicted with the researchers' goals to study the natural progression of the disease. Even after penicillin was discovered as the proven antibiotic treatment for syphilis, none of the men were given treatment.
Rather than informing the men that they were suffering from a treatable disease, the researchers lied to them, and told them that they had the vague condition of “bad blood.” The men were offered free meals, free burial insurance, and free medical care in exchange for their participation in the experiment. However, they were treated not for syphilis, but for “bad blood.” As these men were overwhelmingly too impoverished to afford their own health care, the offer of free medical care was especially enticing.
Ethical Implications of the Tuskegee Syphilis Study
The Tuskegee syphilis experiment has been referred to as “arguably the most infamous biomedical research study in U.S. history (Thomas & Quinn, 1991).” It is now widely regarded as the most brazenly unethical study in the medical history of the United States. To this day, the Tuskegee syphilis experiment is a reminder of the harm that can be done in the name of “good,” especially to minority groups. The Tuskegee syphilis experiment continues to undermine public trust in medical research institutions among African Americans in the United States. Studies (Thomas & Quinn, 1991) have demonstrated that the Tuskegee syphilis experiment has played a role in African Americans' avoidance of participation in clinical research trials.
The Tuskegee syphilis experiment influenced the adoption of informed consent laws in the United States (Faden et al., 1986). Due in part to the study, today it is illegal for researchers to perform experiments on people without ensuring that they understand what the experiment truly entails. Thanks to these changes, all Americans now benefit from the highest ethical standards to which researchers are held.
References
Beecher, H. K. 1996. Ethics and Clinical Research. New England journal of medicine 274 (24): 1354- 1360.
Diener, E., & R. Crandall. 1978. Ethics in social and behavioral research. U Chicago Press.
Faden, R., Beauchamp, T., & N. King. 1986. A history and theory of informed consent.
Paton, H. 1971. The categorical imperative: a study in Kant's moral philosophy. University of Pennsylvania Press, Vol. 1023.
The British Psychological Society. 2009. Codes of Ethics and Conduct. Ethics Committee of the British Psychological Society.
Thomas, S. B., & S. Quinn. 1991. The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community. American journal of public health 81(11): 1498-1505.
