Sir, there’s an ethical dimension in my policy
An international team of researchers is about to embark on a fact-finding study of science. The aim is to discover whether scientists' ethics are as we would hope.
The study, launched this month, is taking place at the request of President Barack Obama following a revelation last year about appalling research ethics in a study of gonorrhoea and syphilis. Between 1946 and 1948, US Public Health Service researchers deliberately exposed Guatemalan prisoners, soldiers and mental health patients to these diseases. The aim was to test whether penicillin was effective in prevention, as well as a cure.
The researcher in charge of this programme went on to lead the infamous Tuskegee syphilis study, in which penicillin was withheld from black men in Alabama suffering from the disease, so that doctors could study its progression. The 399 men who were monitored fathered 19 children with congenital syphilis; 40 wives were infected; more than 100 of the men died, directly or indirectly, from their untreated infection. This study went on for 40 years - it was stopped by a whistleblower in 1972. Not our finest hour.
The question the presidential commission wants to answer is: could such ethical nightmares be going on today? Scientists are split over the answer, but most would say no. All institutions carrying out scientific research now have an ethical review board. In order to be published in a journal, research must be approved by the board, which lays down a set of strict criteria. Scientists must not do anything to anyone without the board's informed consent. The experiment must also be likely to yield beneficial results and avoid unnecessary suffering or injury.
But review boards can be sidestepped. A paper published in the journal Ethics and Behaviour in 2005 showed that some scientists get their data first and ask permission later, if there's anything worth publishing. Others misrepresent their intentions to the board, playing down what might be deemed questionable. The easiest way forward is to do what Andrew Wakefield did with his MMR study. He lied to the Lancet that his study had ethical approval.
Never walk alone
Yet, for every Wakefield, there are many Werner Forssmanns. Forssmann pioneered heart catheterisation in Germany in the 1920s by doing it on himself. When asked to take part in Nazi experiments on prisoners of war, he refused. "To use defenceless patients as guinea pigs was a price I would never be prepared to pay for the realisation of my dreams," he later wrote.
Nazi experiments on prisoners are held up as an example of science gone wrong, but they weren't science: they were driven by ideology, not the spirit of inquiry. There are problems with how some multinational companies carry out clinical trials in developing countries, but most scientists would behave ethically without the safety net provided by review boards. What's more, given the collaborative nature of modern science, very few researchers work alone and a bad apple is unlikely to get away with anything that a team member is uncomfortable with.
So, when the president's commission reports its findings in August, it is likely to be a good day for science.