First do Harm: ethical issues in science

This entry was written by my MSc student Perry Foster and it stemmed from some debates we had in class about ethical issues in science. We questioned our own practices as researchers and discussed the unarguable value of University Ethic Committees. We were made aware of the disparities between countries regarding these issues and were alarmed to realize how easy still is nowadays, in some parts of the world, to conduct unethical research. However, we stretched a bit further and ended up cogitating about  what would we do if we were made aware of unethical procedures. Finally, I asked the students to read a piece of news published in Nature exposing a horrid experiment conducted by USA doctors, in the 1940s, in Guatemala where the said doctors deliberately infected thousands of Guatemalans with venereal diseases. The students were appalled, as we always should be, and a new string of discussions came to live.

In her essay, Perry specifically approaches the adequacy of this kind of news to be published in a journal like Nature.

First do harm

“Human Experiments: First, Do Harm”: is Nature  the adequate outlet to disseminate this kind of news? 

by Perry Foster

Matthew Walter is a freelance writer in New York. In February of last year he wrote a news feature titled: “Human Experiments: First do Harm” (1). There he described how, in the 1940s, US doctors intentionally infected thousands of Guatemalans with sexual transmitted diseases (STDs) to ascertain whether penicillin could prevent and treat such infections. Many of those Guatemalans were Maya. The news was published in the journal‘Nature’ (2012) (2), a science and technology peer-reviewed weekly international journal with an exceptional Impact Factor of 36.101.

Walter’s paper was widely read in the academic community, specifically that of the scientific and clinical research community (3).  However the impact that this paper had on the general public is questionable. The aim of this post is to debate whether Walter’s paper should have been published in Nature or would have been better suited to another outlet.

Susan Reverby discovered lead investigator John Cutler’s unpublished experimental reports and disclosed this ethically questionable investigatory public health research to the public in 2011 (4).

The general public was only roused to this issue when the story was published in very few media outlets. A small number of UK media groups drew attention to the issue later that year through newspaper and online articles (5-7). However this only generated little public interest given that the articles in question were not published as ‘front page news’.  The population worldwide has grown accustomed to scenes of violence and brutality through the media (8), therefore, this report unveiling an occurrence that has happened more than 60 years ago, in a remote place like Guatemala, was bound to be easily and quickly forgotten.  In the US governmental publications were released regarding the Guatemalan experiments, including the Presidential Commission for the Study of Bioethical Issues (9, pp. 108), which states that “it is clear that many of the actions undertaken within [the experiments] were morally wrong”. This highlights the importance of ethical issues and the devastating repercussions that violating them can cause; as was the issue with the Guatemalan experiments. It could therefore be argued that the public in general should be explicitly made aware of this, not just the academic community as was the case with the publication of Walter’s paper.

In a time and age where everybody, within academia, is talking about the importance of “research impact” (see here the definition of research impact according to the Research Excellence Framework 2014, UK)  one can argue if choosing Nature as the main outlet was the most efficient way of spreading the news about this issue.

It should be noted that “more than 2,000 journalists and media organisations subscribe to the [Nature Publishing Group] press releases” (10) of which Nature is part of. However, if an article is not included in the press release, the journalists do not report the story and the general public remain oblivious to it. Consequently, this is an additional argument as to why Walter’s paper should have been published in another outlet. The mass media are one of the most effective means through which to influence and shape audience memories (11-13), consequently an issue as pressing as ‘ethically questionable interventions’3, should be included in the cultural memory of societies so as to avoid instances such as this from occurring in the future. Taking Nature’s limited readership into consideration I would therefore argue that the journal does influence academic cultural and collective memory, but it doesn’t reach the general public with the strength that an issue like this would deserve.

About Perry Foster

Perry Foster

Perry is a Physical Activity and Public Health MSc student at Loughborough University. She completed her undergraduate degree at Durham University. Her main areas of interest revolve around sedentary behavior. She is currently undertaking a meta-analysis of sedentary behaviour and diet in adults. When not studying she enjoys reading, walking, and baking.

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References:

1. Walter M. Human experiments: First, do harm. Nature. 2012; 482:148-52 (http://www.nature.com/news/human-experiments-first-do-harm-1.9980).

2. Nature. About nature. Nature: International weekly journal of science. 2013. Accessed from http://www.nature.com/nature/about/index.html on 8/2/13.

3. Löwy I. The best possible intentions: Testing prophylactic approaches on humans in developing countries. Public health then and now. American Journal of Public Health. 2013;103(2):226-37 http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.300901?journalCode=ajph).

4.  Semeniuk I (2010) A shocking discovery. Nature 476, 64 http://www.nature.com/news/2010/101004/full/467645a.html

5. The Guardian: htttp://www.guardian.co.uk/world/2011/aug/30/guatemala-experiments

6. The Telegraph: http://www.telegraph.co.uk/health/healthnews/8729975/US-STD-experiments-in-1940s-Guatemala-killed-83.html

7. BBC: http://www.bbc.co.uk/news/world-latin-america-14751441

8. McArthur DL. Peek-Asa C. Webb T. Fisher K. Cook B. Browne N. and Kraus J. Violence and its injury consequences in American movies. Western Journal of Medicine. 2000;173(3):164-68. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1730625/).

9. Presidential Commission for the Study of Bioethical Issues. “Ethically impossible”: STD research in Guatemala from 1946 to 1948. Washington D.C. 2011. (http://bioethics.gov/node/654).

10. Nature Publishing Group. Why publish with NPG: Widest possible readership. 2013. Accessed from http://www.nature.com/authors/author_resources/why_publish_with_npg.html on 11/2/13.

11. Edy, JA. Troubled pasts: News and the collective memory of social unrest. Temple University Press. Philadelphia. 2006 (http://www.h-net.org/reviews/showrev.php?id=13451)

12. Van Dijck J. Mediated memories: A snapshot of remembered experience. In Kooijman J. Pisters P and Strauven W. Mind the screen: Media concepts according to Thomas Elsaesser. Amsterdam University Press. Amsterdam. 2008 (http://dare.uva.nl/record/309706)

13. Erll A. Memory in culture. Palgrave McMillan Memory Studies. 2011.(http://books.google.co.uk/books/about/Memory_in_Culture.html?id=9jrOS6o0PI4C&redir_esc=y)

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