Chapter  7: Human Experimentation

Section 3. Presentation of Issues.

Questions:

Answers: http://www.depts.washington.edu/bioethx/topics/resrch.html

Purpose of Experimentation:

To gain information and hopefully to use that information to assist people, to cure illnesses, to alleviate pain.

Resources on Nonconsensual Human Experimentation

http://www.gpc.edu/~shale/humanities/composition/assignments/experiment.html

  1. What kinds of people are involved as subjects in each experiment?
  2. Was there any deception involved in the cases?
  3. Is there any moral difference between the radiation experiments and experiments performed by Nazis physicians on Jews?
  4. Is there any moral difference between the experiments performed on prison inmates and the experiments performed by Nazis physicians on Jews?
  5. What is the moral problem raised by each of these experiments?
  6. What theoretical grounds could be given to morally justify the experiments?
  7. On what theoretical grounds are the experiments morally wrong?
  8. What policies might be adopted to avoid these experiments?

Types of Experiments

Therapeutic- Intended for the benefit of those who are the subjects of the experiment

Non therapeutic-not intended for  the benefit of those who are the subjects of the experiment

Codes Governing Research and Experimentation:  There are National and International codes or guidelines

International

  • Nuremberg Codes
  • Helsinki Code
  • World Assembly

National

AMA

Various Professional Societies

 

PHS 1966

5 Points

1. Subjects must volunteer

2. Freedom to withdraw

3. Unnecessary risks are eliminated - prior animal experiments

4. Benefits to subjects / society must outweigh the risks and harms

5. Only qualified individuals and researchers

CONDITIONS for an experiment to proceed

1. Science has progressed to the point where the experiment is justified

2. prior non human experiments

3. chance of benefit for the subject

4. subject is informed of diagnosis, prognosis, alternatives

5. subject consents

6. No better alternative available

7. Continuation of the experiment is not assumed

8. Repair of any damage or side effects is responsibility of researchers

INFORMED CONSENT

a. Competent individuals-??? Mentally retarded, incurably ill and life threatened, children

b. Informed

c. voluntary

VULNERABLE SUBJECTS

Children

how old? what conditions?

Parental Consent???

Retarded

Mentally ill

Those in PAIN

Those in TOTAL Institutions

Prisoners- rewards versus duress

Ward Patients

Military Service

Students in Colleges/Universities

Fetuses

Non-Human Animals

EXPERIMENTAL DESIGN

valid

reliable

minimize risk

DOUBLE BLIND METHODOLOGY

Medical Research versus Therapy

Who Controls the Experiment??

Peer Review to legitimize research and protect subjects

such peer review groups are often "rubber stamps"

KEY QUESTIONS FOR REVIEW OF EXPERIMENT for APPROVAL

1. Is it worth the risk?

2. Is the information otherwise obtainable?

3. have non human animal experiments been done?

4. Is the experiment meeting scientific standards?

5. Do the experimenters have the proper background? Are they qualified?

6. Are the risks minimal? Have they been minimized?

7. Has the appropriate , competent, and independent peer review group approved?

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Many of these experiments presented in this chapter to illustrate points are alike in two very important respects: they used as subjects the most vulnerable members of society, and the subjects themselves had no idea what the experiment was about.  It would be easy to agree with some of the critics of experiments such as Willowbrook and the radiation studies using children and hold that the researchers performed acts that are morally reprehensible. On the other hand the medical researchers had reasons for conducting these experiments that at least they thought were convincing. If you now examine how the ethical theories could be applied in these cases it is possible to find that on some principles , e.g. Act-Utilitarian grounds , some of these experiments might be morally justifiable.  If the aim is to minimize the disruption to society and bring about the greatest positive results for the mainstream majority then it would follow that on such grounds one ought to conduct research on the most vulnerable members of society.

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Ethical Theories:

Utilitarianism: in general would approve as long as the benefits to society are clear, subjects are protected and compensated.  

Act Utilitarianism would permit research on vulnerable subjects to increase or protect the general welfare. Of course, the fact that Act-Utilitarian theories imply the moral permissibility of these experiments could be used to justify the experiments or reject Act-Utilitarian theories.

Kantian: subjects must be fully competent, rational and autonomous and provide their informed consent for the experiment .

Ross: similar to Kant

Natural Law Theory: applies the principle of the Double Effect and Totality

Rawls: permissive but would protect the vulnerable subjects, preserve liberty and provide advantage for the least well off.

Hans Jonas, author
Philosophical Reflections on Experimenting with Human Subjects  http://www.sfu.ca/~andrewf/jonas.pdf
 

Peter Singer, author
Animal Experimentation  http://philosophy.tamucc.edu/print/610
 

Outline by  Don Berkich,  University of Texas, Corpus Christi (by permission)

We begin by considering a series of cases involving morally questionable experiments on human beings. For example, the case of the Tuskegee Syphilis experiment involved, among other things, the withholding of penicillin from four hundred socially and economically disadvantaged black men who had syphilis. The point of the experiment was to determine the effects of syphilis as it runs its full course.

It is easy to condemn the physicians and administrators who conducted the Tuskegee experiment. But presumably the men and women involved in the experiment were not monsters. It is much harder to understand the justification they might have given for their actions.

It seems that an essential part of the justification is the devaluing of the subjects. Moreover, purely Utilitarian (Act) reasons can be given to justify the experiments, but it is not clear in each case that utility is maximized. Thus, even though there may be benefits from conducting the experiments, the harm greatly outweighs any potential benefit.

In considering each of the cases we look to answer a series of questions:

1. What kinds of people are involved as subjects in each experiment?

Virtually every experiment involved subjects who might be considered the most vulnerable members of society. In addition to the black subjects of the Tuskegee experiment, we discussed cases where the subjects were prisoners, the terminally ill, retarded children, and the insane.

2. Was there any deception involved in the cases?

Each case involved some form of deception or other. Generally the deception amounted to withholding certain pieces of critical information.

3. What theoretical grounds could be given to morally justify the experiments?

Presumably Act-Utilitarianism, Cultural Ethical Relativism, and Divine Command Theory can be used to provide moral justification for the experiments.

4. On what theoretical grounds are the experiments morally wrong?

Kantian Ethical Theory, Social Contract Theory, and perhaps Rule-Utilitarianism can be used to morally condemn the experiments.

5. What is the moral problem raised by each of these experiments?

There are actually a number of problems raised by the experiments. One can point to the deception, the manipulation, and the obvious harm. But to suggest that there is a moral problem is to suggest that there is a conflict of some kind. The conflict raised by these cases is between two very different conceptions of ethics. On the one hand Utilitarianism might be used to justify performing experiments on humans. After all, even if those humans are harmed great good might eventually result for many more people, say from a cure for a disease. According to this view of ethics, the morality of an action is decided by the action's consequences.

But according to Kantian Ethical Theory, every person must be treated as an end in themselves, and not as a means only. According to this view of ethics, morality is a matter of absolute--i.e., universal and unconditional--duty. Recall that this view of ethics is entirely incompatible with Utilitarianism. That is to say, if Kantian Ethical Theory is true, Utilitarianism is false, and vice versa. More importantly, Kantian Ethical Theory would prohibit the vast majority of these experiments.

That is, critics of human experimentation are almost invariably, whether implicitly or explicitly, Kantian. In contrast, those who would defend human experimentation are almost invariably Utilitarian. Thus we see a dramatic practical difference resulting from two extensionally inequivalent--indeed, incompatible--ethical theories.

Thus at least two prominent ethical theories conflict with respect to human experimentation. Since these two ethical theories make precise two basic conceptions of ethics, it follows that human experimentation brings out a conflict between two basic conceptions of ethics.

Clearly the dispute would be resolved if we knew that KET was true or UET was true; they can't both be true. An alternative, however, is suggested in the form of SCT. SCT drives a wedge between the KET-UET divide. Like UET and unlike KET, the thought that human experimentation is important and ought to be pursued is supported on SCT grounds. But like KET and unlike UET, SCT implies that experimentation on the most vulnerable members of society is morally wrong.

After completing the reading of this chapter the reader should be well enough informed to address the questions listed below.

Review Questions:

  • What are some examples of Human Experimentation?
  • What kinds of people are often involved in human experiments?
  • What is the moral problem raised by Human Experimentation?
  • What theoretical grounds could be given to morally justify the experiments?
  • On what theoretical grounds are the experiments morally wrong?
  • What two reasons does Jonas give for thinking that Human experimentation is uniquely morally problematic?
  • What is Jonas' Principle of Identification?
  • What is Jonas' Rule of Descending Order?
  • What are Jonas' conclusions?
  • What theory does Jonas assume?
  • What is the theoretical perspective of the critics of the Willowbrook Experiment?
  • What is the theoretical perspective of the defenders of the Willowbrook Experiment?
  • What is Singer's test for the permissibility of animal experimentation?
  • What is Singer's argument?
  • What is Singer's theoretical perspective?
  • What reasons does Singer give for thinking that speciesism is morally wrong?
  • What is Cohen's argument?
  • What reasons does Cohen give for thinking that speceisism is not morally wrong?

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Copyright Philip A. Pecorino 2002. All Rights reserved.

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