Ethics for scientists: A call for stewardship
by Katrina A. Bramstedt
Biotechnology is a rapidly expanding field in medicine. Star Trek concepts such as body scans and tumor targeted light therapy are now standard clinical practice. Implants are available to treat a range of cardiac, neurological, and orthopedic conditions. Synthetic1 and cross-species replacement organs2 are on the horizon.
While a scientist’s intent may be beneficent clinical technology, the steps between the research and development bench and the patient’s bedside are numerous and complex. Technologies that might seem ethically appropriate conceptually require ethical discourse throughout each stage of development. Even after the technology hits the marketplace, the ethical responsibility does not end. From a Christian perspective, ethical stewardship of our God-given talents and the technologies that arise from them are essential to the growth of science, to fostering trust in science, and to maximizing beneficence amid the clinical applications of science.
A key concept in any research undertaking is trust. Society at large is unskilled in matters of research and science, and because of this, they put their trust in scientists to handle matters. They recognize scientists as experts with unique training and skills that they themselves do not have. Lacking this training and skill, they are in a vulnerable position. Society looks to scientists to tackle the hard clinical questions and hopefully to solve them. Thus said, scientists have a great responsibility to the people who put their trust in them, especially because many of the people who rely on science are the most vulnerable—the sick.
How does this responsibility take shape? Clearly, intellectual honesty is critical to valid scientific research. Unintentional mistakes are different matters from those of outright misconduct such as falsification and plagiarism. Not only is data falsification (making up data or experiments, changing data) a violation of society’s trust in science, it also results in the misuse of scarce resource funding and invalidates future studies that sprout from the project in question. Additionally, research of this nature has the effect of delaying the progress of science that could be beneficial to patients because it can reduce or eliminate opportunities for funding and collegiality with other scientists. Fraudulent science can also harm patients by occluding potentially negative data.
Plagiarism can appear in many forms, but its most prominent manifestation is the taking of another’s work as one’s own. Not only is this dishonest, it also disrespects the diligence and skill that a colleague has invested in the concept or product. While the two parties may be thousands of miles away and unknown to each other, the parties are nonetheless colleagues due to the nature of science as a profession. Even the presence of a power differential in a relationship such as teacher-student and employer-employee does not usurp the ethical responsibility to give credit when credit is due. Further, such a responsible attitude fosters collegial relations and the growth of science as scientists trust one another enough to share and learn from one another.
Often, in the course of a research project, relationships form that could potentially harm the credibility of the scientists or their project. These relationships commonly take the form of financial gain, such as project-related stock ownership or direct payment from the corporate study sponsor. These can be termed a conflict of interest because they could impair the researcher’s objectivity during the course of the project. As government research funding shrinks and academic-industry relationships steadily increase, issues of this nature must be explored for their ramifications for science as a profession and on the patients the technologies intend to serve. Even if conflicts of interest such as financial ties cannot be avoided, at a minimum they should be disclosed to one’s fellow scientists and society (during article publication, for example) in an effort to promote openness and objectivity about the generated data. While dualities of interest may exist, our priorities must be in ethical alignment.
Use of animals
Although this is not the forum to debate the ethical permissibility of the use of animals in scientific research, it is clear that few if any technologies reach human use without first requiring animal testing. Knowing this, the welfare of laboratory animals must be kept in mind. Amid our Christian duty of dominion over animals (Genesis 9:2; Daniel 2:38) this could well include matters of nutrition, hydration, housing, and veterinary care throughout the course of laboratory experimentation. Studies should be designed such that they use the minimum number of animals to provide scientific and statistical validity. Studies should consider the use of non-animal models when appropriate (e.g., computer simulations), and they should be designed in a way that minimizes pain and suffering for the animals. All studies should be approved by an institutional animal welfare committee under the supervision of a licensed veterinarian. As with any study that becomes futile, it should be halted or discontinued in an effort of ethical stewardship of resources (financial and otherwise).3
The ultimate goal of much of scientific research is direct human application, and thus human clinical trials are standard practice. A common misconception held by many clinical trial volunteers is that they believe study participation will benefit them personally.4
This belief is especially a risk for subjects who lack medical insurance and for whom clinical trial enrollment is their only source of “health care.” It is also a risk for patients who have “tried everything” and consider a clinical trial their “only hope.” When enrolling patients in clinical trials, scientists have a moral duty to clearly inform them that clinical research is performed to collect data for the benefit of future patients and that any benefit immediately gained by the research participant is an altruistic bonus.
It is inappropriate for a scientist to portray his or her study in a fashion that might generate false hopes for the participants. Selection of people for trial participation should be carried out under strict guidelines from an institutional review board, using approved protocols that respect the participant’s safety and welfare. Potential participants should be given ample information about the study design and its risks in a manner in which they can comprehend, and they should be allowed to freely volunteer for the study without coercion. Both physical and psychological harms should be minimized and participants should be allowed to withdraw from a research study at any time. Privacy and confidentiality should be maintained, and genetic studies should incorporate additional safeguards as appropriate, including genetic counseling. Research subjects, whether human or animal, should not be used as a means to an end. As God’s creation, they are ends in themselves and should be provided with available protections and treated with respect.
A crucial tool to facilitating the ethical responsibilities that I have mentioned is mentoring. Both young and “seasoned” scientists, can benefit from skillful mentoring by experienced colleagues. This mentoring should take the form of both technical advice and moral guidance. In addition to providing direction through direct verbal or written instruction, good mentors also teach by example. Being able to “walk the talk” speaks volumes to one’s students and fellow scientists and helps train them to be good mentors to others. Good mentoring is also a witness to society that scientists are genuinely concerned about the integrity of their profession.
While practicing any profession, our best ethical mirror is that provided by Christ. Science is imperfect and fallible because scientists are imperfect and fallible. While we may seek knowledge, we are not all-knowing and we may tarry in areas that some would argue are ethically inappropriate (e.g., certain methods of assisted reproduction, genetic manipulation, life-extension research, etc.). Because the Bible is not prescriptive in these “high-tech” areas, Christian scientists should seek counsel from God through prayer. Our Creator has given us, His stewards, talents and tools to facilitate the growth of science and the health of patients, yet these talents and tools aren’t without the responsibility of ethical use. Both the process and the products of using our talents hold the ethical responsibilities of respecting those around us, protecting them from harm, and maximizing the benefits our research efforts can provide.
Katrina A. Bramstedt (Ph.D., Monash University) is a clinical associate at Loma Linda University Center for Christian Bioethics. Her mailing address: Loma Linda, California 92350; U.S.A. E-mail address: firstname.lastname@example.org
Notes and references
1. R. D. Dowling, S. W. Etoch, K. Stevens, et al. “Initial Experience with the AbioCor Implantable replacement Heart at the University of Louisville,” ASAIO Journal 46 (2000):579-581.
2. K. A. Bramstedt, “Ethics and the Clinical Utility of Animal Organs,” Trends in Biotechnology 17 (1999):428-429.
3. Animal Welfare Act, United States Code Title 7, Sections 2131-2156.
4. H. K. Beecher, “Ethics and Clinical Research,” New England Journal of Medicine 274 (1996):1354-1360.