[This article was published in Science and Public Affairs, the journal of the British Association for the Advancement of Science, summer 1997, pp. 46-49.]
Ethical issues abound in many areas of scientific research, so why, asks Udo Schüklenk, do scientists fail to consider them before they start their research and why is so little use made of professional ethicists?
I WENT TO TORONTO THE other day to give a talk about the ethical implications of genetic research on sexual orientation. The occasion? The Human Genome Organization's 1997 Gene Mapping Conference. By chance I bumped into a molecular biologist working at Edinburgh's Roslin Institute. Their research isn't exactly the focus of my own work, but given all the hype about Dolly, the sheep they cloned at Roslin, I was curious and asked him, 'Has the Roslin Institute any professional ethicists on their research ethics committee?' The biologist wasn't sure but couldn't remember having seen or heard of an ethicist sitting on the Institute's research ethics committee. I persisted, and, after my return, emailed and phoned representatives of the Institute in order to find out. At the end of the day, I was told that they have a representative of a religious institution but no-one who has any academic qualifications in ethics. Even more puzzling is the organization's handling of ethical issues. On its worldwide webpage it quotes the lead scientists behind the cloning work as saying, 'prior to publishing the research, we notified many ethical, advisory and religious groups.' I began to wonder, naturally, why they didn't consider the implications of their work before it was actually carried out, but then perhaps that is the peculiar Scottish way of handling ethical issues. The editor of Nature, where the research was published, conceded in an accompanying editorial that the debate about the ethics of this research has been 'grossly inadequate.' Strangely this view has not prevented him from publishing the article from the Roslin group.
The objective of this article is simple: I would like to convince you that religious beliefs or good intentions are no viable substitute for a rational ethical analysis and that people with good motives are not an acceptable substitute for professional ethicists on research ethics committees. Furthermore, I hope to demonstrate that there are actually normative implications of scientific research, and that it makes sense to involve ethicists in order to analyse and to solve them.
Scientists and ethicists
Would you ask a newsagent for advice if you needed specialist information in a problem pertaining to physics? Or, would you ask your secretary for advice if you thought you might be suffering from food poisoning I doubt it. I would go to seek specialist advise, and, with some likelihood, so would you. For one reason or another, research ethics committees such as Roslin's carefully avoid academic advice from competent bioethicists in regard to their biological or biomedical research. They usually opt for well-motivated but academically unqualified theologians, priests and the like. Richard Dawkins in an article headlined 'Dolly and the clothheads' suggested in The Independent that there is no justification for having representatives of religious organizations on research ethics committees. He argued that people who rely on several thousand year old, logically inconsistent scriptures in order to form their ethical worldview are not competent to make any qualified ethical contribution to the debate about, for instance human cloning. Andrew Grove's book Only the Paranoid Survive demonstrates one way in which ethicists might respond to this situation: we might assume that 'they' are against us. Scientists might not like our criticism and opt instead for a 'clothhead', hoping to get away with a less analytically trained mind.
I am less paranoid. I assume that too many people outside the field of professional academic ethics see ethics as an undertaking where everyone with good motives says what they feel. To them there isn't much point in arguing about these points of view because ethics as they see it is a sea of nice words which are fairly useless in what they usually refer to as the 'real world'. Philosophers such as Immanuel Kant have pointed out, of course, that philosophy that doesn't work for the real world is bad philosophy. However, it is easy to find plenty of examples which would fit this scenario. After all, just as there is bad science around, so there is bad ethics around, too. A lot of things that currently trade under the heading 'ethics' have actually nothing much to do with professional ethics as academic ethicists would understand it.
What is ethics?
It is impossible to summarize 2000 years of philosophical ethical thinking in a brief paragraph. I will therefore restrict myself to a brief description of what philosophical bioethicists do in their professional work. Our work is decidedly interdisciplinary. We apply abstract ethical analysis to real world problems in the life sciences. Moralizing of the kind Dawkins has criticized is quite different from this.
Bioethicists have to be familiar with the major rational philosophical ethical theories, and with their implications for real world problems. The thing about logically consistent ethical theories is that they start usually from premises most of us would happily agree with.
The diffilculties arise only when one gets into the nitty-gritty details of their practical implications. For instance, preference utilitarian ideas that we should try to maximize individual interest satisfaction sound like a good thing - let's all go and maximize individual happiness. Add the principle of equality, requiring that each interest counts as much as any equal interest, and you suddenly end up with the unexpected result that you cannot use sentient animals (pretty much all mammals) in research that might cause pain or suffering to them, unless you are willing to use human beings who are in a similar intellectual state in a similar manner. The very idea that someone would dare to compare, for instance, intellectually severely handicapped people and, say monkeys or pigs, is one that many people will find appalling. Yet these ethicists might point out that in regard to the issue of suffering there isn't a morally relevant difference between such humans and some higher mammals. They would reject any criticism of their analysis that merely mentions how appalled one is about their views as irrational. Moral intuitions that cannot be justified rationally, they would argue, should be disregarded.
Confronted with a research proposal, academic ethicists will be able to conceptualize the ethical problems that might result from certain research proposals, rather than to offer a one-line solution to them. My above mentioned sketch of a preference utilitarian position is one of a variety of reasoned ethical approaches that ethics committees should take into account. Our job as professional ethicists would not be to preach to scientists what they should do, even though we might have a firm opinion of what ought and what ought not be done, but rather we would explicate what the ethical problems are. Part of this analysis is, of course, to explain why we think a problem we claim is an ethical problem is actually an ethical problem. In contrast to Bible-wielding priests, we actually have to provide rational arguments that cannot hark back to Bible-fiction such as 'God', 'Devil' and little 'Angels'. Then a properly informed ethics comittee can make a decision pertaining to the proposal. That is how it should be in an enlightened society.
Problems with actual research
As the situation at Roslin shows, one of the problems is that all too often there are no qualified ethicists on ethics committees, because ethics is still confused with a particular strain of sectarian Christian morality. This is akin to the claim that the Anti-Abortion Party represents the political views of all UK citizens.
But there are other problems. Roslin scientists, for instance, believe that debate about the implications of their work should be done after they have completed their work. I doubt that many ethicists working in the field of technology assessments would agree that this is the only viable way to deal with the 'new genetics'. There are a number of areas, for instance, where research does not promise any medical advances, yet threatens whole populations. The search for gay genes is such an example. It is highly unlikely that its results will lead in today's homophobic societies to any consequences we would consider ethically justifiable. Why shouldn't implications of such research be considered before it actually takes place', We might conclude, for instance, that in homophobic societies it should not take place at all. The use of sex selection techniques in India or China has led to what can only be described as female feticide. There is little reason to assume that a potential future genetic probe for genetic information predictive of a higher likelihood of homosexual offspring would be used in a different manner. If geneticists are serious about their claims to be concerned about the ethical and social implications of their research, they would do well to think about these consequences before they present their results to the world. That is what ethical responsibility is all about. Roslin scientists have handed their research results to the world (and to ethicists, churches etc.), and hope that someone else will sort out the ethical problems they have created. I believe there are better ways of handling these issues.
A colleague of mine is doing aetiologic sexual orientation research in his lab at a New York City hospital. When I talked to him about these issues, he referred to the ethics committee approval as another 'loop one has to jump through.' I assume he is not alone with this interpretation of the work of ethics committees. They are basically seen as a hindrance to research. Lewis Wolpert, Britain's ,salesman of science' would concur. He thinks that we need to distinguish between scientific knowledge and its application. However, history demonstrates that, in the case of aetiologic sexual orientation research, the pervasive homophobia that led to research on sexual orientation is inextricably linked to the results and the use of these results. To claim otherwise is naive and reminiscent of the debate between Popperian positivists and the Frankfurter Schule, I lecture about in my philosophy of science classes.
What can science deliver?
I will stick with sexual orientation research to demonstrate another problem. Scientists doing research with obviously wide-ranging social implications have begun to defend their work. They realized that it isn't self-evident that any research they might wish to conduct should actually be undertaken. Unfortunately, most scientists have not received any rigorous ethics or philosophy training, or else they would have been able to figure out themselves that justifications they tend to employ to defend their research are faulty. Dean Hamer and his team at the US National Institutes of Health, for instance, published in Science an article claiming to have found a major genetic factor contributing to homosexuality in men. They state at the end of their article that 'it would be fundamentally unethical to use such information to try to assess or alter a person's current or future sexual orientation, either heterosexual or homosexual, or other normal attributes of human behaviour.' Hamer and colleagues believe that there is a major genetic factor contributing to sexual orientation. From this they think it follows that homosexuality is normal, and thus worthy of preservation. They believe that our understanding of genetic material can tell us what is normal, and that the content of what is normal tells us what ought to be. This is a typical example of a naturalistic fallacy. It is wrong to assume that we could derive an 'ought' from an 'is'. Empirical data cannot solve normative problems. Imagine that someone finds a gene responsible for a behaviour trait that turns peaceful people into mass murderers. If we were to take Hamer's suggestion seriously we would have to refrain from trying to change the genetic make-up of such people because of his mistaken ideas about the normative implications of such a finding. Advice from an ethicist at the beginning of his research might have helped Dr Hamer to understand what the actual normative implications of his research would be.
Salesmen of science
Those who press for a greater public understanding of science, like Lewis Wolpert, confuse the accumulation of scientific knowledge with progress. They confuse quantity with quality. As a society we need to determine which types of knowledge we need, and what we consider as desirable progress. We should make decisions about the research direction of publicly funded work before it takes place, and we should try to undertake a technology assessment of the possible outcomes of available research directions before we decide the direction in which we might wish to go. The ex-post-facto strategies Roslin scientists displayed are obviously problematic. Ethicists, lawyers, and sociologists, among other professionals, are well equipped to assist in finding answers to questions such as these. Lewis Wolpert and his friends clearly fail us in these respects. All they want is more, more, and more knowledge. They never bother to ask 'what for?', unfortunately. So it was not a big surprise when James Watson suggested that selective abortion of fetuses who might test positive for a 'homosexuality gene' would be perfectly legitimate. Richard Dawkins defended Watson against gay critics by pointing out that
Watson would think selective abortion on the basis of a 'heterosexuality gene' would be just as legitimate. Dawkins missed the obvious point, that Watson's first thought was not concerned with the abortion of potentially heterosexual fetuses but with the abortion of potentially homosexual fetuses. I doubt that many gays will find Dawkins's argument convincing.
Conclusion
It seems prudent for me to involve professionals with an academic education in ethics in the work of research ethics committees. My criticism of representatives of religious organizations does not imply that academic ethicists cannot believe in a God. It is evident, however, that the Bible and similar works of fiction are no basis on which to pontificate, for instance on ethical implications of the Human Genome Project.
Furthermore, we should have public debates about the direction of research.
The huge public interest in books addressing bioethics issues ranging from abortion
and euthanasia to genetic screening, shows that the public is interested in
knowing (and debating) what scientists do these days in their labs. In democratic
societies we should applaud this interest and support it. The British Association's
Talking Science+ - a database of speakers on scientific issues - is a good example
of what can be done, and so is the work undertaken by some people serious about
trying to improve the public understanding of science.