Ethics in Biomedical Research and Practice

Abstract

Biomedical research raises a host of ethical questions of import to biology education. This chapter covers ethical questions “intrinsic” to the research: e.g., ethical proscriptions on what kinds of research may be conducted, as well as questions “extrinsic” to research: about which research is prioritized and why, how biomedical research is funded and related considerations of allocation and distributive justice. Research ethics is the branch of biomedical ethics that concerns the responsible conduct of research – including, but not limited to: the ethical treatment of human and non-human subjects, avoiding conflicts of interest, the fair representation of authorship, and the scientist as a responsible member of society. The first part of this chapter will focus more narrowly on the ethics of research on human and non-human subjects. After the Nazi “experiments” on vulnerable populations during WWII, the Nuremberg trials and Code that resulted (1947) codified a set of norms for research on human subjects necessary to protect vulnerable populations from abuse. Until relatively recently, vulnerable populations (prisoners, soldiers) were viewed as optimal candidates for biomedical research, and were invited to participate in medical research that posed serious harms and had very little benefit, often to them as patients, and sometimes to science, in general. The most famous example of this is the Tuskegee syphilis study, in which 400 African-American men with untreated syphilis were left untreated and observed over the course of decades, even after treatment became available. With respect to the “extrinsic” issues, a variety of economists, philosophers, sociologists, and biomedical researchers have brought attention to the fact that the overwhelming majority of biomedical research is directed toward diseases that by and large affect the wealthy. Whereas historically, biomedical research was often conducted in non-profit or government sector, a larger percentage of such research today is conducted in the private sector. This raises questions about potential conflicts of interest – e.g., concerning whether clinicians and clinician researchers are unduly influenced by profit in prioritizing some research projects over others, and, whether efficacy of new drugs or treatment regimes is exaggerated and risk minimized as a result. At the end of this chapter, several proposals for addressing these issues will be reviewed. Addressing these ethical issues is important to biology education, because students from a variety of disciplines need to situate biomedical research in social and ethical context, and reflect on its larger import.