March 25, 2008

Skorton Leads Talk on Ethics of Bio Research

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When 399 illiterate African American sharecroppers degenerated before the eyes of medical researchers between 1932 and 1972 during the infamous Tuskegee Syphilis Experiment, the American public was awakened to the controversial relationship between ethics and science. While the U.S. Public Health Service failed to provide the subjects with adequate medical care as they suffered from tertiary syphilis, the experiment, which was described in The New York Times as an “infamous chapter in the annals of American medical research,” spurred the American populous to ask complex questions highlighting bioethical dilemmas that define science research today: To what extent should scientific research adhere to a moral code? How should scientists balance advancing their own careers with acting in the interest of the greater good?
In his discussion yesterday called “Human Subject Protections in Biomedical Research,” President David Skorton addressed these questions among others as he outlined the complex topic of bioethics and its role in science research to approximately 40 students in an event coordinated by the Cornell’s Bioethics Society in Stimson Hall.
“His talk was very interesting, and [Skorton] was very personable,” said Jake Loewentheil ’09. “He didn’t talk down to us, and he even put together a full computer presentation.”
Skorton’s background as a physician for young adults aged 12 and up with congenital heart disease has led him to remain passionate about bioethics. He explained that an important aspect of human subjects research is maintaining a trusting relationship between the medical care worker and the patient. Using his own experience as an example, Skorton stressed that “communicating information to patients and parents” is crucial to ensuring a strong “partnership between the patient and the medical care worker.”
However, as Skorton described bioethics as it relates to human subject research, the patient-health care worker relationship emerged as only one example of the ethical complications of modern science.
He began his talk by explaining the difference between morals and ethics, and then outlined some of the issues currently facing research projects with people as subjects. These issues include ensuring that an experiment is relevant to the human population and that it maintains a small benefit-to-risk ratio for all involved.
[img_assist|nid=29091|title=Follow the leader|desc=President Skorton gives a talk on bioethics yesterday afternoon in Stimson Hall.|link=node|align=left|width=|height=0]“There has been concern over the transparency of biomedical research,” he said, highlighting the controversies involving the informed consent of subjects, the use of placebos, the practice of unconventional therapies and the presence of institutional review boards, which are “groups that review proposals to do human subjects research,” he said.
As a former president of the Association for Accreditation of Human Research Protection Programs, an organization that offers accreditation to organizations that conduct or review research with humans, Skorton described some of the unresolved issues in human subjects research program accreditation, such as cross-cultural experimentation that leads to ethical conflicts facing researchers.
“Each of us, from our own cultural background, has a way of looking at the world that will inform our relationship with a professional health care worker,” he said, citing a case in which severe culture-clash can limit, and even prevent, a patient from receiving the health care he or she needs. If a western doctor, for example, attempts to offer medical assistance to a tribal woman in Africa who lives according to cultural tradition, she may not be able to receive care without the consent of her husband. If the doctor wishes to act in the best interest of the patient, he would give her care regardless of whether he was given permission by the man. But when abiding by cultural law, he would need to wait for outside consent, posing to the doctor a challenging ethical conflict.
Elizabeth Yoselevsky ’08, president of the Bioethics Society, said that many college students face ethical issues as well while completing their own research with the goal of getting their work printed in a journal, a competitive task. “Many students at Cornell do research, and especially for those who are pre-med, there is a big pressure to get published,” she said.
As the discussion became a question-and-answer session, students were quick to delve into some of the broader topics Skorton addressed in his presentation. One student asked whether universities should be involved in completing research for the Department of Defense, and whether or not it is ethical to use the information obtained from experiments performed unethically. Another student introduced the possibility that information obtained from research could have an unintentional impact on seemingly distant outlets, some of which may not be supported by the original researchers.
Skorton acknowledged that there is no single, correct answer to such questions. “It’s really hard to control what happens to knowledge,” he said. “Nevertheless, more knowledge is better.”