{"id":1578,"date":"2012-03-01T16:39:51","date_gmt":"2012-03-01T15:39:51","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=1578"},"modified":"2012-03-01T16:39:51","modified_gmt":"2012-03-01T15:39:51","slug":"of-tusks-and-tuskegee-a-problem-in-research-ethics","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/01\/of-tusks-and-tuskegee-a-problem-in-research-ethics\/","title":{"rendered":"Of Tusks and Tuskegee: A Problem in Research Ethics"},"content":{"rendered":"

Xtaldave, by his own admission, has the horn<\/a>.\u00a0 Well, if you’re being accurate about it, he has the tusk.\u00a0 But what’s important is that he has a whopping great piece of ivory to play with.<\/p>\n

Dave works in the labs here in Manchester, doing clever things with chemicals and science and crystalography and that sort of thing.\u00a0 The ivory has been confiscated by customs; it found its way into his lab because the dentine in a great big tooth is a useful medium on which to carry out research that may generate significant benefits.\u00a0 In his words, the tusk is<\/p>\n

an acceptable substitute for human bone in the sorts of assays that our lab does to test the effect of various substances on cells called Osteoclasts that are responsible for bone resorption (basically bone destruction).\u00a0 During growth and development of the skeleton, bone is formed (by Osteoblasts) and broken down (by Osteoclasts) \u2013 it is thought that the bone disease Osteoporosis is caused by an\u00a0imbalance\u00a0of bone formation and destruction \u2013 i.e. too much Osteoclast activity.<\/p>\n

If we can find a therapeutic agent that inhibits Osteoclast activity, we might be able to halt or slow the progression of Osteoporosis.\u00a0 The upshot of all this is that our lab has obtained a section of Elephant horn that has been confiscated by the UKBA.\u00a0 We will recycle this and use the dentine in our bone resorption assays.<\/p><\/blockquote>\n

Why’s this of interest here?\u00a0 Well, the ivory trade is (a) illegal, and (b) deeply morally problematic.\u00a0 The fact that it’s illegal means that the UK Border Agency confiscates ivory as it’s imported into the country in most cases.\u00a0 (There are situations in which importation is legal, but they’re rare, and needn’t concern us here.)\u00a0 And this confiscation means that the Agency ends up with a load of ivory on its hands.<\/p>\n

One option might be to sell it; but that’s ruled out by the same considerations that make importation illegal to begin with.\u00a0 Another is simply do destroy the lot.\u00a0 A third is to allow labs like Dave’s to make use of it.\u00a0 This is where the moral claims come in.\u00a0 It would be, he says, immoral (as well as legally problematic) to sell the ivory, and<\/p>\n

if someone has already killed the elephant and removed the Ivory, better that we use it to further medical research and perhaps save or improve some lives, than turn it into a bauble that sits on a shelf gathering dust.<\/p><\/blockquote>\n

Or, to put it another way: that the elephant has been killed is bad; but we can at least salvage something from the moral wreckage.<\/p>\n

Is this correct?\u00a0 Well, the structure of the argument seems to follow quite closely that which is sometimes presented in relation to the use of – for example – data derived from the morally repugnant experiments of the past.\u00a0 If there is, in\u00a0Stan Godlovich’s words<\/a>, “demonstrably important and beneficial information gathered methodically through means completely unacceptable to us”, what should we do with it?<\/p>\n

A famous example of such research is the Dachau hypothermia experiments, of which a good overview is given by Berger in the New England Journal of Medicine<\/em> in 1990<\/a>.\u00a0 Berger concludes that, actually, the results generated are unreliable, and so “attempts to use the data from the Dachau experiments have been puzzling”.\u00a0 But there’s an important question lingering in the background: suppose the results had<\/em> actually been scientifically credible, and could have led to a better understanding of hypothermia – and thence to better treatments: would it be OK to use them?<\/p>\n

The “salvage from the wreckage” argument might apply here.\u00a0 Granted that the murdered people cannot be revived, we should concentrate on the living and making the world as good a place as possible.\u00a0 Some might even say that it would be wrong not<\/em> to use the data, for\u00a0a couple of reasons: first, there’s an obligation to benefit humanity that might be discharged by helping develop new treatments; second, ignoring the data would simply compound the waste that generating them represented.<\/p>\n

On the other hand, we might worry that making use of the data indicates a willingness to see the murdered people simply as a source of information – which was precisely the attitude that allowed the procedures to happen in the first place.\u00a0 A\u00a0more Kantian line might be that willing the end implies willing the means necessary thereto; and if the only way to do the new science is to rely on old murderous science, then the new science involves tacit endorsement of the old.<\/p>\n

Though I find it hard to deny that the salvage argument has power, my own inclination is that using such data would be problematic.\u00a0 I’ve argued in a couple of places that arguments for the obligatoriness of scientific research fail (see here<\/a> and here<\/a>); and part the research I’m doing at the moment involves raising sceptical doubts about whether a duty to pursue scientific research could ever<\/em> be established.\u00a0 If there’s no duty to research, though, it becomes supererogatory.\u00a0 And if it’s supererogatory, then the salvage argument looks weaker.\u00a0 After all, if noone is wronged by the absence of new research, then the imperative to do it diminishes; and granted that certain sources of data are contaminated, then “dirty hands” worries might turn out to carry the moral weight.\u00a0 Sometimes, it’s possible that we ought simply to walk away from some opportunities to benefit humanity.\u00a0 Our duty is not to harm; we don’t have a duty to make things better, and certainly not if other important considerations are at stake.<\/p>\n

Similar\u00a0thoughts might well turn out to apply in respect of using elephant tusk.\u00a0 Of course, some will insist that there’s a world of difference between poached elephants and what went on in Dachau, or Manchuria, or Tuskegee.\u00a0 In one sense, there might be.\u00a0 From the point of view of moral argumentation, though, there isn’t such a gulf.\u00a0 In both cases we’re dealing with actions that we can take to be straightforwardly wrong, but which generate things that turn out to be useful, and which could be used in pursuit of something admirable.\u00a0 (I’m assuming, arguendo<\/em>, that the science is sound.)\u00a0 The structure of the problem seems to me to be very similar indeed.<\/p>\n

Does this mean that Dave shouldn’t be doing his experiments on elephant tusk?\u00a0 I don’t think that anything in this post establishes that.\u00a0 But the salvage argument in favour of making use of morally contaminated resources in science isn’t – I don’t think – always all that compelling.\u00a0 And if it isn’t compelling in this case, then letting the ivory sit on a shelf – even if it means hindering osteoporosis research – might turn out to have something to be said for it.<\/p>\n","protected":false},"excerpt":{"rendered":"

Xtaldave, by his own admission, has the horn.\u00a0 Well, if you’re being accurate about it, he has the tusk.\u00a0 But what’s important is that he has a whopping great piece of ivory to play with. Dave works in the labs here in Manchester, doing clever things with chemicals and science and crystalography and that sort […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1240,963,397,576,472],"tags":[],"class_list":["post-1578","post","type-post","status-publish","format-standard","hentry","category-blogosphere","category-curios","category-research-ethics","category-the-art-of-medicine","category-thinking-aloud"],"yoast_head":"\nOf Tusks and Tuskegee: A Problem in Research Ethics - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2012\/03\/01\/of-tusks-and-tuskegee-a-problem-in-research-ethics\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Of Tusks and Tuskegee: A Problem in Research Ethics - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"Xtaldave, by his own admission, has the horn.\u00a0 Well, if you’re being accurate about it, he has the tusk.\u00a0 But what’s important is that he has a whopping great piece of ivory to play with. 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