Using our best judgment in conducting human research

The federal regulations of human research were written to permit the use of discretion so that research can fit the circumstances under which it is conducted. For example, the researcher and institutional review board (IRB) could waive or alter some informed consent elements if they deem this the morally and scientifically best way to conduct the research. To do so, however, researchers and IRBs would first have to use mature moral and scientific judgment. They might also have to rely on empirical research to discover the most effective way to act on their moral sense (e.g., to discover how best to approach potential research participants and explain the nature and purpose of the research participation for which they are being recruited, to ensure comprehension and competent decision making). On discovering the most ethical way to proceed, they would then need to look to the federal regulations of human research to discover how to document their decision and justify it within that somewhat flexible regulatory structure. Unfortunately, many IRBs and researchers fail to take these sensible steps to solve ethical problems and proceed immediately to a default requirement of the regulations that places science at odds with the regulations and, ostensibly, with ethics. The following articles in this special issue are about the process of learning to engage in ethical problem solving and using the flexibility permitted by the federal regulations. These articles extricate researchers from the mindset that has gotten them into trouble, and, ideally, provoke them to use mature common sense and moral judgment.     

Responsible Conduct of Research Training and Trust Between Research Postgraduate Students and Supervisors

The federal regulations of human research were written to permit the use of discretion so that research can fit the circumstances under which it is conducted. For example, the researcher and institutional review board (IRB) could waive or alter some informed consent elements if they deem this the morally and scientifically best way to conduct the research. To do so, however, researchers and IRBs would first have to use mature moral and scientific judgment. They might also have to rely on empirical research to discover the most effective way to act on their moral sense (e.g., to discover how best to approach potential research participants and explain the nature and purpose of the research participation for which they are being recruited, to ensure comprehension and competent decision making). On discovering the most ethical way to proceed, they would then need to look to the federal regulations of human research to discover how to document their decision and justify it within that somewhat flexible regulatory structure. Unfortunately, many IRBs and researchers fail to take these sensible steps to solve ethical problems and proceed immediately to a default requirement of the regulations that places science at odds with the regulations and, ostensibly, with ethics. The following articles in this special issue are about the process of learning to engage in ethical problem solving and using the flexibility permitted by the federal regulations. These articles extricate researchers from the mindset that has gotten them into trouble, and, ideally, provoke them to use mature common sense and moral judgment.     

A Social Psychological Perspective

Ethics is normative; ethics indicates, in broad terms, what researchers should do. For example, researchers should respect human participants. Empirical study tells us what actually happens. Empirical research is often needed to fine-tune the best ways to achieve normative objectives, for example, to discover how best to achieve the dual aims of gaining important knowledge and respecting participants. Ethical decision making by scientists and institutional review boards should not be based on hunches and anecdotes (e.g., about such matters as what information potential research participants would want to know and what they understand, or what they consider to be acceptable risks). These questions should be answered through empirical research. Some of the preceding articles in this special issue illustrate uses of empirical research on research ethics. This article places empirical research on research ethics into broader perspective and challenges investigators to use the tools of their disciplines to proactively solve ethical problems for which there currently exist no empirically proven solutions.     

Empirical research on research ethics

Ethics is normative; ethics indicates, in broad terms, what researchers should do. For example, researchers should respect human participants. Empirical study tells us what actually happens. Empirical research is often needed to fine-tune the best ways to achieve normative objectives, for example, to discover how best to achieve the dual aims of gaining important knowledge and respecting participants. Ethical decision making by scientists and institutional review boards should not be based on hunches and anecdotes (e.g., about such matters as what information potential research participants would want to know and what they understand, or what they consider to be acceptable risks). These questions should be answered through empirical research. Some of the preceding articles in this special issue illustrate uses of empirical research on research ethics. This article places empirical research on research ethics into broader perspective and challenges investigators to use the tools of their disciplines to proactively solve ethical problems for which there currently exist no empirically proven solutions.     

The Stories We Tell: Introduction to the Special Issue on Ethical Challenges in Community Psychology Research and Practice

This Special Issue examines ethical challenges in community psychology research and practice. The literature on ethics in community psychology has remained largely abstract and aspirational, with few concrete examples and case studies, so the goal of this Special Issue was to expand our written discourse about ethical dilemmas in our field. In these articles, researchers and practitioners share stories of specific ethical challenges they faced and how they sought to resolve them. These first‐person narratives examine how ethical challenges come about, how community psychology values inform ethical decision making, and how lessons learned from these experiences can inform an ethical framework for community psychology.     

Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

Guidelines for training in the ethical conduct of scientific research

Historically, scientists in training have learned the rules of ethical conduct by the example of their advisors and other senior scientists and by practice. This paper is intended to serve as a guide for the beginning scientist to some fundamental principles of scientific research ethics. The paper focuses less on issues of outright dishonesty or fraud, and more on the positive aspects of ethical scientific behavior; in other words, what a scientist should do to maintain a high level of ethical conduct in research. There are a number of fairly specific rules, guidelines, or commonly accepted operating principles that have evolved for the ethical conduct of science. In order to discuss this code of ethics, this paper is divided into sections dealing with specific areas of scientific ethics. These areas are: data collection and storage, ownership of data, confidentiality, communication, authorship, collaboration, the peer review system, and rules of dealing with ethical complaints. Illustrative case histories are presented to provide examples of the type of ethical dispute or problem being discussed. If scientific trainees learn the accepted rules of behavior that govern the conduct of science, ethical problems that arise out of ignorance, misunderstanding, or poor communication can be avoided.     

Institutional culture and individual behavior: Creating an ethical environment

Much of the work in professional ethics sees ethical problems as resulting from ethical ignorance, ethical failure or evil intent. While this approach gets at real and valid concerns, it does not capture the whole story because it does not take into account the underlying professional or institutional culture in which moral decision making is imbedded. My argument in this paper is that this culture plays a powerful and sometimes determinant role in establishing the nature of the ethical debate; i.e., it helps to define what are viable action options, what is the organization’s genuine mission, and what behaviors will be rewarded or criticized. Given these conclusions, I also argue that consulting ethicists need more than an understanding of ethics theory, concepts and principles; they also need a sufficiently rich understanding of organizational culture and a willingness and an ability to critique that culture. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Jewish biomedical ethics and care of the AIDS patient

Jewish biomedical ethics form part of the broader Judeo-Christian ethical system that prescribes appropriate social conduct for most Americans. They are based on law(halachah) that is derived from the Hebrew Bible and its interpretations. The principle on which they center is that every person is sanctified by God and therefore of infinite value. Therefore, every effort must be made to preserve and protect human life. The management of the patient with AIDS engenders many problems of an ethical nature. An appreciation of the Judaic solutions to these problems may assist physicians caring for patients with AIDS in making their management decisions.     

Situationism and the problem of moral improvement

A wealth of research in social psychology indicates that various ethically arbitrary situational factors exert a surprisingly powerful influence on moral conduct. Empirically-minded philosophers have argued over the last two decades that this evidence challenges Aristotelian virtue ethics. John Doris, Gilbert Harman, and Maria Merritt have argued that situationist moral psychology – as opposed to Aristotelian moral psychology – is better suited to the practical aim of helping agents act better. The Aristotelian account, with its emphasis on individual factors, invites too much risk of morally bad conduct insofar as it ignores the power of situational factors which lead us astray. Moral agents are often better off detecting and intervening on situational factors to help themselves act better. This paper offers an argument against the claim that situationism enjoys practical advantages over Aristotelian virtue ethics. There is empirical evidence suggesting that people can improve their behavior via Aristotelian strategies of deliberate self-improvement. This evidence also suggests that focusing our ethical attention on morally trivial factors may result in worse overall conduct. Accordingly, Aristotelianism may fare better than situationism on the practical issue of moral improvement.     

A neurocognitive model of the ethical decision-making process: implications for study and practice

The field of business ethics is entrenched in a cognitive approach that portrays the ethical decision-making process as a completely deliberate and reasoned exercise. In light of growing concerns about the veracity of this approach, I build upon current knowledge of how the brain functions to present a neurocognitive model of ethical decision making. The model suggests that ethical decision making involves 2 interrelated yet functionally distinct cycles, a reflexive pattern matching cycle and a higher order conscious reasoning cycle, and thereby describes not only reasoned analysis, but also the intuitive and retrospective aspects of ethical decision making. The model sparks research in new areas, holds significant implications for the study of ethical decision making, and provides suggestions for improving ethical behavior in organizations.     

CONFUCIAN ENVIRONMENTAL ETHICS,CLIMATE ENGINEERING,AND THE “PLAYING GOD” ARGUMENT

The burgeoning literature on the ethical issues raised by climate engineering has explored various normative questions associated with the research and deployment of climate engineering, and has examined a number of responses to them. While researchers have noted the ethical issues from climate engineering are global in nature, much of the discussion proceeds predominately with ethical framework in the Anglo‐American and European traditions, which presume particular normative standpoints and understandings of human–nature relationship. The current discussion on the ethical issues, therefore, is far from being a genuine global dialogue. The aim of this article is to address the lack of intercultural exchange by exploring the ethics of climate engineering from a perspective of Confucian environmental ethics. Drawing from the existing discussion on Confucian environmental ethics and Confucian ethics of technology, I discuss what Confucian ethics can contribute to the ethical debate on climate engineering.     

Getting Beyond Form Filling: The Role of Institutional Governance in Human Research Ethics

It has become almost a truism to describe the interaction between research ethics committees and researchers as being marred by distrust and conflict. The ethical conduct of researchers is increasingly a matter of institutional concern because of the degree to which non-compliance with national standards can expose the entire institution to risk. This has transformed research ethics into what some have described as a research ethics industry. In an operational sense, there is considerable focus on modifying research behaviour through a combination of education and sanctions. The assessment of whether a researcher is ‘ethical’ is too often based on whether they submit their work for review by an ethics committee. However, is such an approach making a useful contribution to the actual ethical conduct of research and the protection of the interests of participants? Does a focus on ethical review minimise institutional risk? Instead it has been suggested that ethics committees may be distorting or frustrating useful research and are promoting a culture of either mindless rule following or frustrated resistance. An alternative governance approach is required. There is a need for a strong institutional focus on promoting and supporting the reflective practice of researchers through every stage of their work. By situating research ethics within the broader framework of institutional governance, this paper suggests it is possible to establish arrangements that actually facilitate excellent and ethical research.     

Contributions of empirical research to medical ethics

Empirical research pertaining to cardiopulmonary resuscitation (CPR), clinician behaviors related to do-not-resuscitate (DNR) orders and substituted judgment suggests potential contributions to medical ethics. Research quantifying the likelihood of surviving CPR points to the need for further philosophical analysis of the limitations of the patient autonomy in decision making, the nature and definition of medical futility, and the relationship between futility and professional standards. Research on DNR orders has identified barriers to the goal of patient involvement in these life and death discussions. The initial data on surrogate decision making also points to the need for a reexamination of the moral basis for substituted judgment, the moral authority of proxy decision making and the second-order status of the best interests standard. These examples of empirical research suggest that an interplay between empirical research, ethical analysis and policy development may represent a new form of interdisciplinary scholarship to improve clinical medicine.     

The clinical ethicist at the bedside

In this paper we attempt to show how the goal of resolving moral problems in a patient's care can best be achieved by working at the bedside. We present and discuss three cases to illustrate the art and science of clinical ethics consultation. The sine qua non of the clinical ethics consultant is that he or she goes to the patient's bedside to obtain specific clinical and ethical information. Unlike ethics committees, which often depend on secondhand information from a physician or nurse, clinical ethics consultants personally speak with and examine patients and review their laboratory data and medical records. The skills of the clinical ethics consultant include the ability to delineate and resolve ethical problems in a particular patient's case and to teach other health professionals to build their own frameworks for clinical ethical decision making. When the clinical situation requires it, clinical ethics consultants can and should assist primary physicians with case management.     

Research Ethics Education in the STEM Disciplines: The Promises and Challenges of a Gaming Approach

While education in ethics and the responsible conduct of research (RCR) is widely acknowledged as an essential component of graduate education, particularly in the STEM disciplines (science, technology, engineering, and math), little consensus exists on how best to accomplish this goal. Recent years have witnessed a turn toward the use of games in this context. Drawing from two NSF-funded grants (one completed and one on-going), this paper takes a critical look at the use of games in ethics and RCR education. It does so by: (a) setting the development of research and engineering ethics games in wider historical and theoretical contexts, which highlights their promise to solve important pedagogical problems; (b) reporting on some initial results from our own efforts to develop a game; and (c) reflecting on the challenges that arise in using games for ethics education. In our discussion of the challenges, we draw out lessons to improve this nascent approach to ethics education in the STEM disciplines.     

Relationships between personal values and reported behavior on ethical scenarios for law students

Lawyers' values might be considered to play some role in the decisions that are made in everyday legal practice. This study aimed to explore the effects of personal value hierarchies on ethical decision making within the context of several ethical dilemmas. A questionnaire was administered utilizing hypothetical situations presented in 11 ethical scenarios and including the Rokeach Value Survey. Logistic regression results suggested that different personal values were significant predictors of reported behavioral choices on respective ethical scenarios. However, the most important values associated with behavior consistent with ethical conduct in scenarios were 'honesty' and 'equality'. The implications of results are discussed in the contexts of ethics education in a tertiary educational environment and in relation to regulation for the professions.     

Science, Human Nature, and a New Paradigm for Ethics Education

For centuries, religion and philosophy have been the primary basis for efforts to guide humans to be more ethical. However, training in ethics and religion and imparting positive values and morality tests such as those emanating from the categorical imperative and the Golden Rule have not been enough to protect humankind from its bad behaviors. To improve ethics education educators must better understand aspects of human nature such as those that lead to ??self-deception?? and ??personal bias.?? Through rationalizations, faulty reasoning and hidden bias, individuals trick themselves into believing there is little wrong with their own unethical behavior. The application of science to human nature offers the possibility of improving ethics education through better self-knowledge. The author recommends a new paradigm for ethics education in contemporary modern society. This includes the creation of a new field called ??applied evolutionary neuro-ethics?? which integrates science and social sciences to improve ethics education. The paradigm can merge traditional thinking about ethics from religious and philosophical perspectives with new ideas from applied evolutionary neuro-ethics.     

Rethinking research ethics

Contemporary research ethics policies started with reflection on the atrocities perpetrated upon concentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim of this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research.