Ethics

Moral principles for conduct in pursuit of aims and goals and standards of conduct reflecting what is considered proper behaviour or prescriptions for behaviour based upon personal or professional values. 

Consider the ethics of imagined controlled experiments assessing the effects of smoking and heart and lung disease or child abuse and later personality development. Conducting experimental research would require that we recruit subjects, for example, teenage non-smokers or unabused children, and separate them into two groups, a control group and an experimental group, then see to it that the non-smokers in the experimental group take up cigarette-smoking to some particular level (e.g., heavy, moderate, or light), periodically verifying they are continuing to smoke while we monitor them for onset of disease or that we arrange for the abuse of the children in the experimental group and subsequently compare them with the controls on personality variables.

To act thus would be unethical* in that, not surprisingly, we can have a good degree of certainty that we would be exposing the non-smokers and the children to serious harm, even though we may not be able to precisely specify how much and which individuals would be most badly affected. It is clear, though, that smoking leads to debilitating diseases, pain, and premature death in many cases, while child abuse has profound, long-term adverse psychological consequences for those who are subjected to it.

Before research can begin as part of the planning process there is a decision to be made as to whether the benefits of any particular study outweigh the risks. In the imaginary case above the construction of the proposed experiments actually requires harm to be undergone by research participants. This presumes that we should consider that such voluntary (and preventable) infliction of harm to be unjustifiable in the circumstances, and that this harm could not be mitigated or excused by what we might learn from the exercise. Disease agents, ostensibly-helpful drugs, or anything else which might be harmful or beneficial which is proposed to be administered must be considered with the subjects’ welfare in mind.

From the late nineteen-thirties through to the early nineteen-sixties in United States the surgical brain procedure of frontal lobotomy was freely practiced on many psychiatric patients, often without any form of informed consent being sought or given, with at least an initial justification that it calmed aggressive and violent impulses and was to be a treatment of “last resort”. But this supposed “cure” came at the expense of robbing those people of significant human sensibilities and transformed very many such patients into inactive individuals without initiative: in some sense they lost their own ‘selves’ and became different people with very noticeably diminished functioning. Were these injuries and disruptions lobotomy caused “worth” exchanging for some control of the patients’ ‘raging’ behaviour?

How ethical is it to use and/or promote putative therapeutic medicines or treatments which have not been shown by proper scientific trialling and evaluation to be both safe and effective (with a known significant effect beyond placebo)? Is it enough to respond as many proponents of ‘alternative’ or ‘complementary medicine’† do if pressed about whether their treatments and medicines have passed the same standards as scientific medicine, by saying something like: “well, no, we’ve had pilot studies (that is, small numbers, no control groups, no stringent conditions, observation, or evaluation, etc.), but the people who receive the treatments tell us they work wonderfully well and would beg us to keep on with the treatments if we were to suspend using them pending the outcome of scientific testing”. Much the same could have been said had medieval practitioners withdrawn their practice of ‘bleeding’ or ’bloodletting’.

†it would no longer be said to be 'alternative' if it were demonstrated to be safe and effective, it would simply be absorbed by and be counted as general medicine.