Dr. Fleck published in April ‘Journal of Medical Ethics’

Leonard Fleck photoCenter Acting Director and Professor Dr. Leonard Fleck is the author of an article published in the April 2020 issue of the Journal of Medical Ethics. “Just caring: screening needs limits” is in response to “Arrogance of ‘but all you need is a good index finger’: A narrative ethics exploration of lack of universal funding of PSA screening in Canada” by Dr. Jeff Nisker.

Abstract: This personal narrative tugs at the heart strings. However, personal narratives are not sufficient to justify public funding for any screening policy. We have to take seriously the ‘just caring’ problem. We have only limited resources to meet virtually unlimited health care needs. No doubt, screening tests often save lives. The author wants public funding for prostate-specific antigen screening for prostate cancer. However, why only prostate cancer? Numerous cancers at various stages can be screened for. Are all of them equally deserving of public funding? What about screening for a very long list of other life-threatening medical disorders? There is nothing ethically special about cancer. Where does the money come from to pay for all these screening tests? Do we reduce expensive life-prolonging care for patients in late-stage diseases? Ultimately, a balance must be struck between saving statistical lives through screening and saving identifiable lives in the intensive care unit. Achieving a just balance requires rational democratic deliberation as justification for these choices, not personal narratives.

The full text is available online via BMJ Journals (MSU Library or other institutional access may be required to view this article).

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The Promises and Perils of Using Collective Data to Monitor COVID-19

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This post is a part of our Bioethics in the News seriesBioethics-in-the-News-logo

By Laura Cabrera, PhD

In a state of public health emergency, such as the one brought on by COVID-19, different countries have invoked extra powers to help mitigate the public health threat. These special powers would under normal circumstances be considered infringements on our liberty and privacy. A recent Wired article addressed that big tech companies like Google and Facebook are having discussions with the White House to share collective data on people’s movement during the current pandemic. For example, using phone location data or private social media posts to help track whether people are remaining at home and keeping a safe distance to stem the outbreak, and to measure the effectiveness of calls for social distancing. In the U.S., the government would generally need to obtain a user’s permission or a court order to acquire that type of user data from Google and Facebook. But as mentioned above, the government has broader powers in an emergency.

Obtaining this data could help governments prepare for the coming weeks of this public health emergency. For example, smart phone location data analysis from the New York Times has shed light on the disparities regarding which groups can afford to stay home limiting their exposure to the coronavirus. This is certainly useful to better understand the spread of the disease in different areas and across different socioeconomic groups. Facebook is working with Chapman University and other collaborators to develop maps that show how people are moving between areas that are hotspots of COVID-19 cases and areas that are not, and such maps could be useful in understanding the spread of the disease. Announced in a news release this month, Apple and Google have launched a joint effort to help governments and health agencies reduce the spread of the virus by using application programming interfaces and operating system-level technology to assist in enabling “contact tracing.”

brain-magnifying-glass

Image description: an illustrated image of a pink brain coming out of the top of a person’s head; a magnifying glass with a brown handle, silver rim, and blue lens is above the brain as if looking into it.  The background is light green. Image source: artwork from vecteezy.com.

While this sounds promising, one of the main obstacles has to do with concerns over the privacy of users whose data might be handed over by the companies. It would be unprecedented for the government to openly mine user movement data on this scale. To add to the issue, the current state of affairs where many more people now rely on digital tools to work or attend classes remotely, as well as to stay connected with family and friends, makes the amount and type of data gathered richer. However, as pointed out in a New York Times editorial, we should not sacrifice our privacy as a result of this pandemic.

Another relevant concern related to the use of collective data is government surveillance. For example, the use of mobile data to track the movement of individual coronavirus patients in China or South Korea can be seen as more controversial uses of the collected data.

It is certain that during this challenging time, data sharing and collaboration between academia, governments, civil society and the private sector is key to monitor, understand and help mitigate this pandemic. However, without rules for how companies should anonymize the data, and without clear limits on the type of data they can collect and how the data could be used and kept secure by researchers and governments, the perils might be greater than the promises. Furthermore, we need a clear path for what happens after all of this is over. For example, people should be given the option to delete user profiles they created as part of new work and school arrangements.

Given past scandals around privacy and transparency surrounding these big tech companies (in addition to the several scandals with the current government administration), it is hard to trust that the idea would be to only gather aggregate trends, and that they would not collect any identifying information about users, or track people over long periods beyond the scope of the pandemic.

Civil groups and academics have discussed the need to protect civil liberties and public trust, arguing for the need to identify best practices to maintain responsible data collection, processing, and use at a global scale.

The following are some of the key ideas that have been discussed:

  • In a public health emergency like the one we are living, some privacy intrusions might be warranted, but they need to be proportionate. For example, it would not be proportionate to gather 10 years of travel history of all individuals for the type of two-week incubation disease we are dealing with.
  • This type of government and big tech company partnership needs to have a clear expiration date, as there is a hazard for improper surveillance that could come with continuation of data gathering after the crisis is over. Given the historical precedents on how life-saving programs used in a state of emergency have continued after the state of emergency was resolved, we as a society need to be very cautious with how to ensure that such extraordinary measures do not become permanent fixtures in the landscape of government intrusions into daily life.
  • The collection of data should be based on science, and without bias based on nationality, ethnicity, religion, or race (unlike bias present in other government containment efforts of the past).
  • There is a need to be transparent with the public about any government use of “big tech data” and provide detailed information on items such as the information being gathered, the retention period, tools used, and the ways in which these guide public health decisions.
  • Finally, if the government seeks to limit a person’s rights based on the data gathered, the person should have the opportunity to challenge those conclusions and limits.

A few weeks ago the European Data Protection Board issued a statement on the importance of protecting personal data when used in the fight against COVID-19. The statement highlighted specific articles in the General Data Protection Regulation legislation. For example, Article 9 mentions that processing of personal data “for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health” is allowed, provided such processing is proportionate to the aims pursued. In the U.S. we are far from having such a framework to start discussing data collection, sharing, and use under the current circumstances.

There is no doubt as to potential public health benefits associated with analysis of such data and surveillance. For example, the utility of identifying individuals who have traveled to hotspot areas, or tracing and isolating contacts of those infected. However, without a clear framework on how digital data collection companies will address privacy and surveillance concerns, the more cautious we should be about access to other areas of our life, access that would also be shared with governments. Without due caution, not only will public trust continue to be undermined, but additionally people will be less likely to follow public health advice or recommendations, leading to even worse public health consequences.

Laura Cabrera photoLaura Cabrera, PhD, is an Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Translational Neuroscience at Michigan State University.

Join the discussion! Your comments and responses to this commentary are welcomed. The author will respond to all comments made by Thursday, May 7, 2020. With your participation, we hope to create discussions rich with insights from diverse perspectives.

Article narration by Liz McDaniel, Communications Assistant, Center for Ethics.

You must provide your name and email address to leave a comment. Your email address will not be made public.

More Bioethics in the News from Dr. Cabrera: Should we trust giant tech companies and entrepreneurs with reading our brains?; Should we improve our memory with direct brain stimulation?Can brain scans spot criminal intent?Forgetting about fear: A neuroethics perspective

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Dr. Cabrera published in March issue of ‘Journal of Cognitive Enhancement’

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera and Dr. Karen Herrera-Ferrá (Asociación Mexicana de Neuroética) are co-authors of an article published in the March 2020 issue of the Journal of Cognitive Enhancement. Their article is titled “¿Neuroensanchamiento?: Concepts and Perspectives About Neuroenhancement in the Hispanic Literature.”

Abstract: While neuroenhancement has been widely debated in the bioethics and neuroethics literature, the Anglo-American perspective has dominated a majority of these discussions. Thus, little is known about the motives and attitudes towards neuroenhancement in other cultures. Cultural values and linguistic peculiarities likely shape distinct attitudes and perspectives about neuroenhancement. In this paper, we aim to identify universals and points of divergence between the Anglo-American and the Hispanic discussions about neuroenhancement. We carried out a literature review of articles published in the Spanish language discussing perspectives and ethical issues around neuroenhancement. We analyzed the content for (1) the terms used to convey the concept of “neuroenhancement” and (2) the ethical concerns raised. Our results show a wide range of Spanish terms used to refer to neuroenhancement, as well as important differences on the scope and concerns raised. These results invite further research regarding cross-cultural perspectives on neuroenhancement and neuroethical discussion.

The full text is available online via Springer (MSU Library or other institutional access may be required to view this article).

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Brittany Ajegba presents at Diversity in Medicine Conference

In early March, College of Human Medicine student Brittany Ajegba presented at the second annual Diversity in Medicine Conference at the University of Michigan in Ann Arbor. Ajegba presented a poster titled “Rationales for expanding minority physician representation in the workforce: a scoping review.” The poster presented the work of a multi-institution research team comprised of Karen Kelly-Blake (MSU), Libby Bogdan-Lovis (MSU), Nanibaa’ Garrison (UCLA), Faith Fletcher (University of Alabama at Birmingham), Brittany Ajegba (MSU), Nichole Smith (University of Chicago), and Morgan Brafford (Walden University). The team’s scoping review of the same name was published in the September 2018 issue of Medical Education.

Ajegba shared her experience on attending: “I was so happy I was able to attend and present at the [conference]. While I got to present on our physician-patient racial/ethnic concordance research, it was great to see what researchers from around the country are doing to address underrepresentation in medicine. Being from the area, it was nice to reconnect with future colleagues and to see what work was being done around various topics of diversity in medicine that included but was not limited to: unconscious bias projects, pipeline programs, LGBTQ+ healthcare, and much more.”

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Image description: Brittany Ajegba smiles next to her poster that is pinned on a display board at the Diversity in Medicine Conference. Photo courtesy of Brittany Ajegba.

The team’s poster presented findings of their scoping review of the 2000-2015 literature on strategies for and approaches to expanding underrepresented minority (URM) representation in medicine, “which reveals a repetitive, amplifying message of URM physician service commitment to vulnerable populations in medically underserved communities. Such message repetition reinforces policies and practices that might limit the full scope of URM practice, research and leadership opportunities in medicine. Cross-nationally, service commitment and patient-physician concordance benefits admittedly respond to recognized societal need, yet there is an associated risk for instrumentally singling out members of URMs to fulfill that need. Additionally, the proceedings of a 2001 US Institute of Medicine symposium warned against creating a deterministic expectation that URM physicians provide care to minority populations.”

Listen to Episode 6 of our podcast series No Easy Answers in Bioethics, featuring Libby Bogdan-Lovis and Dr. Karen Kelly-Blake, to learn more about this ongoing research.

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Dr. Cabrera published in journal’s special section on feminist neurotechnologies

Laura Cabrera photoDr. Robyn Bluhm, Associate Professor in the Department of Philosophy and Lyman Briggs College, and Dr. Laura Cabrera, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Translational Neuroscience, are co-authors of an article in the Spring 2020 issue of IJFAB: International Journal of Feminist Approaches to Bioethics.

Their article, “Deep Brain Stimulation and Relational Agency: Negotiating Relationships,” appears in a special section on feminist neurotechnologies. From the article’s introduction:

In this commentary, we consider three aspects of [Timothy] Brown’s discussion of DBS and relational agency: (1) the importance of thinking critically about what it means to have a relationship with a DBS device; (2) how the development of “closed loop” implants might change the kinds of relationships that are possible; and (3) the need to consider how an individual’s relationship with their device is shaped by their relationship with others in their lives. We see ourselves as building on, or offering suggestions for further developing, Brown’s important paper.

Drs. Bluhm and Cabrera are co-investigators on the project “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions,” funded by the NIH BRAIN Initiative. Deep brain stimulation (DBS) is one of four types of psychiatric electroceutical interventions (PEIs) included in the scope of the project.

The full text is available online via University of Toronto Press (MSU Library or other institutional access may be required to view this article).

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A Reasonable and Virtuous Response to a Pandemic

Bioethics in the News logoThis post is a part of our Bioethics in the News series

By Larissa Fluegel, MD, MHS

Within five days of the first two registered cases here in Michigan, social media traffic about COVID-19 visibly ramped up, with a significant amount of COVID-19-related posts on my news feeds. This was the same for my friends. People were posting photos of entire local store aisles almost empty. I went to the store and to my astonishment, checkout lanes had long lines of individuals with carts filled with toilet paper, water, and hand sanitizer. Every single cart looked the same. I thought, what is happening? The apocalypse? Where have the virtues of altruism and selflessness gone? Anyway, this blog is not about toilet paper or human responses to fear, but about the question of what is safe, appropriate, and virtuous to do at the individual level, all things considered.

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Image description: Empty shelves that normally contain toilet paper in a Walgreens store, shared on March 13, 2020. Image source: Raed Mansour/Flickr Creative Commons.

What we know.

  • This is a new virus. The fact that it is new means that humans lack the immunity to mount a quick and sufficiently strong response to clear the virus before it causes disease.
  • Based on all 72,314 cases in the Chinese population, most (80.9%) are ‘mild’ respiratory flu-like (but also gastrointestinal); 4.7% turn critical and 2% are fatal.
  • Severity and risk of death increase with age and with pre-existing conditions.
  • There is a two to fourteen-day incubation time (this is the period of time from when the virus first enters one’s body and the time one shows symptoms).
  • Mild soap and water used as recommended are highly effective in eliminating the virus.
  • There is no effective treatment or vaccine against the virus yet.
  • Michigan’s Governor declared a state of emergency on March 10 and mandated all Michiganders to stay home as of March 23. This state of emergency declaration is not intended to cause panic, but instead is to allow the State to quickly deploy resources to support local responses in combatting the spread. This also is done to avoid overwhelming the healthcare system, where patients are being treated in hospital hallways, cared for by exhausted healthcare workers who might be pressed to decide which patients warrant oxygen assistance and which die.

Why do we want to stop the spread?

What we really hope to achieve is to flatten the curve of the spread. The goal is to decrease the rate of infection so that too many people don’t get sick at the same time, going beyond our current health care system’s capacity to safely and effectively treat. By doing so, we protect our fellow citizens. How? By preserving access to necessary medical resources.

What do these things mean to us?

We should understand that eventually we might all get sick. We must not make decisions based on fear. We instead should make decisions based on what we know about the virus and its spread, i.e., the facts and recommendations from reputable health authorities like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) who are carefully monitoring and studying the situation, while avoiding unsupported advice appearing on social media. This is ethical, responsible, and virtuous behavior.

When public health officials strongly recommend that we stay home, we follow their recommendations to the best of our ability because this helps save lives. Remember the issue is no longer about us individually but about us as a community and a nation:

“…[T]o prevent the state’s health care system from being overwhelmed, to allow time for the production of critical test kits, ventilators, and personal protective equipment, and to avoid needless deaths, it is reasonable and necessary to direct residents to remain at home or in their place of residence to the maximum extent feasible.” -The Office of Governor Gretchen Whitmer, Executive Order 2020-21 (COVID-19)

When public health officials strongly recommend that we immediately practice appropriate social distancing, we do that. What this means is that whenever we are able to do so, we should anticipate and avoid places where we cannot be at least 6 feet from another person—except, of course, family members who we live with. If you work in an industry that requires you to show up, do not fret. If the rest of us altruistically do what we can, you should also be okay. If you have a friend or relative who may be at increased risk because of a prior condition, stay away from them—again, let us take care of each other.

But be mindful that social distancing does not mean social isolation. We can and should stay connected through technology that enables us to reach out and connect. This is also good for our emotional and mental health.

Of course, we must not forget to practice respiratory and hand washing etiquette, washing our hands the right way, with soap and running water, when:

  1. You arrive at your location (if leaving home is necessary) and when you return home.
  2. Before and after handling food.
  3. After toileting.

None of these cautions and behavioral virtues suggest that it is necessary to freak out and purchase all the available toilet paper or hand sanitizer. All indications are that food and basic necessities will continue to be available. It does not mean to be obsessively and compulsively spraying disinfectant on every surface of your home multiple times a day, every day. If we practice social distancing or stay home where mandated and practice appropriate hand washing and respiratory etiquette, this is not necessary.

Times like this call for bolstering virtuous behavior. Do what we are told for the sake of all. Do what we can to reconnect with our families and our local community. Do remember those in need. We can go out for a walk or a run or a hike. With appropriate distance these are all okay.

The bottom line is that it is appropriate and virtuous to calmly and sensibly take measures to slow the spread, following guidelines from valid sources while taking care of each other… keeping our distance but keeping in touch.

fluegel-larissa-blogLarissa Fluegel, MD, MHS, is an Adjunct Assistant Professor with the Center for Ethics and Humanities in the Life Sciences and the College of Human Medicine at Michigan State University where she teaches bioethics and the social context of clinical decisions. Her academic interests include the integration of bioethics, social determinants of health, shared decision-making, and health policy into medical education.

Join the discussion! Your comments and responses to this commentary are welcomed. The author will respond to all comments made by Thursday, April 9, 2020. With your participation, we hope to create discussions rich with insights from diverse perspectives.

You must provide your name and email address to leave a comment. Your email address will not be made public.

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Listen: Why I Left the U.S. for My Surgical Procedure

No Easy Answers in Bioethics logoNo Easy Answers in Bioethics Episode 21

What would you do if you needed surgery, but seeking care would mean $25,000 or more in medical debt? Would you consider traveling to another country to receive the same surgery at a fraction of that cost? Would you put off seeking care entirely, until it became an emergency situation?

These questions related to access to care, health insurance, and medical tourism are explored in this episode, which features Center for Ethics and Humanities in the Life Sciences faculty members Len Fleck and Larissa Fluegel. Dr. Fluegel, a clinician born and raised in the Dominican Republic, shares her personal experience of needing gallbladder surgery, and the reasons why she traveled from Michigan to the Dominican Republic to receive that surgery. It may not be surprising that the main reason was cost. Discussing the healthcare systems in both countries, Drs. Fleck and Fluegel explore the challenges that under- and uninsured individuals in the U.S. face when seeking care.

Ways to Listen

This episode was produced and edited by Liz McDaniel in the Center for Ethics. Music: “While We Walk (2004)” by Antony Raijekov via Free Music Archive, licensed under a Attribution-NonCommercial-ShareAlike License. Full episode transcript available.

About: No Easy Answers in Bioethics is a podcast series from the Center for Ethics and Humanities in the Life Sciences in the Michigan State University College of Human Medicine. Each month Center for Ethics faculty and their collaborators discuss their ongoing work and research across many areas of bioethics. Episodes are hosted by H-Net: Humanities and Social Sciences Online.

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Dr. Cabrera gives community talk on psychiatric neurosurgery

Laura Cabrera photoOn February 18, Center Assistant Professor Dr. Laura Cabrera presented a talk entitled “The ethics of psychiatric neurosurgery” at Schuler Books & Music in Okemos. The event was part of the Cafe Scientifique series presented by the Lansing Community College Science Department.

In her presentation Dr. Cabrera shared results from her Science and Society at State grant with the audience, and discussed how the insights from that project led to her current NIH-funded project, “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions.” The presentation also highlighted the role of neuroethics in examining and addressing public perceptions and values around psychiatric neurosurgery.

Visit the Lansing Community College website for information on future Cafe Scientifique events, which are free to attend and open to the public.

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Trust and Transparency in Quarantine

Bioethics in the News logoThis post is a part of our Bioethics in the News series

By Parker Crutchfield, PhD

As of February 11, more than 1,000 people have died from the novel coronavirus, the vast majority of them in China. As the virus spreads, China has been implementing the largest quarantine in human history. The virus has spread beyond the borders of China, and has been observed in at least twenty-four countries. There is no way of knowing how effective the quarantine has been. It obviously didn’t prevent the virus’s spread, though it’s likely fewer people are infected because of it. Part of the reason that the quarantine has not worked to prevent the spread is that many in China evidently don’t trust those implementing the quarantine. About five million people left Wuhan before the quarantine locked down the city. And the images in this video are certainly not of a family trusting their government.

Trust and quarantine
A prominent account of what makes public health interventions permissible implies that public trust is necessary for public health interventions to be morally permissible. As a general rule, this is false. Public trust in Flint has been totally undermined. But in that city, public health interventions on the water supply are not only permissible, they are obligatory. So, it’s not true that trust is necessary. But that is not to say that public trust isn’t critical to the value of a public health intervention.

Trust and mistrust street signs image

Image description: two green street signs with white lettering, one reads “trust” with an arrow pointing to the right, the other reads “mistrust” with an arrow pointing to the left. Image source: Pixabay.

The value of a public health intervention, and its moral authority, is primarily a matter of the value of the benefit it achieves (the value of the cases prevented) minus the disvalue of the burdens it requires people to bear (the disvalue of social isolation). Trust may not be necessary, but it certainly impacts the benefits and burdens of a public health intervention. There is significant benefit in not having five million people evade a quarantine because they mistrust those implementing it. Who is more burdened, the family who fights tooth and nail the officials forcibly removing them from their home, or the family who goes willingly because they trust them? Mistrust creates burdens; trust promotes value. In other words, mistrust encourages people to break quarantine. If the goal is to encourage social isolation and compliance, public trust is key.

Trust and transparency
If trust is so important to the effectiveness of a quarantine, what factors promote trust? That same theory of the morality of public health interventions derives the value of transparency from the claim that transparency promotes trust. The idea is that the more open policy decisions, the more the public will trust them. As before, this is not generally true. Some research indicates that transparency actually undermines trust (De Fine Licht, 2011; Grimmelikhuijsen, 2014).

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Image description: A screen display on the side of a building showing “early discovery, early report, early quarantine, early diagnosis, early treatment” during the Wuhan coronavirus outbreak in Hefei, Anhui, China. Image source: Zhou Guanhuai/Wikimedia Commons.

That is, the more people know about policy implementation the less they trust the people implementing it. If accurate, this research suggests instead that if we want people to trust public health policies, information should be withheld from them. This is in line with earlier research that suggests what people really want is for decision-makers to be empathetic and non-self-interested and that, if they are, for them to make mostly non-transparent decisions. People may want “stealth democracy” (Hibbing and Theiss-More, 2002).

So, probably it is not generally true that transparency promotes trust. But quarantine might be a special case. When the public already mistrusts those implementing public health policies, it’s not clear that there is any way to rebuild trust other than by being transparent. China was already in a tough spot, after their mishandling of the SARS outbreak in 2003, about which officials withheld information from the public and the global health community. Combined with the attempted silencing of the coronavirus whistleblower and his recent death, officials’ actions set the stage for a mistrustful public and less effective quarantine.

The next outbreak
Given officials’ actions in response to SARS, the public response to attempts to control coronavirus was probably never going to be trusting. Regardless of when the next outbreak occurred, the public was never going to trust the interventions to control it, whatever they happened to be. That was determined in 2003. Transparency now won’t help trust now, and so it won’t help the effectiveness of the present quarantine or any of the other interventions, such as the disinfectant now being sprayed. The damage to the present is done. Sadly, given that officials have responded like they did in 2003, interventions aimed at controlling their next outbreak, whenever that happens to be, will be upon a mistrusting public. When that time comes, if officials choose to quarantine, it seems likely that that quarantine will elicit similar responses: people will evade and resist, grabbing door frames as they are pulled from their homes. The virus will not be contained as well as it could have been, and more people will get sick and die. Present transparency could have promoted future trust, greater compliance, and prevented sickness and death, but that opportunity has come and gone.

There is a lesson for local officials as they try to intervene on the ongoing water crisis in Flint, the PFAS scare in West Michigan, and, in my hometown, the threat of mosquito-borne illness. The lesson is: transparency now purchases trust later. And that trust may prevent suffering and save lives.

parker-crutchfield-cropParker Crutchfield, PhD, is Associate Professor in the Program in Medical Ethics, Humanities, and Law at the Western Michigan University Homer Stryker M.D. School of Medicine, where he teaches medical ethics and provides ethics consultation. His research interests in bioethics include the epistemology of bioethics and the ethics of enhancement, gene editing, and research.

Join the discussion! Your comments and responses to this commentary are welcomed. The author will respond to all comments made by Thursday, March 5, 2020. With your participation, we hope to create discussions rich with insights from diverse perspectives.

You must provide your name and email address to leave a comment. Your email address will not be made public.

More Bioethics in the News from Dr. Crutchfield: Public Health Crisis Warrants Liberty RestrictionsWe Should Tolerate and Regulate Clinical Use of Human Germline Editing

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Brews and Views: Trust Me, I’m a Scientist!

Scientist [ˈsīəntəst] — a person who has expert knowledge.

Brews and Views logo with people, brain, DNA, and gear icons

Last month more than 100 faculty members and researchers attended the latest Brews and Views session: “Trust Me, I’m a Scientist! Responsibility and Accountability in Science.” The event series, presented collaboratively by the Center for Ethics and Humanities in the Life Sciences and the Institute for Quantitative Health Science & Engineering, features moderated discussions addressing fascinating and provocative areas of bioscience and engineering.

The event was moderated by Dr. Monique Mitchell Turner, Chair and Professor in the Department of Communication, College of Communication Arts and Sciences. Dr. Turner began with an audience response poll that asked attendees to consider both the role of institutional review boards regarding responsible and ethical research conduct, and the ethical obligations of scientists studying risky innovations that could potentially cause harm. Subsequent questions focused on the concept of dual use, which Dr. Turner clarified as referring to “technologies that alternately can be used for peaceful as well as for hostile purposes.” Regarding potential dual use harms, who is ultimately responsible: the principal investigator, the journal that published the work, or someone else entirely?

V211-social media

Image description: an illustration depicts four scientists holding a double helix, beaker, atoms, and a magnifying glass. Image source: vecteezy.com.

Discussant Dr. Heather Douglas, Associate Professor in the Department of Philosophy, College of Arts & Letters, examined moral responsibility in scientific endeavors, focusing on two qualities of dual use concerns, i.e., the intention of the researcher and that which might or might not be foreseeable. She clarified that when the ultimate use is readily predictable, ignoring the prospect of use for hostile purposes would be reckless, but unfortunately, many things are not predictable.

Dr. Douglas pointed out that the two checks on scientific endeavors include responsibility and accountability, but the conundrum is that those two checks are not necessarily synced — scientists can be held responsible for things which they are not accountable and accountable for things which they are not responsible. It’s reasonable to hold scientists accountable to good methodology, to their colleagues, and to society. But there are other actors who are accountable as well, including the institution (as well as journals that publish research). The paradox is that the more an institution enforces accountability checklists, the more an individual scientist might mistakenly feel that they’ve met their responsibility by simply complying with that checklist. Dr. Douglas urged that to be accountable, scientists have a responsibility to think beyond such checklists to imagine future possibilities including dual use concerns.

Discussant Dr. Victor DiRita, Rudolph Hugh Professor & Chair in the Department of Microbiology & Molecular Genetics, College of Natural Science, acknowledged that scientists need to be both responsible and accountable, but he pointed out that science “works” by advancing incrementally, building on the base of prior work. For this reason, he rejected the broad notion of dual use, since it is impossible to have sufficient imagination to accurately predict future nefarious use of any given innovation. To illustrate, he noted that dual use concerns are often related to “gain of function” in which research builds on and extends the capacity of previous work. He noted that governance, carried out through the vehicles of institutional policies is unable to predict such capacity extension, and therefore dual use itself is impossible to predict.

Dr. DiRita expressed worry that excessive focus on potential risks can blur the lines between real risk and perceived risk, possibly impeding the progress of important useful research. While institutional regulatory policies are well-intended, he is concerned about undue regulatory burdens in those labs that lack the resources necessary to be compliant. Moreover, he was in agreement with Dr. Douglas that such checklists erroneously allow scientists to believe that simple compliance with regulation is sufficient to meet their responsibilities, and that journals should share responsibility for publicizing dual use science.

Brews-Views-01-24-2020 Douglas Turner and DiRita photo

Image description: Pictured left to right are Heather Douglas, Monique Mitchell Turner, and Victor DiRita presenting to the audience at Brews and Views on January 24, 2020. Photo courtesy of Libby Bogdan-Lovis.

Brews and Views is collaboratively organized by Dr. Christopher Contag, Dr. Laura Cabrera, and Libby Bogdan-Lovis. Visit our website for more information on past events in the series.

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