Ethics in Clinical Research

chillibreeze writer — Anupama Ramanarayan

Ethics: “a system of principles governing morality and acceptable conduct.”
As a society and as a race, we are individuals prone to subjective judgment. While this may hold true for various facets in society, scientific conduct is definitely not a subjective matter. As societal animals, we have the tendency to pin down anything objective as rebellious and defiant. But rebellion and defiance are what define out-of-the-box thinking, which is one characteristic science cannot survive without.

How do we relate the philosophical areas of ethical arguments with research? In fact, the discussion has become popular. Biomedical research, involving the use of human beings as subjects, is a prickly topic to deal with. As the discoveries of drugs and medicines related to human welfare grow in dimension and scope, so do the requirements for human experimentation in the field. It cannot be opined that the use of human beings as subjects is entirely unethical. Meanwhile, it cannot also be accepted that for the welfare of a population, a few hundreds are to be put at stake.

What then is the middle path? Neither can human experimentation be stopped, nor can it be made ideal.

There are various methods devised by researchers and people who are concerned with research conduct to keep the proceedings as ethical as possible. Practically speaking, a few loopholes are what we all expect in the course of a generalized conduct. But expectations and reality fall wide apart when we come under the purview of actual research. The incidents of various trials gone wrong, some deliberately and some accidentally, are too many to be ignored. Be it the Tuskegee Syphilis study in the U.S, or the more recent Cervical Dysplasia study conducted by none other than the Indian Council of Medical Research in India, researchers are apparently not able to resist treating human subjects as guinea pigs.

The infamous Nazi war crimes, which occurred during the Holocaust from 1939 to 1945, were indicative of the latent human tendency to be extremely objective about research. Here is where a contradiction of sorts arises. On one hand a physician has to be extremely objective about his patients and is supposed to have no feelings apart from the awareness that the patient is a body to be healed. But when physicians approach research with the same objective intent, there are more chances than one that he or she may be tempted into unethical conduct. Herein we can ask a valid question. Does being a physician and a researcher concurrently involve a paradigm shift? And if it does, then what defines it? Who defines the boundaries?

We can confront the issue from the various sides it exposes us to. Understanding points of view from all sides ensures some clarity, but we have to accurately judge the distance we have to travel to cover the space between ideal conduct and the presently followed line of conduct.
Maybe we can conclude here with the famous lines by poet Robert Frost:

And miles to go before I sleep, miles to go before I sleep.”

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Anupama writes for chillibreeze.

Ethics in Clinical Research

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