Wednesday, August 3, 2011

Ethics in Science

So, right now the UK is in a big uproar about ethics in science. There have been parliamentary hearings which have deeply concerned scientists. In one opinion piece from the guardian the author argues that it's been too long going that the scientific community has been able to function without some sort of regulation. Scientists of course object to this. Because there is a method to the manner in which they work. Many, from the tone at the hearings, feel this is another assault on the scientific community.

However, it maybe that there's some scientific work that is more likely to have fraudulent activity in it. Today the Guardian published an article about scientific ghost writers. Scientific Ghost writers can come in two forms. The first is harmless where the author is really the person that got the funding. Depending on the journal these authors are either the second or very last author on the paper. This is normal, as typically you're working in that person's lab and they are paying you. So they should get some credit for the work done as they may also have had an advising role. The second kind of ghost writing is much worse. These writers were in no way associated with the research and their names are put on the article to give it weight, or if they were the ones supposed to be doing the research and some one else did it. In the Guardian article they are focusing on clinical trials for medicines.

This isn't the only country where fraud, exaggerating claims or ghost writing occurs. Although, the UK has had one of the most famous cases with the retracted article linking MMR vaccine to Autism (meaning it was fraud). This also happens in the US and in many clinical trials. In fact a Greek doctor has made it his mission to unearth clinical trial fraud and really understand what was going on there. The Atlantic had a great write up about this in November of 2010. The doctor  Ioannidis has been making a career out of debunking claims as well as researching the causes of these problems. He argues that the double blind clinical trial isn't giving us the best results we could possibly be getting in medical science. Although, he doesn't offer a huge amount of alternatives. 

The New York Times also ran a story about in September of last 2010 about some of the ethics behind clinical trials. This article discusses how two cousins ended up in the same trial and one cousin was given the treatment and the other was not. It was a story that was really questioning the ethics of the clinical trial, because it was obviously working. However, pushing through these treatments without fulling testing them can be just as dangerous. Granted these people were near the end as it was. The cousin that didn't receive the new treatment died from only getting the chemo.

One the one hand we want to get promising medicine out as fast as possible. However, we want to ensure we are properly testing these medicines to ensure safety. This leads to a great deal of ethical concerns. For promising medicines do we make exceptions? Do we allow fully untested medicine into the wild? These are difficult questions. From an ethical and moral standpoint allowing a patient to die because of a randomized test is very questionable, which is what happened in the case above. However, in some cases rushing through medicines like these end up causing deaths in other manners. In the case of Vioxx this is exactly what happened. In many people it reduced the risk while in others it out right killed them. Where is the balance? I think this is why the UK is pushing for more oversight in these cases.

*Note: my dad, a nurse practitioner pointed out that i was slightly wrong about Vioxx. He's correct. There were more ethical problems than the fact it was a bad drug. Simply the creators of Vioxx hid the fact that it impacted african americans differently than white americans. If Vioxx hadn't done this it wouldn't have been a problem for the drug to stay on the market. If you want to read more about Vioxx there's a chapter in the book Denialism By Michael Specter

In my next blog I'll discuss scientific fraud and ethics in other fields.

No comments:

Post a Comment