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Anger and Forgiveness"Are You There Alone?"10 Good Questions about Life and DeathA Casebook of Ethical Challenges in NeuropsychologyA Companion to BioethicsA Companion to BioethicsA Companion to GenethicsA Companion to GenethicsA Companion to Muslim EthicsA Cooperative SpeciesA Critique of the Moral Defense of VegetarianismA Delicate BalanceA Fragile LifeA Life for a LifeA Life-Centered Approach to BioethicsA Matter of SecurityA Mirror Is for ReflectionA Mirror Is for ReflectionA Natural History of Human MoralityA Philosophical DiseaseA Practical Guide to Clinical Ethics ConsultingA Question of TrustA Sentimentalist Theory of the MindA Short Stay in SwitzerlandA Tapestry of ValuesA Very Bad WizardA World Without ValuesAction and ResponsibilityAction Theory, Rationality and CompulsionActs of ConscienceAddiction and ResponsibilityAddiction NeuroethicsAdvance Directives in Mental HealthAfter HarmAftermathAgainst AutonomyAgainst BioethicsAgainst HealthAgainst MarriageAgainst Moral ResponsibilityAgency and AnswerabilityAgency and ResponsibilityAgency, Freedom, and Moral ResponsibilityAging, Biotechnology, and the FutureAlbert Schweitzer's Reverence for LifeAlphavilleAltruismAltruismAmerican EugenicsAmerican PsychosisAn American SicknessAn Anthology of Psychiatric EthicsAn Introduction to EthicsAn Introduction to Evolutionary EthicsAn Introduction to Kant's Moral Philosophy Ancient Greek and Roman SlaveryAnd a Time to DieAnimal LessonsAnimal RightsAnimal Welfare in a Changing WorldAnimals Like UsApplied Ethics in Mental Health CareAre Women Human?Arguments about AbortionAristotle on Practical WisdomAristotle's Ethics and Moral ResponsibilityAristotle's WayAssisted Suicide and the Right to DieAutonomyAutonomy and the Challenges to LiberalismAutonomy, Consent and the LawBabies by DesignBackslidingBad PharmaBad SoulsBarriers and BelongingBasic Desert, Reactive Attitudes and Free WillBeauty JunkiesBefore ForgivingBeing AmoralBeing YourselfBending Over BackwardsBending 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Values and ScienceCutting to the CoreCyborg CitizenDamaged IdentitiesDeaf Identities in the MakingDeath Is That Man Taking NamesDebating ProcreationDebating Same-Sex MarriageDecision Making, Personhood and DementiaDecoding the Ethics CodeDefining DifferenceDefining Right and Wrong in Brain ScienceDefining the Beginning and End of LifeDelusions of GenderDementiaDemocracy in What State?Demons of the Modern WorldDescriptions and PrescriptionsDesert and VirtueDesire, Practical Reason, and the GoodDestructive Trends in Mental HealthDeveloping the VirtuesDid My Neurons Make Me Do It?Difference and IdentityDigital HemlockDigital SoulDignityDignityDisability BioethicsDisability, Difference, DiscriminationDiscrimination against the Mentally IllDisordered Personalities and CrimeDisorders of VolitionDisorientation and Moral LifeDivided Minds and Successive SelvesDoes Feminism Discriminate against Men?Does Torture Work?Doing HarmDouble Standards in Medical Research in Developing CountriesDown 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Challenged ProfessionsEthicsEthicsEthicsEthics and AnimalsEthics and ScienceEthics and the A PrioriEthics and the Discovery of the UnconsciousEthics and the Metaphysics of MedicineEthics at the CinemaEthics at the End of LifeEthics Beyond the LimitsEthics Case Book of the American Psychoanalytic AssociationEthics Done RightEthics ExpertiseEthics for EveryoneEthics for PsychologistsEthics for the New MillenniumEthics in CyberspaceEthics in Everyday PlacesEthics in Health CareEthics In Health Services ManagementEthics in Mental Health ResearchEthics in PracticeEthics in PsychiatryEthics in PsychologyEthics in Psychotherapy and CounselingEthics of PsychiatryEthics without OntologyEthics, Culture, and PsychiatryEthics, Sexual Orientation, and Choices about ChildrenEvaluating the Science and Ethics of Research on HumansEvilEvil GenesEvil in Modern ThoughtEvil in Modern ThoughtEvolution, Gender, and RapeEvolutionary Ethics and Contemporary BiologyEvolutionary Psychology and ViolenceEvolved MoralityExperiments in EthicsExploding the Gene MythExploiting ChildhoodFacing Human SufferingFact and ValueFacts and ValuesFaking ItFalse-Memory Creation in Children and AdultsFat ShameFatal FreedomFellow CreaturesFellow-Feeling and the Moral LifeFeminism and Its DiscontentsFeminist Ethics and Social and Political PhilosophyFeminist TheoryFinal ExamFirst Do No HarmFirst, Do No HarmFlashpointFlesh WoundsForced to CareForgivenessForgivenessForgiveness and LoveForgiveness and ReconciliationForgiveness and RetributionForgiveness is Really StrangeFoucault and the Government of DisabilityFoundational Issues in Human Brain MappingFoundations of Forensic Mental Health AssessmentFree WillFree Will And Moral ResponsibilityFree Will and Reactive AttitudesFree Will, Agency, and Meaning in LifeFree?Freedom and ValueFreedom vs. InterventionFriendshipFrom Darwin to HitlerFrom Disgust to HumanityFrom Enlightenment to ReceptivityFrom Morality to Mental HealthFrom Silence to VoiceFrom Valuing to ValueFrontiers of JusticeGender in the MirrorGenetic PoliticsGenetic ProspectsGenetic ProspectsGenetics of Original SinGenetics of Original SinGenocide's AftermathGetting RealGluttonyGood WorkGoodness & AdviceGreedGroups in ConflictGrowing Up GirlGut FeminismHabilitation, Health, and AgencyHandbook for Health Care Ethics CommitteesHandbook of BioethicsHandbook of Children's RightsHandbook of PsychopathyHappinessHappiness and the Good LifeHappiness Is OverratedHard FeelingsHard LuckHardwired BehaviorHarmful ThoughtsHeal & ForgiveHealing PsychiatryHealth Care Ethics for PsychologistsHeterosyncraciesHistorical and Philosophical Perspectives on Biomedical EthicsHoly WarHookedHookedHow Can I Be Trusted?How Fascism WorksHow Propaganda WorksHow to Do Things with Pornography How to Make Opportunity EqualHow Universities Can Help Create a Wiser WorldHow We HopeHow We Think About DementiaHuman BondingHuman Dignity and Assisted DeathHuman Dignity and Assisted DeathHuman EnhancementHuman 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EdenOut of Its MindOut of the ShadowsOverdosed AmericaOxford Handbook of Psychiatric EthicsOxford Studies in Normative EthicsOxford Studies in Normative Ethics, Volume 7Oxford Textbook of Philosophy of PsychiatryPassionate DeliberationPatient Autonomy and the Ethics of ResponsibilityPC, M.D.Perfecting VirtuePersonal AutonomyPersonal Autonomy in SocietyPersonal Identity and EthicsPersonalities on the PlatePersonhood and Health CarePersons, Humanity, and the Definition of DeathPerspectives On Health And Human RightsPharmaceutical FreedomPharmacracyPharmageddonPhilosophy and This Actual WorldPhilosophy of BiologyPhilosophy of Technology: The Technological ConditionPhysician-Assisted DyingPicturing DisabilityPilgrim at Tinker CreekPlaying God?Playing God?Political EmotionsPornlandPowerful MedicinesPractical Autonomy and BioethicsPractical EthicsPractical Ethics for PsychologistsPractical RulesPragmatic BioethicsPragmatic BioethicsPragmatic NeuroethicsPraise and BlamePreferences and Well-BeingPrimates and PhilosophersPro-Life, Pro-ChoiceProcreation and ParenthoodProfits Before People?Progress in BioethicsProperty in the BodyProzac As a Way of LifeProzac on the CouchPsychiatric Aspects of Justification, Excuse and Mitigation in Anglo-American Criminal Law Psychiatric EthicsPsychiatry and EmpirePsychological Concepts and Biological PsychiatryPsychology and Consumer CulturePsychology and LawPsychotropic Drug Prescriber's Survival GuidePublic Health LawPublic Health Law and EthicsPublic PhilosophyPunishing the Mentally IllPunishmentPursuits of WisdomPutting Morality Back Into PoliticsPutting on VirtueQuality of Life and Human DifferenceRaceRadical HopeRadical VirtuesRape Is RapeRe-creating MedicineRe-Engineering Philosophy for Limited BeingsReason's GriefReasonably ViciousReckoning With HomelessnessReconceiving Medical EthicsRecovery from SchizophreniaRedefining RapeRedesigning HumansReducing the Stigma of Mental IllnessReflections on Ethics and 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and the Good Life?TestimonyText and Materials on International Human RightsThe Moral Psychology of AngerThe Age of CulpabilityThe Age of CulpabilityThe Aims of Higher EducationThe Almost MoonThe Altruistic BrainThe American Psychiatric Publishing Textbook of Forensic PsychiatryThe Animal ManifestoThe Animals' AgendaThe Art of LivingThe Autonomy of MoralityThe Beloved SelfThe Best Things in LifeThe Big FixThe Bioethics ReaderThe Biology and Psychology of Moral AgencyThe Blackwell Guide to Medical EthicsThe Body SilentThe BondThe Book of LifeThe Burden of SympathyThe Cambridge Companion to Virtue EthicsThe Cambridge Companion to Virtue EthicsThe Cambridge Textbook of BioethicsThe Case against Assisted SuicideThe Case Against PerfectionThe Case Against PunishmentThe Case for PerfectionThe Case of Terri SchiavoThe Challenge of Human RightsThe Character GapThe Code for Global EthicsThe Colonization Of Psychic SpaceThe Commercialization of Intimate LifeThe Common ThreadThe Connected SelfThe 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HappinessThe Virtuous Life in Greek EthicsThe Virtuous PsychiatristThe Voice of Breast Cancer in Medicine and BioethicsThe War Against BoysThe War for Children's MindsThe Whole ChildThe Woman RacketThe Worldwide Practice of TortureTherapy with ChildrenThieves of VirtueThree Generations, No ImbecilesTimes of Triumph, Times of DoubtTolerance Among The VirtuesTolerance and the Ethical LifeTolerationToxic PsychiatryTrauma, Truth and ReconciliationTreatment Kind and FairTrusting on the EdgeTry to RememberUltimate JudgementUnborn in the USA: Inside the War on AbortionUndermining ScienceUnderstanding AbortionUnderstanding CloningUnderstanding EmotionsUnderstanding EvilUnderstanding Kant's EthicsUnderstanding Moral ObligationUnderstanding Physician-Pharmaceutical Industry InteractionsUnderstanding TerrorismUnderstanding the GenomeUnderstanding the Stigma of Mental IllnessUnderstanding Treatment Without ConsentUnhingedUnprincipled VirtueUnsanctifying Human Life: Essays on EthicsUnspeakable 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How Much?Why Some Things Should Not Be for SaleWisdom, Intuition and EthicsWithout ConscienceWomen and Borderline Personality DisorderWomen and MadnessWondergenesWould You Kill the Fat Man?Wrestling with Behavioral GeneticsWriting About PatientsYou Must Be DreamingYour Genetic DestinyYour Inner FishYouth Offending and Youth Justice Yuck!
The theme of The Price of Truth is that the ideal of science as the objective, disinterested pursuit of knowledge is just that, an ideal, and that modern science is intimately tied up with the business world, and with financial incentives of one sort or another. While there are some who would see this state of affairs as a travesty, Resnik is more pragmatic. Drawing on examples of classical scientists, and from the current practice of science, Resnik argues for a middle road, one in which there can be room for financial incentives to encourage science, but where there are adequate restraints on the excesses of money to maintain the more communitarian goals of science. This position does not come without warnings, however. There are real risks from conflicts of interest, and ample evidence that in the absence of safeguards, these risks will come to fruition. Resnik canvasses the issues and calls for a balanced approach. Fittingly for a book on science, Resnik's is a voice of reason, and if his call for balance doesn't satisfy supporters of lasseiz-faire libertarians or principled conservatives, this is probably no bad thing. As Resnik is fond of saying, the truth lies somewhere in between.
Over almost two decades Resnik has published many books and papers on the ethics of science. The Price of Truth focuses on the potential for money to influence the practice of science, but the book does more than explore examples of potential conflicts. Over nine chapters Resnik explores the history of science and money, the nature of science and how money can undermine scientific endeavor, and some specific issues such as intellectual property, publication, and government funding of research and development. A brief concluding chapter returns to the underlying theme of truth and integrity in research.
The historical and philosophical background is important, as recent developments have directly challenged accepted norms of scientific practice. Scientists' financial interests in laboratories and their products, while not a new phenomenon, has become more widespread and substantial. Many academic institutions now have extensive financial relationships with private companies. Resnik documents a massive shift in private funding of research and development over the second half of last century (especially the last 20 years) with private sources now funding two thirds of a rapidly increasing R & D budget, compared to a roughly equal share in the mid 1980s. In the first chapter of the book Resnik provides a number of case studies that illustrate the high stakes involved when financial interests conflict with science. The case studies include the Human Genome Project, suppression of adverse findings in medical research, and the "cold fusion" controversy of 1989. These case studies set the scene for the rest of the book.
The second chapter "The norms of science" is a fairly breathless summary of the history and philosophy of science. Resnik wastes no time in declaring, against the commonly held view of science as "value-free" that science is a "type of social activity" (p. 35). The chapter explores epistemological and ethical issues, noting that when the different norms of science conflict, scientists must exercise judgment to make decisions. The argument for the judgment of scientists is augmented later in the book when Resnik explores the role of boards of ethics and the like. The message is that science cannot avoid conflicts, and it must develop processes of managing them. Chapter three explores the notion of "objectivity". Resnink provides an outline of the major philosophical positions on realism and idealism, concluding that science must test theories against a mind-independent world. In the end he argues for degrees of objectivity rather than an absolute standard, but also that science ought to be objective, something that can only be achieved when scientists work towards accepted norms.
The following five chapters explore ways in which money can affect the norms of science, and specific issues such as conflicts of interest, intellectual property, publication, and government funding of R & D. These chapters make use of the conceptual issues explored earlier, and provide many case studies of situations in which money has threatened or compromised the norms of science. Publication bias, for example, takes a number of forms, from inflation of the authorship of scientific publications (aimed at enhancing an institution's standing so that it will attract more grant money) to duplicate publication, something which has the potential to distort the accepted "gold standard" of meta-analysis by artificially increasing the numbers of publications reporting the beneficial effects of an intervention (usually a drug). There is also the issue of non-publication of negative studies, something mentioned earlier in the book in relation to Boots' attempt to suppress the research of Dr Betty Dong.
On the issue of conflict of interest, something that underlies issues of publication bias and intellectual property, Resnik recognizes both the potential benefits of private business interests in promoting scientific research, and the potential problems. He cites the example of the steam engine to show that these issues are not altogether new, even if they have become more common, and to show that a balanced approach can provide the necessary ethical safeguards as well as the benefits of privately financed research. Resnik's recommendation, explained by the use of examples, is for the use of three strategies: disclosure, management and prohibition. How to apply these strategies is itself a matter of negotiation and collaboration. Resnik recommends the approach established by the Association of American Universities for practical guidance: disclose first, manage the conflict in most cases, prohibit to protect the public or university's interest.
Money clearly has the potential to influence the norms of science. Resnik's message is that this is not something that can be left to scientists to manage, but that scientists do bear the major responsibility for ethical practice. Conflicts of interest are not completely avoidable, hence the need for constant vigilance. A very large proportion of the examples used in this book are to do with medical research, perhaps because the potential for harm is more immediate in the case of administration of drugs or investigations of new treatments. But conflicts of interest can impact on any area of science, so this book has a wide target audience.
On the negative side there are more than a few editing errors, and while they don't detract from the arguments, they do make the book less pleasurable to read. There are at least two instances where the omission of a word gives an important sentence the opposite meaning to that intended. For example on page 181 we are told: "While it is often appropriate to bypass the normal peer review channels in the allocation of government research funds, this does mean that one should do without any scientific input or advice". Surely not. The omission of the word "not" after "should" stops the reader dead, rather like a misplaced negative sign that renders an experiment invalid. There are other, lesser, editing errors, that detract a little from what is an interesting and worthwhile book.
This is a useful book for anyone involved in funded research and its flow-on activities such as product development and marketing. At all stages of the research process there is the potential for science to become corrupted by the influence of financial incentives. Yet there is no easy way to eliminate this risk. As a start, it seems important that members of the scientific community have an understanding of the sorts of ethical issues discussed by Resnik. It also seems important that institutions, including universities and private institutions, have robust safeguards to against misconduct. What is at stake is not just ethical science, important as that is. In the end, ethical safeguards also protect the integrity of the scientific process itself, and that is not something that can be left to chance.
© 2007 Tony O'Brien
Tony O'Brien RN, MPhil, Senior Lecturer, Mental Health Nursing, University of Auckland, email@example.com