There
are many resources dealing with a variety of the ethical aspects of the
biological sciences. However, if you
want a readily accessible compendium that is really THE collection detailing,
as the book title describes it, the ethical dimensions of the biological and
health sciences, you need go no further. 
This simply excellent second edition offers something for everybody.
Indeed it is difficult to do such an excellent collection justice in this
review.

This
comprehensive 371-page book is edited by Ruth Ellen Bulger (Uniformed Services
University of the Health Sciences), Elizabeth Heitman (University of
Mississippi Medical Center and University of Texas Health Science Center at
Houston) and Stanley Joel Reiser (University of Texas Health Science Center at
Houston). This collection has something
to offer to ethicists, scientists, those involved in public policy, educators
and students interested in the ethical dimensions of their studies. It can be of assistance to both specialist
and non-specialist in the biological and health sciences. One of the most helpful aspects of the book
is its division into sub-themes and chapter headings. This will assist people
seeking an answer about a specific question or issue. To this end there is also an impressive index. Clearly designed for a variety of uses
perhaps one of the most helpful aspects for those who will use this book for
educational purposes is the inclusion of questions for discussion and
recommended supplemental reading at the end of the twelve sections into which
this book is divided. They are not
complex questions, but they help to get to the core of the articles in the
various sections.

In
necessarily only attending to the brief overview of the twelve sections, I do a
disservice to the individual contributions made by chapter writers within those
sections. However, an overview of the
contents of the sections helps to give an impression of the broad coverage of
this book in a way that shows an appreciation of the insights of a variety of
disciplines, from ethics and the history and philosophy of science through to a
variety of the biological sciences.

Section
I, “Introduction to the study of ethics in the biological and health sciences”
includes an excellent account of the rise of “the ethics movement” in the
biological and health sciences by Stanley Joel Reiser. In his self-styled “voyage of discovery”
Reiser charts four phases or episodes of the “ethics movement”. These commence in 1945 with the Nuremberg war crimes
trials at the end of World War II, with the fourth phase from 2001 onward
involving the institutionalization of ethical discourse. This chapter is indicative of a book which
is enriched by a strong historical perspective coupled with an understanding of
the socio-political dimensions of ethics and of science.

Such
a strong foundation is built upon in Section II, dealing with “the roots of
honor and integrity in science”. As
part of this, Bentley Glass’ short essay on “The Ethical Basis of Science” is a
particularly noteworthy contribution. 
This recognizes the importance of integrity by scientists, and moves
beyond mere accounts of science as just an objective exercise. His suggestion of the social and ethical
responsibilities of scientists as being Four Commandments (to cherish
truthfulness, avoid self-aggrandizement, fearlessly to defend freedom of
scientific inquiry and opinion and to communicate findings) is to some extent
simplistic. However, it does provide significant food for critical reflection.

Continuing
that vein in Section III “The Responsible Conduct of Research” such topics as
fraud in medical science, statistics and deception, and preventing scientific
misconduct are covered. As Douglas Weed
notes in his chapter on “Preventing Scientific Misconduct”, there is hardly an agreed upon definition of
scientific misconduct. Indeed, I
couldn’t help reflecting that in all of these things misconduct is not only in
the eye of the beholder, but has significant power dimensions as to who is
defining misconduct. However Weed makes
an important point in observing:

“We can accept (perhaps on faith) that
the discussion of the role of ethics and the conduct of science in medicine
should be expanded. Those of us who act
as mentors can and should conduct ourselves virtuously. For the sake of those we train and
especially for those whose lives are improved by scientific results, we must
exhibit excellence, self-effacement, and perhaps above all, an unwavering
commitment to the truth.” (p.84)

Not
only is this a very important statement, but it also shows the depth of the
thinking involved in this book in making an appeal to the virtues as opposed to
the principalist accounts which tend to dominate books about ethics.

Section
IV has a variety of chapters dealing with “the ethics of authorship and
publication”. It includes some
excellent discussion of issues to deal with plagiarism, irresponsible
authorship and the publication of research results. A particularly important
discussion of ethical issues for scientists is provided by Ward Pigman and
Emmett B Carmichael in their chapter “An Ethical Code for Scientists.” I was at
the same time disappointed as well as relieved that they do not spell out such a
code. Rather, in their frank discussion they make a case for a code of ethics
for scientists in general by discussing the problems of authorship. As they
argue:

“We suggest that the establishment of a
definite code of professional ethics and conduct by our major by our major
scientific groups would have profound and favorable effects for science,
society and the scientist.” ( p 103)

There
is no doubt that this is the case. However further discussion is needed about
the importance of fostering ethical culture and involving society in the
establishment and regulation of such a code.

Section
V deals with “Research with Human Beings”. 
In addition to some excellent discussion there is also some important
inclusions. Specifically both the
Nuremberg Code and the Declaration of Helsinki are incorporated. Both of these are enormously important
documents in the development of contemporary approaches to ethics. There inclusion helps to provide an
important benchmark against which other more contemporary codes need to be
measured.

In
Section VI, “Ethics in Epidemiologic Research”, some of the challenges of
epidemiology are explored, including ensuring protection of research subjects
and the vexed issue of race in the study of disease causation. A.M. Capron makes
a helpful contribution in identifying a difference between harming and wronging
someone. Likewise , in a discussion of
the importance of informed consent in protecting against such wrongs and in
stressing steps that can be taken in avoiding or minimizing harms associated
with breeching privacy and confidentiality.

Section
VII deals with the “Humane care and use of animals in research.” Both Arthur L. Caplan and Elizabeth Heitman
provide important chapters with regard to humane care and ethical issues in
animal experimentation. There are also contributions provided by the American
Veterinary Medical Association Panel on Euthanasia, and the American
Association for Laboratory Animal Science. I couldn’t help here reflecting that
on these and other ethical issues there are a variety of views. In this and
other sections it is arguable that more attention could have been given to
non-professional accounts of ethics with not only references to these but even
the use of the voices of members of the community.

Section
VIII deals with the increasingly important issues of “management of an access
to scientific data”. Ruth Ellen Bulger
provides an important overview of “ethical issues in data acquisition, access,
and management”. Various practical
issues are dealt with by a variety of individual and corporate contributors.
The contribution by the Brain Tumor Research Center of the University of
California, San Francisco , “Guidelines on Research Data and Reports” is a
particularly valuable concrete example for readers seeking such guidance for
their practice.

Inherently
related to all of this is “the work of the academic scientist”, the subject of
Section IX. The realities recognized
here, including in contemporary medical schools, are reflected in section 10 dealing
with “the scientist and industry”. 
There is a very interesting chapter provided by Eric G Campbell, Karen Seashore Lewis and David
Blumenthal dealing with corporate gifts and the support of life sciences
research. This arises from a survey of
a stratified, random sample of 4000 life science faculty conducted between 1994
and 1995. Such an evidence-based
chapter raises important issues to do with the relationship between the
scientist and industry.

Likewise
the issue of the interactions and relationship between the scientist in society
are tackled in section XI. To wrap it
all up, Section XII deals with the use of cases in the study of ethics. The chapter by Elizabeth Heitman on this
topic provides a concrete chapter with instructors very much in mind.

Of
course, readers may well ask what is the relevance of this collection for Metapsychology readers, with a
particular interest in mental illness? 
The insights of this book can help people with an interest in
psychology, ethics, mental illness and psychiatric disability to explore more
fully the ethical dimensions of science and indeed to understand some of its
limitations and relationships with broader society. It will perhaps be most useful to many readers as a source of
reference and as a resource for further exploration of particular ethical
questions.

One
of the noticeable omissions from such an eclectic collection is an explicit
acknowledgement of markedly different accounts of ethics. A valuable addition
would have been a coherent feminist perspective and critique of dominant
accounts of ethics and science. Likewise, there is a markedly different
perspective regarding science and ethics that can flow from a developing
country perspective compared with the predominantly Western developed country
account which dominates this collection.

There is no
doubt however that this is an invaluable reference worthwhile for teachers,
practitioners, researchers and administrators in a variety of biological and
health sciences. Certainly, an essential
inclusion to any reading list for courses dealing with the ethical and social
dimensions of the biological and health sciences.

 

© 2003 Christopher Newell

 

 

Christopher Newell, PhD, Senior
Lecturer in Medical Ethics, School of Medicine, University of Tasmania,
Australia

Categories: Ethics, Philosophical