Tuesday, April 2, 2013

Your Turn to Sacrifice


Fifty years later, some experiments involving human subjects are still garnering controversy in the bioethics community. Unlike the Tuskegee syphilis scandal, in which impoverished African-American with syphilis were observed for decades even though a cure existed, that has become almost universally recognized as repugnant and the black mark on the record of human experimentation, the Milgram experiment is still hotly debated today. In 1960, professor of psychology Stanley Milgram of Yale developed a study famous for its cleverness—and its tiptoeing the line of respect for human dignity. The question at hand is the trickery necessary for the experiment: in Milgram’s study, the “subjects” were actually researchers . . . and the “research aides” were actually the subjects, unbeknownst to them. Milgram gathered ordinary participants from the New Haven community under the pretense of helping him in his research. He ordered them to administer electric shocks to test “subjects” (really just pre-recorded voices of fellow researchers) who were supposedly in another room answering questions via an intercom. Every time the “subject” answered a question incorrectly, the “aide” raised the amount of voltage to the next level and pressed a button to shock him. In response, the sound of a scream was played, which the “aide” believe belonged to the actual “subject.” The study, which found that 65% of “aides” administered even the highest level of shock (450 volts, marked “XXX” and higher in intensity than lower levels marked things like “Danger: severe shock”), to show the compliance of those under authority and how they shifted their moral responsibility to superiors.

Many today are quick to condemn this form of experimentation. One harm of the experiment on its subjects is the psychological trauma induced by causing pain to “subjects” and hearing corresponding screams. Another problem in the study to which critics point is the lack of informed consent by the actual subjects; so much so was this lack of consent that the subjects didn’t truly understand their function as subjects of the study (by necessity of the study’s nature). This notion of informed consent is a bedrock of practically every code of ethics, so the revulsion of onlookers is understandable. But while some press their criticisms with words like “the days when experimenters could do what they want are gone,” there exist defenders of such practices in high places even today. For instance, more than half of the standing committee that reviews human experimentation at Harvard today says that they would approve of Milgram’s research (slightly modified, but largely intact). One reason is that most medical codes of ethics allow for lack of full knowledge on the part of the subjects in cases when knowing everything would defeat the point of the research. In addition, goes their refrain, how will we progress in important fields of science? “Human experimentation limits the classic unfettered freedom of academic research.” Harvard professor Regina Yando on the Harvard experimentation committee puts this another way by saying that she would approve of Milgram’s research if “there was serious, important research to be obtained” that “outweighed” the harm to the subjects. The problem with this line of thinking, though, is that employs a utilitarian calculus so pure that even most staunch utilitarian adherents will shy from it. While the benefit of the knowledge may far outstretch the pain suffered by the subjects in some ways, modern ethics considers these questions in more than just a simple calculation of net gain for humanity. Regardless of the benefit, there are certain lines that we all agree must not be crossed: and sacrificing someone else’s livelihood, however small it may be, for the greater good can never be used as justification.

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1 comment:

Marta said...

I thought this case was an extremely interesting example of the risk/benefits balance in human experimentation. To me, what struck me in reading this article was the fact that the information that was extracted from conducting this trial, while important for better understanding human psychology, did not seem to be indispensible to a degree that would justify purposefully causing a non-consenting adult emotional and psychological trauma. When designing a clinical trial, the risks are always heavily weighted against the potential benefits of the experiment. We equate the possibility of causing physical harm to various degrees with the chance of saving lives by discovering effective medication, or we equate asking someone to take survey with the importance of the outcome of informational data. In this case, however, it seems as though the risks outweigh the benefits: how can we say that inflicting emotional trauma on someone is justified by improving our knowledge of psychology by assessing people’s reactions to authority and responsibility? The question of informed consent in this case also walks the line of ethical permissibility – it is obvious that these subjects did not give informed consent. That said, the experiment could not have been executed had the subjects known what they were being tested on or even if they suspected they being studied as part of the trial. The Declaration of Helsinki states “There may be situations where consent would be impossible or impractical to obtain for such research or would pose a threat to the validity of the research. In such situations the research may be done only after consideration and approval of a research ethics committee.” The trial falls into this category where informed consent would jeopardize the results, therefore the fact that the subjects volunteered should be enough if a committee approved the trial beforehand.