Protection of Conscience Project Library
Service, not Servitude
Abstract
The duty of care is a fundamental principle of medicine that should be at the heart of the debate surrounding Planned Parenthood and fetal tissue research. And that duty includes taking advantage of avenues of hope for current and future patients.
Charo RA. Fetal Tissue Fallout. N Engl J Med. 2015 Sep 03;373(10):890-891. Available from:
Abstract
There is surprising confusion surrounding the concept of biological totipotency, both within the scientific community and in society at large. Increasingly, ethical objections to scientific research have both practical and political implications. Ethical controversy surrounding an area of research can have a chilling effect on investors and industry, which in turn slows the development of novel medical therapies. In this context, clarifying precisely what is meant by “totipotency” and how it is experimentally determined will both avoid unnecessary controversy and potentially reduce inappropriate barriers to research. Here, the concept of totipotency is discussed, and the confusions surrounding this term in the scientific and nonscientific literature are considered. A new term, “plenipotent,” is proposed to resolve this confusion. The requirement for specific, oocyte-derived cytoplasm as a component of totipotency is outlined. Finally, the implications of twinning for our understanding of totipotency are discussed.
Highlights
Concid ML. Totipotency: What It Is and What It Is Not. Stem Cells and Development. April 15, 2014, 23(8): 796-812. doi:10.1089/scd.2013.0364.
Abstract
Laboratory classes in which animals are seriously harmed or killed, or which use cadavers or body parts from ethically debatable sources, are controversial within veterinary and other biomedical curricula. Along with the development of more humane teaching methods, this has increasingly led to objections to participation in harmful animal use. Such cases raise a host of issues of importance to universities, including those pertaining to curricular design and course accreditation, and compliance with applicable animal welfare and antidiscrimination legislation. Accordingly, after detailed investigation, some universities have implemented formal policies to guide faculty responses to such cases, and to ensure that decisions are consistent and defensible from legal and other policy perspectives. However, many other institutions have not yet done so, instead dealing with such cases on an ad hoc basis as they arise. Among other undesirable outcomes this can lead to insufficient student and faculty preparation, suboptimal and inconsistent responses, and greater likelihood of legal challenge. Accordingly, this paper provides pertinent information about the evolution of conscientious objection policies within Australian veterinary schools, and about the jurisprudential bases for conscientious objection within Australia and the USA. It concludes with recommendations for the development and implementation of policy within this arena.
Knight A. Conscientious objection to harmful animal use within veterinary and other biomedical education. Animals. 2014 Jan 21;4(1):16-34.
Extract
As is now known, from 1946–48, the Venereal Disease Research Laboratory of the U.S. Public Health Service (PHS), the Pan American Sanitary Bureau (PASB), and the Guatemalan government spearheaded a study4 that intentionally infected and tested Guatemalan prisoners, asylum inmates, soldiers, and orphaned children.5 The research team, led by Dr. John C. Cutler, exposed Guatemalans to syphilis “through the use of infectious prostitutes or directly through [an] inoculum made from tissue of human and animal syphilitic gummas and chancres,”6 and then treated the Guatemalans with penicillin.7 Although the researchers acknowledged they could not use such methods in the United States,8 they experimented in secrecy and did not seek consent from human subjects.9 . . .
The Guatemala study was horrendous, and the legal standards and guidelines of its day failed to protect Guatemalans who were infected with syphilis. Similar studies are being conducted by U.S. researchers in developing nations around the world, whether through grants from the U.S. government or by private U.S. companies. These problems must be remedied, and the Research Participants Protection Modernization Act of 2011 provides the impetus for the U.S. to do so. As Amy Gutmann, Chair of the Presidential Commission for the Study of Bioethical Issues stated, “a civilization can be judged by the way that it treats its most vulnerable individuals. There is no position of vulnerability that is greater than to be the subject of a medical experiment.”.
Scheperle MC. The Guatemala STD Inoculation Study as the Incentive to Change Modern Informed Consent Standards. Washington Lee J Civil Rights Soc Just. 2012 Mar;18(2):425-471.
Abstract
The Perceptions of Conscience Questionnaire (PCQ) and the Stress of Conscience Questionnaire (SCQ) have previously been developed and validated within the ‘Stress of Conscience Study’. The aim was to revalidate these two questionnaires, including two additional, theoretically and empirically significant items, on a sample of healthcare personnel working in direct contact with patients.The sample consisted of 503 healthcare personnel.To test variation and distribution among the answers, descriptive statistics, item analysis and principal component analysis (PCA) were used to examine the underlying factor structure of the questionnaires.Support for adding the new item to the PCQ was found.No support was found for adding the new item to the SCQ. Both questionnaires can be regarded as valid for Swedish settings but can be improved by rephrasing some of the PCQ items and by adding items about private life to the SCQ.
Ahlin J, Ericson-Lidman E, Norberg A, Strandberg G. Revalidation of the perceptions of conscience questionnaire (PCQ) and the stress of conscience questionnaire (SCQ). Nurs Ethics. 2012;19(2):220-232.
Extract
One in seven UK based scientists or doctors has witnessed colleagues intentionally altering or fabricating data during their research or for the purposes of publication, found a survey of more than 2700 researchers conducted by the BMJ.
The survey, which was emailed to 9036 academics and clinicians who had submitted articles to the BMJ or acted as peer reviewers for the journal (response rate 31%), found that 13% of these researchers admitted knowledge of colleagues “inappropriately adjusting, excluding, altering, or fabricating data” for the purpose of publication.
Tavare A. Scientific misconduct is worryingly prevalent in the UK, shows BMJ survey. BMJ2012;344:e377
Abstract
In a military-sponsored research project begun during the Second World War, inmates of the Stateville Penitentiary in Illinois were infected with malaria and treated with experimental drugs that sometimes had vicious side effects. They were made into reservoirs for the disease and they provided a food supply for the mosquito cultures. They acted as secretaries and technicians, recording data on one another, administering malarious mosquito bites and experimental drugs to one another, and helping decide who was admitted to the project and who became eligible for early parole as a result of his participation. Thus, the prisoners were not simply research subjects; they were deeply constitutive of the research project. Because a prisoner’s time on the project was counted as part of his sentence, and because serving on the project could shorten one’s sentence, the project must be seen as simultaneously serving the functions of research and punishment. Michel Foucault wrote about such ‘mixed mechanisms’ in his Discipline and punish. His shining example of such a ‘transparent’ and subtle style of punishment was the panopticon, Jeremy Bentham’s architectural invention of prison cellblocks arrayed around a central guard tower. Stateville prison was designed on Bentham’s model; Foucault featured it in his own discussion. This paper, then, explores the power relations in this highly idiosyncratic experimental system, in which the various roles of model organism, reagent, and technician are all occupied by sentient beings who move among them fluidly. This, I argue, created an environment in the Stateville hospital wing more panoptic than that in the cellblocks. Research and punishment were completely interpenetrating, and mutually reinforcing.
Comfort N. The prisoner as model organism: malaria research at Stateville Penitentiary. Stud Hist Philos Biol Biomed Sci. 2009;40(3):190-203. doi:10.1016/j.shpsc.2009.06.007
Abstract
Progress continues in Russia with growing awareness and implementation of alternatives in education. Further outreach visits and negotiations for replacement have been made by InterNICHE campaigners. Russian language information resources have been complemented by the distribution of translated freeware physiology and pharmacology alternatives; and the InterNICHE Alternatives Loan Systems continue to provide valuable hands-on access to a range of learning tools. Donations of computers and alternatives have established exemplary multimedia laboratories, with software having directly replaced the annual use of several thousand animals. New agreements have been made with institutes to abandon animal experiments for teaching purposes. Work to consolidate the successes is being done, and Russian teachers have begun to present at conferences to share their experiences of implementation. Further development and implementation of alternatives is being achieved through grant funding from the InterNICHE Humane Education Award. Using a different approach, cases of determined conscientious objection have included a campaign against the use of stolen companion animals for surgery practice in the Russian Far East, and a continuing legal challenge to experiments at Moscow State University. This multi-pronged, decentralised and culturally appropriate campaigning strategy has proved to be an effective approach to achieving sustainable change in Russia..
Jukes N. Russia: update on animal experiments and alternatives in education. Alternatives to Animal Experimentation (ALTEX). 2008;25(1):56-62.
Extract
Man is a free being who establishes his behaviour and forges his will in a series of ethical and/or religious principles. Loyalty to these principles brings the right and the need of conscientious objection. Man, in his own legitimate exercise of freedom, can and must object to exercising any action that is against or transgresses those principles that his conscience dictate. . .
One should have to distinguish between civil disobedience and conscientious objection. The latter comes from a personal motivation. One person feels that he cannot fulfil a certain juridical regulation because it goes against his/her conscience and moral principles, which are based on faith and on ethical considerations. However, civil disobedience , which can also be founded on conscience motivations, is a type of attitude that pretends to put forward a change or a breach in the law. In case of civil disobedience the law is also considered immoral or unjust. Civil disobedience and conscientious objection can happen together because civil disobedience is considered massive conscientious objection, if not massive, at least very numerous.
Barahona PL. Conscientious Objection and Testimonials in the Field of Bioethics Research. In: Sgreccia E, Laffitte J editors. Proceedings of the 13th General Assembly of the Pontifical Academy for Life. 2007;123-126.
Extract
Since visiting Auschwitz, I have grappled with the question of how I would have behaved as a doctor in Nazi Germany or Stalinist Russia. I hope I would have had the moral courage to refuse to participate in the various perversions of medicine that these regimes demanded — for example, respectively, eugenic “research” and psychiatric “treatment” of dissidents. . . . My chances of behaving honourably would have been
greatest if I had felt part of an independent medical profession with allegiance to something higher and more enduring than the regime of the day. They would have been least if Savulescu’s opinions had prevailed . . .After 30 years of reading the BMJ, Sava-
lescu’s article was the first one to make me feel physically sick.
Smith VP. (Correspondence) Conscientious objection in medicine: Doctors’ freedom of conscience. Br Med J. 2006 Feb 18;332(425)