Dr. John C. Cutler’s Other Activities

• NIH funded research to test the effectiveness of penicillin in preventing sexually transmitted infections (1946-1948).

• Dr. John Cutler led the project in Guatemala in which 696 men & women were exposed to syphilis (and in some cases gonorrhea) by means of jail visits by infected prostitutes.

• The Surgeon-General at the time indicated that the study couldn’t be run in the US and that Guatemalan officials were never informed when the experiment was started.

Prof. Susan Reverby

Wellesley College

Dr. John C. Cutler’s Other Activities

• If not infected by the prostitutes, prisoners had the bacteria poured onto scrapes made on their penises, faces or arms, and in some cases it was injected by spinal puncture.

• They were then given penicillin. Hospitalized mental patients were also infected.

• The study produced no useful information and was hidden for decades.

• Prof. Reverby made the discovery in 2009 and spoke at a medical historian’s conference in May 2010.

• June 2010—Reverby presented her findings to the US gov’t.

• On October 1, 2010, the U.S. gov’t apologized to Guatemala.

Major Ethical Concerns in Research

• Informed consent• Explanation of the research: risks/benefits• Protection of the subject’s well being• Confidentiality of data• Control group issues• Ethical review/decision process• Privacy issues• Stopping participation

Special Ethical Issues Arise With:

• Children• Mental patients• Prisoners• Poor people• Undergraduate psychology students

Recent ethical codes for research: The Canadian Tri-Council Ethics Code (www. nserc.ca/programs/ethics/english/policy.html#contents)

The new American Psychological Association Code (www.apa.org/ethics/code2002.html)

These websites are linked in my website(www.psych.yorku.ca/davidw

Rationale for a new ethics code?

Medical ethics model based upon:BeneficenceAvoidance of maleficenceRespect for autonomyEquity/distributive justice

Importance of informed consent (derived from the principle of autonomy)

Need for a new, Canadian national model of ethics across all disciplines has never been made clear

Cost/benefit analysis employed in medical research may not be appropriate for psychological research

Terminology

Tri-Council (the combined Social Sciences and Humanities Research Council [SSHRC], Natural Sciences and Engineering Research Council [NSERC], and the Canadian Institute of Health Research [CIHR, the successor to the Medical Research Council, MRC]).

REB (Research Ethics Board [Canada])

IRB (Institutional Review Board [USA])

PRE (Interagency Advisory Panel on Research Ethics)

Guiding Ethical Principles

• Respect for human dignity• Respect for free and informed consent• Respect for vulnerable persons• Respect for privacy and confidentiality• Respect for justice and inclusiveness• Balancing harms and benefits• Minimizing harm• Maximizing benefits

Some Differences Between Psychology and Medical Research

• Psychology has no history of flagrant ethical abuses• No ostensible benefits or costs to research

participants• In psychology research, boredom is usually the only

cost to participants• In psychology, only investigator benefits from the

research, while in medical researcher the benefits are received by the patient, patient’s family/community

• No history of self-experimentation after the decline of introspection

Coverage of Tri-Council Code

• All research conducted in Canadian universities and hospitals (both funded and unfunded, faculty and student projects)

• Canadian researchers working abroad• Visiting researchers• Each institution must conduct an ethical

review in collaborative research• Proposed certification of REB members

Psychology’s Difficulty with the Tri-Council Code

• Only the investigator-subject is covered. No corresponding concern with the sponsors of research or with the protection of the research endeavour (e.g., Olivieri affair, Healy appointment issue, pharmaceutical funding of medical research)

• What is “minimal risk” research? Is risk defined equally for all? How may we decide what is an acceptable risk (e.g. cell phones in driver stress research)

• Difficulty of demonstrating psychological harm

Psychology’s Difficulty with the Code

• Deception research precludes informed consent• Alternatives (e.g., role playing) presents

methodological problems as well as its own ethical dilemmas.

• Paradox of ethical controversies and the importance of the findings (e.g., Milgram’s obedience research)

• Difficulties of informed consent with special populations of interest to psychology (e.g., mental patients and children)

Psychology’s Difficulty with the Code

• Necessity of signed consent for interviews, questionnaire administration for academics, but not for journalists or polling organizations.

• Routine statement of non-penalized withdrawal from project may not be necessary

Psychology’s Difficulty with the Code

• Researchers may not be able to anticipate what may be stressful or pleasant for every research participant

• Naturalistic observation requires research ethics board (REB) approval, but campus security videocameras do not fall under similar review, nor do other cameras in downtown streets

• Controversy over whether payment for participation constitutes coercion

• Controversy over the use of undergraduate subject pools

• Confidentiality guarantees are questionable—no “certificates of confidentiality” in Canada