Monday, January 14, 2008

Adventures in Ethics and Romania

Unfortunately, these particular adventures in Romania did not involve visiting Peleş Castle.

Dr. Janet D. Stemwedel, a philosophy professor at San Jose State and author of the blog Adventures in Ethics and Science, has a great two-part piece on the ethics of a developmental psychology research study conducted with abandoned Romanian children (Nelson et al., 2007) and published recently in Science. The abstract of the paper begins in a way that set off alarm bells (at least in my head):

In a randomized controlled trial, we compared abandoned children reared in institutions to abandoned children placed in institutions but then moved to foster care.
Young children living in institutions were randomly assigned to continued institutional care or to placement in foster care, and their cognitive development was tracked through 54 months of age.

Tens of thousands of children grew up in Romania's institutions
BBC News)

Being neither a developmental psychologist nor an ethics expert1,
I thought it best to consult a professional in at least one of those topics. The posts below are essential reading for those interested in human subjects research issues, such as informed consent, standard of care, and "clinical equipoise."
Research with vulnerable populations: considering the Bucharest Early Intervention Project (part 1).
. . .

...My aim in these two posts will be to lay out the recognized ethical guidelines for research with human subjects as they apply to the Bucharest Early Intervention Project (BEIP), and to identify the worries we might raise about this kind of research -- and, by extension, with the prevailing standards.
Research with vulnerable populations: considering the Bucharest Early Intervention Project (part 2).

In an earlier post, I looked at a research study by Nelson et al. [1] on how the cognitive development of young abandoned children in Romania was affected by being raised in institutional versus foster care conditions. Specifically, I examined the explanation the researchers gave to argue that their work was not only scientifically sound but also ethical.

In this post, I examine the accompanying policy forum article, Millum and Emmanuel, "The Ethics of International Research with Abandoned Children" [2]. Millum and Emanuel are in the Department of Bioethics at the Clinical Center of the National Institutes of Health. As such, it's not unreasonable to assume that they are not coming to their understanding of this research -- and to the question of whether it rises to the appropriate ethical level -- from the point of view that good science should trump all other interests.


1 Not that The Neurocritic is unethical or anything...


[1] Charles A. Nelson, III, Charles H. Zeanah, Nathan A. Fox, Peter J. Marshall, Anna T. Smyke, and Donald Guthrie, "Cognitive Recovery in Socially Deprived Young Children: The Bucharest Early Intervention Project," Science 21 December 2007: Vol. 318. no. 5858, pp. 1937 - 1940.

[2] Joseph Millum and Ezekiel J. Emanuel, "The Ethics of International Research with Abandoned Children," Science 21 December 2007: Vol. 318. no. 5858, pp. 1874 - 1875.

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