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Academic Fraud and Conceptual Transfer in Bioethics:
Abortion, Human Embryo Research and Psychiatric Research
" … there has emerged a phenomenon unknown to antiquity that permeates our modern society so completely that its ubiquity scarcely leaves us any room to see it at all: the prohibition of questioning … We are confronted here with persons who know that, and why, their opinions cannot stand up under critical analysis and who therefore make the prohibition of the examination of their premise part of their dogma … The questions of the "individual man" are cut off by the ukase of the speculator who will not permit his construct to be disturbed."(emphasis added)
Eric Voegelin, Science, Politics and Gnosticism
I am confident that Voegelin's insights1 strike a cord with many in pro-life, but they are probably especially provocative to those of us in academia. In concert with my beleaguered past as an inveterate questioner, and in the spirit of true academic freedom, several questions loom which must be posed and actively addressed in the interests of academia itself. My concern is academic fraud and the harm that it has already engendered. It is also about "political correctness", and how it can be conducive to academic fraud. Who bears the responsibility and accountability for the concrete harm that has been generated?
II. Is there such a thing as "academic fraud"?
Scientific fraud, even by accounts of those within the field, is running rampant.2 It destroys the integrity of those very fields of science, and further erodes the public trust in the scientific enterprise itself. Scientific fraud fundamentally confuses and distorts our own perceptions of ourselves and of our world. But worse, it is the agent of concrete harm when applied to millions of innocent human beings, to our already-fragile environment and to public policy considerations. Who is responsible for this scientific fraud and harm? And who is accountable for it? Are there any validly equivalent phenomena in other areas of academia?
"Fraud" is not to be predicated of scientists only. Several recent books and articles, detailing the intellectual and political woes of our elementary, secondary and university educational systems, attest to the fact that "academic fraud" is not restricted to the field of science.3 Is academic fraud in other fields also in the process of destroying those affected academic fields? Is it engendering more and more public distrust in the very enterprise of academia itself? Does it also confuse and distort our own perceptions of ourselves and of our world? And when it is applied, does it also cause concrete harm? Who is responsible for this "other" academic fraud? And who is accountable for it?
An anticipated retort to such questions would understandably come in the guise of "academic freedom". Academia requires the "free" expression of opinions and ideas - politically correct and otherwise. But an important distinction is being lost. What is presently missing in this equation is the "otherwise". If only "political correctness" is allowed to constitute the "free exchange of ideas", then there is not "free" exchange of ideas at all - only pompous propaganda. And if only fallacious and fabricated ideas constitute the "dialogue", then there is no true dialogue at all - only self-aggrandizing soliloquies. "Academic freedom" requires both free expression and free dialogue - but it also requires that all of these ideas and theories be vigorously attacked, defended and evaluated -a game in which not every idea or theory can win. -- Unless, of course, defenders of the "otherwise" are prohibited from questioning these "constructs".
In this pluralistic society and age of relativism, subjectivism and "political correctness", the increased tendency (and often the imperative) is to be "tolerant" of a diversity of opinions. As educators, our profession demands foremost the respect that is due to each student that comes under our influence. We know that students come from a variety of cultural, social and familial backgrounds; that they are in uneven stages of maturity, abilities, experience and preparation; and that great care and prudence is demanded in our teaching relationships and interactions with them. But in the process of respecting their diversity of opinions, do we in fact actually harm them - and our colleagues and institutions - if we are so overly sensitive (or cowardly) that we resort to the fabrication and falsification of our subject matters, and selectively use only "politically correct" materials in our teaching efforts?
III. Has "sensitivity" training become a source of fraud and harm?
Where are the limits or boundaries of our moral and professional responsibilities as "sensitive" educators? To what extent do we actually harm our students, colleagues and institutions by compromising the truth, in any of its forms - and with it, true academic freedom - for the purpose of not hurting a student's or colleagues' "feelings" or "opinions" or cultural-bound ideologies? How far are we willing to go to be collegial, reasonable, fair, gracious, understanding, generous and loving in heart and spirit, mature and "with it"? And at what point does being overly sensitive (or cowardly) become unethical? Is it "mature" and "reasonable" to knowingly teach the subject matter of a course incorrectly - or to be silent when we know it is - in order to be "sensitive"? Given that some courses lend themselves to an "objective" subject matter more so than others - where is the dividing line between fact and fantasy in teaching the subject matter of any given field? Are we not suppose to teach something about our subject matter because it might offend someone? Or because our student evaluations might be lower?
For example, if there were students in my ethics class who were from a culture or a community in which cannibalism was taught and practiced, should I refrain from presenting critiques of their sincerely-held beliefs about cannibalism because it would embarrass or anger them? Should I teach that cannibalism is ethically acceptable - or at least as ethically acceptable as any other ethical position? If there were students in my ethics class who were child molesters or thieves, should I present material that disagrees with their opinion that molesting children or stealing the property of others is ethically acceptable - or should I teach that it is just as acceptable as any other strongly held belief or opinion? Should I "modify" ethicists' actual historical theories to "make" them say what would be considered "politically correct" today? Should I leave out certain ethical theories (or certain parts of ethical theories) because they might make some students uneasy? Isn't that really academic fraud?
In order no to offend anyone in my metaphysics class, should I purposely reword, transliterate or incorrectly quote or interpret Plato's, Aristotle's, Descartes' or Kant's treatises and theories to make them more "palatable" or less "offensive" to my students or colleagues who disagree with those philosophers' theories? I was recently interviewed for a position to teach what I am now teaching -the history of philosophy. I was directed to teach only Plato, Plotinus - and then skip to Descartes and Hume - and to please leave out the pre-Socratics, Aristotle and all of the medieval philosophers (especially Thomas Aquinas) - because the students (they thought) would find it "boring"! Is leaving out 900 years of the history of philosophy in a history of philosophy course really a bad case of "political correctness" - or, more harshly, academic fraud? Has "political correctness" really become co-extensive with academic fraud?
Would deliberately modifying those philosophical texts be any less fraud than, say, deliberately modifying and falsifying established scientific texts? What if a chemistry professor taught students that there were only 12 elements in the periodic chart; or a music professor taught students that there were only 4 piano keys in an octave, or that Beehoven's fifth symphony was really his first, etc. Isn't that academic fraud? If chemists and biologists are now held professionally and legally accountable for negligently misinterpreting or deliberately producing fraudulent and incorrect data and theories - why shouldn't other academics be held equally accountable for their own brand of academic fraud?
As "politically incorrect" as this may sound, not all translations of historical works are equal, and not all interpretations of those works are valid. In fact, not all ideas and theories - historical or contemporary - are equally valid or sound.4 Some ideas and theories match reality and some do not. Some can be successfully defended, and some can not. And ideas and theories have concrete consequence. When they are based on the subject matter of a field which has been abjectly politicized, the damage in terms of valid and sound knowledge is alone sufficient for concern.5 When they are also applied 6 to innocent and unsuspecting human beings, institutions and societies, the negative impact of inaccurate, indefensible and politicized ideas and theories can be long-term and cause devastating personal, familial, academic, institutional, social and cultural damage. Perhaps you fervently want to believe that the world is composed of monads or muons or juggleskoots - you are certainly "free" to think whatever ideas you wish. But you are not necessarily "free" to apply them, or to put them into action. Much less should our public policies be based on them.
IV. Is there discrimination against pro-life faculty?
I also question if in the academy more and more pressure is being brought to bear on "pro-life" - or "politically incorrect" - faculty members to modify, modulate, leave out or even deliberately after that part of their subject matters which in any way is offensive to the pro-choice (read: pluralistic or multi-cultural) belief-systems of students and colleagues alike. If so, is resistance met with isolation, loss of friends, tenure and grants - and low student evaluations? But of more concern than being "politically correct", or of hurting someone's feelings, educators need to be at least as concerned about the inevitable decay of academic standards (and with it the academy itself), and the real harm that consequentially plays out.
Again, an important distinction has been lost. Being pro-life should not equate with insensitivity or with academic incompetence. If educational materials are found to be fraudulent, or course contents found to be no more than worthless collections of intellectual ramblings based on historically or factually incorrect theses, any educator and any institution has the moral and professional responsibility to fairly address these problems.
Yet it is abundantly clear that any such attempts by pro-life educators to factually and historically correct educational materials are often just rejected out of hand as being "emotional" and "religious-based, right-wing radical ploys". These educators are effectively barred from any further access to the system, and then severely discriminated against for even raising these questions in the first place. Shades of Voegelin!
No official academic vehicle of recourse is now effective or available to these pro-life educators. But judging from the hundreds of personal accounts I have received over the last several years, the situation is so acute that it will probably soon force these educators to turn to the law for justice and redress in current employment practices in academia and research.
One would think that educators and educational institutions would be more concerned about incorrect facts and theories. One doesn't have to be a rocket scientist to understand that abstract theories and ideas - especially if they are really incorrect - have serious and very real concrete consequences when applied. Furthermore, like the domino effect, incorrect theories and ideas (or facts) once "set in concrete" in one field can then be transferred to other fields and harmfully applied - a phenomenon I will call "conceptual transfer". I will present briefly three short examples from my own academic experiences in science and bioethics, to briefly demonstrate how the concept of "personhood", already so successfully set in the abortion debates by academia, is transferable and applicable to the issues of human embryo research and psychiatric research. Considerable concrete harm is the consequence.
V. "Personhood" in the abortion debates
The current concept of "fetal personhood" was established over a period of about 20 years, primarily through the efforts of "bioethicists" who sought to combine some scientific claim about embryogenesis with some philosophical (or theological) theory of "personhood". These theories claim that real "personhood" (and therefore real ethical and legal rights and protections) do not begin until some embryological marker event during embryogenesis. Thus the concept denotes "delayed personhood" - and thus abortion is ethically permissible up to some selected biological marker event.
But how valid or sound are these theories of "delayed personhood"? By what criteria are they determined to be true or false? In analyzing over 23 "representative" arguments for "delayed personhood", I found that in virtually all 23 arguments the science used was objectively incorrect, the philosophy used was historically incorrect or theoretically indefensible, and that none of the conclusions even followed logically from their premises. Just the statistical odds of this happening by chance are mind-boggling. All of this I have presented in great detail to this conference before.7
A. Fake science
How is it possible that such massive scientific mis-information has been flowing from our scholarly and academic institutions for so many years - without correction? Citing just one example, the blatant and purposeful use of incorrect "human" embryology (which was, in fact, amphibian embryology) has been taught in academia for over 15 years in bioethics courses, bioethics conferences, incorporated into bioethics textbooks and computer software - even filed in the MEDLINE computer searches of the National Library of Medicine under BIOETHICSLINE, and thus literally circulated around the world. Clifford Grobstein.8 the embryologist most responsible for this (who is not even a human embryologist) has recently acknowledged on more than one occasion that his "human" embryology was and is incorrect. His response was simply: "But so what - what's the big deal?"
The "big deal" - aside from being scientific fraud - is that the moral and legal status of the early human embryo and fetus in those debates has been based on that wrong "human" embryology. For many years theologian Richard McCormick9 has published his arguments for "delayed personhood" based on this science. For many years lawyer John RobertsonRobertson10 has published his arguments for the status of human embryos and fetuses as property (and has subsequently won court battles), quoting Grobstein's "science" virtually for pages in his legal publications and briefs. Mountains of volumes of similar examples of incorrect science have been pumped into the academic and political systems, and are bulging the shelves of our university libraries.
Indeed, such grossly incorrect science has permeated our highest courts since Roe v Wade (1973). In that watershed decision, the Supreme Court contended that there was no scientific or medical consensus as to when the life of a human begins. That was scientifically false then, and is scientifically false now. In fact, the U.S. Senate held hearings shortly after their decision, to determine if in fact there really was such a consensus. After hearing scientific and medical testimony from around the world, it was incontrovertibly determined that there was, indeed, a scientific and medical consensus that the life of a human being begins at fertilization. But, it was countered, women now had a constitutional right to privacy to deal with their pregnancies; the scientific and medical consensus was not an issue any more.
Again, Dr. C. Ward Kischer,11 who has been teaching human embryology for over 30 years, researched the scientific credentials of the 167 "scientists" who authored an amicus curiae brief in support of the Webster case and its "scientific" assumptions of "delayed personhood". Of the 167 scientists, only 31 could even be classified as developmental biologists, and only one of those was credentialed in embryology per se - and he was not even a human embryologist. Does the Supreme Court not care about the scientific veracity of the amicus briefs which are presented to them by scientific "experts", on which they ground so many of their important and far-reaching decisions? Is the Supreme Court basing its decisions on "political correctness", or on the objectively correct science, the Constitution and the laws of this land? The Supreme Court has refused to even hear the correct scientific arguments,12 for if they did, they would have to reverse the Roe decision. And the women in this country are not yet "ready to hear the truth".
B. Weird philosophy
The philosophy used in these debates is just as bad. It is either grossly historically inaccurate, or a reductio ad rationalism or empiricism (the orphaned and embarrassing historical offshoots of Descartes' unworkable metaphysics, epistemology and anthropology).13 The definitions of "personhood" inherent in these philosophical systems contain an inherent mind/body split. In short, there is no interaction possible - either theoretically or concretely - between the mind and the body which are separated from each other. Thus they are both theoretically and practically untenable and unworkable - a fact amazingly lost on many contemporary "expert" philosophers. Hence either "rational attributes" (autonomy, willing, loving, interacting with the world around one, etc., from rationalism) and/or "sentience" (the ability to feel pain and pleasure, from empiricism) have now become the currently fashionable criteria for "personhood".
The concrete practical results of using these theoretically deficient theories were systematically inevitable. Since empirically we know that full "rational attributes" and full "sentience" are not present until well after birth, the infanticide of normal healthy human infants is considered morally permissible by more than just a few contemporary academics. Peter Singer, of Monash University in Australia, founder of "animal rights" philosophy, and now president of the International Bioethics Association, deduced correctly (although from false premises) when he wrote many years ago:
"I have argued that the life of a fetus is of no greater value than the life of a non-human animal at a similar level of rationality, self-consciousness, awareness, capacity to feel, etc., and that since no fetus is a person, no fetus has the same claim to life as a person. Now it must be admitted that these arguments apply to the newborn baby as much as to the fetus. A week old baby is not a rational and self-conscious being, and there are many nonhuman animals whose rationality, self-consciousness, awareness, capacity to feel, and so on, exceed that of a human baby a week, a month, or even a year old. If the fetus does not have the same claim to life as a person, it appears that the newborn baby does not either, and the life of a newborn baby is of less value than the life of a pig, a dog, or a chimpanzee."14 (emphasis added)
From selective bits and pieces of the historic systems of rationalism and empiricism have also evolved the present bioethics principles of autonomy, justice, beneficence and non-maleficence - otherwise known as "the Georgetown mantra" of bioethics principles, or the Belmont principles. These principles have virtually defined the field of bioethics since its inception. Most bioethics textbooks, conferences, courses and think tanks - world-wide - have been exclusively based on them. More than considerable numbers of medical, healthcare and research policies and decisions - as well as local, state, national and international regulations and guidelines - have been as well.
Yet these bioethics principles are fundamentally fraudulent.15 Even Albert Jonsen,16 one of the several originators of these principles during the 1975 National Commission, related recently that in order to address our pluralistic society, the few members of that commission who were really philosophers decided to abandon their traditional philosophical training and discipline in the search for more pluralistically-pleasing principles. At bottom these new principles, he implies, were basically made up (one might say, fabricated) from bits and pieces of Kant and Mill, with a smattering of Rawls mixed in. One has to seriously question the credentials of these "philosophers" to begin with, if they saw in advance no theoretical problems in combining separate bits and pieces of different and contradictory philosophical systems, and expected that such "mental constructs" could be philosophically valid, sound or defensible.
For a long time there has existed an uneasiness and ambivalence toward these principles from real philosophers as well as from real practitioners in the field who were "expected" to apply them. Early attempts to constructively criticize or correct them were perceived by the bioethics gurus in almost paranoiac fashion as sabotage, and effectively barred. Or they were dismissed by professionals, even within pro-life, as too complicated and technical, too focused on the "baby" and not enough on the "mother", "silly", professionally incompetent or irrelevant. But lately there has been a rising tide of articles and books, both here and abroad, which are openly and severely critical of these principles and of their application. Even Daniel CallahanCallahan17 himself, founder and president of the Hastings Center, the oldest bioethics think tank, has recently published an article in which he frankly admits the abject failure of these bioethics principles. His "new" solution is to be found in "communitarianism" (which could easily be "molded" into utilitarianism), and he ends with the consoling words that this should keep bioethicists employed for at least the next 25 years! Some tribute to the integrity and motives of the architects of these bioethics principles, which have reigned supreme in almost totalitaran fashion for over 20 years.
How did the newly created field of bioethics manage to take virtual control of so many related fields in so short a time? How could such butchering of sound science and of traditional historical philosophical systems, and the pure fabrication of both theoretically and practically indefensible theories, have taken place right before our eyes - even "in our face", one might say? With the aid of willing "scientists", "bioethicists", "philosophers", "theologians" and "public policy makers" - outside and inside pro-life - "delayed personhood" has consequently been simply declared to begin at some arbitrarily designated embryological point during embryogenesis. Who in bioethics is responsible and accountable for the immeasurable arm which has resulted from the applications of these "theories", which were based directly on now-admittedly fake science and philosophically untenable and unworkable bioethics principles? No one? No sanctions? No corrections? Just a fascinating, stimulating and harmless "intellectual exercise" or amusing "thought experiment"?
These theories have been allowed to be perpetuated for so long now, that they have become ingrained in the academy as well as in our mainstream American culture. The "dumbing"and the "numbing" of America is well on its way. Why haven't more competent scientists and philosophers spoken out?
Perhaps they are silent because they would loose their friends, jobs, tenures or grants. Or maybe it is because their student ratings would go down, since it would embarrass students who, e.g., have innocently procured abortions, thinking that it was justifiable because the early human embryo or fetus is just a blob of tissues, and not a real "person" yet? Has there been no real harm to the students, faculty, educational institutions - and to our society in general - from these academically engendered and incorrect theories of "delayed personhood"? Is there no real responsibility and accountability for the perpetuation of these fake "theories" in the academy by "professional" educators, theories which are so transparently and obviously incorrect and inaccurate? Haven't we been here before?
VI. Conceptual transfer to human embryo research
Regardless, these rationalist and empiricist definitions of "delayed personhood" are, unfortunately, being transferred to several other bioethics issues. For example, the NIH18 has been holding hearings since January (1994) on how to regulate human embryo research (not fetal research). The issue, they claim, is not whether living human embryos should be produced by in vitro fertilization (IVF) solely to be used in destructive experimental research. That, they tell us, is already a given and not up for discussion. The only issue they will discuss is how this research should be regulated.
Very short and limited notice was given about these meetings, and - in the words of its own chairman - the panel is appropriately stacked 19 by not including even one member who is opposed to the production of living human embryos for destructive experimental research. Among the kinds of research being discussed are:
- taking the ovaries from aborted human female fetuses to use for egg donation for IVF and pure research.
- parthenogenesis - inducing the formation of a human embryo by stimulation of a female child or adult or female fetus' ovum without the use of sperm.
- cloning - making exact physical copies of individual human beings, to be used for backup tissue and organ donation for the born child, or as backup in case a couple loses the "original" child through death.
- keeping only parts of human embryos alive in cell culture to provide organs for transplantation.
- fusion of human embryos with other human embryos or animal species to create chimeas (eventually to be implanted).
- use of pre-implantation genetic diagnosis to discard and/or experiment with human embryos that have a wide range of possible genetic abnormalities, or are of the "wrong" sex.
There are many serious problems surrounding these NIH hearings. Aside from the fact that it is admittedly stacked, there are clear violations of FACA involved,20 and obvious conflicts of interests. Of the 19 panel members, 10 members have collectively received over 21 million dollars in NIH research grants in these very same experimental areas since 1987 alone. Many members are also directly connected with abortion and eugenics interests and organizations. Even their professional competency is in question, especially considering the "embryology" and the bioethics principles which they are using to determine which experiments are ethical. Perhaps more interesting is the fact that there is no real human embryologist on this HUMAN Embryo Research Panel! The same non-human embryology and "personhood" claims are still being used by the panelists and by their invited academic "experts" - despite efforts and testimony to the contrary.21
Why? Because if they corrected the embryology and the "ethical" theories, then they simply could not condone or recommend as ethical most of the kinds of research experiments which they are reviewing. If "personhood" does not begin at fertilization, but at some later embryological marker event when "rational attributes" or "sentience" are even rudimentarily present,then these living IVF-produced human embryos are only human beings (if that) and not human persons. Just as in the fetal tissue debates, the early human embryo has now been conceptually reduced to an object of experimentation, rather than remaining as a subject of experimentation (and thus the federal OPRR Regulations for the ethical treatment of human "subjects" of research do not apply). Therefore these living human embryos can be allowed to be split, cloned, fused, made into cultures for later body parts and destroyed in experiments designed for curing genetic diseases and infertility, the improvement of contraceptive and IVF techniques and the necessary advancement of pure scientific knowledge. The concept of "delayed personhood", set by academia in the abortion debates, is necessary for the approval of these kinds of research, and has been successfully transferred to the medical and experimental research arenas. It is a "fait accompli".
VII. Conceptual transfer to psychiatric research
But my concern is not limited or restricted to the conceptual transfer of fetal "personhood" definitions from the abortion debates to pre-born human embryos. Regardless of one's position on abortion, research using tissues from human fetuses or human embryo research, these two-tiered theories of humanity and definitions of "personhood" can be transferred and applied to millions of adult human populations.
If a human being is not necessarily a human person until he/she exhibits "rational attributes" or "sentience" then the following list of adult human beings are also not persons: Alzheimer's' and Parkinson's patients, the mentally ill and retarded, the depressed elderly, alcoholics and drug addicts, the comatose and patients in a "persistent vegetative state", praplegics and the paralyzed, etc. If these populations of human beings are not persons, then they also lack full ethical and legal rights and protections. They then also fall into the "lower tier of humanity". They also loose their status as human "subjects".22 Why couldn't they also be used as experimental objects - as Singer might have it?
Preposterous as this might sound to you now, I am concerned that this may become a reality -if it hasn't already. I do know that an invited "scholarly" paper was presented at the Georgetown Kennedy Institute of Ethics a couple of years ago in which a philosopher, following Peter Singer, argued that since the higher primates are "persons" because they have higher degrees of "rational attributes" and "sentience" that some of the mentally ill, the mentally ill should be used in purely experimental research in place of those higher primates. Aside from the fact that some faculty members present objected to such a presentation - it is interesting that such a "theory" has attained such academic standing that it was even invited to be presented at all. I have also had seminary students argue this same point - genuinely convinced that such research would be morally acceptable.
My work with the families of the National Association for the Mentally Ill concerns issues of the ethics of psychiatric research. I will relate just three examples of questionable - I would argue unethical - research involving the mentally ill which might be justified by many because of a perceived"lack of personhood" in the mentally ill.
(1) A present policy at the Clinical Center, National Institutes of Health,23 allows cognitively impaired patients to give informed consent (in the form of a durable power of attorney) to select a surrogate decision-maker who can then decide if the patient can take part in medical research at the Center. In fact, this is an invalid application of the DPA, which only allows a competent citizen to give informed consent for a surrogate to make decisions later about normal healthcare alternatives in the event the citizen was to become incompetent at a later date.
(2) With the lifting of the moratorium on fetal research, a recent NIH grant - which was approved by an NIH Institutional Review Board (IRB) - allows fo 20 Parkinson's' patients to be used (with their informed consent) as controls by boring holes in their skulls (and receiving no fetal tissue implants), as compared with 20 Parkinson's' patients who will have holes bored in their skulls and who will receive fetal tissue transplants.24
(3) A large number of recent experimental protocols in schizophrenia research were designed in such a way that they would purposefully actually induce schizophrenic relapses25 - so that the investigators could study the relapse process itself - a pertinent fact not disclosed in the informed consent forms signed by these patients with schizophrenia. It is safe to say that very few patients with schizophrenia would knowingly agree to endure a relapse, as relapses are avoided at all costs by patients and their families alike. Relapses are extremely debilitating, harmful, painful, often cause permanent brain damage, and in some cases have actually led to suicides.
Are any such abuses in psychiatric research perhaps caused by the afore-mentioned conceptual transfer of "personhood"? Are the mentally ill only human beings and not also human persons? Are there really two layers of humanity - those who are "just" human beings, and those who are also, in addition, human persons? How much more harm will be caused - and justified - by the conceptual transfer of "personhood" from the abortion debates?
VIII. What about ethics?
Do we as individual educators, or as educational institutions, bear any real, tangible moral responsibility or accountability for the propagation of this massive misinformation for so many years, its perpetuation in and through the academy, and the concrete and harmful human and cultural consequences which have already ensued? I will mention only the most asic of ethical considerations.
A. Research institutions and its scientists
There are at least four very basic and fundamental criteria required before an experiment can be considered "ethical",26 and therefore approved by any IRB. First, the science that is being used to design the protocols and to analyze the data must be correct science. Institutionally, NIH has refused to admit that they are using incorrect embryology. Furthermore, given that the "human embryology" being used by the NIH panel in their acceptance of "delayed personhood" and in their invited papers and panel discussions is not human embryology but amphibian (sometimes, mouse) embryology, to be consistent the experiments which are under consideration must also use that same incorrect embryology in the very designing of the protocols and in the analyzing of their data. Therefore, they would be automatically unethical. One has to wonder how any bench research embryologist can even expect to obtain correct data or be able to analyze his/her data correctly if the embryology being assumed is amphibian! And if correct data are obtained and published, then it could only have been accomplished by manufacturing one's data, or by contradicting the "embryology" used and cited by the Panel and slipping the correct human embryology into the design of their experimental protocols - both alternatives being automatically unethical.
Second, the design of the protocol itself must be ethical. In three of the research experiments discussed, the protocols themselves - all approved by IRB's - are designed to either destroy a living human embryo (who is a human being and human person), to inflict major physical damage to a patient so as to have an experimental "control", or to induce very painful, damaging and potentially lethal relapses in uninformed schizophrenic patients. On this second count, all three kinds of research are unethical.
Third, the goal of the experiment - no matter how lofty that goal may be - as well as the means used to reach that goal must be ethical. All of these kinds of research violate the very right to life, or physical and psychic health and well being of the subjects of this research. In fact, both human embryos and the mentally ill are being used as objects of research rather than as subjects of research - a clear violation of the OPRR regulations for the protection of human subjects. Again, because the means used to reach the goal are unethical then the experiments themselves are unethical.
Fourth, when research is using human subjects, these subjects must give their informed consent before taking part in these experiments. Even informed consent is not legally permissible if the experiment knowingly leads to grave and injurious harm. Proxy (or surrogate) consent can only legally be permitted if the research is for the direct benefit of the patient. But obviously human embryos cannot give informed consent themselves. And it is highly questionable if patients who are cognitively impaired, or who have mentally impairing diseases such as Parkinson's or schizophrenia, can automatically give valid informed consent. As for surrogate consent, in none of these examples is the research experiment being performed for the direct benefit of these patients. I also raise the question whether women can give legally valid informed consent to abort their children, donate their children's tissues and organs, or donate their "surplus" human embryos (or ova), if they do not know the correct nature of that which they are aborting or donation, or if they refuse to know. Furthermore, a woman should loose her standing as a "surrogate" decision maker, if she wills to abort or donate her pre-born child (in whole or in part), since this is obviously not for the direct benefit of or in the best interests of her pre-born child.
B. The academy and its educators
More subtle is an ethical analysis of the academy and its educators. However, at least the following basics should be pointed to. First, the starting point of moral decision making is the intellectual information which is presented to the agent's will as both true and good.27 If the content of this intellectual starting point is deficient due to incorrect facts or theories, or because important and significant facts and theories have bee left out, then the entire moral decision making process, including the conclusion arrived at, is deficient. Although this point is rarely discussed in ethics classes, it goes to the very heart of our moral responsibilities as educators.
Do we not, as educators, have a moral responsibility to assure our students, faculty, institutions, and society that the facts and information that we disseminate are at least objectively true where possible and historically correct? Moral decision making depends to a great extent on the quality of the information we disseminate, information which is then used by others as the starting point in the weighing and measuring of their moral decisions. Indeed, without correct information, our students cannot even formulate, and therefore cannot even then raise the questions which are essential for the true give and take required for true academic freedom.
The purposeful dissemination of corrupt science and weird "philosophy" or "bioethics" theories as true, and the leaving out of correct science and valid and sound competing theories is a considerable source of both concrete and moral harm. Any real ethical analysis must address the source of the misinformation used to ground these dubious concepts of "delayed personhood". And here the "source of the misinformation" is the institution of academia itself, as well as those individual educators who have spawned this misinformation.
Second, if academicians are true professionals, they are so at least because they have accurately and correctly mastered a body of knowledge - and because the application of that knowledge can seriously impact the welfare of our society.28 If they have not truly mastered their respective bodies of knowledge - or have modified or even falsified it - they are clearly neither experts nor professionals - and, in this case, have obviously caused a chain-reaction of real concrete and moral harm by their negligent or false theories of "science" and "philosophy" on which the equally false theory of "delayed personhood" is grounded.
Third, it is also unethical for educational institutions to perpetuate such theoretically and concretely harmful theories by allowing such "educators" to knowingly teach these fabricated theories as true to our students, who then, e.g., use them to justify abortions, fetal research, human embryo research or the substitution of the mentally ill (or any other disadvantaged population) for animals in research protocols. It is also unethical to allow these so-called "educators" to use our institutional credentials to further their own ambitious public policy careers, lending even more unqualified institutional credence to the validity and viability of these brilliant "scholarly" deductions.
True academic freedom requires the intellectually honest give and take of all opinions and arguments - not just those from the "politically correct" - whichever side of the "political" aisle. Unless those dialogues are based on correct educational materials, no real dialogue is possible, and the very raison d'etre of the academy is destroyed. Ideas have consequences - especially when they are applied. No where is this more obvious than in the debates about abortion, human embryo research and psychiatric research.
The purposeful manipulation and fabrication of educational materials in the liberal arts - for whatever reason - and the imposition of these defective "mental constructs" on students, educators and institutions alike, constitute academic fraud, causing very serious and life-long damage and harm. As professional educators we should recognize that such harm is every bit as serious and concretely damaging as the kind of harm engendered by scientific fraud. Our response should be as concrete as that of the scientific community: acknowledge our responsibilities to prevent it; provide mechanisms to detect and correct it (especially in the form of public, published retractions of incorrect information in the journals and books); and understand that we are accountable to the American public if we do not.
One of the most unpopular jobs for philosophers is to at least formulate and "raise the questions" that nobody else wants to raise. I have formulated and raised a few questions here which I think need urgent attention - but I leave it up to my colleagues, who have vastly more experience than I, to "answer the questions"!
1. Eric Voegelin, Science, Politics and Gnosticism (Washington, D.C.: Regnery Gateway, 1968), p.23 ff. [Back]
2. For example, see the entire issue, Journal of the American Medical Association (July 13, 1994) 271:26; Dianne N. Irving, "'New Age' Embryology Text Books: 'Pre-Embryo', 'Pregnancy' and Abortion Counseling; Implications for Fetal Research", Linacre Quarterly (May 1994), 61:2:42-62; Ruth Ellen Bulger et al (eds.), The Ethical Dimensions of the Biological Sciences (New York: Cambridge University Press, 1993); Darwin Cheney (ed.), Ethical Issues in Research (Frederick, MD: University Publishing Group, Inc, 1993) (containing an amazing must-see unreferenced contribution by Grobstein); Susan E. Cozzens, Social Control and Multiple Discovery in Science (New York: State University of New York Press, 1989); Raphael Sassower, Knowledge Without Expertise (New York: State University of New York Press, 1993); Brian Martin, Scientific Knowledge in Controversy (New York: State University of New York Press, 1991); Daryl E. Chubin and Edward J. Hackett, Peerless Science: Peer Review and U.S. Science Policy (New York: State University of New York Press, 1990); Doug Levy, "Science Only As Strong As Its Integrity", U.S.A. Today (March 16, 1994), A1. [Back]
3. For example, see Roger Kimball, Tenured Radicals: How Politics has Corrupted Our Higher Education (New York: Harper & Row, 1990); Allan Boom (d.), The Closing of the American Mind (New York: Simon & Shuster, Inc., 1987); William J. Bennett, The Book of Virtues (New York: Simon & Shuster, 1993); Mary Jordan, "Respect Is Dwindling In the Hallowed Halls", The Washington Post, June 20, 1004, A3 "Professors Not Impressed With U.S. Students", The Washington Times, June 20, 1994, A3; Peter Shaw, "The Demise of Literature at the hands of the Professors", The Washington Times (August 30, 1994), A15; Carol Iannone, "Rise of the Irrational", Commonsense (Summer 1994), 1:3:1-10. [Back]
4. See any good history of philosophy text, e.g., Frederick Copleston, A History of Philosophy (New York: Doubleday Anchor Books, 1959); Etienne Gilson, Being and Some Philosophers (Toronto: Pontifical Institute of Mediaeal Studies, 1963). [Back]
5. Dianne N. Irving, "Science, Philosophy and Expertise: An Evaluation of the Arguments of 'Personhood'", in Joseph W. Koterski, S.J. (ed.), Life and Learning: Proceedings of the Second University Faculty For Life Conference (Washington, D.C.: University Faculty For Life, 1993), 162-194 and reprinted in Linacre Quarterly (Feb. 1993), 60:1:18-46; C. Ward Kischer, "Human Development and Reconsideration of Ensoulment", Linacre Quarterly (Feb. 1993) 60:1; William B. Smith, "The Revision of Moral Theology in Richard A. McCormick", Homiletic & Pastoral Review (March 1981), 8-27; Bernard D. Green, "The Old Mythologies Are Back: The Gnostic Temptation in the Catholic Church", New Oxford Review (Sept. 1994), 8-13. For a sobering example detailing how philosophy and science should be "politicized" for stranger-than-fiction reasons, see: Wilson L. Duke, "The New Biology", Reason, (Aug. 1972), 4-11. [Back]
6. Dianne N. Irving, "The Impact of Scientific 'Misinformation' on Other Fields: Philosophy Theology, Biomedical Ethics and Public Policy", Accountability in Research (April 1993), 2:4:243-272; also, "Can Either Scientific Facts Or 'Personhood' Be Mediated?", Pontis (The Center for Medical Ethics and Mediation, San Diego, CA)(March 1994), 2:1:-5; also, "Psychiatric Research: Reality Check", The Journal of the California Alliance for the Mentally Ill (Spring 1994), 5:1:42-44; also, "Post-Abortion Trauma: Bring on the Facts", Linacre Quarterly (Feb. 1994), 61:1:3-5; Francis J. Beckwith, Politically Correct Death: Answering Arguments For Abortion Rights (Grand Rapids, MI: Baker Books, 1993); Christina Hoff Sommers, Who Stole Feminism? (New York: Simon & Shuster, 1994); Celia Wolf-Devine, "Abortion and the "Feminine Voice", Public Affairs Quarterly, (July 1989), 3:3:81-97; Doris Gordon, "Why Abortion Violates Rights", Life, Liberty, Responsibility (Libertarians For Life) ((March 7, 1994), 4-7; see also, note 5 op cit. For another sobering example detailing how science can be "philosophied" for stranger-than-fiction experimental goals, see the details of a research protocol for human/chimpanzee cross fertilization, by: Charles Remington, "An Experimental Study of Man's Genetic Relationship to Great Apes, By Means of Interspecific Hybridzation", in Jay Katz, Experimentation With Human Beings (New York: Russell Sage Foundation, 1972), 461-464. [Back]
7. See Note 5 op cit. [Back]
8. Clifford Grobstein, "The Early Development of Human Embryos", Journal of Medicine and Philosophy (1985), vol. 10. [Back]
9. Richard McCormick, S.J., "Who or what is the pre-embryo?", Kennedy Institute of Ethics Journal (1991), 1:1. [Back]
10. John A. Robertson, "Extracorporeal Embryos and the Abortion Debate", Journal of Contemporary Health Law and Policy(1986), 2:53; also, see his arguments as representing the father in the Davis vs Davis case (Maryville, TN: No. E-14496, August 1989). [Back]
11. C. Ward Kischer, "Quid Sit Veritas?", in Science for Life (July 1994), 4:1:1-10. [Back]
12. University Faculty For Life briefs amicus curiae, prepared by Dianne N. Irving and Daniel M. Gray, in support of petitions for writ of certiorari, United States Supreme Court: J.M. vs V.C. (No. 92-1934) and Alexander Loce vs The State of New Jersey (No. 93-1148) and Tina Krail vs The State of New Jersey (No. 93-149). [Back]
13. Dianne N. Irving, Philosophical and Scientific Analysis of the Nature of the Early Human Embryo (Doctoral dissertation, Washington, D.C.: Georgetown University, 1991), esp. summaries pp. 23, 53, 59, 70, 82, 114, 131, 145, 169, 205, 247, 259; lso, "Which Ethics For Science And Public Policy?", Accountability in Research (1993), 3:2-3:77-99; also, "Quality Assurance Auditors: How To Survive Between A Rock And A Hard Place", Quality Assurance: Good Practice, Regulation and Law, (March 1994), :1:33-52; also "Science, Philosophy and Expertise:…", Note 5, op cit; Gilbert Meilander, Challenging the Limits of Dualism (University Park, PA: Pennsylvania State University Press, 1987); Frederick Wilhelmson, Man's Knowledge of Reality (New Jersey Prentice-Hall, Inc., 1956); Christopher Fox, Locke and the Scriblerians: Identity and Consciousness in Early Eighteenth Century Britain (Los Angeles: University of California Press, 1989); Norman Kemp-Smith, A Commentary to Kant's 'Critique of Pure reason', (London: The Macmillan Press Ltd., 1979), xxxiv, xlii, xliv. [Back]
14. Peter Singer, "Taking Life: Abortion", in Practical Ethics (London: Cambridge University Press, 1981), 122-124; for other arguments for infanticide, see H. T. Engelhardt, The Fondation of Bioethics (New York: Oxford University Press, 1985), 111; Michael Tooley, "Abortion and Infanticide", in The Rights and Wrongs of Abortion, M. Cohen et al (eds.) (New Jersey: Princeton University Press, 1974), 59 and 64; P. Singer and Helga Kuhse, "The Ethics of Embryo Research", Law, Medicine and Health Care (1987), 14:13-14; H. Kuhse and P. Singer, "For Sometimes Letting - and Helping - Die", Law, Medicine and Health Care (1986), 3:40, 149-153; H. Kuhse and P. Singer, Should the Baby Live? The Problem of Handicapped Infants (Oxford University Press, 1985), 138. [Back]
15. D. N. Irving, "Which Ethics …", and "Quality Assurance …", Note 13 op cit. [Back]
16. Albert R. Jonsen, "Foreword", in Edwin R. DuBose et al (eds.), A Matter of Principles?: Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994), ix-xvii. [Back]
17. Daniel Callahan, "Bioethics: Private Choice and Common Good", Hastings Center Report (May-June 1994), 28-31. [Back]
18. "National Institutes of Health Human Embryo Research Panel Meetings", and "National Institutes of Health: Report of the Human Embryo Research Panel" (Sept. 27, 1994). To receive (free) the transcripts of all six meetings, the invited papers, and the final recommendations, call Peggy Schnoor at NIH (01-496-1454) - they are priceless. [Back]
19. Congressman Robert K. Dornan's letter of response to Dr. Varmus, Director of NIH, September 19, 1994 (signed by other members of the Congressional pro-life caucus); American Life League's response to Dr. Varmus, August 26, 1994 (prepared by Suzanne M. Rini); see also series of articles by Richard M. Doerflinger in National Right to Life News, also series of articles by Mary Meehan in The National Catholic Register. For an interesting explanation of how Congress was duped into passing the NIH Revitalization Act (1993), see revealing article by Joseph Palca, "A Word to the Wise", Hastings Center Report (March-April 1994), 5. See also articles by Dianne N. Irving: "Embryo Research: A Call For Closer Scrutiny", National Catholic Register (July 17, 1994); and interviews for articles: Peter H. Mullen, "An Interview With Dianne N. Irving on Human Embryo Research: Questions and Answers", National Catholic Register (October 7, 1994); Mary Meehan, "Halt These Proceedings", National Catholic Register (June 1994); Diane Gianelli, "Embryo Research Decision Set to Spark Controversy", American Medical News (June 1994), 7; Mark Zimmerman, "NIH Panel Examines the Benefits and Risks in Human Embryo Research", Catholic Standard (March 24, 1994), 4. [Back]
20. See suit filed by Randy Engle on behalf of The Michel Fund: Mary Doe vs Donna Shalala, et al (Baltimore District Court, MD, No. PJM-94-1703), June 1994. [Back]
21. Dianne N. Irving, "Individual Testimony Before The NIH Human Embryo Research Panel", Linacre Quarterly (November 1994, forthcoming). There were many excellent testimonies given before the NIH Panel, too numerous to list here, but a list is available from NIH. [Back]
22. See D. Irving, "Psychiatric Research …", and "Can Either Scientific Facts …" in Note 6 op cit; also, in amicus briefs in Note 12 op cit; Adil E. Shamoo and D. Irving, "Accountability in Research With Persons With Mental Illness", Accountability in Research (November 1993), 3:1:1-17; also, Robert A. Destro, Law, Professionalism, and Bad Attitude", The Journal of the California Alliance for the Mentally Ill (Spring 1994), 5:1:50-53. [Back]
23. John Fletcher et al, "A Trial Policy for the Intramural Programs of the National Institutes of Health: Consent to Research With Impaired Human Subjects", IRB (1985), 7:6:1-6. [Back]
24. John Cohen, "New Fight Over Fetal Tissue Grafts", Science (1994), 263:4:600-601. [Back]
25. Michael Davidson et al, "L-Dopa Challenge and Relapse in Schizophrenia", American Journal of Psychiatry (July 198), 144:7:934-938; Kenneth J. Rothman and Karin B. Michels, "The Continuing Unethical Use of Placebo Controls", New England Journal of Medicine (Aug. 11, 1994), 331:6:394-398; "Medical Ethics in the Dock", editorial in The New York Times (Monday, March 1, 1994); similar research being done with hundreds of veterans at the V.A. Hospital, UCLA (reports forthcoming); see also several articles on this issue, e.g., Shamoo, Becker, and Irving, in The Journal of the California Alliance for the Mentally Ill (Spring 1994), 5:1; Shamoo and Irving, "Ethics of Clinical Research Protocol Designs: Relapse Experiments, Comparing U.S. to Non-U.S. Studies" (forthcoming). [Back]
26. Nuremberg Code - part of the judgment handed down to Karl Brandt, and The Declaration of Helinki, in Jay Katz, Experimentation With Human Beings (New York: Russell Sage Foundation, 1972), 305-306 and 312-313; also, Katz, "The Consent Principle of the Nuremberg Code: Its Significance Then and Now", in George J. Annas and Michael A. Grodin (eds), The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation, (New York: Oxford University Press, 1992); also, D. Irving, "Individual Testimony …", Note 21 op cit, and "Psychiatric Research …", Note 6 op cit. [Back]
27. Aristotle, Etica Nicomachea, in Richard McKeon, The Basic Works of Aristotle (New York: Random House, 1941), 935-947 and 1022-1024 and 1030-1036; Austin Fagothey, Right and Reason (3rd edition only) (St. Louis, MO: C. V. Mosby, 1963), 92ff, 101-113, 198; D. Irving,"Which Ethics ….", Note 13 op cit. [Back]
28. Robert Sokolowski, "The Fiduciary Relationship and the Nature of Professions", in Pellegrino et al, Ethics, Trust and the Professions (Washington, D.C.: Georgetown University Press, 1991), 23-43; Rena A Gorlin ed.), Codes of Professional Responsibility (Washington, D.C.: The Bureau of National Affairs, inc., 1991). [Back]
- Category: Documentation
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The New World of Managed Care: Creating Organized Delivery Systems
- Category: Documentation
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- Published in Volume: 2 Issue 1: April 19, 2005
Objective: To examine whether use of the Medicare Hospice Benefit between health maintenance organization (HMO) and Fee-For-Service (FFS)-enrolled beneficiaries varies by income or race. Data source: Medicare enrollment and claims data for South Florida. Results: In the FFS system, rate of death in hospice varied by income. In the HMO system, it did not. Time spent in hospice varied by income in the HMO system and not in the FFS system. There was little evidence that racial differences in hospice use differed between FFS and HMO options. Conclusions: These differences raise questions about whether some hospice use may be in response to system-level incentives.
Article Must Be Purchased.
- Category: Documentation
- Hits: 58
Impact of Individual and Market Factors on the Timing of Initiation of Hospice Terminal Care
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Health Care Rationing: Can we Afford to Ignore Euthanasia?
First Published February 1, 1997 Research Article
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