letters

Do Researchers Learn to Practice Misbehavior?

To the Editor: Those of us with recent experience in clinical research in
any country will not be surprised at the
findings of Elizabeth Heitman and her
colleagues (Do Researchers Learn to
Overlook Misbehavior? HCR, SeptOct 2005). We are familiar with misbehaviorssome seriousand we know
from experience that training in research methodology and ethics has little
impact. For reasons of personal and institutional self-interest, such training
has a tendency to focus on securing approval for studies and publication of interesting results.
But theres more. Heitman et al. are
concerned that universities cannot rely
only on the traditional apprenticeship
system and role modeling to transmit
standards of scientific integrity to
trainees. Yet the apprenticeship may be
a part of the problem. In part, the reason trainees might keep inadequate
records, change methodologies, or drop
data that they believe to be erroneous,
even though they have been trained to
be so scrupulous, is that we are often actively encouraged to do so by those to
whom we are apprenticed. I have direct
experience (outside the United States,
but in a developed country with a comparable academic culture balancing research scrutiny with pressure to undertake and publish research) of: instructions to write mendacious descriptions
of interview methodology; patients
being misled into participating in research or being recruited under threat of
inferior care; instructions to revisit data
that appeared inconsistent with the
working hypothesis, an inconsistency
that was apparent only because midstudy comparisons were being made in
violation of a blinded protocol; having
decisions on whether to submit work
for publication being taken on the basis
of whether the study results were posi4 HASTINGS CENTER REPORT

tivethe most direct form of publication bias that inevitably leads to grossly
misleading aggregate evidence in the literature; my inclusion by eminent researchers as a coauthor of papers that I
had not even read, in violation of the
codes of the journals in which the work
was published; exclusion from research
groups and from publication of previously undertaken collaborative work as
a direct and explicit consequence of
raising concerns about some of these irregularities; and stern warnings from senior colleagues (whose own behavior is
scrupulous) that I would risk serious
harm to my future research and clinical
career if I rocked any more boats. I
heeded these warnings because I know
people who did notpeople whose careers, and sometimes lives, are broken.
Training for researchers is necessary
and must be aimed at shaping attitudes
tonot just knowledge ofresponsible
conduct of research (RCR). But it is insufficient. Too much misbehavior is
taught by the example of some misbehaving teachers and researchers. We
should expect deep-seated opposition to
discussion of any new rules in this area,
but we must consider them simply because their unwritten spirit is so widely
flouted. In developing our understanding of what it means to research ethicallyand alongside the evolution of our
understanding of other important concepts discussed in this issue, such as coercion, consent, and equipoisewe
must give urgent consideration to some
key questions. How do we remove from
senior researchers the incentives to misbehave, including having their progression and tenure dependent on the quantity of their published work? Should we
require that research is separated more
rigorously from clinical care, perhaps
even that clinicians do not undertake
research on their own patients, so that

professional relationships cannot be

abused in recruiting subjects or in creatively reinterpreting results? How do
we improve the oversight of clinical research, going beyond mere scrutiny of
study design with too exclusive a focus
on patient protection and insufficient
attention to honesty? Perhaps most importantly, how do we protect trainees
from being encouraged to develop behaviors which they know to be wrong,
and how do we protect witnesses to research misconduct from retribution or
fear of retribution if they speak up?
Only by answering these questions,
alongside RCR training, can we secure
lasting improvements in research conduct.
Anonymous

The Debate over

Liberal Eugenics
To the Editor: Bernard Prusak clarifies and deepens Jrgen Habermass critique of liberal eugenics; namely that,
when the technologies permitting it are
deemed safe, parents should have a limited prerogative to genetically enhance
their children (Rethinking Liberal Eugenics: Reflections and Questions on
Habermas on Bioethics, HCR, NovDec 2005). I think his discussion
should prompt an explicit statement of
complexities omitted from breezy presentations of the liberal view about
human enhancement.
Habermass exploration of the illiberal consequences of liberal eugenics
seems to me altogether more sophisticated than those of other critics. Francis
Fukuyama, for example, is operating
very much in the mode of the Hollywood movie, Gattaca, when he expresses the fear that large gaps between the
genetic haves and have-nots will make
the cooperative relations characteristic
March-April 2006

of liberal societies impossible or unlikely. However, Habermas argues that full

participation in liberal democracy depends on finding a starting point for
oneself external to society, and that the
contingency of our genetic makeup constitutes such a point. According to
Habermas, [t]he programmed person,
being no longer certain about the contingency of the natural roots of her life
history, may feel the lack of a mental
precondition for coping with the moral
expectation to take . . . the sole responsibility for her own life (The Future of
Human Nature, pp. 81-82). Her genetic
enhancers have, in effect, appointed
themselves coauthors of her life, creating
an illiberal asymmetry between them
and their child.
This is certainly an interesting argument. But I have to confess some skepticism about the need for any
Archimedean point external to society
from which to autonomously move ourselves around in it. Isnt it better to view
our identities as shaped by a variety of
social influences, both intended and unintended? We have long selected the genetic material of our children by mating
with people we find attractive. Some
have children with intelligent, good
looking people because they just happen
to find themselves in relationships with
them, but others see in a partners intelligence and good looks the promise of
intelligence and good looks for their
children. Once born, we are shaped not
only by parents choices about how to
raise us, but also by our peers resolutions about what kinds of activities are
cool. We are all coauthors of each others
lives, or at least proofreaders of paragraphs of them. We protect the symmetry that Habermas thinks is essential to
interactions with other members of liberal societies by recognizing that as one
is influenced, one influences. The ways
in which our fellow citizens shape our
identities are as varied as the ways in
which we shape theirs.
Habermas finds a moral difference
between the selection of genes and deciMarch-April 2006

sions about how to raise children. He argues that the former is unilateral and irresistible. While there is the possibility
of protest against a parental plan to turn
you into a Wimbledon champion by
mandating daily tennis practice, one is
simply born with ones genome athletically enhanced. But this objection misunderstands what parents who would
genetically enhance their children are
trying to do. They will choose a childs
genes for their effects, many of which require the cooperation of the genetically
modified individual. To deny that this is
so is to buy into the genetic determinism that pervades popular understanding of biology. Choosing not to exercise
can prevent the genetic modifications
purchased by sports-obsessed parents
from having the effects they desire just
as certainly as healthy eating can prevent
genetic variants that elevate the risk of
heart disease from having the effects genetic testers have warned of. A parent
may quash these acts of rebellion, but
the fact that he has chosen genetic forms
of influence does not make rebellion impossible.
I think Habermas and Prusak misdiagnose the threat to liberal democracy
from genetic enhancement. The technologies of genetic enhancement are
worrisome not because they represent a
morally distinct variety of influence, but
because they may grant too much control. Parents who already decide how to
school their children and what to feed
them will now select their genes. This
threat should not be tackled by giving
one class of influences an automatic
moral pass mark. Pregnant women are
now encouraged to design their childrens uterine environments by eating
certain foods and undertaking specific
exercise programs. Parents feed their
children low-carbohydrate or exclusively
vegetarian diets. They pursue various
measures to stimulate cognitive development, including the playing of baby
Einstein DVDs and the setting of infant
Sudoku puzzles. When they do this,
they hope that their children not only

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of the letters published here are available
on our web page at http://www.
thehastingscenter.org/publications/hcr/
hcr.asp. Letters to the editor may be sent
by email to griffinj@thehastingscenter.org,
or to Assistant Editor, Hastings Center Report, 21 Malcolm Gordon Road, Garrison,
NY 10524; (845) 424-4931 fax. Letters
appearing both in the Report and on the
website may be edited for length and stylistic consistency.

achieve the same level as their contemporaries, but surpass them. Concern for
the prospective welfare and autonomy
of our children should lead us to recognize many ways of manipulating environmental influences as morally problematic. By analogous reasoning, some
genetic enhancements are likely to be
among the interventions that preserve
our childrens capacity to fully participate in society.
Nicholas Agar
Victoria University of Wellington,
New Zealand
To the Editor: Bernard Prusak argues
that Habermas provides grounds for rejecting the liberal eugenics that I (together with my coauthors) defended in
From Chance to Choice: Genetics and Justice. The core of the Prusak-Habermas
position is that the contingency of our
genetic makeupthe fact that its production was not under anyone elses
control . . . might well be necessary for a
person to be capable of regarding herself
as an autonomous being. To evaluate
their criticism, it is crucial to emphasize
that the genetic manipulation we defended must be compatible with the
childs right to an open future, which
implies that such manipulation must
enlargeor at least not restrictthe
childs range of opportunities; it must
enhance all-purpose means or capacities
useful in pursuing nearly any plan of
life. If this limitation on acceptable liberal eugenics is kept firmly in mind,
most of the Prusak-Habermas worries
become unfounded.
HASTINGS CENTER REPORT