Morality in Medical Science

For those fortunate enough to experience it, fundamental research is very enjoyable. Outstanding scientists who tend to "work'' nearly every waking hour of the day are often described as "dedicated, devoted, or even married'' to their work. In fact, most of them are just having so much fun that they are unwilling to stop for less enjoyable activities. (We are referring here to real scientists - not to the granta-holics who spend vast amounts of time at their desks generating paper in a never-ending search for more of the tax collector's loot and most of the rest of their time rushing to meetings where their activities reinforce this political quest.) When it became clear at age 25 years that I could have a permanent laboratory of my own in exchange for a modest amount of teaching, I often thought to myself, "This is great. I may never have to work. I am going to get to play all my life, and people are going to pay me for it.'' This reverie became more sophisticated and subsequently led to a moral conclusion - that I owed something in return to those who were financing my fun. (I was then still oblivious to the involuntary nature of their contributions and therefore to the inherent immorality of accepting tax money at all for research - except for defense research in which I was not engaged.) These thoughts led the idealistic young tax recipient to decide that he should spend half of his time doing work that was immediately applicable to human well-being, so I chose medical research. Medical research turned out to be actual work (not play) and also turned out to have moral and political components that are far more difficult to deal with than are scientific experiments.

Although initial progress can be made in simpler systems, medical research ultimately involves experiments on human beings. Humans are generally the worst experimental animal that one can choose. They are inherently complicated in chemistry and biology, subject to great individual variability, difficult to work with in large numbers, time consuming, almost impossible to control, and not expendable. In a single afternoon, one can perform a rigorous experiment on 100,000 brine shrimp. The same experiment, more crudely done, could probably not be completed on humans in an entire lifetime.

"Brookhaven Prepares for Boron Trials'' by Andrew Lawler in Science 267, p 956 (1995), provides an example. Embellished with a "photo-op'' picture of energy bureaucrat Hazel O'Leary with her arm around a recently treated brain cancer patient, this article describes a research project to test the use of boron neutron capture therapy. A boron compound is administered which concentrates in the brain tumor. A beam of neutrons then activates the compound, making it radioactive. This kills the tumor.