Ethics in Conservation MedicineOctober 3, 2012

What are ethics? “the discipline dealing with what is good

and bad and with moral duty and obligation”

“a set of moral principles or a theory or system of moral values”

-Merriam-Webster Dictionary

Morals

“About morals, I know only that what is moral is what you feel good after and what is immoral is what you feel bad after.”

-Ernest Hemingway, Death in the Afternoon

Determinants of Ethics Personal moral values Personal responsibility Religion Culture Societal norms Professional code of conduct Laws, rules, regulations

Areas of Ethics Meta-ethics: ethical theory, ideas of

right and wrong (focus on meaning)

Normative ethics: studies how to take an ethical action (focus on actions)

Applied ethics: how to achieve an ethical outcome (focus on outcome)

What is ethical? How to determine right and wrong People are most comfortable with

dichotomous issue Often many sides to one issue Universal ethics: everyone agrees:

Don’t lie, don’t steal, don’t kill But…

Complicated Ethics Thou shalt not kill

Death penalty? Abortion? Human euthanasia? Self defense? Animals?

Defining Ethics in the Sciences Driven by professional values Concerns for values at different levels:

individual, patients, profession, society, scientific community

Mapping values helps define professional values

Identification of most troubling issues

Professional Value Mapping:Veterinarians Self oriented:

Monetary gain Personal satisfaction Recognition

Patient oriented: Alleviation of pain and suffering Promotion of patient health

Client oriented: Client’s monetary gain Satisfaction

Knowledge/Science/Theory Oriented: Scientific aspects of disease Promotion of basic research

Society oriented: Public health Individual human health Animal control

Enforcement of Ethics in Research Cannot rely on ethical code alone Numerous determinants of individual

ethics Some people are amoral or immoral Regulations introduced to safeguard the

rights of humans and animals

Ethical Review Boards Before 20th century, human and animal

research ethics left to individual researcher conscience

Professional codes of conduct Laws and customs of society Elaborate rules and regulations

developed: IACUC (animals) and IRB (humans)

IACUC Institutional Animal Care and Use

Committee Self regulating body required of all federally

funded research institutions to review and regulate animal research

Covers vertebrate animals IACUC reports to Office of Laboratory Animal

Welfare (OLAW) at the NIH

IACUC History 1963 – veterinarians form Animal Care

Panel and publish The Guide for the Care and Use of Laboratory Animals

1966 – Animal Welfare Act – USDA 1971 – AWA revised – animal care

committee used for compliance 1979 – Public Health Service required

institutional committees 1986 – IACUC formally used – regulated

by PHS policy

IACUC Requirements Committee of at least 5 people Inspections of animal facilities every 6 mo Review research protocols Evaluate institutional animal care Report to OLAW at NIH yearly Maintain OLAW assurance Report noncompliance to OLAW Take institutional action to correct

compliance issues

IACUC at Tufts 2 committees for 3 campuses

(Boston/Grafton and Medford) Division of Teaching and Research

Resources (DTRR) – Grafton Campus Division of Laboratory Animal Medicine

(DLAM) – Boston campus

Tufts Research involving Animals

IACUC Protocols New protocols reviewed monthly Species and number with rationale Details of all procedures Details of anesthesia, pain relief,

euthanasia Efforts to minimize discomfort or distress Assurance that research does not

duplicate previous experiments Assurance no non-animal model exists

IRB Institutional Review Board Committee that reviews and approves

research protocols involving human subjects

FDA and DHHS Office for Human Research Protections regulate IRBs

IRB History 18th century BC - evidence of restrictions on

human use in experiments 1600s - laws pertaining to specific activities 1946 – Nuremberg Code – permissible

medical experiments after WWII 1964 – Declaration of Helsinki from World

Medical Association – governs research ethics and designs for human subjects

1966 – Public Health Service requires IRBs for federally funded research

IRB Requirements At least 5 members of different

professions Scientists and non-scientists Review research protocols involving

human subjects Ensure safety and safeguard the rights

and wellbeing of trial subjects Ensure informed consent

IRB at Tufts Provides guidance on consent forms, research training,

research guidelines, laws, institutional policies TUHS (Tufts Medical Center and Tufts University Health

Sciences) IRB Tufts Medical Center Floating Hospital for Children New England Eye Center Tufts School of Medicine Tufts School of Dental Medicine Cummings School of Veterinary Medicine Department of Agriculture Human Nutrition Research

Center on Aging Friedman School of Nutrition

Tufts Institutional Review Board

HIPAA Health Insurance Portability and

Accountability Act Includes privacy rules for health

information Gives patients right to privacy of

personal health info Rule is balanced to permit disclosure

when needed for patient care

IRB Protocols Reviewed monthly Details of all procedures Informed consent forms HIPAA forms

IRB Forms

Environment Humans and animals protected, what

about the rest of nature? 1970 – first Earth day Dec 2, 1970 – EPA established

Ecological Ethics Values are given to non-human as well

as human nature A view not restricted to treatment of

humans Ethics focused on maintaining health of

the natural world

What are the values of conservation medicine?

Discussion of Articles

Advocacy, Ecology, and Environmental EthicsEcological Medicine Values

Biodiversity value Intrinsic value – an inherent or essential

value that is not dependent on good to humans

Demand value – value based on perceived usefulness

Ecosystem Services Water purification Air purification Carbon cycle Waste decomposition Seed dispersal Recreation

How do these services affect conservation medicine ethics?

Ethical Example: Logging A logging company has approval to

clear an old growth forest to convert to paper products. Is this ethical?

Ethical Example: Logging A logging company has approval to clear

an old growth forest to convert to paper products. Is this ethical?

Two sides: in favor of logging or not Is one side ethical, the other not? Driven by different values, thus different

ethics: Value of the trees, intrinsic vs demand Jobs, profit

Conservation Medicine Ethical Dilemmas

Taxonomic Chauvinism Parasites represent majority of species Play important ecological Many at high risk of extinction Often overlooked in conservation

medicine research and education Large vertebrates receive more

attention and more funding Ethical considerations?