Chapter 4: Introduction

ACHRE Report

Part I

Chapter 4

Introduction

Chapter 4: Introduction

According to the mission set out in our charter, the Advisory Committee is in essence a national ethics commission. In this capacity we were obliged to develop an ethical framework for judging the human radiation experiments. This proved to be one of our most difficult tasks, for we were not only dealing with complex events that occurred decades ago, but also with some of the most controversial issues in moral philosophy. This chapter sets out the standards that we believe are appropriate for evaluating human radiation experiments and offers reasons for relying on them. It then applies these standards to the results of the historical research we have conducted and draws ethical conclusions.[*]

Fulfilling our charge to "determine the ethical and scientific standards and criteria" to evaluate human radiation experiments that took place between 1944 and 1974 requires consideration of a complex question: Is it correct to evaluate the events, policies, and practices of the past, and the agents responsible for them, against ethical standards and values that we accept as valid today but that may not have been widely accepted then? Or must we limit our ethical evaluation of the past to those standards and values that were widely accepted at the time? This is the problem of retrospective moral judgment.

* Some of the features of the moral framework presented in this chapter pertain to biomedical experiments only and not to intentional releases. A moral analysis of intentional releases involves somewhat different elements than a moral analysis of biomedical experiments, because they engage different ethical issues. For example, a requirement of individual informed consent is not applicable to the intentional releases, and the concepts of risk and benefit and national security have different implications for them. Ethical and policy issues specific to intentional releases are discussed in chapter 11.

Quite apart from the issue of the validity of projecting current standards onto the past, there is another question that this chapter must address: In a pluralistic society such as ours, is there at present a sufficiently broad consensus on ethical standards to make possible a public evaluation that is not simply the arbitrary imposition of one particular moral point of view among several or even many? This is the problem of value pluralism. The ethical framework the Advisory Committee employs takes both these issues into account.

This chapter is divided into two parts. In the first part we present and defend the ethical framework adopted by the Committee for the evaluation of human radiation experiments conducted from 1944 to 1974 and the agents responsible for them. We begin by identifying the types of moral judgments with which the Committee is concerned and the different kinds of ethical standards against which these judgments can be made. We next address two challenges to the position that the Advisory Committee can use these, or any other, standards to make valid ethical judgments. These challenges are (1) that the diversity of views about ethics in American society invalidates any effort by a public body such as the Advisory Committee to make moral judgments and (2) that the diversity of views about ethics across time similarly invalidates our making defensible moral judgments about the past. Although the Committee does not accept these challenges as definitive, we discuss these as well as other factors that influence or limit ethical evaluation. We include here a discussion of an issue of particular relevance to our charge: what role, if any, considerations of national security should play in the Committee's ethical framework. We also consider factors that can mitigate the blame we would otherwise place on agents (whether individuals or collective entities) for having conducted morally wrong actions.

In the second part of the chapter, we explore how the Committee's ethical framework can be used to evaluate both experiments conducted in the past and the people and institutions that sponsored and conducted them. Drawing on the history presented in chapters 1 through 3, we illustrate how, when applied, the framework is specified by context and detail. This specification of the framework continues in part II of the report, when the framework is used to evaluate specific cases.