New Research Ethics Blog

A hearty welcome to Nancy Walton who has just started blogging on research ethics -- Nancy is an RN and PhD, and Associate Director of the School of Nursing at Ryerson University in Toronto. Chris MacDonald, author of the Business Ethics Blog, (who has been busily blogging delightfully about monkey business in the last few days) is also co-piloting the research ethics blog. By way of welcome and introduction, we are cross-posting one of their blog entries today:

Children's Cold Remedies: the Ethics of Doing Research
From Reuters: Don't use cold drugs in kids under 4, industry says

Oral cough and cold medicines sold over the counter should not be used in children younger than 4 years old because of the risk of rare complications linked to inappropriate use, manufacturers said on Tuesday.

The move seems a good one. Maybe it's step 1 towards action on the real issue:

Currently, the medicines are available under decades-old FDA rules that allow over-the-counter products to be sold without clinical trials showing their risks and benefits.

"The bottom line remains the same: that these products have never been proven to work in children," said Diana Zuckerman, president of the National Research Center for Women & Families.

Two quick, relevant, rules of thumb for business ethics, rules that seem entirely relevant here:

1) Information asymmetry matters. If customers don't understand what they're getting, they're not making fully voluntary purchases, and even the most zealous fans of free markets say that markets don't work properly in the absence of reliable information. Parents almost certainly do not know that the safety & efficacy of these products have not necessarily been proven in clinical trials.

2) All the standards get cranked up a notch where kids are concerned.

Original post here.

Are you a Bully?

Now it is time to end the silence: There is a hidden culture of girls’ aggression in which bullying is epidemic, distinctive and destructive. It is not marked by the direct physical and verbal behavior that is primarily the province of boys. Our culture refuses girls access to open conflict, and it forces their aggression into nonphysical, indirect and covert forms. Girls use backbiting, exclusion, rumors, name-calling, and manipulation to inflict psychological pain on targeted victims. Unlike boys, who tend to bully acquaintances or strangers, girls frequently attack within tightly knit networks of friends, making aggression harder to identify and intensify the damage to the victims.

The book Odd Girl Out: the Hidden Culture of Aggression in Girls by Rachel Simmons describes the hidden culture of aggression, where girls fight with body language and relationships instead of fists and knives. In this world, friendship is a weapon, and the sting of a shout pales in comparison to a day of someone’s silence. There is no gesture more devastating than the back turning away. Beneath a chorus of voices, one girl glares at another, then smiles silently at her friend. The next day a ringleader passes around a secret petition asking girls to outline the reasons they hate the targeted girl. The day after that, the outcast sits silently next to the boys in class, head lowered, and shoulders slumped forward. The damage is neat and quiet, the perpetrator and victim invisible.

Students and parents expect schools to be safe, where students can learn and teachers can teach in a warm and welcoming place, free from bullying, intolerance and violence. Teachers and support staff have the right to a safe and harassment-free workplace under their collective agreements. Students however have no special protection and must rely upon adults to keep them safe. As adults and parents, we have a responsibility to ensure incidents of bullying are reported and action is taken. If nothing is done, the problem will likely get worse.

Researchers have found signs of an apparent connection between bullying and suicide in children, according to a new review of studies from 13 countries. Nevertheless, there is no definitive evidence bullying makes kids more likely to kill themselves. Still, “once we see there’s an association, we can act on it and try to prevent it,” said review lead author Dr. Young-Shin Kim, an assistant professor at Yale University School of Medicine’s Child Study Center. According to international studies, bullying is common and affects anywhere from 9-54% of children. In the United States, many have blamed bullying for spurring acts of violence, including the Columbine High School massacre.

Lori Drew of St. Louis, MO., allegedly helped create a false-identity My Space account to contact Megan Meier-13 years old, who thought she was chatting with a 16-year-old boy named Josh Evans. Josh didn’t exist. Drew was talking to Megan via the Internet to find out what Megan was saying about her daughter, who was a former friend. Megan hung herself at home in October 2006 after receiving Drew’s cruel messages, including one stating the world would be better off without her. This is an extremely rare case of an adult woman posing as a teenage boy but the cyber bullying is very real and very hurtful, notes CBS technology analyst Larry Magid (2008). “About one-third of teens say they have been bullied or harassed online and though suicide is rare, there are plenty of cases where it has led to depression and extreme anxiety”.

Public awareness of bullying has grown in recent years, propelled by the tragedies of youth gun violence. The national conversation on bullying has trained its spotlight mostly on boys and their aggression. Defining bullying in the narrowest of terms, it has focused entirely on physical and direct acts of violence. The aggression of girls, often hidden, indirect, and nonphysical, has gone unexplored. It has not even been called aggression, but instead “what girls do.” Yet women of every age know about it. Nearly all of us have been bystanders, victims or bullies. So many have suffered quietly and tried to forget. Indeed, this has long been one of girlhood’s dark, dirty secrets as described by Rachel Simmons. Nearly every woman and girl has a story. It is time to break the silence and change the story.

What greater gift can we give girls than the ability to speak their truths and honor the truths of their peers? In a world prepared to value all of girls’ feelings and not just some, girls will enjoy the exhilarating freedom of honesty in relationships. They will live without the crippling fear of abandonment. It is my hope that as they, and any woman who has ever been the odd girl out, will step forward and not be a victim but instead an example to others --- By being true to themselves and supporting each other our young girls can become positive role models and leaders.

Boys Suck: Science Proves It

Evolutionary biologist Virpi Lummaa has discovered that Finnish women in previous generations suffered a variety of adverse effects when they bore and raised sons.

Among the impacts: a reduced lifespan, greater vulnerability to disease due to higher testosterone exposure during pregnancy, daughters who were less likely to reproduce, and smaller subsequent children. Additionally, having a grandmother around was more helpful than having a grandfather (probably because she helped with childrearing while he just sat around and ate food).

While modern reproductive technologies have mitigated a lot of the effects seen in pre-industrial families, it is still intriguing to consider these impacts in light of the strong cultural bias favoring the bearing of sons. Perhaps it is a type of "peacock effect", whereby the individuals who still thrive in the face of handicapping or indulging in risky behavior are considered stronger and more robust. Or, as my mother asserts, the value balances out an apparent difference in general robustness and health between male and female young, where males often are weaker to start with.

Of course, having too many sons can be evolutionarily disadvantageous too...

Should Children be Vaccinated against Addiction?

blog.bioethics.net points to an article in Time on the new "cocaine vaccine" and asks whether it should be given preemptively to children.

Basically, the "cocaine vaccine" works by stimulating the body to produce antibodies that bind to cocaine molecules, preventing them from binding to the receptors in the brain that, when activated, produce the "high" from the drug. As a result, the "high" is negated or greatly reduced, which removes the incentive to continue to use the drug.

While I see the potential for this treatment to help addicts overcome cocaine addiction, the talk of giving this preemptively to children worries me. Beyond the issues of informed consent mentioned, I have concerns about using any treatments that could affect brain receptors in children unless it is medically indicated. Psychoactive drugs affect us because our brains have receptors that respond to particular drug molecules; these receptors probably have some other function in normal life. Stimulating the body to produce antibodies that bind to drug molecules to inhibit them from binding to our receptors could have adverse impacts on the natural auto-stimulation and regulation from our bodies. In children whose brains are still developing (and will go into overdrive during puberty), we cannot safely anticipate what the long-term effects on neurotransmitters and brain activity could be.

Because the vaccine has been show to be effective on adults, and because there is usually sufficient time to respond to cocaine addiction, I do not feel that vaccinating children in this case is justified.

And because I still am bitter about the controversy over the HPV vaccine: aren't moralists worried that giving the cocaine vaccine to children will tell them it's okay to start doing drugs?