Ethical Considerations Of Hm Case Study

Introduction

  • State what you are doing in the essay 
    • This essay will attempt to offer a balanced review of ethical considerations related to research at the cognitive level of analysis (CLA). 
  • Define the cognitive level of analysis 
    • The cognitive level of analysis (CLA) is based on mental processes such as perception, attention, language, memory, and thinking. 
  • Describe ethical considerations 
    • In psychology, ethics must be considered to ensure participants (humans and animals) are not harmed and that research conducted is ethically valid
    • Researchers should always conduct research in an ethical manner and studies should always be critically evaluated for ethical issues. 
    • Ethical standards made by the American Psychology Association (APA) that all research done in psychology must abide by.
    • These ethics are: 
      • Protection of participants 
        • Participants should be protected from physical and mental harm and distress 
        • This includes humiliation, stress, injury, etc. 
        • Participants should not be forced to reveal personal information. 
      • Consent 
        • Participants must be informed of the true aims and nature of research before giving consent
        • Sometimes it is not possible to give full information about research. 
          • Participant bias: knowing the true aims of a study may affect participants' behaviour and thus the results of a study 
          • It is considered acceptable not to give full informed consent if no harm is expected 
      • A guardian or family member should also give consent to the study if the participants are 
        • Children under 18 years of age 
        • Adults incompetent of understanding the true nature and aims of the study 
      • Right to withdraw 
        • Participants should be informed of their right to withdraw their participation and data at any time in the study (even at the end) without penalty. 
      • Confidentiality 
        • Data collected in a study should remain confidential and anonymous to protect participants from possible consequences that may result from their data 
      • Deception
        • Deception should be avoided
        • But slight deception is considered acceptable if: 
          • Participant bias would result from participants knowing the true aims of the study 
          • The research has potential significant contribution 
          • It is unavoidable 
          • The deception does not cause any distress to the participant, including upon being informed of the deception
        • If deception is involved, informed consent is not obtained 
        • Any deception must be revealed at the earliest opportunity 
      • Debriefing 
        • Any deception must be revealed and justified
        • Participants should leave the study without undue stress 
        • Findings of the research should be made available to participants as soon as possible

Body

Evidence

Study 1: ‘Genie’ Curtiss (1981)

Background:

  • Genie was a girl who had been deprived of normal exposure to language early in life 
  • She had no apparent language skills when she was discovered at age 13. 

Aim: 

  • To investigate the sensitive period hypothesis there is a sensitive learning period (before puberty) during which language must be acquired to develop normally. 
Method: 
  • Researchers encouraged her to verbalise and socialise. 
  • They communicated with her, taught her sign language, and provided a caring environment for Genie. 

Ethical issues of this study:

  • There were a set of ethical issues in this study, which include:

Participant Protection

  • Genie was protected from harm during the study 
  • But when researchers concluded the study, Genie was left to live in an adult foster home 
    • Genie may have experienced mental distress from the dramatic change in environment and carers and the leaving of the researchers 

Consent 

  • Genie could not be fully informed or give consent to the study due to language restrictions and mental state 
  • But Genie was not in a healthy state of mind to understand the nature and aims of the study 
    • Therefore, it may not be possible to gain informed consent 

Withdrawal 

  • Genie would not be able to express any desires to withdraw from the study due to language restrictions and mental state 
Confidentiality 
  • Her identity was kept anonymous as 'Genie' is not her real name 
  • Although her real name was not revealed, her case was exposed to the world of psychology 

Debriefing 

  • Genie was not debriefed at the end of the study 
  • She ended up living in an adult foster home, still requiring treatment as she is still language impaired. 
  • However, since she did not know that she was being studied, she would not desire a debriefing. 

Inappropriate behaviour of researchers 

  • Researchers had a very personal and attached relationship with Genie 
  • This was inappropriate for scientific research 
  • Leads to the questioning of objectivity and their aims for studying Genie 

Study 2: Clive Wearing Sacks (2007)

Background: 

  • Clive Wearing was a musician who got a viral infection encephalitis. 
  • This left him with serious brain damage in the hippocampus, which caused memory impairment. 
  • He suffers: 
    • anterograde amnesia impairment in ability to remember after a particular incident 
    • retrograde amnesia impairment in ability to remember before a particular incident. 
  • Wearing still has ability to talk, read, write, and sight-read music (procedural knowledge) 
  • He could not transfer information from STM tLTM. 
  • His memory lasted 7-30 seconds, and he was unable to form new memories. 

Ethical issues of this study

  • There were a set of ethical issues in this study, which include:

Consent

  • Wearing did not give consent to being in a study 
    • His wife gave consent for him to be studied 
  • But Wearing would not remember being informed of the study or giving consent due to his short memory span 

Confidentiality 

  • Sacks violated Wearing's right to confidentiality 
    • Wearing’s real name was revealed 
    • His case was revealed to the world of psychology 
  • But since Wearing's memory lasts a short period of time, he would not remember that his confidentiality was violated 

Withdraw 

  • Wearing would not remember being in a study or his right to withdraw and so would not express any desires to withdraw 
Debriefing 
  • Wearing was not debriefed 
  • But because of his short memory span, he would not know he is in a study and would not desire a debriefing

APA Guidelines for Animal Research 

  • Tries to avoid harm to animals 
    • But harm may still be inflicted on animals, 
      • The research may potentially provide significant benefit to the health or welfare of humans or other animals 
      • If it is unavoidable 
  • If the procedure would cause pain to humans, it should be assumed that it will cause pain to animals 
  • Animal welfare should be monitored 
  • Animals should be euthanized as soon as possible if research 
    • Causes long term/serious harm 
    • Affects their ability to live 
      • Normally 
      • Pain-free 

Study 3: Blakemore & Cooper (1970) “Kitten carrousel” 

Aim: 

  • To investigate the effect of exposure to spatially periodic patterns on the brains of cats 

Ethics:

Participant protection

  • 6 male cats were placed in a drum with only vertical or only horizontal lines 
  • Kittens were made to wear a cuff around the neck to prevent them seeing lines of any other orientation 
    • Cats may have experienced distress from being forced to live in a confined, unnatural environment and wearing a cuff 
  • The cats' primary visual cortex would fire in response to the lines presented in the orientation they were exposed to and not lines which were perpendicular 
    • There was physical degeneration in the visual cortex as a result of the lines the cats were exposed to 
      • Researchers caused permanent physical damage to the cats' visual cortex

Animal ethics

  • Researchers had done permanent damage to the cats that may have affected their ability to live a normal, pain-free live 
  • But the cats were not euthanized 
  • The welfare of cats was not monitored 

Consent 

  • Cats could not be fully informed about the study 
  • Cats could not give consent 
  • But cats would not be able to understand if they were being studied 
    • Therefore, it would not be possible to gain informed consent 

Withdrawal 

  • Cats could not express any desires to withdraw from the study 
Debriefing 
  • Cats were not debriefed 
  • But since they are animals and they did not know they were in a study, they may not desire a debriefing

Study 4: Gardner and Gardner (1969) “Washoe”

Aim: 

  • To demonstrate that a chimpanzee has the capability to use human language 
Ethical issues of this study:
There were a set of ethical issues in this study, which include:

Participant protection 
  • Researchers caught Washoe an infant female chimp, estimated to be 8-14 months old and reared her as a human child in America 
  • They attempted to teach Washoe American Sign Language (ASL) 
    • Washoe may have experienced distress from being removed from her natural environment, living in an unnatural environment and learning sign language

Consent

  • Washoe could not be fully informed about the study 
  • Washoe could not give consent 
  • But Washoe would not be able to understand if she was being studied 
    • Therefore, it would not be possible to gain informed consent 

Withdrawal 

  • Washoe could not express any desires to withdraw from the study due to language restrictions 
Debriefing 
  • Washoe was not debriefed 
  • But since Washoe is an animal and may not have not known she was in a study, she may not desire a debriefing 

Conclusion 

  • Ethical considerations in all research in psychology includes, 
    • Protection of participants from harm 
    • Consent
    • Withdrawal
    • Confidentiality 
    • Deception 
    • Debriefing 
  • But there are slight exceptions for consent and deception 
  • Animal research has slightly different ethical considerations 
    • Differences regard harming participants and ethical euthanasia

The author of a recently published book questions ethics of research involving one of the best-known neurology patients, evoking a passionate response from both the public and the research community.

The positive impact of medical research on the quality of life today is undoubted. Along with the victories, medical research had its failures, such as devastating consequences of early-day psychosurgery, but lessons from these early failures contributed to success of modern research just as much. The case of Henry Molaison, formerly known as Patient H. M., is one of such therapeutic failures that taught us so much. Breakthroughs in understanding of memory aside, an important lesson learned from this and similar cases was that of ethics. Although tremendous advances in research and medical ethics have been made since the mid-20th century, it continues to be questioned. Most recently, the issue came up in Patient H.M.: A Story of Memory, Madness, and Family Secrets, a book by Luke Dittrich.1

Briefly, in a fragment of his book published in The New York Times Magazine, Dittrich suggests that Suzanne Corkin, PhD, a researcher who dedicated her life to studying Patient H. M., destroyed research data, opposed publication that could question the validity of her work, and violated research ethics principles.2 The fragment and, shortly after, the book evoked a range of responses from the public, research community, and the Massachusetts Institute of Technology, where Corkin conducted her research.

The public found Corkin’s actions, as described by Dittrich, disturbing, judging by the comments on The New York Times website such as “Dr. Corkin comes across as evil!” Many were convinced by Dittrich’s story, which he, as a journalist, so skillfully tells. (I was unable to confirm whether Dittrich has any medical or research background.) In a follow-up interview to The New York Times, Dittrich shares his reasons for telling the story: “I believe Henry’s story is important … because of what his case can teach us about our sometimes ruthless pursuit of knowledge.”3

Even if we assume for a second that Corkin indeed pursued her research interests ruthlessly, this lesson has been learned many times over, and multiple measures are now in place to minimize the risk to research participants. Thus, Dittrich’s motives for telling his version of this story are unclear to me, as is its educational value. In fact, his mention of “researchers who’d built their careers on [Henry] and who had an interest in presenting his story in a particular way” made me wonder about Dittrich’s interest in telling the story in the way he does.

Unlike the public, I was not disturbed by Corkin’s actions because I am familiar with research practices. I found her actions not only acceptable but perhaps even appropriate, and my opinion echoed that of the research community’s.4 As I am not currently involved in research and do not represent interests of any research institution, my opinion lacks bias the public might suspect in opinions of researchers.

What I did find disturbing was the fact that the book was published shortly after Corkin’s death, when she could no longer defend her work and remediate the damage the book did to the public perception of research. I was very pleased to see the research community take on this role by sending an open letter to The New York Times.5 As long as journalists with little knowledge of research practices feel the need to tell their stories, researchers must continue to tell theirs to help the public to form an educated, unbiased opinion. 

References: 

1. Dittrich L. Patient H.M.: a Story of Memory, Madness, and Family Secrets. New York: Random House; 2016.

2. Dittrich L. A brain that could not remember. The New York Times Web site. http://www.nytimes.com/2016/08/07/magazine/the-brain-that-couldnt-remember.html?_r=1 Accessed October 16, 2016.

3. Carey B. A Brain Surgeon’s Legacy Through a Grandson’s Eyes. The New York Times Web site. http://www.nytimes.com/2016/08/09/health/brain-patient-hm-book-dittrich.html Accessed October 16, 2016.

4. Hurley D. New allegations in book about patient HM kick up controversy on medical, scientific ethics. Neurology Today. 2016;16(19):48-50.

5. International Community of Scientists. Letter to the Editor of the New York Times Magazine. The MIT Department of Brain and Cognitive Sciences Web site. https://bcs.mit.edu/news-events/news/letter-editor-new-york-times-magazine Accessed October 16, 2016.

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