The value of (unrealistic) case studies in ethics education.

Dr. Isis posted a case study about a postdoc’s departure from approved practices and invited her readers to discuss it. DrugMonkey responded by decrying the ridiculousness of case studies far more black and white than what scientists encounter in real life:

This is like one of those academic misconduct cases where they say “The PI violates the confidence of review, steals research ideas that are totally inconsistent with anything she’d been doing before, sat on the paper review unfairly, called the editor to badmouth the person who she was scooping and then faked up the data in support anyway. Oh, and did we mention she kicked her cat?”.

This is the typical and useless fare at the ethical training course. Obvious, overwhelmingly clear cases in which the black hats and white hats are in full display and provide a perfect correlation with malfeasance.

The real world is messier and I think that if we are to make any advances in dealing with the real problems, the real cases of misconduct and the real cases of dodgy animal use in research, we need to cover more realistic scenarios.

I’m sympathetic to DrugMonkey’s multiple complaints: that real life is almost always more complicated than the canned case study; that hardly anyone puts in the years of study and training to become a scientist if her actual career objective is to be a super-villain; and especially that the most useful sort of ethics training for the scientist will be in day to day conversation with scientific mentors and colleagues rather than in isolated ethics courses, training modules, or workshops.

However, used properly, I think that case studies — even unrealistic ones — play a valuable role in ethics education.

That role is not, as DrugMonkey suggests, to bludgeon trainees over with obvious no-nos in order that the obviousness of such no-nos does not escape them. Rather, ethics case studies function in much the same way as do the systems of weight and strings and frictionless inclined planes one encounters in introductory physics problems sets. They provide scenarios with which to practice the problem-solving strategies one has learned. Especially when one is just learning those strategies (and recognizing, for example, that acting ethically involves more than having a gut feeling you think you can trust and following that gut feeling), it doesn’t hurt to have a case where the details are somewhat less nuanced. Starting with easier problems is often useful before moving on to more complex ones.

And, one thing that unrealistic case studies (like, perhaps, the one Dr. Isis posted) can illustrate is that a case that seems obvious can still provoke disagreement — about what exactly the ethical violation in the case might be, or how it is best addressed, or even whether it rises to the level of an ethical violation in the first place. Talking about these disagreements — and more importantly, about what strategies might be helpful in understanding them and resolving them — is a tremendously important part of learning how to make ethical decisions.

The case Dr. Isis posted was published in the journal Lab Animal, and I’m willing to bet it was selected because it was a case anticipated to provoke some interesting disagreement (e.g., on the duties of the IACUC in addressing the situation and/or in what the animal welfare regulations require as far as reporting to federal agencies in a situation like the one described in the case). Possibly these are not the most deeply interesting disagreements to explore, but they do have practical relevance to IACUC members (who I imagine are part of the intended audience for this journal). Just reading the text of each of the regulations is hardly ever sufficient to prepare you to make good calls about applying those regulations in real life situations. A canned case study can help you notice some of the features that become important (and problematic) in applying them — and they can help you refine your strategies in advance of when you’re faced with a tough call in real life.

That said, I agree with DrugMonkey that real life situations are frequently more complicated and more interesting than the stark scenarios we use in the early stages of ethics education. Writes DrugMonkey:

More realistic to have a care person find one or two animals in questionable shape. There will be an assertion that was the poor surgical technique, of course, but on investigation it turns out that there is a nonzero failure rate even for the most trained, effective and highly regarded individuals performing the same surgical techniques including the veterinary staff when doing the training or demos or the techniques as a core service. The investigation then descends into trying to determine when poor outcome rises above the background level of performance, institute wide. Possibly across subfields of science. The investigation has to try to figure out if a given level of aseptic/sterile procedure really improves outcome on a group basis … or only sounds good, has no direct benefit and, oh by the way, extends the duration of the surgical technique.

This, to my eye, is where the interesting questions lie. Yes, even for IACUC members. How do you determine the worth of assertions about the “best” way to do a procedure? There should be knowable answers. And taking matters to the utmost excess of sterile surgical proficiency may have no health benefit for the research subjects… while coming at substantial cost to research output. Or, in some cases, there may be actual drawbacks to a seemingly “better” technique, like the duration of surgical anesthesia for a longer process. How do you generate evidence and evaluate it? Can the IACUC demand a lab do two parallel groups with Techniques X and Y and answer the question about outcome?

These are exactly the kinds of ethical cases that scientists might productively discuss in their day to day interactions with each other. And, I think they are the kind of cases that might be useful for them to discuss with their trainees. But, I think that those discussions of interesting real-life cases with trainees will be a lot more productive if the trainees already have some experience applying ethical reasoning strategies to easier cases. Otherwise, those trainees may not have the basis for getting beyond their gut feelings, or the vocabulary for having a productive discussion with their colleagues when they discover disagreement in their initial responses to a particular situation.

The unrealistic case studies are not where ethics discussions should end, but frequently they’re the right place for those discussions to begin.