The values which underlie the market are not the same as those which characterize science — thus, when the market intrudes upon science, the latter becomes corrupted. This is particularly true in academia, where the future of science is created and developed. Greenberg cites one egregious incident where market-driven values resulted in a horrendous ethical lapse. The University of Pennsylvania contracted with a biotech company to become a leader in human gene therapy.
Their work went well until a 19-year-old patient died while receiving a therapeutic gene solution. He was not properly informed about the toxic effects found in other patients, about the deaths of several monkeys who received this treatment, or about the fact that the university and the bio-tech company and its director all had “a financial interest in a successful outcome from the research involved in this study” (there were a few words about this in the final paragraph of an eleven-page consent form — hardly adequate).
Why isn’t more done to uphold the ethics guidelines? Because such enforcement is detrimental to the bottom line:
- Endorsements of integrity are a popular and painless pastime of science; enforcement is not, for many understandable reasons: it can scare away money, besmirch reputations, and bring on ruinous publicity and litigation.
The problems at the University of Pennsylvania, however, are nothing compared to those at the University of Texas Medical Branch. The UTMB manages healthcare for prisons in Eastern Texas, which amounts to about 80% of prisoners in the state. In 1999, a federal judge wrote that he had heard evidence of “significant, even deadly, inadequacies” in the medicine care provided to inmates in the medical clinics. The same judge, however, found the care to be “exemplary” in a separate prison hospital also run by UTMB.
Why the difference? One difference between the two is that UTMB runs experimental drug trials at the hospital, and any inmate who agrees to be a guinea pig for them is taken to the hospital where they get adequate medical treatment. Until 2001, UTMB didn’t even tell the state what it was doing, violating the system’s rules. According to Dr. David Egilman, a professor in the community health department at Brown University, “Prisoners who join trials get better care. Better care is coercive.”
So much for the problems - does Greenberg offer any solutions? Yes, but sadly he devotes a mere 5 of his 500 pages to his “modest” recommendations. Paradoxically, the first and foremost of these is not that politics should be removed from science, but rather that the science “industry” should become more political — political enough that we know it is political and that the political debates are no longer hidden from the public:
- More involvement with politics would surely be uncomfortable for science, because it would threaten the reigning combination of support without scrutiny or responsibility. But it would be beneficial for society in its dependence on science, and possibly even helpful for science itself. The aim is to dislodge science from its comfortable ghetto and move it into the rough waters of the political mainstream.
He argues that scientists should become more involved in the political process and should speak out more on political issues, both national and international. They should stop pretending that they and their works are “above” mundane political debates. Greenberg also argues that science writers should become less reverent and more critical about researchers and companies. They should strive to inform readers not simply of the facts, but also of the divisive debates and hard questions which exist in any area of research.
Greenberg’s book is well written and fast-paced. It should appeal not only to those involved with science, but to lay readers as well. Greenberg covers a lot of ground and his arguments are very sound — they deserve careful consideration on the part of anyone concerned with the future of science and the scientific enterprise.
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