Ethics, abortions, and VA research

[David Scherer <scherer@uiuc.edu>]

There is a common link between two recent threads: they are issues of
ethical theory, not radiation science.  Because we are technical types,
rather than philosophy types, we missed the essential points in both cases.

Abortions because of radiophobia are truly regrettable, but not an ethical
issue in radiation protection standards.  Here I use the word "ethics" in
the limited sense as a discipline of philosophy.  Ethics is the study of
theories of obligation and of values.  (I believe that the HP article was
using the word in this limited sense, also.)  In common conversation, the
word ethics is used as a synonym for morality, right and wrong.  In
philosophy, as I understand it, it has more to do with the tension between
social obligations and personal freedom.  Because of our scientific bent,
we ask technical questions like "How can they estimate the number of
abortions?" rather than ethical questions like "Is the ICRP responsible for
irrational use of its risk estimates?"

In the VA situation, the central issue is not the numerical value of the
patient dose, but the adequacy of informed consent.  The crucial question
is this:  Were patients given a clear explanation of the risks in everyday
language?  Instead, we ask we ask technical questions.  Who made the
allegation?  Is he expert enough to provide accurate dose estimates?  In
reality, either the patients were informed of the radiation exposure or
they were not.  This has been a basic obligation in human use research
since the Nuremburg Trials.

We would do well to add a course in ethical theory (not just "professional
ethics") to our HP curricula and PEP sessions.  Health physics touches on
several ethical questions.  These questions are scientifically informed,
but the bottom line in each case is determined by a theory of values and
obligation.

For example, this list has had innumerable threads on radiation protection
standards.  Suggestions have ranged from Al T (If health effects cannot be
directly observed, there should be no regulation.) to the EPA (Every
unnecessary exposure should be tightly controlled.)  We have discussed them
as though they were technical questions, debating the radiobiology.  if we
came to unanimous agreement on the health effects of radiation, it would
inform the discussion, but it would not settle the matter.  There would
still be a tension between differing values and views of social obligation.
 Many things are prohibited even if they do not cause death and many other
things are accepted (even required) even though they include some risk of
fatality.

Again, it would be helpful if HP training included some exposure to the
categories used in ethics.  It would help us to frame our discussion in a
wider context.