Re: Ethics, abortions, and VA research

[Al Tschaeche <antatnsu@pacbell.net>]

David Scherer wrote:

Very well put.  I have a couple of comments.

 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?"

This is really the question.  To me, of course both the ICRP and NCRP
are responsible for irrational use of their risk estimates when those
bodies make estimates based on an hypothesis that extrapolates data far
beyond the data points.  If there were data demonstrating real harm at
low doses, there would be no question that the ICRP and NCRP risk
estimates were a true representation of reality.  There would be no
irrational use of their risk estimates.  But, and here's the point,
their estimates are NOT based on data.  Accordingly they are ethically
and morally responsible to set the record straight when others make
irrational use of their estimates.  I have not seen them do that, ever!

I suspect the ICRP and NCRP attitude is: "we made the estimates, now it
is out of our hands.  We are not responsible for the irrational use of
our estimates and will do nothing to correct the erroneous use of those
estimates."  To me, such a point of view is immoral and unethical.  It
is so particularly because the ICRP and NCRP members are best qualified
to correct the erroneous use of their estimates.  My suggestion to them
would be: each time one of the members sees use of the estimates by
anyone that is or could be interpreted to be erroneous, that member
should immediately communicate the truth to those who have used the
estimates erroneously and to the media, if the estimates were in the
public domain.  Particularly, the NCRP should tell the EPA and other
governmental agencies and Congress to stop using the estimates in any
document and as the basis for any regulation.  If the NCRP were to do
that, I would think much more highly of them than I do.


The crucial question
> is this:  Were patients given a clear explanation of the risks in everyday
> language?  

Exactly!  I just finished having my prostate surgically excised.  The
surgeon was very careful to tall me all of the side and other effects of
the operation.  However, I still needed to know enough about the
procedure, particularly in relation to other procedures that could be
used, to be able to ask him additional questions.  And there were a lot
of them.  Whenever my body is to be invaded or otherwise worked on, I am
very careful to know as much as possible about what is to be done.  I
expect no all persons are able to, or think about all of the things they
should know about what is to be done to them.  Many people just agree
with the doctor and think that the doctor knows best.  That's a
dangerous thought sometimes.  

Since that is the case, the doctors have a great responsibility to
completely inform the patient or the person who is to be experimented
upon, just as the NCRP has the responsibility suggested above.  I
suspect some doctors don't fully exercise that responsibility.


> We would do well to add a course in ethical theory (not just "professional
> ethics") to our HP curricula and PEP sessions.  

Great idea.  Maybe Margaret Maxey should be contacted for her
suggestions as to who should do that.

 Suggestions have ranged from Al T (If health effects cannot be
> directly observed, there should be no regulation.) 

Thanks for the plug.  Of course I think that this is the correct way to
go.

Any comments from radsafe land?  Al Tschaeche antatnsu@pacbell.net