Ethics in Conservation Medicine

1. Ethics in Conservation Medicine October 3, 2012

2. What are ethics? • “the discipline dealing with what is good and bad and with moral duty and obligation” • “a set of moral principles or a theory or system of moral values” -Merriam-Webster Dictionary

3. Morals “About morals, I know only that what is moral is what you feel good after and what is immoral is what you feel bad after.” -Ernest Hemingway, Death in the Afternoon

4. Determinants of Ethics • Personal moral values • Personal responsibility • Religion • Culture • Societal norms • Professional code of conduct • Laws, rules, regulations

5. Areas of Ethics • Meta-ethics: ethical theory, ideas of right and wrong (focus on meaning) • Normative ethics: studies how to take an ethical action (focus on actions) • Applied ethics: how to achieve an ethical outcome (focus on outcome)

6. What is ethical? • How to determine right and wrong • People are most comfortable with dichotomous issue • Often many sides to one issue • Universal ethics: everyone agrees: • Don’t lie, don’t steal, don’t kill • But…

7. Complicated Ethics • Thou shalt not kill • Death penalty? • Abortion? • Human euthanasia? • Self defense? • Animals?

8. Defining Ethics in the Sciences • Driven by professional values • Concerns for values at different levels: individual, patients, profession, society, scientific community • Mapping values helps define professional values • Identification of most troubling issues

9. Professional Value Mapping:Veterinarians • Self oriented: • Monetary gain • Personal satisfaction • Recognition • Patient oriented: • Alleviation of pain and suffering • Promotion of patient health • Client oriented: • Client’s monetary gain • Satisfaction • Knowledge/Science/Theory Oriented: • Scientific aspects of disease • Promotion of basic research • Society oriented: • Public health • Individual human health • Animal control

10. Enforcement of Ethics in Research • Cannot rely on ethical code alone • Numerous determinants of individual ethics • Some people are amoral or immoral • Regulations introduced to safeguard the rights of humans and animals

11. Ethical Review Boards • Before 20th century, human and animal research ethics left to individual researcher conscience • Professional codes of conduct • Laws and customs of society • Elaborate rules and regulations developed: IACUC (animals) and IRB (humans)

12. IACUC • Institutional Animal Care and Use Committee • Self regulating body required of all federally funded research institutions to review and regulate animal research • Covers vertebrate animals • IACUC reports to Office of Laboratory Animal Welfare (OLAW) at the NIH

13. IACUC History • 1963 – veterinarians form Animal Care Panel and publish The Guide for the Care and Use of Laboratory Animals • 1966 – Animal Welfare Act – USDA • 1971 – AWA revised – animal care committee used for compliance • 1979 – Public Health Service required institutional committees • 1986 – IACUC formally used – regulated by PHS policy

14. IACUC Requirements • Committee of at least 5 people • Inspections of animal facilities every 6 mo • Review research protocols • Evaluate institutional animal care • Report to OLAW at NIH yearly • Maintain OLAW assurance • Report noncompliance to OLAW • Take institutional action to correct compliance issues

15. IACUC at Tufts • 2 committees for 3 campuses (Boston/Grafton and Medford) • Division of Teaching and Research Resources (DTRR) – Grafton Campus • Division of Laboratory Animal Medicine (DLAM) – Boston campus Tufts Research involving Animals

16. IACUC Protocols • New protocols reviewed monthly • Species and number with rationale • Details of all procedures • Details of anesthesia, pain relief, euthanasia • Efforts to minimize discomfort or distress • Assurance that research does not duplicate previous experiments • Assurance no non-animal model exists

17. IRB • Institutional Review Board • Committee that reviews and approves research protocols involving human subjects • FDA and DHHS Office for Human Research Protections regulate IRBs

18. IRB History • 18th century BC - evidence of restrictions on human use in experiments • 1600s - laws pertaining to specific activities • 1946 – Nuremberg Code – permissible medical experiments after WWII • 1964 – Declaration of Helsinki from World Medical Association – governs research ethics and designs for human subjects • 1966 – Public Health Service requires IRBs for federally funded research

19. IRB Requirements • At least 5 members of different professions • Scientists and non-scientists • Review research protocols involving human subjects • Ensure safety and safeguard the rights and wellbeing of trial subjects • Ensure informed consent

20. IRB at Tufts • Provides guidance on consent forms, research training, research guidelines, laws, institutional policies • TUHS (Tufts Medical Center and Tufts University Health Sciences) IRB • Tufts Medical Center • Floating Hospital for Children • New England Eye Center • Tufts School of Medicine • Tufts School of Dental Medicine • Cummings School of Veterinary Medicine • Department of Agriculture Human Nutrition Research Center on Aging • Friedman School of Nutrition Tufts Institutional Review Board

21. HIPAA • Health Insurance Portability and Accountability Act • Includes privacy rules for health information • Gives patients right to privacy of personal health info • Rule is balanced to permit disclosure when needed for patient care

22. IRB Protocols • Reviewed monthly • Details of all procedures • Informed consent forms • HIPAA forms IRB Forms

23. Environment • Humans and animals protected, what about the rest of nature? • 1970 – first Earth day • Dec 2, 1970 – EPA established

25. Ecological Ethics • Values are given to non-human as well as human nature • A view not restricted to treatment of humans • Ethics focused on maintaining health of the natural world

26. What are the values of conservation medicine?

27. Discussion of Articles Advocacy, Ecology, and Environmental Ethics Ecological Medicine Values

28. Biodiversity value • Intrinsic value – an inherent or essential value that is not dependent on good to humans • Demand value – value based on perceived usefulness

29. Ecosystem Services • Water purification • Air purification • Carbon cycle • Waste decomposition • Seed dispersal • Recreation • How do these services affect conservation medicine ethics?

34. Ethical Example: Logging • A logging company has approval to clear an old growth forest to convert to paper products. Is this ethical?

35. Ethical Example: Logging • A logging company has approval to clear an old growth forest to convert to paper products. Is this ethical? • Two sides: in favor of logging or not • Is one side ethical, the other not? • Driven by different values, thus different ethics: • Value of the trees, intrinsic vs demand • Jobs, profit

36. Conservation Medicine Ethical Dilemmas

37. Taxonomic Chauvinism • Parasites represent majority of species • Play important ecological • Many at high risk of extinction • Often overlooked in conservation medicine research and education • Large vertebrates receive more attention and more funding • Ethical considerations?