How should conflicts of interest between interested parties in the clinical setting be resolved when there is a question concerning informed consent, competence and confidentiality.This scenario highlights potential dilemmas encountered by postdoctoral fellows in a research setting.
From: Graduate Research Ethics: Cases and Commentaries - Volume 4, 2000
edited by Brian Schrag
Doug, a new post-doc in Professor Gordon Cook's lab, is working on a project that involves completing the work of a previous post-doc. Doug is content with this arrangement because the work is closely related to his dissertation research, giving him ample opportunity to get used to his new environment. As Doug works on the project, Cook becomes very impressed with Doug's diligence, resourcefulness and productivity as a scientist. Upon completion of his project, Doug and Cook have the following conversation:
Cook: Doug, you have done a nice job completing this project. Now, I feel that you're ready for a real challenge. How would you like to work on purifying protein X from liver tissue?
Doug (thinks to himself): I'm not sure if I have the knowledge and expertise required to undertake a protein purification project from scratch, but it would give me some great publications. Plus, Dr. Cook wouldn't ask me to pursue this project if he felt I wouldn't succeed, would he? (replies to Cook) : I'd love to take on the protein purification project. I truly appreciate this opportunity. I know this is a challenging project, but I'm looking forward to getting started.
Cook: Great! I'm happy that you're excited about the project. I have a class to teach now, but if you have any questions or concerns about the project, we can discuss them later.
Doug begins working on the project with a lot of enthusiasm, but his unvoiced hesitations are soon confirmed. He realizes that neither he nor the others in the lab have the knowledge or expertise required to carry out the protein purification project. Doug gets frustrated and goes to Cook for advice.
Doug: Dr. Cook, do you have a few minutes?
Cook: Sure. What is on your mind? How is the protein purification project coming along?
Doug: Well, that is what I wanted to talk to you about. All the procedures I have tried are problematic.Doug hesitates. He decides not to tell Cook that his expertise in this area is limited and that he has reservations about continuing to work on the project. Instead, he mentions that he still has some other alternatives to test. However, I still have not tried the procedures used by Kane's group.
Cook (looking at his watch) : Doug, I know that you are a very capable scientist, and I have the utmost faith in your abilities. (Cook pats Doug on the back.) Try the procedure used by Kane's group. If you will excuse me now, I have a meeting to go to. We can discuss this later, if you like.
Doug leaves Cook's office feeling no better than he did before going to him for advice. Doug continues to work on the project but with less enthusiasm and growing frustration.
Through a friend, Doug finds out that Maria, a post-doc in Janet Black's lab, is working on purifying a novel protein from kidney tissue. Frustrated, Doug decides to go to Maria for advice.
Doug: Hello, Maria. My name is Doug, and I'm a new post-doc in Cook's lab. Anna told me that you've been working on trying to purify a novel protein from kidney tissue. I'm trying to purify protein X from liver tissue, but with little success. I am at a loss. I tried talking to Cook, but he hasn't been much help. Would you mind pointing me in the right direction?
Maria: Sure. I just spent over four months working out the kinks in my protein purification assay and I would be happy to help you avoid some of the roadblocks that I ran into. Also, I know adjusting to a new lab can sometimes be a challenge. (Maria says this knowing that Cook has a reputation for giving his post-docs little guidance with difficult projects.)
Doug: Maria, you are a life-saver. (thinks to himself) This is the break that I have been waiting for!
Maria gives Doug a few pointers, and Doug leaves. A few days later, Doug shows up at Maria's lab with some preliminary data. Without hesitation, Maria looks over Doug's data and helps to outline his next set of experiments. Doug thanks Maria for her advice and leaves.
Over the next two months, Doug's visits and requests for advice from Maria become more and more frequent. Doug drops by Maria's lab at least three times a week. Maria even allows Doug to use some of her lab's equipment and reagents and shows him how to set up the necessary assays. Initially, Maria was more than willing to help Doug, but over time she begins to feel as if she is taking on the role of his principal investigator, Cook. She wonders whether Doug has told Cook that he is getting help from her. Maria begins to realize that she inadvertently has become invested in Doug's project, and that her own work has been suffering as a result. Meanwhile, Black, Maria's adviser/ supervisor, is unaware of her charitable activities.
Posted 12 years and 9 months ago
Deborah G. Johnson Georgia Institute of Technology
The sequence of events in this case illustrates how a seemingly altruistic action (furthering the goals of science) can lead, through subsequent events, to an awkward situation in which professors, post-docs and graduate students seem to fail to fulfill their responsibilities
The events described in Part 1 of the case suggest a situation that is far from ideal, although not unethical per se. The case description hints at something wrong because of Doug's feeling that he is not qualified for the assignment he has been given and because of Professor Cook's apparent lack of understanding of DougÀs qualifications and/or his lack of involvement in the project. Without knowing many more details, it is difficult to determine whether Doug is overly concerned about his competence for the project or whether Professor Cook is being negligent.
Since Doug has doubts about his own competence and since he is unsure how to proceed, the ideal thing for him to do would be to tell Cook of his concerns. Of course, it is possible that Cook will fail to respond in a helpful way, but without DougÀs expression of concern, it is difficult to fault Cook. He has no way of knowing there is a problem. If Doug were to express his concerns, then the two of them might be able to come to a shared understanding of how Doug (and Cook) should proceed.
By the end of Part 1 no one has acted unethically, although it seems possible that Cook is being negligent and Doug, in not talking to Cook, is not managing his situation well.
As the situation evolves at the beginning of Part 2, it is still difficult to pinpoint any unethical behavior on the part of either Doug or Maria. Doug has sought assistance from someone who has relevant knowledge, and Maria has given Doug assistance. She has been helpful to him and, initially, at little cost to herself or her project, has helped Doug and promoted scientific work. If the case had stopped with Maria giving Doug tips on how to proceed and if Doug had proceeded to take charge of his research building on the tips but becoming independent, there would be no ethical issue. The case would simply illustrate an altruistic act by Maria, an act illustrating cross-fertilization of ideas and the value of cooperation in science.
However, that is not how the case proceeds. Instead, Maria continues to help; Doug continues to rely on Maria's help; and Maria is being distracted from her research for Professor Black. Moreover, Doug never informs Professor Cook of Maria's involvement in the research. While it is difficult to spell out in detail the responsibilities of professors, post-docs, and graduate students, especially in a way that anticipates every possible situation that might arise, this case confronts us with a situation where the lines of responsibilities are or are about to be crossed. The case points to more than one responsibility being ignored or neglected.
Let me focus on each of the actors.
This case illustrates the subtle but important responsibility issues in research relationships. The parameters of these relationships are rarely made explicit so they lurk beneath the surface. Often the responsibilities of professors, post-docs and graduate students become visible only when the grossest violations occur.
From: Graduate Research Ethics: Cases and Commentaries - Volume 4, 2000 edited by Brian Schrag
"In Need of a Helping Hand" presents a scenario that individuals may commonly encounter in a research setting. The case itself does not present a specific ethical dilemma, but rather highlights situations that could lead to serious ethical concerns surrounding issues, such as adviser-advisee relationships, conflict of commitment, and authorship.
A successful research environment fosters the development of strong working relationships among individuals, including but not limited to the principal investigator, research technicians, postdoctoral fellows, and graduate students. The success of young investigator is highly dependent upon the success and guidance of their research advisers, who may or may not be their mentors. For example, the postdoctoral period traditionally is considered to be an additional "training" period in which individuals ideally have the opportunity and freedom to pursue their own ideas, while securing a solid foundation for their careers and contributing intellectually to the laboratory and to the research endeavor. The career development of the postdoctoral fellows requires both the advisers (in this case Cook and Black) and the advisees (in this case Doug and Maria) to play an active role. This case is meant to bring some of the issues involving scientists-in-training to light and to serve as a stimulus for a healthy discussion of these issues.
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The case begins with Doug working on a project that is closely related to his dissertation research. This situation allows Doug ample time to become familiar with the new lab and to gain confidence in a new setting. Later, Cook asks Doug to undertake a more difficult and challenging project, which Doug agrees to do. However, Doug chooses not to disclose his hesitation and makes no attempt to discuss his feelings with Cook. At the same time, Cook makes no attempt to determine Doug's ability to undertake the new project. This point is where some of the problems begin, since Doug does not indicate his lack of expertise in purifying proteins to Cook and Cook makes no effort to evaluate Doug's knowledge and abilities in the area of protein purification.
Cook has given Doug ample time and opportunity to get used to the laboratory and feels that he is ready for a more challenging project. He cannot know that Doug has hesitations, if Doug does not express his concerns. However, as the situation develops and Doug grows increasingly frustrated, Cook does not seem to have time for Doug. Cook appears to be willing to talk with Doug but repeatedly postpones their conversations to an undetermined time. Cook appears to have a conflict between his commitments to the lab and to the class that he teaches. Cook fails to see Doug's hesitation and does not spend enough time with Doug to discuss his project and career goals.
In any adviser-advisee relationship, it is imperative for both parties to maintain open communication. At the beginning of Doug's post-doctoral appointment, Doug and Cook should have discussed their expectations and goals. Doug should be honest with Cook in saying that he has little experience with protein purification, but that he is willing to pursue the project with adequate resources and guidance. At the same time, Cook should ask Doug whether he is comfortable with the project and provide ample resources. In addition, the adviser and advisee should meet periodically to assess progress.
With the adviser-advisee relationship comes certain responsibilities that both parties must meet. Doug has a responsibility to be honest and to work toward the goals of the lab, while Cook has a responsibility to advise Doug on his research efforts and to provide a stimulating research environment that will allow Doug to grow as a scientist. Cook seems to have a conflict of commitment since his teaching responsibilities seem to be taking precedence over his responsibilities to the lab. Whether Doug should have taken on the project is debatable. In my opinion, Doug should have agreed to the project but mentioned that he would need guidance since he would be working in an unfamiliar area. Both Cook and Doug are failing to fulfill their responsibilities in this adviser-advisee relationship.
In Part 2 of the case, Doug begins to seek assistance from another post-doc, Maria. Maria is willing to help Doug, but along the way she begins to feel that she is providing too much assistance. Her own work begins to suffer as a result of her altruistic efforts. Due to Doug's unwillingness to be realistic about his abilities, he has created a situation in which he becomes reliant on another post-doc for advice and guidance. Maria should inform Black of her contributions to Doug's project and ideally Doug, Maria, Cook, and Black should meet to discuss relative contributions to the project and authorship of any papers that involve Maria's contributions.
This situation has the potential of becoming increasingly complicated if it is not handled appropriately. On one hand, Doug does not seem inclined to acknowledge Maria's contributions and is merely preoccupied with completing the protein purification project and impressing Cook. However, due to his preoccupation with the project, Doug may not have considered discussing authorship issues with Maria. As a result, Maria should confront Doug and insist that they discuss the project and her contributions with their advisers. Given this scenario, several outcomes can be imagined: 1) Cook does not understand why Doug went to others outside of the lab for assistance and becomes angry with Doug. 2) Black is not as sympathetic as Maria and reprimands Maria for her contributions to Doug's project. 3) Both Cook and Black are pleased with the collaborative efforts between laboratories and commend Doug and Maria for taking the initiative to work together.
This case represents a situation that could affect anyone working in a collaborative research setting. It is important to be open and honest from the beginning, making sure people are thinking along the same lines and expectations are mutually understood. It is easy to see that if these things are not done subtle actions could lead to serious ethical dilemmas and even breeches of scientific conduct.