Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true patient care case. You vote on your decision in the case and, next week, we'll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel's 2019 book, .
Emma, a medical student, dabbles in historical research during her spare time. She is writing a paper on the "Oakfield" hepatitis experiments, a series of studies conducted at her state's hospital for mentally impaired children during the 1960s.
The most disturbing of these experiments involved intentionally infecting patients, many of them African American toddlers with IQs under 70, with viral hepatitis in order to study potential treatments. While no children died, several became severely ill. At the time, the study was not considered objectionable by mainstream investigators, but it is now held up as an example of abusive and unethical research.
In the hospital archive, Emma discovers a document naming several college students who worked as volunteers on the experiment. One of them is 85-year-old "Van Helsing, MD," Emma's mentor and the university's most preeminent physician, who has been a long and vocal advocate for patient welfare at the local hospital and for human rights around the world. Emma knows that revealing Van Helsing's role in the experiments would tarnish his reputation significantly. At the same time, she is troubled that he has never revealed his part in this tragedy.
See the results and what an ethics expert has to say.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
And check out some of our past Ethics Consult cases:
Withdraw Life-Saving Treatment if Siblings Can't Agree?