Through A Narrow Chink: An Ethical Dilemma Essay, Research Paper
Through A Narrow Chink: An Ethical Dilemma
by Pablo Baez
In 1951 Carl Djerassi, with the Mexican pharmaceutical company Syntex, developed the first oral contraceptive by synthesizing and altering the natural hormone Progesterone into a superpotent, highly effective oral progestational hormone called “norethindrone”.
Admittedly, the dynamics and importance of this find were astounding, since before this the only means of contraception was abortion, and even that was not legalized at the time.
The race to produce this synthetic agent was highly competitive, being sought after by many pharmaceuticals throughout the world, and for a small fledgling company in Mexico of all places to find it first only added to the excitement of the achievement.
Yet aside from all this excitement and competitive fervor something great and disturbing was being bypassed. Science, in my view had done something great without looking into the possibilities of where this would lead.
I believe Djerassi, similar to most scientists of his day, was so entranced by the excitement of synthesizing his product and achieving his goal that he did not stop to think of the ramifications of his accomplishment. The ethical dilemma was not explored before hand, and this to me is the great tragedy of most scientific discovery, since I firmly believe each scientist is responsible for that which he creates.
Djerassi does confront a few questions of ethics and morality after the fact.
On page 61, in chapter 6, he reflects on the argument of the use of poor Mexican and Puertorrican women for preliminary experiments. Is this just another manifestation of exploitation of the poor?
Djerassi says absolutely not.
Yes, the poor our the initial guinea pigs for research but this is no different from what dentists, barbers, and young surgeons do. All of these groups use the poor to hone their skills, not because of the poor women’s ignorance but because middle class, suburbanite, white women are unlikely to volunteer their services for the sake of science.
My main problem with this is that he claims they will not “volunteer” their services. Of course not, they are aware of the possible detrimental effects of such experimentation. This is obviously because they are probably more highly educated the poor Hispanic women. Poverty often precludes a lack of good schooling and education. Thus the awareness of such a group to scientific studies will most likely be much lower. They probably knew nothing of scientific research at all, let alone how to read a consent form that leaves them without legal recourse.
Djerassi mentions this as well, the idea that he can not offer them consent forms because they can’t read.
That seems preposterous to me!
If he can not inform his patients of the possible side effects then what chance do they have at justice if some carelessly administered drug causes them harm?
Coming back to his original argument, he claimed suburbanites were not likely to volunteer their services for the sake of scientific study, but I dare argue the poor women most likely did not volunteer but were asked. Did he ask the suburbanites? I highly doubt it was even proposed.
In chapter 9 Djerassi addresses another question he was often confronted with. “How do you feel about the social outcome of the work?”. He answered this with a shrug of his shoulders and a simple, “I couldn’t have changed things”.
Again, I am disturbed by the flippant manner of his response. Yes, he acknowledged the impact the Pill had on the sexual revolution, but fails to see beyond what has already occurred, claiming powerlessness against the pace of science.
Let me say that he is most likely partially correct. There is very little to be done when science determines to do something and the race begins toward that goal. But to claim oneself unable to have made a difference, especially someone of his intelligence and influence, is remarkably sad.
I firmly believe that the direction of science, though difficult to stop or turn entirely, can be manipulated by those forefront scientists enough to at least seek discovery with a certain social awareness.
This claim of powerlessness is a cop out, clear and simple, and no euphemistic jargon or claim of ignorance will give the victims their normal lives back. This has been the case in nuclear, medical, and chemical research. Invariably someone suffers due to the insincerity of others.
Maybe I am being a bit harsh. Djerassi’s Pill did give women a great power, the power to control childbirth, as well as a greater freedom toward sexuality that before this was monopolized by men. But medical ethics and moral responsibility must become wed with research in the minds of scientists for a real change in perspective to occur.
In 1994, my wife came home one day with tears in her eyes after having gone to the Gynecologist for a regular check up. She mumbled through shaky lips the words cervical cancer and something about a biopsy. I was mortified. Somehow, at the young age of 25, my wife had gotten the beginnings of cervical cancer and something had to be done fast. After a few tense days of waiting for the biopsy results we were told she should have cryogenic surgery for the removal of the tissue. It was removed and we were told not to worry.
Inquiring as to how such a young woman could have gotten cancer our doctor said it was a possible side effect of using the same Pill prescription for so long. We had never known this. If we had known we would never have used it!
Personally, that scare was enough to prove to me that scientific research and development must be extraordinarily careful as to what it finds as acceptable risk.
William Blake was quoted by Djerassi as saying in The Marriage of Heaven and Hell: “If the doors of perception were cleansed everything would appear to man as it is, infinite”. This infinite view of all means that everything overlaps, interconnects into an almost constant dance between particles, people, and ideas. In other words nothing is independent and of itself. If this simple concept of everything being related were to be assimilated into all that we think and do, imagine the difference it would make. But our problem as Blake continues is: “… man has closed himself up, till he sees all things thro’ narrow chinks of his cavern.”
Djerassi admits that only late in his life did he begin to widen those chinks. He realized he had not seem all that was there, leading a sheltered life with a somewhat narrow scientific perspective. He sustained social and political attacks about the side effects of the Pill, survived through three marriages, and dealt with the suicide of his depressed daughter. Arguably, he had had a rewarding yet tough life.
But like my incidence with the side effects of the pill, his lack of respect for the relationships between science and the rest of the world has cost many dearly.
Yes, he has later in life admitted to his narrow sighted perspective of his younger years, but that still doesn’t address the issue that today’s scientists are still being trained in the same manner and with the same tunnel vision. Something must be done, and it falls to the senior scientists such as himself to rectify the problem!