Guidelines for medical behavior: Putting Clark in the forefront of bioethics and the philosophy and history of science

Philosophy professor Patrick Derr wants to understand what is right and wrong in medical research--and to refine the codes and guidelines that govern medical research. According to Derr, bioethics will be able to deal more effectively with these moral questions if it can learn something from the philosophy of science about how to use history--whether history of science or history of medicine--as a kind of laboratory. He's been looking at the relationship among these three fields for most of his 30-year career at Clark.

The Krugman/Rose Problem

In his research, Derr has been looking at medical research throughout history, paying close attention to the work of Dr. Gerhardt Rose and Dr. Saul Krugman. Rose was in charge of tropical disease research for the German air force for the Nazis. Ordered to develop a typhus vaccine because the disease was attacking German troops on the battlefield, he tested his vaccines on concentration camp inmates despite never joining the Nazi party and protesting to the SS about the use of camp inmates. At Nuremburg, he was sentenced to life in prison for crimes against humanity. Krugman was charged with developing a hepatitis B vaccine for the U.S. troops during the Korean War. He tested his vaccine on severely retarded children living in a state institution and later received the Lasker Public Service Award.

For Derr, the critical question is: What is so hugely different about these two scientists' medical research that it could make the difference between prison and the Lasker Award? Derr's answer is the subject of his lecture "The Krugman/Rose Problem," which he delivered at the African Genome Initiative Conference in Kenya in summer 2005. The conference brings scientists from around the world together to study a wide range of current public health issues, from genetic science to killer diseases.

"There's nothing in the current codes about precisely who benefits from medical research," Derr explains. "It actually matters which chunk of humanity benefits from the research. Rose knew that the people he was experimenting on would never get the typhus vaccine. In contrast, Krugman intended to vaccinate institutionalized children if he got his vaccine, and, indeed, he worked with marginalized groups throughout his career." Derr is working on refining codes so that they are sensitive to the differences between the Rose and Krugman scenarios.

Asking public health questions

Derr thinks that if his theory is correct, it has relevance to a lot of what is happening in medical research today. He cites testing HIV treatments in developing countries as one of those examples. Derr asks, "Is it moral to do safety tests for an HIV-1B vaccine in Africa where there is almost no HIV-1B? No, because people who are not exposed to a particular disease cannot benefit from a vaccine against it."

Moving research forward

To further his research, visiting the scientists who are doing the work is critical for Derr. "Talking to other philosophers is not enough for this research. It's talking to the people doing the research in the places where they are doing it that is really important to tease out details about subjects and benefits. And improving our international research codes is critically important to both the scientists and the subjects."

In addition to his speech in Kenya, Derr has received invitations from scientists in India, Canada and the World Health Organization to visit and lecture to further his research. However, without the travel funding, he can't accept these invitations.

"Travel funding is a critical component to advancing faculty scholarship," says Associate Provost Nancy Budwig. "Clark faculty are known for being engaged with the world, which means they need to be out in the world in order to pursue their research."

Top