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Monday, November 28, 2011

On Research Ethics

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I'm going to take a small step away from neuroscience for this post.  In a startlingly real case of life (i.e. my day job) imitating art (i.e. my online presence), I was asked about the following article on the exact same day I find myself having to think like a microbiologist/immunologist again at work.

Way back in the dim mists of time... as a Master's student, I studied Biology, with a strong emphasis on Aquatic Biology.  However, to pay the bills, I taught labs and graded papers... in Microbiology.  It's a skill I picked up in the course of my undergraduate studies in Biology and Chemistry, and it contributes to the fact that I am a rather well-rounded scientist, with background knowledge of Biology, Chemistry, Geology, Physics and Medicine in addition to my primary (doctoral) skills in Physiology, Pharmacology and Neuroscience.  Under the circumstances that I like to use this forum for Q&A and discussions of research ethics, I thought it would be a good diversion to address the following headline:

Man-made flu virus with potential to wipe out many millions if it ever escaped is created in research lab

One version of the story that is making its way around the internet is here:

http://tinyurl.com/6p2xa5w The picture at right is from the Daily Mail article, and purports to show the new virulent H5N1 virus. I can't verify the accuracy of the photo, but I will tell you that it certainly looks like the glycoprotein coat of a virus - note, that this is not the active part of the virus itself, it is only the outer shell.  The "infectious" part of a virus is the DNA or RNA on the inside.

H5N1 is bird flu.  It has the potential to be every bit as nasty as the Influenza pandemic which killed between 50 and 100 million people between 1918 and 1920.  It should be noted that the so-called "Spanish Flu" was the influenza viral strain H1N1 - more recent known as "Swine Flu" which was responsible for the influenza pandemic of 2009.  H5N1 is not yet in the dangerous state because it is not easily transferred between individual humans except through exchange of bodily fluids - and even then it is not terribly virulent in what would be termed the F1 or F2 generation. 

In the article, however, it is revealed that scientists have mutated the H5N1 virus to a more virulent form that is transmissible, and they did so in 5 relatively easy mutations.  There is much discussion about whether scientists should be "allowed" to perform such dangerous research, and even then if it should be published.  I was asked what I thought about (A) the dangers of this flu, (B) whether it should be published, and (C) the ethics of this research.  This is particularly apt because a few years back, and SF author friend of mine proposed an H5N1 pandemic as part of the plot line of his book, and asked me to consult on the medical science.  For the interested, that book is "The Last Centurion" by John Ringo, and it is available in eBook form here:   http://www.webscription.net/p-770-the-last-centurion.aspx and in hardcopy from Amazon or Uncle Hugo's SF Bookstore.

So, under the circumstances, how could I refuse?

Dangerous Research Ahead...

In response to the questions about "should scientists do dangerous research?"  My answer is a qualified "Yes."  The qualification is that I feel appropriate safety should be taken to prevent release.  In my work as a neuroscientist, we have to work with many chemicals that the Centers for Disease Control (CDC) have declared as "Select Agents" meaning that these are essentially dangerous chemicals.  Note that these are not synthetics, they are plant and animal toxins that are collected, concentrated and purified.  Botulism, cholera and typhus are terrible diseases, and the toxins are deadly, but from research into these toxins we know how they work and how to prevent and treat the disease.  Puffer fish (fugu) and cone snail toxins are deadly, yet they are also essential pharmacologic tools to the neuroscientist to better understand neuron/brain cell function both in normal and disease states.

Therefore, the danger of the subject of study alone is not sufficient cause to stop or prevent the research.  Yes, precautions *must* be taken, yet still - viruses mutate on their own!  The likelihood that such a virulent strain of H5N1 could develop on its own is NOT unlikely.  When it does, you'd better believe that our doctors and scientists NEED to know how it behaves and how to treat it (as well as preventing the spread).

Publish or (and) Perish!

There is fear that publishing the results of the scientific experiments would provide a "cookbook recipe" to terrorists or even disgruntled citizens to duplicate the result and create a terror weapon.  Basically this comes down to "once we know, shouldn't we keep it a secret?"  To this, I say "No," once we have the information, we should publish it.  Again, this is the best way to ensure that scientists and doctors have ALL of the tools they need to treat disease.  I'm afraid my answer to the fear that terrorists might get hold of the "recipe" and recreate their own "Superbug" will not be entirely reassuring.  In the first place, creating super influenza viruses is not something to cook up in the bathtub.  It is not within reach of the casual kitchen sink experimenter.  It will require specialized lab equipment and materials - viruses do not grow like mold on bread, they must be specifically cultured in living cells (human cells, if it is to target humans).  On the other hand - there is no guarantee that the enemies of civilization do not already have the scientists and equipment working on "weaponizing" H5N1.  Choosing to suppress publication is not going to stop them.  In fact, refusing to publish may rob our medical researchers of the very knowledge they need to develop effective treatments!

A Question of Ethics

So - is it ethical to perform such dangerous research that could be turned into weapons against civilized peoples?  In many cases... Yes.  In fact, I would argue that we as scientists have an obligation to research the greatest dangers that face our society.  Research into the smallpox and polio have virtually wiped out these diseases from Western society - yet the microorganisms themselves could have devastating consequences if released from a lab.  Research into botulinum toxin has resulted in not just a cosmetic treatment, but an important cure for intractable migraines.  research into plant and animal toxins results in improved drugs and treatments for neurological diseases.  Research with corrosive chemicals led to development of rocket fuels and the space program, with the end results of improved telecommunications, compact electronics, lightweight/high strength materials and improved medical diagnostics.   Research with radioactive materials has led to energy production, medical imaging, treatments and food preparation and safety.

Each field of study has its dangers and its detractors.  Denying research and publications because "it's dangerous" is short-sided at best, criminally ignorant at worst. 

Yes, we need to proceed with caution...

Yes, we need to proceed with safety controls in place...

Yes, we need to proceed with public disclosure and monitoring ...

...but we need to proceed!


Wednesday, November 23, 2011

An Open Letter to U.S. Retailers

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 An Open Letter to U.S. Retailers:

You wouldn't allow your employees to be intoxicated at work.


Why are you encouraging them to work while sleep-deprived?

The frank truth is that lack of sleep produces many of the same mental effects as being drunk or high, and Black Friday will be staffed by employees operating on too little sleep.  The busiest retail day of the year is also the day when clerks and shoppers both are at the greatest risk of making serious judgmental errors at potentially high costs.

The factors that could lead to serious lapses in judgment include:
  1. Sudden shift from working during the day to working during normal sleep hours.
  2. Long work hours
  3. Difficulty in sleeping during the day
Many stores are opening at very early hours on the Friday after Thanksgiving.  Shops which normally open at 8, 9 or 10 AM will open at Midnight, 3 or 4 AM.  The employees will have to report to work 5-8 hrs early than normal, in fact, they will start work during the times of the day when they are usually asleep and all bodily functions are at a minimum.  It is as if they had suddenly traveled from the U.S. to Europe, with all of the symptoms of jet lag, without the elapsed time.

To make matters worse, many of your employees will attempt to go to sleep in the afternoon or early evening so that they get a decent amount of sleep before getting up and going to work.  The human body's daily cycles and rhythms involve 6-10 hours of sleep, followed by 16-18 hrs awake.  Most people find it difficult to sleep when they have been awake for less than 12 hours, thus even if the employee *tries* to go to sleep at 6 PM (to be up at midnight and at work at 2 AM) they will spend a lot of time *trying* to sleep, but not succeeding.  It is a well known factor of "swing-shift" workers that it takes about a week for a worker to adjust their sleep schedules from day to night shifts (or vice-versa) [Kolla and Auger, Cleveland Clinic Journal of Medicine, October 2011, volume 78, number 10, pages 675-684].

So now your employees have disrupted sleep cycles, are working during the time of night when their body is conditioned to be asleep, and they are sleep-deprived. What does that mean for their ability to function at their job?  Sleep deprivation slows reaction times, impairs memory and alters judgment.  A study in primates a few years ago demonstrated that following a single night of lost sleep, critical brain areas showed reduced activity, while other brain ares have to work harder to compensate [Porrino et al., Public Library of Science - Biology, September 2005, volume 3, number 9, page e299].  When sleep deprived, it is difficult to form and use short term memory - such as ringing sales and making change.  It is also difficult to make critical decisions, such as identifying shoplifters or when to allow exceptions to sale terms.

Essentially, people who are sleep deprived show many of the same impairments of a person with a legally impaired blood alcohol level even though they do not show the same physical effects [Citek at al., Journal of Forensic Science, September 2011, volume 56, number 5, pages 1170-1179].  While factories, shops and offices that normally operate evening and night shifts have employees who are accustomed to working in the dark hours of the morning, most retail employees (and shoppers) are not.  Thus, not only are your employees *working* impaired, your customers are *shopping* and driving while impaired.  The increase in traffic incidents and police responses on Black Friday is commonly attributed to the size of the crowds, however, the increasing trend of early opening and sleep-deprived public has to be be compounding the problem. 

Finally, the trend of increasingly early opening is robbing your employees of the very holiday and family time that is provided by closing businesses on Thanksgiving day.  In order to *attempt* the sleep necessary to be at work at midnight or 4 AM, your employees have to shut their families out and attempt to sleep or nap during the afternoon or early evening hours.  As described above, they may make the effort, but the likelihood of success is low.

It is a nice sentiment to close your business to allow employees to be at home with their families, but it all rings hollow when you steal the time back in order to be the first store open the next day - particularly with employees who are working while impaired..

UPDATE:

This is not a rant against retail or capitalism.  For many years I shopped on Black Friday because it was the only time to shop *for* the kids, *without* the kids.  I understand that retailers are depending on increased volume of sales at discounted prices in these economic times.  From personal experience I know that Black Friday crowds mean that most shoppers will be able to visit only one or two store, thus early opening is an incentive to get shoppers in your store *first*.  

My wife works in retail - operations support - and will be busy from 1:30 AM onward fixing the problems that are guaranteed to occur on Black Friday.  Thus, I *will* be out in the early hours of Black Friday driving my wife to work to ensure that she arrives safely - but then, I have already adjusted my sleep schedule to be able to function appropriately after midnight, a luxury not afforded to employees working day-light shifts on any other day.  

Please understand that this is a reasoned appeal, backed by scientific evidence, to reverse a trend that *encourages* Americans to work, shop, drive and make decisions under conditions that impair all of those functions.  We may *not* be able to reverse the trend, but at the very least I hope that by understanding these effects we will be better informed if/when incidents occur due to sleep deprivation.