It is with a bit of trepidation that I write about this.
The reason, for anyone who reads ScienceBlogs specifically or science blogs in general, should be obvious. Richard Dawkins is such a polarizing figure with a penchant for stirring things up with regards to the most deeply held beliefs of both the religious and atheists, that he has all too often served as a flashpoint for battles between secularism and religion or a convenient excuse for the two most popular of my fellow ScienceBloggers to indulge their mutual animosity publicly. Posting about Dawkins, whether you defend or criticize him, can result in a real storm of argument, and who needs that?
After all, I routinely write about antivaccination loons, sometimes resulting in 100+ comment storms of vilification descending upon me. Ditto writing about alternative medicine and Holocaust denial. So why on earth would I worry about a little reaction about anything I write? Answer: I shouldn’t. Besides, as the only physician on ScienceBlogs with a special interest in skepticism, rationalism, and critical thinking as main themes of his blog, not to mention the only one who is actually involved in clinical research and the ethical issues inherent in such activities, I cringed when I read the title of Dawkins’ article published in the L.A. Times last week: Saddam should have been studied, not executed (also published here, on Dawkins’ website).
The response to this article was fairly predictable. Mixing Memory and Telic Thoughts, for example, jumped all over Dawkins for either “scientism” or being more concerned with Hussein as a source of potential research data than as a human being. In response, PZ predictably offered a knee-jerk and unconvincing defense of Dawkins. From my perspective, the criticism of Dawkins as some sort of Mengele lite (which, let’s be honest, is the not-so-subtle underlying implication behind some of the more vociferous criticism of this article, such as that by John Hawks) is overblown. On the other hand, Dawkins, as he does with maddening frequency (at least from the perspective of someone who generally admires his defense of evolution, rationalism, and science) walked right into it by stating his point clumsily.
Before getting to my specific objections to Dawkins’ article, I should mention what my take on the execution of Saddam Hussein. There was a time when I would have viewed his execution as perfectly justifiable, even applauded it, given what a brutal, murderous dictator he was and the suffering and carnage that could be laid at his doorstep. Over time, though, I’ve come to view the death penalty as inherently immoral. Worse, the manner in which the execution was carried out didn’t pass the “smell” test; it looked and felt like a hurried sectarian lynching more than the culmination of a process of impartial justice. Compounding the damage it caused, the ineptitude and haste with which the hanging was carried out did more to rehabilitate the image of a murderous dictator among our enemies than anything else could have done. Grudgingly, I have to admit that Hussein faced his end bravely, whether it was due to his view of himself as some sort of Arab warrior or whatever the reason. My disgust at this execution then reached a crescendo later, when I realized that the view of Michael A. Hoffman III, a white nationalist, anti-Semite, and Holocaust denier whom I utterly loathe otherwise, was uncomfortably close to what I was thinking about the execution, minus his paranoid (and typical) allusions to “American Pharaohs” dispatching gravediggers so that their secrets would not be divulged. From my perspective, letting Saddam Hussein rot for the rest of his miserable life in a small jail cell, forgotten and disgraced, would have been a far more appropriate punishment.
Now let’s move on to what Dawkins wrote about the execution:
The obvious objections to the execution of Saddam Hussein are valid and well aired. His death will provoke violent strife between Sunni and Shiite Muslims, and between Iraqis in general and the American occupation forces. This was an opportunity to set a good example of civilized behavior in dealing with a barbarically uncivilized man. In any case, revenge is an ignoble motive. If President Bush and British Prime Minister Tony Blair are eventually put on trial for war crimes, I shall not be among those pressing for them to be hanged.
But I want to add another and less obvious objection: Hussein’s mind would have been a unique resource for historical, political and psychological research, a resource that is now forever unavailable to scholars.
Imagine that some science-fiction equivalent of Simon Wiesenthal built a time machine, traveled back to 1945 and returned to the present with a manacled Adolf Hitler. What should we do with him? Execute him? No, a thousand times no. Historians squabbling over exactly what happened in the Third Reich and World War II would never forgive us for destroying the central witness to all the inside stories, and one of the pivotal influences on 20th century history. Psychologists, struggling to understand how an individual human being could be so evil and so devastatingly effective at persuading others to join him, would give their eyeteeth for such a rich research subject.
Kill Hitler? You would have to be mad to do so. Yet that is undoubtedly what we would have done if he hadn’t killed himself in 1945. Hussein is not in the same league as Hitler, but, nevertheless, in a small way his execution represents a wanton and vandalistic destruction of important research data.
He should have been locked up, by all means. Kept him in jail for the rest of his life, to be sure. But to execute him was irresponsible. Hussein could have provided irreplaceable help to future historians of the Iran-Iraq war, of the invasion of Kuwait and of the subsequent era of sanctions culminating in the invasion. Uniquely privileged evidence on the American government’s enthusiastic arming of Hussein in the 1980s is now snuffed out at the tug of a rope (no doubt to the relief of Donald Rumsfeld and other guilty parties; it is surely no accident that the trial of Hussein neglected those of his crimes that might — no, would — have implicated them).
Even while PZ admires Dawkins for “placing sticks of dynamite under people’ chairs and blowing them up,” because I have actually been involved in human subjects research, I cringed. Dawkins has apparently never been involved with human subjects research (not unexpected, given his area of research and expertise), and it is painfully obvious that he probably hasn’t bothered to take the time to educate himself about the ethics of such research. (PZ mentioned that Dawkins had “bounced the op-ed off me and some other people before publishing it.” I wonder if any of the people off whom he bounced the article were physicians or psychologists involved in human subjects research. My guess is that the answer is no.)
Of course, subtlety has never been one of Dawkins’ strengths, and this article is just more example of his tendency to shoot from the hip in a way that sabotages the very point he’s trying to make. He’s also prone to making bad historical analogies as well (his infamous “Neville Chamberlain school of evolutionists” chapter in The God Delusion being almost certainly dumbest thing that Dawkins has ever written) and does so again in the article with his claim that it would have been madness to execute Hitler. In the context of the postwar period, it would have been anything but. Indeed, justice and morality aside, there were plenty of good, rational reasons to execute the war criminals of the Third Reich (to make an example of them, to buttress a new international system of justice, and to placate the Soviets are all examples), and I presume that’s why Dawkins used the device of imagining a time traveler bringing Hitler to the present.
The problem with this device is that it conveniently allows Dawkins to ignore the realpolitik of 1945 in which utilitarian arguments over whether to execute Nazi leaders or use them instead to help stabilize West Germany against the Soviet Union were key considerations, something that can’t be so easily done with regard to the present day situation in Iraq and the argument over whether Iraqi criminals like Hussein should be executed. In any case, in 1945, studying Nazi leaders in order to understand their origin was a relatively minor consideration in the overall scheme of things. Indeed, although psychologists were used in the interrogations of the captured Nazis, their main purpose was to try to figure out how to get the maximal amounts of information and cooperation out of them. (These interrogations are described in detail with included transcripts in Richard Overy’s Interrogations: The Nazi Elite in Allied Hands, 1945, a tedious, but illuminating read.) Bringing Hitler forward in time in a “thought experiment” of this sort thus allows Dawkins to ignore this fact as well, and pretty much destroys much of the theoretical validity of his comparing Hussein to Hitler with regards to studying him. After all, it is almost certainly indeed “mad” to execute a historical figure as important as Hitler brought forward to the present day, but it may not have been quite so “mad” for his contemporaries execute him in his own time (or for Saddam Hussein’s contemporaries to execute him today), at least not for the reasons Dawkins argues.
In any case, even if I were to accept Dawkins’ analogy, I find PZ‘s defense of the article a bit odd when he says:
I’m not impressed with the complaints. I don’t see that Dawkins was suggesting that the only reason Hussein should have been spared was because of his utility as a guinea pig; what is clear from the very first sentence of his piece was that there are many valid, obvious objections to the executions, and that all he was doing is adding one more small objection. I think that what he actually did was toss out one example of a purely scientific motivation for committing a moral act, the sparing of a man’s life, as part of the whole parcel of demonstrating that an atheist’s and scientist’s position is not an amoral one.
What’s odd that PZ apparently ignores that the very first two reasons that Dawkins criticizes the execution of Hussein are not primarily moral arguments, either. Rather, they are primarily utilitarian, just as utilitarian as the reasons argued in 1945 for and against executing Nazi war criminals: that Hussein’s death would provoke violent strife and that the execution was missed opportunity to set a good example of civilized behavior in dealing with a barbarically uncivilized man. Only number three is the comment that “revenge is an ignoble motive” (agreed wholeheartedly). Equally odd, although he seems to be implying it, nowhere does Dawkins state unequivocally that capital punishment itself is immoral (only that revenge is an “ignoble motive”). Couple that odd omission with his characterization of executing Hussein as an “act of vandalism” and it is not surprising that Dawkins provoked a storm again. As Joshua put it:
It is disappointing that Dawkins does not even address the issue of consent, nor the thornier issues of consent to experimentation from a person involuntarily constrained. Such experimentation is a common part of many authoritarian societies, religious and irreligious, and scientists should be on the vanguard against any such regime.
Any humanist – secular, agnostic or religious – will agree that the life of a human being – any human being – is worth more than a brick wall. Dr. Dawkins does not display any such recognition when he concludes with the question: “Wasn’t the judicial destruction of one of the very few research subjects we had [among ruthless national dictators] — and a prime specimen at that — an act of vandalism?”
Although I think much of the criticism of Dawkins’ article is overblown and based on looking for the worst possible interpretation of his words, I have to reiterate that nonetheless the article left me with an uneasy feeling, mostly because Dawkins didn’t make even a passing reference to the ethics of studying a human subject, even if that subject is a brutal dictator. Dawkins didn’t even mention in passing whether it is possible to justify such research on an uncooperative subject even if the benefits could be as great as he apparently believes; rather, he simply seems to assume that they can be justified. Almost any academic physician involved in human research could have told him that any hint of coercion in human subjects research automatically raises grave bioethical concerns, regardless of the potential benefits of the research. Dawkins seems blithely unaware of this.
Imprisonment is punishment for a crime; coercion is necessarily involved. Not so with biomedical research. One of the most important points of emphasis in bioethics is informed consent. An absolutely essential condition to any ethically valid human subjects research is that there must be no coercion in recruiting research subjects, a condition that is very difficult to meet when studying prisoners. The impetus for this rule, of course, came from the horrific experiments that the Nazis (and, although it’s much less often mentioned, the Japanese) carried out on prisoners and was solidified by experiments on disadvantaged and vulnerable groups, examples of which include the Tuskegee syphilis experiment. Informed consent without coercion is about as ironclad a principle in bioethics as there can be, and that’s why any experimental protocol or study that will be carried out on prisoners is subject to especially rigid protections, as the Belmont Report, which forms the basis of the rules governing human subjects research in the U.S. states:
In most cases of research involving human subjects, respect for persons demands that subjects enter into the research voluntarily and with adequate information. In some situations, however, application of the principle is not obvious. The involvement of prisoners as subjects of research provides an instructive example. On the one hand, it would seem that the principle of respect for persons requires that prisoners not be deprived of the opportunity to volunteer for research. On the other hand, under prison conditions they may be subtly coerced or unduly influenced to engage in research activities for which they would not otherwise volunteer. Respect for persons would then dictate that prisoners be protected. Whether to allow prisoners to “volunteer” or to “protect” them presents a dilemma. Respecting persons, in most hard cases, is often a matter of balancing competing claims urged by the principle of respect itself.
Questions of justice have long been associated with social practices such as punishment, taxation and political representation. Until recently these questions have not generally been associated with scientific research. However, they are foreshadowed even in the earliest reflections on the ethics of research involving human subjects. For example, during the 19th and early 20th centuries the burdens of serving as research subjects fell largely upon poor ward patients, while the benefits of improved medical care flowed primarily to private patients. Subsequently, the exploitation of unwilling prisoners as research subjects in Nazi concentration camps was condemned as a particularly flagrant injustice. In this country, in the 1940’s, the Tuskegee syphilis study used disadvantaged, rural black men to study the untreated course of a disease that is by no means confined to that population. These subjects were deprived of demonstrably effective treatment in order not to interrupt the project, long after such treatment became generally available.
The Common Rule, the regulations that govern the ethics of all human subjects research funded by the federal government, and much research that is not, place special burdens on Institutional Review Boards that approve studies involving prisoners in addition to the requirements for beneficence, respect for persons, and informed consent. Indeed, the Common Rule only permits such studies under the following conditions:
(a) Biomedical or behavioral research conducted or supported by DHHS may involve prisoners as subjects only if:
(1) The institution responsible for the conduct of the research has certified to the Secretary that the Institutional Review Board has approved the research under §46.305 of this subpart; and
(2) In the judgment of the Secretary the proposed research involves solely the following:
(i) Study of the possible causes, effects, and processes of incarceration, and of criminal behavior, provided that the study presents no more than minimal risk and no more than inconvenience to the subjects;
(ii) Study of prisons as institutional structures or of prisoners as incarcerated persons, provided that the study presents no more than minimal risk and no more than inconvenience to the subjects;
(iii) Research on conditions particularly affecting prisoners as a class (for example, vaccine trials and other research on hepatitis which is much more prevalent in prisons than elsewhere; and research on social and psychological problems such as alcoholism, drug addiction, and sexual assaults) provided that the study may proceed only after the Secretary has consulted with appropriate experts including experts in penology, medicine, and ethics, and published notice, in the FEDERAL REGISTER, of his intent to approve such research; or
(iv) Research on practices, both innovative and accepted, which have the intent and reasonable probability of improving the health or well-being of the subject. In cases in which those studies require the assignment of prisoners in a manner consistent with protocols approved by the IRB to control groups which may not benefit from the research, the study may proceed only after the Secretary has consulted with appropriate experts, including experts in penology, medicine, and ethics, and published notice, in the FEDERAL REGISTER, of the intent to approve such research.
(b) Except as provided in paragraph (a) of this section, biomedical or behavioral research conducted or supported by DHHS shall not involve prisoners as subjects.
The bioethical constraints on any research on Saddam Hussein or any other imprisoned war criminal are very clear: There must be informed consent with as little coercion as humanly possible; there must either be minimal risk or the benefits to the subject must outweigh the risks; and there must be respect for the autonomy of the subject (in this case, Hussein). Leaving aside the fact that it is highly unlikely that Hussein would have given his consent for such research or to allow blood or DNA samples to be taken to use for research (not to mention that the utilitarian argument that it is unlikely that much useful information would come out of such research anyway, a point that PZ concedes and Joshua mentions), the sort of research proposed would be so skewed in favor of benefit to society over potential benefit (or at least neutrality) to the subject and so tainted by coercion that it is unlikely that it could ever pass ethical muster. Remember, the ethical principles enumerated in the Belmont Report and the Common Rule apply even if the research proposed only involves interviews, questionnaires, or taking blood samples.
At the risk of being presumptuous, let me make Professor Dawkins an offer (an offer he is unlikely ever to hear about, much less accept, but, hey, this is the blogosphere, and surgeons’ egos are infamously inflated). If at some point in the future Professor Dawkins wishes to write about any sort of human subjects research again, I would be happy to be one of the people he “bounces his column off of.” Or, if I’m not eminent enough or schooled enough in bioethics for him, I would be happy to suggest some bioethicists who could do so (Art Caplan, for example). At the very least, Dawkins ought to read up on the terrible abuses of human rights committed by the Nazis and in experiments such as the Tuskegee syphilis experiment, and then read the Belmont Report, the Common Rule, and other documents that guide our ethical considerations in designing human subjects research. Defenders of Dawkins may argue that Hussein was such a tyrant that it’s hard to see what harm some minor psychological testing and medical tests would represent, even under some coercion, and it is true that an ethical case can be made that the principles of the Belmont report are not sacrosanct. If, however, we truly view each individual as having worth and autonomy, we should only with great trepidation exempt even mass murderers from the human subject protections that have been so carefully built up over the last several decades. It’s a very tricky business indeed if we start saying that it’s acceptable to use coercion to force some prisoners participate in human subjects research and but not for others, be it because of the nature of their crimes or whatever other reason. There are good reasons based on a long and sad history for why human subjects protections are now so strict, and we discard some or any of them at our peril. In emphasizing primarily a utilitarian argument as his “additional reason” for keeping Hussein alive, Dawkins, apparently without realizing it, is echoing the bad old days of biomedical research.