Cases in Bioethics: Health Research Ethics in Southeast Asia
Keywords

cancer treatment, unauthorized use of equipment, research misconduct, laboratory research

Several approaches are used for treating and managing cancer, including chemotherapy medications, surgery, and radiation therapy. One of the pitfalls of cancer treatment is resistance, when tumor cells no longer respond to treatment, and the cancer progresses or returns. Researchers often use molecular techniques to study the process of resistance to radiation, such as exposing laboratory-grown cancer cells to certain doses of radiation with an instrument called an irradiator.

A researcher wanted to study the effects of radiation on cancer cells grown in a laboratory culture but did not have access to the appropriate equipment to conduct the experiment. The researcher asked the head of a nearby hospital-based laboratory to borrow a radiation machine typically used for radiating blood in patients receiving radiation treatment. The hospital laboratory did not agree because of the heavy use of the machine for clinical diagnostic purposes and services. The researcher then decided to work around the refusal and sent an acquaintance to the hospital laboratory to help with a different issue related to sample processing. The acquaintance used the opportunity to irradiate cancer cells using the radiation machine intended for clinical use, then measured gene expression levels in the cancer cells after exposure to radiation after office hours, when staff were no longer present.

Staff working in the hospital laboratory raised concern about unauthorized use of the equipment and facilities to the researcher, who dismissed the concern, explaining the research was time-sensitive and that they have gotten the needed approvals. The laboratory staff felt obligated to stay silent because they are worried about keeping their jobs.

Questions

  1. What potential harms may result from the actions of the researcher and their acquaintance?

  2. What should the laboratory staff do, given their concerns and hesitations?

  3. What should be the consequences for the researcher?

References

AERB. “Gamma Irradiation Chambers/Blood Irradiators.” Atomic Energy Regulatory Board (AERB). 2017. https://www.aerb.gov.in/english/regulatory-facilities/radiation-facilities/application-in-medicine/blood-irradiators.
Council for International Organizations of Medical Sciences. International Ethical Guidelines for Health-Related Research Involving Humans. World Health Organization, 2017.
ICH. “Integrated Addendum to ICH E6(R1): Guideline for Good Clinical Practice E6(R2).” November 9, 2016. https://database.ich.org/sites/default/files/E6_R2_Addendum.pdf.
Lovitt, Carrie J., Todd B. Shelper, and Vicky M. Avery. 2014. "Advanced Cell Culture Techniques for Cancer Drug Discovery." Biology 3, no. 2 (2014): 345-67. https://www.mdpi.com/2079-7737/3/2/345.
Malaysian Medical Council. “Code of Professional Conduct 2019.” 2019. https://mmc.gov.my/wp-content/uploads/2019/12/CODE-OF-PROFESSIONAL-CONDUCT-2019-Amended-Version.pdf.
Ministry of Health Malaysia. “National Institutes of Health (NIH) Guidelines for Conducting Research in Ministry of Health (MOH) Institutions & Facilities.” 3rd ed., 2021. https://nih.gov.my/images/media/publication/guidelines/NIH_Guideline_2021.pdf.
The Royal Children’s Hospital Melbourne. “Blood Transfusion: Irradiation of Blood Products.” 2019. https://www.rch.org.au/bloodtrans/about_blood_products/Irradiation_of_blood_products/.
World Health Organization. “Code of Conduct for Responsible Research.” November 2017. https://www.who.int/about/ethics/code-of-conduct-for-responsible-research#:~:text=The%20Code%20of%20Conduct%20for.

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