Through A Narrow Chink: An Ethical Dilemma


by Pablo Baez
Chemistry 104
Prof. Holme


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