Ethical Issues in Environmental Health Research
Sharp, Richard R., Environmental Health Perspectives
Environmental health research encompasses a wide range of investigational topics, study designs, and empirical methodologies. As that arm of public health research concerned with understanding the health effects of the many environments in which humans live and work, the field is intimately connected with social concerns about environmental quality and disparities of power and privilege that place differential burdens upon members of underserved communities. Environmental health researchers thus engage many ethical and social issues in the work they do. These issues relate to the choice of research topics to study, the methods employed to examine these topics, the communication of research findings to the public, and the involvement of scientific experts in the shaping of environmental policy and governmental regulation. These and other topics are reviewed in this article. These ethical, legal, and social issues are becoming increasingly more complex as new genetic and molecular techniques are used to study environmental toxicants and their potential influence on human and ecologic health. Key words: environmental health research, ethics, governmental regulation, justice, participatory research, public policy. Environ Health Perspect 111:1786-1788 (2003). doi:10.1289/ehp.6778 available via http://dx.doi.org/[Online 6 October 2003]
Environmental health research is that arm of public health concerned with understanding the health effects of the many environments in which humans live and work. It is a diverse field, encompassing a range of research methodologies and study designs. This spectrum of activities includes a) identification of ecologic hazards and environmental toxicants, b) assessment of biological mechanisms through which environmental toxicants affect human health, c) evaluation of interventions designed to mitigate harms associated with environmental hazards, and d) identification of susceptible populations at increased risk of developing occupational and environmental diseases.
Each of these basic spheres of environmental health research presents its own set of ethical, legal, and policy challenges, some of which are familiar to environmental health researchers; whereas others have received little attention (Coughlin and Beauchamp 1996; Lavery et al. 2003). In addition, as in other scientific fields, some of the perennial ethical and social challenges raised by environmental health research are being transformed by new molecular and genetic techniques that aid investigators in studying human and environmental health (Christiani et al. 2001). Several of these ethical, legal, and policy challenges are reviewed below.
Identifying Environmental Toxicants
Identifying environmental toxicants is a normative enterprise on several levels (Vineis 1995). The decision to regard a particular substance as toxic, for example, carries moral force--environmental toxicants are harmful agents that should be avoided. Hence, the decision to regard a particular substance as a toxicant requires that researchers reach some level of moral consensus regarding the level of risk that is sufficient to regard a substance in the environment as a potential threat to human and ecologic health (Vineis and Soskolne 1992). Similarly, after a decision has been made to regard a particular substance as an environmental toxicant, researchers knowledgeable about the presence of that agent in a specific environment must then consider how best to disclose this information to persons who may have been or continue to be exposed to that substance (Carpenter 1995; Schulte and Singal 1996). This can involve disclosures to individual research participants or disclosures to members of geographically defined communities in which an environmental toxicant has been identified (Deck and Kosatsky 1999). With all knowledge comes responsibility--in this case, the responsibility to develop effective strategies for communicating known health risks to persons who may be living in areas where an environmental toxicant is believed to be present. …