WEEK 2 – Ethical Decision-Making Case 1: Lesotho

Prompt:

Lesotho is a small developing country contained within South Africa. You and your team of academic researchers (10 in all) are spending the next two weeks travelling to different communities throughout Lesotho to test water sources for disease-causing pathogens. The testing you need to do is simple but requires significant assistance from the community – showing your team all the different locations where individuals get their water from, and places/methods for storing the water. You do not see the need to pay the community members, considering if someone asked you about your water source, you would not mind driving them up to the lake! The ultimate goal of the project is to understand the lifecycle and characteristics of a specific pathogen, which is found only in this region of Lesotho. Several publications are expected from this research study. A comprehensive profile of this pathogen can help in many ways including development of chemical additives to make the water safe to drink. Is it ethical to conduct this research study? What will you do next?

Step 1: Determine the facts in the situation – obtain all of the unbiased facts possible. Clearly state the ethical issue. 

• The research team (10 people, including you) is going to Lesotho for two weeks to conduct research on the pathogen in their water source
• The goal of the research is to investigate the lifecycle and chemical/biological features of disease-causing pathogen
• There are no stated benefits to the locals in their research proposal
• The results from this research could be used to develop chemical additives to make the water safe to drink.
• The researchers will release publications on their findings of the pathogen
• The researchers will need the help of the local people to locate where the people obtain and store their water.
• Assume we have all necessary approvals needed for research
• Ethical issue: As of right now, the locals are not benefitting from the research in any way, and the academic researchers have no intentions to pay the community members.

Step 2 & 3: Define the Stakeholders and assess their motivations 

1. Academic researchers:
   • Test the water in Lesotho for disease-causing pathogens
   • Understand the lifecycle and characteristics of the pathogen
   • Write several publications from the research study → further your professional career
   • Possibly develop chemical additives to make the water safe to drink
   • Patents discover to possibly profit from findings
   • Driven by social impact or fame in helping the local community
2. Locals
   • Provide location of water sources
   • By providing access to the water sources, they contribute to the development of chemical additives in hopes of getting access to them for safe consumption of water
3. Your research university/institution:
   • The findings could add to their reputation, making them highly regarded
   • Strengthen new/existing partnership with other funding agencies
   • Open rooms for future collaborations within the area/country (e.g., new ventures)
   • Create opportunities for students to gain experience on social impact projects (and make impact)
4. Sponsors of the research:
   • Want to gain the benefit of discovering a new pathogen
   • Gain the opportunity to develop chemical additives against any harmful chemicals that are found in the water
   • Can potentially earn monetary benefit from the chemical additives that will be developed
   • Gain a better reputation and have their name attached in the breakthrough of helping treat water issues in another country
   • Publicity that will aid in gaining funding for other projects or investigations
5. Local government:
   • Make sure the research team does not cause any harm (mentally or physically) to its own citizens (for example, poison the water sources, etc)
   • Validates whether or not the water source in the area is safe to drink for the community
   • Ensure that the citizens have accessibility to the research
   • Ensure the area have some sort of benefit to the chemical additives that is developed if pathogens are found in the water
   • Building/expanding relationships with other funding agencies/countries

Step 4: Formulate (at least three) alternative solutions 

Solution 1: Get a map to find the water source (Use sources like Google Earth which 3-D renders Earth)

• • Pros:
    • Not have to rely on locals for help/take time out of their day
    • Less of an obligation to pay back locals in some way
  • Cons:
    • Maps may not be updated
    • Local knowledge can be useful, and we wouldn’t have that in this scenario
    • Not using locals can create distrust with the researchers – conflicts can complicate things
    • Do not have access or knowledge to places that the town is storing water (the storage area could be a potential location where the pathogen is entering the water source)
  • Ethical Principle: 
    • Virtue-based thinking: we would be doing the work on our own as independent researchers, reducing disturbance among the locals, keeping them in mind

Solution 2: Ask the government to assign some local leaders and supervisors to assist the research team to find the locations of the disease-causing pathogenic water

• • Pros:
    • Local leaders might also help facilitate the communication between the researchers and the locals
    • Local government permission makes the research less intrusive
    • Researchers will obtain guides or a map of the locations of the water source and storage location
  • Cons:
    • Might be more work to set up beforehand
    • Might cost a lot of money to train locals to properly extract the water sample (assuming locals do not have the education to do so)
    • Local government may not welcome the research team to conduct investigation on their water
  • Ethical Principle: 
    • Consequence-based thinking: we would be communicating with local leaders to get their insight and expertise on the community, respecting them and their cultures à have everyone on board and collaborate with your research to maximize the results and minimizes the risks.

Solution 3: Offer the local government access to the research and a promise to provide/implement water purification system to clean their water if harmful pathogens are discovered (could be through an organization such as Engineers Without Borders)

• • Pros:
    • Locals benefit! They will be happy that their water is clean 🙂
    • Locals will have access to the researcher’s findings
    • A relationship between the institution and the local government can be created
    • School receives prestige through findings and project
  • Cons: 
    • Cost a lot more money to implement -promise to clean water
  • Ethical Principle: 
    • Virtue-based thinking: we will keep our promise to the community and earn their trust through them having access to all our research and us aiding them in implementing a water purification system

Solution 4: Share the information/results to the Lesotho government; make the publications accessible to the research community (who focus on researching disease-causing pathogen)

• • Pros:
    • Advance the knowledge frontier of disease-causing pathogen that can benefit the community (e.g., development of chemical additives that make water safer to drink).
  • Cons:
    • There might be competing interests among the researchers about the use of insight gained from this study (e.g., profits, reputation, service)
  • Ethical Principle: 
    • Duty-based thinking: We are giving the country of Lesotho access to all of our findings in exchange for conducting research in their country. This way they would see all that we did and not question any of our intentions. This can also add to trust worthiness.

Solution 5: Creating clean drinking water for Lesotho, which can increase tourism

• • Pros:
    • Tourism can bring more profit for the government, which could be a good motivator for why they should allow us to do research for them in order to create a potential solution for their contaminated water
    • The locals will be able to drink clean water and not get sick as well as experience their country become wealthier through tourism
    • Potentially create more jobs for locals as a result of the success of the tourism
  • Cons:
    • Not many foreigners might know that Lesotho is a tourist worthy-destination, so the government might not be able to afford the promotions to advertise their country as a tourist destination and they could have a low tourist turn-out.
    • Might not be able to create a solution that is affordable or available to clean all the drinking water sources in Lesotho, so the deal would not be able to be met and the government/locals might not receive any benefits
  • Ethical Principle:
    • Virtue-based thinking: Create/maintain a relationship between the researchers and government/locals of Lesotho by being granted to find solutions to the contaminated water problem and in return, the clean water as a result of our solution can bring better health to the community and possible tourism for its beautiful scenery.

Solution 6: Reach out to healthcare workers in Lesotho and convince them to help educate the locals about the methodologies to have a safer way to drink/clean water/persuade locals to support researchers in their study.

• • Pros:
    • Healthcare workers would be able to understand the benefit of the research to the community and help the researchers in gaining access to the water sources
    • Educate the community on methodologies in obtaining clean drinking water and improve their health
    • Trusted by the local community
  • Cons:
    • Not that easy to reach out and find the right people to trust or understand your research
    • Healthcare workers may be too busy or limited in number to help
    • Healthcare workers may not know where the water sources are located
  • Ethical Principle:
    • Consequence-based thinking: Researchers would help educate the locals on methodologies in obtaining safe drinking water in exchange they would get aid in their research à mutual benefits

Step 5: Seek additional assistance, as appropriate – engineering codes of ethics, previous cases, peers, reliance on personal experience, inner reflection 

• Peers: listening to other classmates talk about their thoughts and ideas, helped with creation of some of our ideas and overall collaboration
• Treat a local for lunch to find out their thoughts and determine which approach would be the most appropriate solution
• This case study also reminds about the Belmont Report that summarizes the three fundamental ethical principles for using any human subjects in the research: Respect for persons, Beneficence, and Justice. While this research aims for understanding the life cycle and characteristics of the disease-causing pathogen, interaction with the locals is inevitable and researchers should do their best to prevent any harm too all related research subjects and ensure reasonable, comprehensive, and non-exploitative procures to be administered equally and fairly.

Step 6: Select the best course of action – that which satisfies the highest core ethical values. Explain reasoning and justify. Discuss your stance vis-a-vis other approaches discussed in the class. 

The best course of action for the researchers would be to first seek permission from the governments and/or local health authorities to conduct their research on disease-causing water sources. If possible, the research team should ask the government, their partners, their universities, and/or sponsors for local contacts in their area to serve as a point of contact/assistance. These local buddies will be of great help to bridge the cultural and societal-economic difference between the foreign research team and the community members, making it easier for the team to earn the trust of the community and have them assist in showing directions to the water sources.

With this said, this is not always the case that you can find a point of contact in Lesotho, and even if you do, it doesn’t guarantee that this person will understand your perspective and the purpose of your research. If that is the case, the research team will have to find a way to communicate with the locals and get their assistance. Now, personally, I think it is unethical for the team to not acknowledge and reward the knowledge and time of the local volunteers from the community. At the very least, they should be paid a fair wage rate for their assistance, just like how Lehigh’s psychology group rewards volunteers to participate in a case study or fill out a survey with a ~$25 gift card for, let’s say, a 2-hour voluntary session. Therefore, the research team should reward the locals from the community for their assistance in their research. Yet, it should be taken into consideration that conducting international research is expensive. The sponsors of the research might provide only a fixed amount of funding to the team, and any of the additional expense might need to come out from the team’s individual pocket money.

If the team is short on budget but still want to reward the community for their assistance, the reward doesn’t need to be monetary – it can be intellectual knowledge. Once the research is concluded and their research might be used for clean water applications, the research team can communicate the results via a concise written report/publication to the Lesotho government and the local community leaders. Alternatively, the team can acknowledge the support and assistance of local members and the government in the “Acknowledgement” section in their publication. If the research cannot be used for clean water applications, the research team might be able to serve as a resource to connect the government and/or the local community with other non-profit agencies/organizations that might be able to implement water purification system for low- and middle-income countries.

Lastly, establishing trusts among all identities (sponsors, researchers, local government, people from the community) are important. Without trusts from the local government and people from the community, the researchers wouldn’t be able to do as much work as they could in the duration of 2 weeks. Looking beyond the scope, the research team might still want to conduct further research on pathogen later in the future, so keeping good relationships with the existing stakeholders are truly essential.

Of course, it is impossible to earn trusts from everyone, and it is also impossible to make all of the 10 researchers in your team to all agree with how they will use the insight from this field trip (some might be driven by professional motivations; others might be drive by personal interests, either fame or reputations). Therefore, to make sure that the competing interests will not hinder the process of the research and ruin the reputation of the research team in the eyes of the local government and the sponsors, it is important that the research team has a clear and open discussion among all members and comes up with some ground rules, ensuring that all procedures are well-thought and ethical.

Step 7: (If applicable) What are the implications of your solution on the venture. Explain the impact of your proposed solution on the venture’s technology, economic, social and environmental aspects.

• Economic:

• • If the venture does not represent themselves well due to the miscommunication among the entities, this will not only have a negative impact on the venture but any other research groups that might want to conduct research in Lesotho. The image of the sponsors of the research might be also negatively affected, which might cause disruptions to funding for future research.

• Social:

• • Relationships and partnerships are important in creating a successful venture in an international context

• Environmental:

• • As a venture is conducting research in an international context, it is always the best practice for the venture to preserve the nature and not to disrupt the ecological system. In the case of the team in Lesotho, the team should be mindful not to leave any trash behind the testing locations or bring any invasive particles/plants that might contaminate the water sources. The same mindset for our team if we visit coconut farms in the Philippines for testing in the future.