I was just
hoping you could give me some examples
of a social value, because clinical value
and scientific values are fairly easy
to understand and visualize even.
But I'm not sure exactly how to interpret
social value.
Okay.
So social value is well, two ways to answer your
question.
One is that that's the rubric under
which we put all of it.
So there's some of that.
But I did say valuable or useful clinically scientifically or
socially.
And so I think there, there could be
I have to think of an experiment to study
which had,
I don't know, maybe,
Cash transfers
for certain vaccine uptake or something like that.
That's a it's health related.
It's got social value as well as perhaps
individual value for the,
the participants or the people who if we prove that it works.
That just comes to mind.
But there are definitely other examples.
I'm just blanking on what that might be.
Yeah.
I think one important thing is
some people think about social value
as has to have clinical relevance.
And I think that's my own view is that that's too narrow.
Because if you think about, for example,
early phase studies, early phase
experiments,
maybe they'll have clinical value down
the road.
But what they at the time have is scientific
value.
We're learning what this thing does
or how this thing has safe it is.
And then we can go on and test it for clinical value.
Great.
Do you want to introduce yourself?
Yeah, sure.
I'm Charlene I'm a pulls back IrDA.
And I just want to say it was a great introduction.
Doctor. Doctor.
Thank you so much.
And I actually had a similar question
about the justifications for research.
And while I do understand the reasons
why we want social value or value
in some sense for any form of research,
I guess I was wondering
about arguments against it and what type of arguments they
look like.
Is it just the inability to measure value
or is there something else?
And is there any cases I could think of where it's
conception?
The research may not have any value
or projected value,
but then ended up being very valuable
down the line.
Yeah. Great question.
So where this idea came from is a,
scholar who wrote in the,
in the 1980s, who named Benjamin Friedman,
and he wrote a paper one time called Social Value
and basically described in the paper
that he had what he called the nightmare.
I was walking down the hall in his nightmare,
and his friend came up to him and said,
I just successfully transplanted an appendix.
And in in the article, Benjy says he scratched his head
and said,
is that ethical?
And his friend said, well, I got the guy's informed
consent.
But the the question was,
what's the usefulness of understanding
a transplantation of an appendix?
Is there anything that we can learn from
that?
Is there any reason that transplanting
an appendix would be a good thing,
or could be a good thing,
or we would use it clinically or scientifically or socially?
What's the point?
So that's an example.
I think at the same time, you might
imagine that at a different point in time.
And I don't know that I don't I can't
come up with a scientific explanation, but
maybe there is a scientific reason
to transplant an appendix, for example.
And so if there is and we could learn something
really
valuable that might help understand
or promote human health,
then maybe then it would become socially
valuable.
But the question to start with is
what's the reason?
What's the what's the so what of doing this
study?
What are we going to.
Why are we doing it and what are we going to learn
from it?
And so that's really the motivation
behind social value.
There are examples of studies that have been done
that people say why did why did anyone ever do that?
We didn't.
You know, what's what's the usefulness of that
question?
And certainly there have been studies that have come out,
more positively valuable
than were predicted at the time.
Does that answer your question?
Sort of.
Go ahead. Hi.
I'm Jonathan.
So I was wondering if you could talk
a little bit
about the methodologies that were used,
in, like, the Belmont Report?
Or the Helsinki.
What was it?
The Helsinki Declaration of Helsinki.
So, like, I mean, was it was it sort of an interdisciplinary
background,
people bringing different views?
Did they just argue about these things
and try to solve them, or what?
What did they do exactly?
Yeah, that's a great question.
Here's what I know, which is probably not
everything.
So the Belmont Report was written
by the National Commission,
and the National Commission was one of
the first commissions in the United States
that focused on ethics at all, but certainly was focused on
protection of human subjects.
The staff
wrote the Belmont Report with documents,
and you can find them historical versions of them.
Bottom line was a,
ethicist, a physician ethicist at Yale
who did a lot of work in the establishment
of the ethics of clinical research.
He wrote,
a background paper that was given to the staff,
and the staff included people like
Tom Beecham, who is a philosopher
at Georgetown who was is famous for the four
principles,
the Georgetown mantra that in bioethics,
I'm hopefully I'm not saying things
that you guys don't know what I'm talking about.
But anyway, I think it was the combination
of background materials
from people that were asked to supply them,
plus the expertise of the people in the room,
the staff, and then it had to be approved
by the commission.
So there's that, that sort of multidisciplinary effort
there.
And Helsinki is different in in each
of the domestic medical association.
So we have the American Medical Association.
They're associations like that in many countries around the
world.
And so the World Medical Association
is the collaboration of all of those.
And so most of the people who would be around the table
deciding
are physicians who run their medical
association in their country.
But at least in the last several iterations of the Declaration of
Helsinki,
they had these consultancies, like I was mentioning, they're
having now
where they bring in people.
They invite people to come and give them,
you know, talks and information and background materials
about specific issues.
And then they deliberate about those.
And a quick sidebar,
the transcripts of everything the National Commission
did are in a room at Georgetown.
I visited it many years ago.
And you have to be monitored.
And the faculty, a member of the library staff,
had to sit there with me to make sure
that I didn't run off with anything.
So if you're interested, Jonathan,
there is a plethora of paper to review.
There's also a whole set if, for those of
you interested, for each report
that the commission wrote, including the Belmont Report,
there's one
on IRBs, there's one on, psycho surgery.
There are bound copies
of the reports that then,
so the Belmont Report and then these that
sort of led to additional,
there's one on kids additional regulations.
They're on our shelf.
You have a lot of them in the department?
Yeah.
And if they're not there, they're in the library.
So thank you again, Christy.