This post is also available in Dutch.
Scientific research can provide us with many things. Smartly designed experiments allow us to determine correlations (‘people carry more umbrellas when it’s raining), and to separate cause and effect (‘because it’s raining, more people carry umbrellas’). In a previous blog, I wrote that researchers do this using randomisation: Participants are randomly placed in conditions to reduce or exclude any structural differences between groups. We should not, however, simply apply this principle everywhere; there are situations where randomisation is possible, but perhaps unwanted…
Randomisation can impact lives
A particular example of such a situation is a study on children and orphans in Bucharest, Romania. The researchers were interested in the effects of different healthcare environments on the stress responses of children. To investigate this relation, they looked at three different groups: orphans in miserable orphanages (the standard situation for orphans in Bucharest), orphans in foster care, and children that were raised in a regular environment. The crucial aspect was that the two groups of orphans were randomised: it was decided at a very young age (6 – 30 months old) whether an orphan would stay in an orphanage or was allowed into foster care. They would have to spend their entire childhood in that environment.
An important consideration in approving this kind of research is the scientific merit of such a study; what can it teach us? In this case, the study provided important insights in the application of foster care: Children that went into foster care after 18-24 months, did not show any improvement in stress responses compared to children that were admitted earlier. Apparently, there is a ‘sensitive’ period in which it is crucial that children receive proper care to prevent any damage to their stress system. This knowledge can be applied immediately to improve the lives of many orphans.
However, the children unlucky enough to not be assigned to a foster care group saw no benefit of this research; they had spent their entire youth in an orphanage. So, should this research have been performed in the first place?
Is there another way?
Maybe there is another way to obtain the same knowledge. The most obvious alternative is a study where orphans that are already taken in by foster parents or institutions are compared to orphans in orphanages. This way, we researchers are not directly responsible and do not harm children for the rest of their lives.
Research like this, however, has big consequences for the conclusions we can draw, since we no longer have any control over the different groups. There is a chance that adopted children are already more intelligent, social, or healthier than the children that are not adopted. This means that measurements are difficult to interpret, because everything we find can be caused by all those different aspects. If we had performed such a study, we would not have had any new knowledge on the importance of early foster care, and we could not have helped children in the future. You might prevent short-term harm to children, but it would be at the cost of better care in the long run.
What would you do?
This is an extremely complicated matter. Would you approve this research if you were part of an ethical committee? Why would you, or why wouldn’t you? I have changed my mind multiple times already, and I do not believe there is an objectively right or wrong answer.
Original language: Dutch