The ethical issues in uranium mining research in the Navajo Nation

We explore the experience of Navajo communities living under the shadow of nuclear age fallout who were subjects of five decades of research. In this historical analysis of public health (epidemiological) research conducted in the Navajo lands since the inception of uranium mining from the 1950s untill the end of the 20th century, we analyze the successes and failures in the research initiatives conducted on Navajo lands, the ethical breaches, and the harms and benefits that this research has brought about to the community. We discuss how scientific and moral uncertainty, lack of full stakeholder participation and community wide outreach and education can impact ethical decisions made in research.     

Diagnostic Plots for Assessing the Frailty Distribution in Multivariate Survival Data

In biomedical studies, frailty models arecommonly used in analyzing multivariate survival data, wherethe objective of the study is to estimate both the covariateeffect and the dependence between the multivariate survival times.However, inference based on these models are dependent on thedistributional assumption of frailty. We propose a diagnosticplot for assessing the frailty assumption. The proposed methodis based on the cross-ratio function and the diagnostic plotsuggested by Oakes (1989). We use kernel regression smoothingwith bandwidth choice by cross-validation, to obtain the proposedplot. The resulting plot is capable of differentiating betweenthe gamma and positive stable frailty models when strong associationis present. We illustrate the feasibility of our method usingsimulation studies under known frailty distributions. The approachis applied to data on blindness for each eye of diabetic patientswith adult onset diabetes and a reasonable fit to the gamma frailtymodel is found.     

Reflexive Research Ethics in Fetal Tissue Xenotransplantation Research

For biomedical research in which the only involvement of the human subject is the provision of tissue or organ samples, a blanket consent, i.e., consent to use the tissue for anything researchers wish to do, is considered by many to be adequate for legal and Institutional Review Board (IRB) requirements. Alternatively, a detailed informed consent provides patients or study participants with more thorough information about the research topic. We document here the beliefs and opinions of the research staff on informed consent and the discussion-based reflexive research ethics process that we employed in our fetal tissue xenotransplantion research on the impact of environmental exposures on fetal development. Reflexive research ethics entails the continued adjustment of research practice according to relational and reflexive understandings of what might be beneficent or harmful. Such reflexivity is not solely an individual endeavor, but rather a collective relationship between all actors in the research process.