Science in Christian Perspective



Personal Decisions In Biomedical Research*

From: JASA 14 (September 1962): 74-77.

The choice of a vocation and the preparation for an effective contribution in the field always involve a series of significant decisions. Some special comments appear to be in order, however, when scientific research is considered. Most research is neither as glamorous as some young people might think nor as impossibly difficult as others might assume. Furthermore, a convinced Christian may face a tension between a strong service motive, which leads him away from research, and a desire to extend the bounds of knowledge, which draws him toward it. Some church groups express their ambivalent feelings toward science by an anxious interest intermingled with a suspicious distrust. Such a "climate of opinion" cannot help but influence and bias vocational decisions by capable young people.

The term "biomedical research" is used in the title to indicate that there are no sharp dividing lines between basic medical research and that in other basic fields of biology. Furthermore, all these areas show a close dependence upon chemistry and physics. Clear divisions no longer exist between pure and applied research, or between basic and clinical studies. Thus, a discussion of biomedical research should have some implications for other fields of investigation.

In past centuries medical research was carried out by single investigators as an incidental, yet commendable, activity. Today, research has become a vital necessity requiring many investigators, complex and costly equipment, and large sums of money. The magnitude of the total effort can be seen in the increased national expenditure on medical research, from about $240 million in 1955 to an estimated $715 million in 1960. The popular support for medical research is equally impressive, for the contributions to voluntary health organizations show a public concern greater than for any other broad area of science.

The term "research" does not imply that there is some formula, technique, or "scientific method," which is guaranteed to produce results. One of the most fundamental requirements is the ability to state questions in an answerable form. This requires, of course, thorough acquaintance with a field together with a tendency to be dissatisfied with easy answers. The investigator must also have the mental and physical tools needed to collect the information which will answer his questions.

The choice of a research career is influenced not only by personal abilities and experiences, but also by the public "image" of what a scientist does. Perhaps the best incentive is the example of teachers actively pursuing research. From them students will learn that the boundaries of science move rapidly and will develop a capacity to master new insights and techniques as they arise. Church-related colleges and universities have a particular obligation to encourage and support research by faculty members as an essential part of the educational process.

Wide reading and careful study are essential. Mathematics is so important as the "language of science" that a good background during high school will soon be almost mandatory. Students should be encouraged to read Scientific American regularly by the time they are college freshmen; they should add Science and more specific journals by the junior year. Some of the recent excellent biographies and autobiographies about scientists also might be included.

Christian young people will want to explore those books which consider the philosophical assumptions of science and the meaning of the doctrine of creation in order to develop personal answers to questions such as these: What is the relationship between God's revelation through the Scriptures and man's world view which is continually changing as the result of research? Is the accumulation of knowledge about the universe one possible way of showing that we love the Lord out God with all our minds? Or is it an optional enterprise which keeps us from other activities which would be more pleasing to Him? The implications of the Christian faith for social concern and service have been considered by many writers, but there is a further need for what might be called "a theology of research."

Finally, it is important to realize that generous fel-

*Based in part upon a paper prepared for a conference on "Church-State Aspects of the Churches' Involvement in Human Need" sponsored by the Baptist joint Committee on Public Affairs, Washington, D. C.

**Dr. Anderson is Assistant Director, Dight Institute for Human Genetics, University of Minnesota.

lowships and grants now help to reduce the financial restrictions imposed by a long period of training. Concern on the part of the federal government, for example, is shown by the provision of $75 million in 1960 for training grants in the medical fields.

The time for decisions is not past when a young person has been led to choose research as a vocation. Throughout graduate work he must in a step-wise fashion delimit his interests in order to produce a thesis. After completion of formal training, the major initiative in the choice of a research problem still lies with the individual investigator. Some of the factors involved have been described as follows:

The individual scientist's selection of a project is largely determined by the interplay of his natural curiosity and predilections, his special talents or technical skills, the focus of his previous training and experience, his personal assessment of the needs and opportunities in his field, and the facilities and research materials that are available to him in the environment in which he happens to be working . . . . Within this framework of factors affecting a scientist's choice, his selection of a particular research project and his plan of attack derive, first, from information gleaned through his personal contacts with colleagues in the same or related field through his attendance at professional meetings, and from literature, and second, from the availability of support under terms which provide the best conditions for work(2).

The two major factors are thus information and support. A serious limitation of the information available through literature is the time lag between experiment and publication. The Bio-Sciences Information Exchange helps to bridge this gap through its registry of projects currently in progress. At present BSIE has information on over 30,000 active projects and over 90,000 investigators. Through this means a scientist can find out which other investigators are interested in a given problem.

When research support is considered, it is clear that the emphases in current research depend in part upon the value judgments held by the scientists and administrators who approve grant applications. How does one decide which are the most important problems deserving the highest priority in support? Many decisions about the general allotment of funds are based upon the mortality or morbidity attributed to a given disease, or the number of working days lost, or the total cost to the patient, his relatives, and the community. Some arguments, such as the following, appear to be too strongly economic in motivation. "Medical research has saved the lives of more than 1,800,000 individuals in the past 15 years. The annual earnings of these now amount to over $3.6 billion and their tax contribution to the Federal Government to $263 million). To what extent would a Christian world-view suggest a system of priorities in biomedical research different from the present strategy?

It must not be assumed, however, that good ideas are often rejected because they fail to fit into some master plan. The multiple sources of support, both public and private, make it very likely that well-designed proposals will receive support from one or another agency. Furthermore, the agencies take Positive steps "to stimulate work in neglected fields, to initiate new lines of investigation, and to shift the distribution of effort in accordance with emerging needs and opportunities" (2).

The choice of research problem may also involve one in a choice of institution. Traditionally, most investigators have carried out their work in universities. With the rapid expansion of knowledge in the medical fields, however, some thirty countries have created central research organizations. The major health center in the United States is now provided by the National Institutes of Health, which supports work at other centers (an extramural program) and also carries on active research in its own facilities (an intramural program). The nature of such a central organization has been described in a report by an international conference on research.

The special functions of a central research organization are to keep research as a whole under consideration, to estimate its trends and developments, to direct support where it is specially needed, to undertake work which cannot properly be undertaken by universities or local organizations, to advise government and to act as a focus for national and international co-operation. In addition, it shares with the universities the responsibility for developing research of its own, with the broad distinction that, while the research policy of a university must be framed with due regard to its responsibilities for teaching and the proper distribution of its resources over the whole field of knowledge, a central research organization can concentrate its efforts according to its estimate of the research needs and determine the scale of each according to its timeliness and promise(3).

The importance of the investigator's environment is stressed by the same conference report. "No man can work without tools, without adequate access to the material he wishes to investigate, or when his mind is distracted by irrelevant duties or personal financial worries. Few men can give of their best if they are set to work in an environment which is either indifferent or discouraging to their efforts" (3).

Over a lifetime of research the choice of problems cannot help but reflect an individual's personality and his convictions as to what is important. In any single research problem divine guidance may not be apparent, but many Christians in science are humbly aware of the role of personal faith and prayer at critical points in their careers.

The major sources of support for medical and healthrelated research and the estimated expenditures for 1960

were as follows:

                                                    Dollars                    Per cent

                                                    (In millions)
Federal government .............................. $380.................53%
State government .................................... 20.....................3
Industry ................................................. 215...................30
Philanthropy ............................................ 81....................11
Endowment ............................................. 19.....................3

The changes in federal and non-federal support from 1940 to 1960 are indicated by the following tabulation('):

                                                                    Non                       Federal as a percent
                                                     Federal   federal         Total          of total
                                                    (In millions of dollars)
1940                                                 $ 3       $ 42            $ 45               7%
1947                                                  2 8          60               88             32
1954                                                107        118             225             48
1960 (est.)                                        380        335            715              53

Some general implications evident from such data are these:

1. The proportion of support for biomedical research which comes from federal sources has increased markedly since 1940, but the change in the last few years has been slight. Federal support is now about half of the total.

2. The amount spent from non-federal funds increased eight-fold from ig4o to ig6o. The use of federal funds apparently has not discouraged contributions from other sources.

3. The increase in expenditures from $45 million in 1940 to $715 million in 1960 parallels the national expenditure for all forms of research and development, (Medical research was 5 per cent of all research for both 1950 and 1960.)

Some of the complexities involved in research support can be illustrated by a discussion of the problems encountered by foundations:

Foundations-in common with other donors of research funds-have always been beset by the necessity for difficult decisions, among them: the choice between supporting the man or the project; the question whether to favor long- or short-term grants; when to renew and when to discontinue them (involving decision as to whether or not a given piece of work is in a productive stage or ever will be, and to what degree funds are available from other sources for the man, the institution, the problem, the field); the question whether the advantage lies with fixed grants to the worker or fluid funds to the institution: whether there is greater need to explore new ideas and extend basic research or to make existing knowledge more generally available. The foundations now reflect the growing trend among all supporters of research to consider the man more and the project less(4).

The great variety in types of granting agencies provides a flexibility for adapting to changes in patterns of research. After the development of the Salk vaccine, for example, the former National Foundation for Infantile Paralysis became The National Foundation with wider interests. The recent increase in federal funds for physical and biological research has led some foundations to shift support to the social sciences. The American Heart Association lays emphasis on the support of career investigators, while the American Cancer Society stresses basic research. Pharmaceutical laboratories must continually aim at new products or the improvement and wider use of old ones; and the amount of basic research supported by them is correspondingly less.

Federal support is based upon the assumption that "the health of the people is the greatest resource of the Nation, absolutely vital to its welfare, economy, and security-0). A more explicit statement of working principles is provided by two recommendations in a recent Senate committee report:

Role of Federal Government in Support of Medical Research. The Federal Government should supplement private, industrial and State funds, as may be necessary, to support medical research on the scale required to carry out a determined attack on major health problems. The magnitude of Federal support should be neither limited by, nor paced by, the rate of increase of non-Federal sources of support.

Diversity of Federal Support for Medical Research. Other Federal agencies besides the National Institutes of Health should continue to maintain strong programs in support of medical research. These programs should not only serve the specific health missions of these agencies and make their operations more effective, but should also utilize their special opportunities to make contributions of particular value to the total medical research effort of the country. The agencies should be given the funds to support both basic and applied research and to sustain both inservice programs and strong extramural programs in support of medical research in non-Federal, nonprofit research institutions1.

There is apparently no serious question as to the need and wisdom of governmental action in agricultural research, but public disagreement and concern has been expressed concerning the government's role in medical research. Some of the problems raised in the discussions preceding the establishment of the National Science Foundation in 1950 were these: "What are the implications of financing a large volume of the total national program of fundamental research by the War and Navy Departments? What is the impact of extensive federal research contracts on the speed with which new scientists are being produced? What is the division of federal research effort between preparation for war and improvement of the arts of Peace?"(4).

Such conflicts may reflect in part lack of clarity about the ideological framework of research. "A democratic government has to consider how far its functioning in the organization of research not only for the national defense but also for the social needs of the people is compatible with the principles of democracy as we understand them" (4) . Further illustration is seen in our popular acclaim of Soviet science and our insistence that we match their efforts, with little acknowledgment of the different concept of the role of government in research in totalitarian countries.

Church-related institutions which are concerned about the separation of church and state face special problems in soliciting funds for research. It would be difficult to maintain a well-balanced program of biomedical research without some use of federal funds. Private funds should be available, however, for the great majority of spccific projects.

The American Scientific Affiliation has been very much concerned about the need to help young people understand the tensions between science and the Christian faith. There is more than we can do, however, to actively encourage youth with Christian convictions to consider research as one of the fields into which God might lead them. Here are some suggestions for consideration:

a) Prepare a brief annotated guide to some selected publications about the nature of research.
b) Encourage the wider use of ASA members en gaged in research as "visiting scientists."
c) Plan chapter meetings around the theme of re search as a career.

Any church-related institution which is committed to some research activity should provide a good environment for the investigators, including appropriate equipment, adequate funds, and freedom of investigation. Scientists who are also active churchmen should be encouraged in their work by the use of their abilities and insights in conferences and meetings, and in some instances by direct financial support. The ASA itself 
might be able to stimulate research on significant prob lems which will involve scientists from several differ ent institutions.

1. Committee of Consultants on Medical Research. Federal Support of Medical Research. Washington: U. S. Government Printing Office, May 1960.

2. Committee on Government Operations. Coordination of Activities of Federal Agencies in Biomedical Research. Washington: U. S. Government Printing Office, 1960.

3. Himsworth, Harold and Delafresnaye, J. F., Editors. The Support of Medical Research. Oxford: Blackwell Scientific Publications, 1956.

4. The American Foundation. Medical Research: A Midcentury Survey. Vol. I. American Medical Research: In Principle and Practice. Boston: Little, Brown and Company, 1955.