Kennedy Institute of Ethics Journal

This issue of the Kennedy Institute of Ethics Journal contains a couple of papers that may be difficult to read for some: one concerning the sexual violation of young Black boys (Curry and Utley) and one on the Guatemalans who were intentionally infected with sexually transmitted diseases and sexually abused in the hands of the United States government and other US-based institutions (Spielman). I’m honored and proud to be publishing these papers in the journal; both dive headfirst into formidably painful topics of enormous social and ethical importance. However, readers should understand before reading these papers that they contain descriptions of sexual violation within relationships of gross power inequality, and under conditions of enormous vulnerability.

Our first article this issue is Daniel Steel’s “If the Facts Were Not Untruths, Their Implications Were: Sponsorship Bias and Misleading Communication.” This work is an important and innovative contribution to the growing literature on the ineliminable roles that values and interests play in the production of scientific knowledge. This literature draws upon the tools of ethics, social epistemology, and philosophy of science in order to excavate the places in which scientific knowledge is shaped by the investments of scientists, funding agencies, governments, individual researchers, and society-wide ideologies. Most of the focus in this literature has been on the role of values in ‘inductive risk’—that is, in determining our evidentiary standards when we balance the risk of false positives against the risk of false negatives in drawing inferences from statistical data. Recently, some authors have focused on the role of values and interests in shaping other parts of the scientific knowledge production process, including what questions we ask, how we operationalize our terms, how we describe our results, and so forth. Steel argues that research can mislead its users even when it presents only true claims. Even when scientists are confident in the truth of their conclusions and hence worries about inductive risk are not directly at issue, values and interests can shape how research is designed and described, in ways that will have a profound effect on the implications [End Page ix] that readers take from what they read. Steel explores how such interested management of implications shaped industry-funded research on statins, in particular. The management of implications is made possible, in part, by what he calls “inferential asymmetry”: researchers and sponsors can count on readers having different access to information and different background assumptions than they do, and these will help constitute what they infer from the presentation of results. This means we need to vet scientific articles not just for truthfulness, but also for how they may be strategically misleading by implicature. This is a sophisticated and deeply important contribution to our critical thinking about the ethical import and risks of biomedical science as a social institution.

In “Effective Reparation for the Guatemala S.T.D. Experiments: A Victim-Centered Approach,” Bethany Spielman takes a hard look at what might count as appropriate reparation for the horrific mistreatment of over 1300 Guatemalans at the hands of U.S.-funded ‘researchers’ studying sexually transmitted diseases. In the late 1940s, Guatemalan prisoners, patients, sex workers, and others were nonconsensually subjected to intentional STD infection and sexual abuse. President Obama apologized for the experiments in 2010, but this leaves open the question of what might count as appropriate reparations. Spielman asks, who do we owe reparations to? What might count as actual restitution and that victims would recognize as valuable? And perhaps most importantly for her purposes, how should we decide such questions. She argues powerfully for a bottom-up, participatory approach, in which victims’ voices are centered. It is victims who are best able to determine what they need by way of restitution. Top-down decisions are likely to result in attempts at reparation that are viewed as irrelevant and out of touch at best, and as symbols of elitist impositions and reminders of harm at worst.

In “Reconceptualizing Autonomy for Bioethics,” Lisa Dive and Ainsley Newson argue for a conception of autonomy suited to complex bioethical situations—one that draws on the philosophical literature on the metaphysics of autonomy but is still suited...