Yesterday, on the Hastings Center Bioethics Forum, Carl Elliott pondered the question of why a petition asking the governor of Minnesota to investigate ethically problematic research at the University of Minnesota has gathered hundreds of signatures from scholars in bioethics, clinical research, medical humanities, and related disciplines -- but only a handful of signatures from scholars and researchers at the University of Minnesota.

At the center of the research scandal is the death of Dan Markingson, who was a human subject in a clinical trial of psychiatric drugs. Detailed background on the case can be found here, and Judy Stone has blogged extensively about the ethical dimensions of the case.

Elliott writes:

Very few signers come from the University of Minnesota. In fact, only two people from the Center for Bioethics have signed: Leigh Turner and me. This is not because any faculty member outside the Department of Psychiatry actually defends the ethics of the study, at least as far as I can tell. What seems to bother people here is speaking out about it. Very few faculty members are willing to register their objections publicly.

Why not? Well, there are the obvious possibilities – fear, apathy, self-interest, and so on. At least one person has told me she is unwilling to sign because she doesn’t think the petition will succeed. But there may be a more interesting explanation that I’d like to explore. ...

Why would faculty members remain silent about such an alarming sequence of events? One possible reason is simply because they do not feel as if the wrongdoing has anything to do with them. The University of Minnesota is a vast institution; the scandal took place in a single department; if anyone is to be blamed, it is the psychiatrists and the university administrators, not them. Simply being a faculty member at the university does not implicate them in the wrongdoing or give them any special obligation to fix it. In a phrase: no guilt, hence no responsibility.

My view is somewhat different. These events have made me deeply ashamed to be a part of the University of Minnesota, in the same way that I feel ashamed to be a Southerner when I see video clips of Strom Thurmond’s race-baiting speeches or photos of Alabama police dogs snapping at black civil rights marchers. I think that what our psychiatrists did to Dan Markingson was wrong in the deepest sense. It was exploitative, cruel, and corrupt. Almost as disgraceful are the actions university officials have taken to cover it up and protect the reputation of the university. The shame I feel comes from the fact that I have worked at the University of Minnesota for 15 years. I have even been a member of the IRB. For better or worse, my identity is bound up with the institution.

These two different reactions – shame versus guilt – differ in important ways. Shame is linked with honor; it is about losing the respect of others, and by virtue of that, losing your self-respect. And honor often involves collective identity. While we don’t usually feel guilty about the actions of other people, we often do feel ashamed if those actions reflect on our own identities. So, for example, you can feel ashamed at the actions of your parents, your fellow Lutherans, or your physician colleagues – even if you feel as if it would be unfair for anyone to blame you personally for their actions.

Shame, unlike guilt, involves the imagined gaze of other people. As Ruth Benedict writes: "Shame is a reaction to other people’s criticism. A man is shamed either by being openly ridiculed or by fantasying to himself that he has been made ridiculous. In either case it is a potent sanction. But it requires an audience or at least a man’s fantasy of an audience. Guilt does not.”

As Elliott notes, one way to avoid an audience -- and thus to avoid shame -- is to actively participate in, or tacitly endorse, a cover-up of the wrongdoing. I'm inclined to think, however, that taking steps to avoid shame by hiding the facts, or by allowing retaliation against people asking inconvenient questions, is itself a kind of wrongdoing -- the kind of thing that incurs guilt, for which no audience is required.

As well, I think the scholars and researchers at the University of Minnesota who prefer not to take a stand on how their university responds to ethically problematic research, even if it is research in someone else's lab, or someone else's department, underestimate the size of the audience for their actions and for their inaction.

A hugely significant segment of this audience is their trainees. Their students and postdocs (and others involved in training relationships with them) are watching them, trying to draw lessons about how to be a grown-up scientist or scholar, a responsible member of a discipline, a responsible member of a university community, a responsible citizen of the world. The people they are training are looking to them to set a good example on how to respond to problems -- by addressing them, learning from them, making things right, and doing better going forward, or by lying, covering up, and punishing people harmed by trying to recover costs from them (thus sending a message to others daring to point out how they have been harmed).

There are many fewer explicit conversations about such issues than one might hope in a scientist's training. In the absence of explicit conversations, most of what trainees have to go on is how the people training them actually behave. And sometimes, a mentor's silence speaks as loud as words.