Research ethics during the first half of the last century, particularly in pregnant women and in the postpartum period, was abusive and immoral. A paper published in 1948 studying the milk ejection reflex is a good example of this (1).
In this study, a series of immoral procedures were performed on a 25-year-old woman while she was breastfeeding her daughter to assess whether pain, stress, or distraction could influence the milk ejection reflex. Three procedures, which they called distraction, were applied while breastfeeding.
They consisted of immersing the feet in ice water or applying moderate-intensity electric shocks when the woman responded incorrectly to a math problem or took more than 10 seconds to respond, and provoking pain by attaching a piece of surgical bandage to each of the woman’s big toes and pulling it intermittently, causing sharp pain from the stretching and tension of the gauze around the toe.
Without a doubt, this is not an ethical study and could not be performed today, since there are ethics committees that ensure the safety and proper treatment of participants in studies, and therefore evaluate and approve research projects before they begin. Each ethics committee has its own principles and ethical codes according to its field, but they all follow the basic ethical principles of the Helsinki declaration.
The Declaration of Helsinki was adopted in 1964 and promoted by the World Medical Association. It is addressed to the medical community and to individuals engaged in human experimentation. This declaration promotes the principles and ethical codes that prevent studies such as the one presented above from being carried out today (2).
Despite the fact that today, in order to conduct research, everyone must ensure that the subjects are well informed and that the tests to be performed are necessary, fair and safe, there are still multiple current studies that are based on these immoral former studies. For example, the study described has been cited by 18 studies according to PubMed and most of these citations are from between 2007 and 2022. Of these citations, there are even articles whose approach and justification of the paper are based on the above unethical study.
Therefore, this fact is irresponsible since researchers should not only promote research ethics by designing ethical studies but should also have the responsibility to carefully select the literature used to build and base their research on.
Therefore, it is important that when new research is proposed, not only should it be ensured that it is conducted ethically, but that the justification for the study is not based on immoral studies or using such papers to argue in favour of new findings or possible hypotheses.
- Newton M, Newton NR. The Let-Down reflex in Human Lactation. Journals Pediatr [Internet]. 1948;33(6).
- World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.