Ethical considerations are very important in the design, practice, and reporting of scientific research.

However, I think there is something else behind the need for a document like the APA’s extensive manual.  A quote from the Tao Teh Ching will help to illustrate this:

Chapter 18
When the great Dao is lost to sight,
codes of goodness and morality appear.
When cleverness and shrewdness are produced,
massive hypocrisy appears.
When family relationships lose natural harmony,
“filial piety” and “devoted parenthood” arise.
When there is strife and anarchy within the state,
“loyal patriots” abound.
(trans. Chilcott, 2009).

I don’t think that a manual like the APA’s points, necessarily, to rampant unethical behavior.  As one of my graduate professors pointed out, ethical “breaches” are reportedly around 1-2%.  But the manual does point to something, which is the issue related to the field of kinesiology, and ethics in science that I’d like to address here.

It is the habit we have gotten into as scientists of investigating symptoms, instead of causes.

The first example that comes to mind is that of modern gait research.  Modern gait research studies the human foot in a shoe.  However, “The human foot was anatomically modern, and therefore fully functional for bipedal walking and endurance running, more than 100,000 years ago” (D’Aout, et al., 2009, pg. 103).  The use of footwear in general has only been seen in the fossil record as early as 30,000 years ago (Trinkaus, 2005, pg. 1516).  Habitual use of the type of rigid footwear in vogue in our current culture extends back to the 17th century – and at that time was seen mostly in wealthy, or aristocratic populations.  Widespread use of rigid footwear by a majority of Western Europeans probably began only around the time of industrialization – about 150 years ago.

As reported in D’Aout, et al. (2009) – “Habitually shod Indians wear less often, and less constricting shoes than Western people.  Yet, we found significant differences with their habitually barefoot peers, both in foot shape and in pressure distribution” (D’Aout, et al., pg. 104).  This shouldn’t come as a surprise.  Modifications of tissue morphology following the use of a plaster cast are well known to anyone who has ever had to wear one.  Modern footwear, or even sandals (as shown by D’Aout), alters truly normal (as opposed to an “observed” or “cultural normal”) foot kinematics in much the same way as a plaster cast.

In Western European culture (or those of Western European descent), which have generated the majority of gait research in the past 100 years, the large majority of research has been on individuals who habitually wear shoes.

Can we safely say, then, after 100 years of research, that we truly have a good understanding of normal human gait (as in “physiologically normal” – concerning the human animal as a species that has existed without footwear for roughly 100,000 years)?

Further, if, as Booth and Laye point out, it is true “that removal of 8500 steps (dropping from ~10,000 to ~1500) in the absence of a structured exercise program for two weeks results in abnormal physiological changes in healthy young men” (Booth and Laye, 2009, pg. 2), and we have not noted the daily activity levels of participants in gait research studies, can we claim to have studied “physiologically normal” human gait at all (with or without shoes)?!

First, we are studying an abnormal population in terms of morphology and kinematics, due to the use of footwear (both the restrictive effect of footwear on truly normal movement of the foot, and the accompanying loss of tissue tonus and function accompanying that loss of normal movement).  Then, we are studying a potentially (in terms of gross physiology) abnormal population (in terms of evolutionary history of the animal) due to lack of sufficient movement in general, and the accompanying loss of proprioception and tissue strength/tonus.

When we then begin to recommend “orthotic inserts” as solutions to musculoskeletal or movement impairments, based on those studies of “normal” human gait, are we treating the problem(s) itself (or themselves – namely, lack of physiologically-normal movement, both in quality and quantity), or are we treating the symptom of the problem (i.e., dysfunction caused by lack of physiologically-normal, not culturally-normal, movement)?

What are the ethical implications of pursuing science in this manner?  And shouldn’t the discussion and resolution of this ethical issue precede the practice of designing, performing, and reporting scientific research?

Booth, F.W., Laye, M.J.  (2009).  Lack of adequate appreciation of physical exercise’s complexitiescan pre-empt appropriate design and interpretation in scientific discovery.  Journal of Physiology, Ahead of Print.

Chilcott, T.  (2009).  Daode Jing.  http://www.tclt.org.uk/translations.html

D’Aout, K., Pataky, T.C., De Ciercq, D., & Aerts, P.  (2009).  Plantar pressures in habitually barefoot walkers.  Footwear Science, 1(1), pp. 103-105.

Trinkaus, E.  (2005).  Anatomical evidence for the antiquity of human footwear use.  Journal of Archaeological Science, 32, pp. 1515-1526.