How much rigor is worth a child’s life? Reconsidering the Ethics of the Bucharest Early Intervention Project

October 31, 2013
A conference presentation by Dr. Nathan Fox focusing on developmental outcomes in Romanian orphans raised in deprived circumstances has prompted a response by eminent neuroethicist Dr. Joseph Fins, a member of NeuroDevNet’s Scientific Advisory Board.

Dr. Fins rose to highlight the potential for child exploitation risked in the name of scientific rigor in the orphan study following Dr. Fox's talk, a keynote address at the Fourth Annual Brain Development Conference Sept. 29-Oct. 1, 2013.
 
The outcome of subsequent dialogue between the two researchers, and Fins’ reflections on his concerns now appear in an online article, “Romanian Orphans: A Reconsideration of the Ethics of the Bucharest Early Intervention Project,” posted on the Bioethics Forum website.

In Dr. Fox et al’s study, “Cognitive recovery in socially deprived young children: the Bucharest Early Intervention Project,” 136 young children living in institutions were randomly assigned to continued institutional care that had been mandated by the Romanian Government, or placed in foster care. At the end of 54 months of observation, Dr. Fox and his team found that cognitive improvement occurred among the children in foster care, particularly among children under the age of two.
 
“I wondered,” Dr. Fins writes, “were there not alternative methods of study available to achieve the same scholarly ends? Might it not be possible to have put a time limit on the duration of each child’s exposure to the orphanage and to follow everyone subsequently in foster care? Each child had been there for varying amounts of time, and one could have stopped the clock right there, taken all those children, followed them progressively, and done a regression analysis to see what variables contributed to the ultimate outcomes.”

A control group was unnecessary, Dr. Fins contends.”I questioned Fox about this, and he said that rigor was necessary. He noted that he would not have been able to have as much influence on the policies of the Romanian government if he and his colleagues had not produced studies with the requisite statistical standing. Romania now has no children under two years old in orphanages because of these findings.”

To read Dr. Fins commentary in its entirety, click here.