Is there always an ethical choice?

Many professional organizations have codes of ethics. [1]^,[2],[3] Professional medical writing societies, including many editor organizations (ICMJE and AMA, among others) have codes by which its writers and editors are expected to abide. Among the codes governed are conduct, publication, duplication, original authorship, and authorship qualifications. Most would agree that these codes are important in keeping scientific research open, honest, and rigorous.

However, non-professional considerations may come into play. Scientific and medical writers may have spouses, children and other dependents. And although whistleblowers are glorified in movies and fiction (“Erin Brockovich”, “Silkwood”), the reality is frequently less glamorous and more frightening. Although companies may pay lip service to their admiration of and support for employee whistleblowing, the messenger is frequently killed (more accurately, the offending employee marginalized, demoted, let go or fired).

In a case of scientific misconduct where a medical writer may be required to either hide something damning to a company or disclose it and be fired, is it possible that there is no correct answer, that there is no ethical answer? Making a stand to disclose a pharmaceutical company’s malfeasance or ‘spin’ may appear to be the ethical choice, especially as outlined in all the professional societies’ codes of ethics. But what if it results not only in losing one’s job, but losing the possibility of future jobs in that field, perhaps the only one for which a writing professional is truly qualified? What is the ethical obligation one has to feed, clothe and keep safe one’s family? Is it a lesser obligation? Ethics can be applicable to a person, to a small group, to a community, a state, a nation or an entire species. But how does one stratify the importance of each of these?

Is it possible that sometimes there is no ethical choice, but only an array of unethical ones?

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[1] Zigmond MJ. Implementing ethics in the professions: Preparing guidelines on scientific communication for the Society for Neuroscience. Science and Engineering Ethics. Springer Netherlands, June 2003. Found at http://www.springerlink.com/content/2266871061636r40/. Accessed 23 Sep 2007.

[2] Code of Ethics for the Endocrine Society, 2001. Found at http://www.endo-society.org/ ethics/upload/ ee20018398.pdf. Accessed 23 Sep 2007.

[3] Regulatory Affairs Professionals Society Code of Ethics. Found at http://www.raps.org/s_raps/docs/ 4900/4869.pdf. Accessed 23 Sep 2007.