Education

Colleges should consider reopening with the ethical approach of an institutional review board (opinion)

Colleges and universities are required to have ethicists. Why aren’t they required to talk to them?

That question resonates in this pandemic time, because so many COVID issues — such as whether and how to reopen in person — raise serious ethical questions.

Colleges employ ethicists to teach ethics to their students, but outside the classroom, applied ethics is typically limited to institutional review boards, or IRBs.

The job of IRBs is to approve research involving human subjects. The ethicists, scientists and community members who staff the IRBs do risk-benefit analyses before they allow a proposed experiment to go forward. Unlike hospitals — nearly all of which have ethics committees — colleges typically lack any mechanism other than IRBs to make ethical decisions about anything else they do.

Most colleges and universities have reopened or are currently planning to reopen this fall with some level of in-person instruction (and some have been forced already to reverse that decision). They’ve been consulting faculty, safety officials and community leaders. Some are providing personal protective equipment, or PPE, to their faculty.

That’s all to the good. When we hear discussion of colleges reopening because they can’t afford not to, it’s easy to understand why. But especially given the severe financial pressures colleges face, how do they know that they are behaving ethically?

This is not just a question for colleges, of course. The Berman Institute for Biothethics at Johns Hopkins University has issued white papers on ethical ways to reopen the whole economy, including how to reopen K-12 schools.

But colleges have a clearer moral choice. Short-term online education certainly helps students. The question is whether the additional benefit of in-person instruction — including more meaningful student-faculty interaction and the better creation of learning communities — outweighs the risks to all the stakeholders.

Reopening in person brings an influx of people from outside the immediate community. What health risk does their arrival pose to other students, their families, faculty and staff members, and the people who live near the college?

One former colleague put it this way: If reopening were an experiment, would it be approved by an IRB?

An IRB would demand a risk-benefit analysis of in-person instruction. The analysis would have to show that the potential benefits to students outweigh the potential risks to all stakeholders. Further, in the analysis that determines the benefits to students, “extraneous considerations” like the financial health of an institution must be ignored. Then — and only after determining that the risk-benefit analysis supports in-person instruction — ethical principles would demand that the institution do everything it can to minimize the potential risks to students, faculty members, administrators and people in the community.

As far as we can tell, however, many colleges are working hard to minimize the risks of in-person instruction without first doing the requisite risk-benefit analysis to see if such a reopening is ethical in the first place.

An IRB would also make sure that research subjects freely give informed consent, with an option to opt out of the research at any time. That consent can take different forms. The American Medical Association, for example, demands that informed consent take place in a conversation between a patient and a physician, so that the patient’s concerns are addressed by a competent professional looking out only for their interests.

For the same reason, colleges and universities should at least provide trained independent counselors to discuss with students and their families the risks they take if the students come to campus this fall.

That goes double for student athletes who will be asked to compete. A few years ago, we sat on a college committee investigating the morality of contact sports in light of what we are learning about the risk of traumatic brain injury. We were struck then by the lack of health information student athletes received before they accepted scholarships. Are they now being provided with what they need to know about COVID-19?

In the end, who should receive the right to opt out this fall? Many colleges are giving students the choice to stay home and take classes remotely. But what options are they giving to faculty and staff members?

The same ethical principles would require colleges to offer their faculty and staff members the same access to independent advice about the risks of coming to the campus. To protect themselves and their families, those stakeholders deserve the same option to stay home that the students receive.

Ethical analysis is more than just an academic exercise. When a college maintains ethical principles, it will make better decisions. Equally important, following ethical guidelines shows students and their families, faculty members, and administrators that the institution is making those decisions with their interests in mind — and not for financial expediency. Ethical decision making also improves the relationship between town and gown, because community members can trust an institution that carefully balances everyone’s benefits and risks.

Trust is sorely lacking these days. In fact, when it comes to reopening, trust may be the PPE in shortest supply.

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