This post has emerged out of a 24-hour Twitter debate with Stuart Buck regarding the (de)merits of a randomized control trial (RCT) to test whether paying former criminals causes them to murder or be murdered less.
Background: Richmond (known for its high murder rate) has initiated a policy to pay former criminals not to murder, and their homicide rate has declined with the majority of former inmates in the program remaining alive without also killing anyone else. People are skeptical that paying criminals is worth the cost and are calling for a RCT, given the awareness that before and after analyses (i.e., murder rate in Richmond before and after initiation of payment policy) are imperfect, and RCT provides the gold standard for causal inference. The move to a RCT is motivated by economics and the belief that payment actually has no difference on murder outcomes.
But dismissing the knowledge that payment appears to have kept people alive is problematic. It fails to take into account that, to date, the Richmond experience does suggest that initiating payment is protective, at least temporarily. Given this, how could randomization into the non-payment group be justified? When it comes to a trial where the outcome is murder, how is not providing what might prevent murder even considerable? Further, supposing a RCT went forward, the informed consent process would necessitate full disclosure of the risks, which would likely alter or bias participant behavior, calling into question the validity and usefulness of the trial itself.
Though a RCT could complement and inform government policy, does that justify it? As soon as we leave practice and enter the research enterprise, we are held to a different (and high) standard, one that places the interests of the particular humans enrolled first. The interests of the State are no longer on the table. When we take our sights off individuals, we risk violations to trust, and we fail as scientists, even if the research is statistically meaningful and economically useful.
Invoking the Declaration of Helsinki, "while the primary purpose of medical research is to generate new knowledge, this goal can never take precedence over the rights and interests of individual research subjects."
Nothing, not even the benefits to the State gained from causal inference, can impinge on the rights and interests of individual humans in the context of research. As soon as we conceive of former criminals as research participants, we are bound by the principles of beneficence and respect and have a duty to not randomize due to the knowledge that payment seems to be protective. And this holds until the state of knowledge from other natural (policy) experiments, such as that done in Richmond, changes. Thus, given what we know now, the proposal for the RCT of payment on murder is denied.
I'm a Public Health Genetics PhD student at the University of Washington and a molecular epidemiology research fellow at the Fred Hutchinson Cancer Research Center. I post (mostly) about topics in epidemiology and genetics.