Supplement
Designated Discussion
by Paul H. Gebhard
(Excerpt. William H. Masters, Virginia E. Johnson, and Robert C. Kolodny. Ethical Issues in Sex Therapy. Little Brown & Co., Boston, Massachusetts, 1977, pp. 11-15)

While it will surprise no one to learn that ethical considerations were prime concerns of Kinsey and of the Institute for Sex Research he subsequently founded, few people know that the genesis of the Kinsey research was an ethical struggle between science and social tradition. Scientists with a strong sense of responsibility, such as Robert Yerkes, Alan Gregg, and George Corner, felt that science could no longer avoid the obligation to study human sexuality and, with this as one of their goals, helped establish in 1922 the National Research Council Committee for Research in Problems of Sex. This goal conflicted with social tradition, which held sex a taboo subject. Corner |1] describes the situation nicely; “Because of this long-standing aversion in our culture to the open consideration of sex matters, sexual conduct was viewed only in reference to established codes, not as a natural phenomenon suitable to be studied with the same detachment as digestion, muscular activity, or nerve function.”

The struggle impeded and in some cases aborted early research efforts, even those supported by the Committee. For example, Roger Lee surveyed Harvard medical students about their sexual lives, but the university felt that the results should not be published. Adolf Meyer did a similar survey of students at Johns Hopkins and, despite the fact that he was one of the proponents of sex research, decided not to make his findings known lest they damage sexual morality. Consequently, when Kinsey appeared on the scene with a substantial number of case histories and an obvious desire to publish, the Committee welcomed him, especially since he shared their belief that research was imperative if one was to ameliorate social and individual sexual problems. In brief, he, like they, felt this to be an ethical obligation.

While this sex research arose from high moral and ethical motivation, subsequent ethical considerations generally presented themselves in the guise of problems.

First, who was qualified to do sex research and promulgate the findings? A dean of the Indiana University Medical School strongly expressed his opinion that such research should be in the hands of physicians. The local Ministerial Association also expressed concern over the “moral and social implications” of sex education provided by scientists rather than clergy. Almost 40 years later we are still wrestling with this problem.

A continuing ethical consideration was the effect on impressionable youth of being interviewed or taught by us, or of reading our publications. A physician sex educator, Thurman Rice, at the beginning warned Kinsey that he would sexually stimulate the young with his unnecessarily explicit questions and statements, that they would consequently fall into evil sexual habits, and that when the state legislature learned of the damage, not only Kinsey but the entire university would be punished. Years later, after the publication of the Institute’s first two volumes, the same basically ethical complaint was loudly voiced by prominent persons. Reinhold Niebuhr [2] spoke of Kinsey’s “moral anarchism, and the vulgar quality of his hedonism.” Millicent McIntosh [3], President of Barnard College, wrote, “I am concerned about the effect of the Kinsey Reports on young men and women of high school and college age . . . no one in his wildest dreams would say that they provided constructive reading for the boy or girl of sixteen.” Billy Graham [4] added, “It is impossible to estimate the damage this book will do to the already deteriorating morals of America.”

In our present times, when nearly every campus has its committee for the protection of human subjects and the matter of informed consent is paramount, it is interesting to look back over the decades and see that this ethical matter of consent resulted in one of Kinsey’s few defeats, ironically administered by his friend and supporter, Herman B. Wells, President of Indiana University. Wells gave Kinsey the choice of continuing a sex-education course Kinsey had formulated and giving up his research interviewing, or pursuing the research and giving up the course. Wells was acutely aware that when a professor asks students in his course if they would like to volunteer as research subjects, there is unavoidably an element of duress. Kinsey abandoned the course—which, deprived of his leadership, soon died.

Aside from such historical instances of how ethics were interwoven with the beginning and development of the Institute, there have always been several ethical considerations that do, or could, plague us. Despite our general policy of complete honesty, one problem involves the deception of subjects. In order to obtain cooperation and maintain rapport, one must empathize rather than conflict with one’s subjects. To pretend overtly to share a subject’s values and interests would be a hypocrisy contrary to our research ethics. On the other hand, a truly objective scientific approach would be so cold as to repel some people, and if carried to extremes would become absurd (for example, “We make no value judgments about rape.”). Our solution to this dilemma consists of avoiding judgmental statements, making seemingly supportive ambiguous remarks, and expressing an interest in and sympathy with the respondent. The subject almost invariably assumes we share his or her attitudes and values, although we never say so. While one can call this efficient interviewing and good public relations, an objective scientist must also label it deception. We feel it is warranted as a necessary adaptation to human diversity.

A second ethical problem involves the absence of informed consent, as well as the element of deception that frequently characterizes participant observation. For example, the habitues of a homosexual bath are not asked whether they consent to be scrutinized by a researcher masquerading as another gay individual. The opponents of sex education listening to a fervid harangue by a member of the John Birch Society would not have consented to our presence, let alone talked with us freely, had we revealed ourselves.

A third and extremely important ethical matter centers on confidentiality. We have always insisted on maintaining confidentiality, even at the cost of thereby becoming amoral at best and criminal at worst. Examples of amorality are our refusal to inform a wife that her husband has just confessed to us he has an active venereal disease, and our refusal to tell parents that their child is involved in seriously deviant behavior. An example of criminality is our refusal to cooperate with authorities in apprehending a pedophile we had interviewed who was being sought for a sex murder. Nevertheless, without an ironclad guarantee of confidentiality we would never have been entrusted with the vital information ordinarily denied researchers who cannot make such a guarantee.

Lastly, there is the inescapable quagmire representing a mixture of ethics and law. The sex researcher is in an awkward and potentially dangerous situation. If he learns of a felony and does not report it, he is an accessory after the fact. If he knows that a felony (for example, adultery or homosexual activity) is to be committed and neither reports nor tries to prevent it, he is an accessory before the fact. If he is physically present when the felony occurs, he could be charged as an accomplice. The sex researcher does not enjoy privileged communication rights, as does the attorney or priest, and his records as well as his memory are subject to subpoena. The question remains: Does one owe one’s primary ethical obligation to one’s subjects or to the statutory law? Considering the nature of the majority of laws dealing with sex, we find this question easy to answer.

In summary, sex therapy and sex research exist in a matrix of ethical considerations, which, like all man-made things, change according to circumstances and with time. The researcher cannot escape the task of deciding which ethic will be honored and which sacrificed in the process. Each researcher must establish his or her own ethical hierarchy and decide as problems present themselves whether the ultimate good resulting from the research or therapy supersedes a particular ethic.

    REFERENCES
    1.    Aberle, S., and Corner, G. Twenty-Five Years of Sex Research. Philadelphia: Saunders, 1953. P. 2.
    2.    Niebuhr, R. Kinsey and the Moral Problem of Man’s Sexual Life. In D. Geddes (Ed.), An Analysis of the Kinsey Reports on Sexual Behavior in the Human Male and Female. New York; Dutton, 1954. P. 67.
    3.    McIntosh, M. I am Concerned . . . In D. Geddes (Ed.), An Analysis of the Kinsey Reports on Sexual Behavior in the Human Male and Female. New York; Dutton, 1954. P. 139.
    4. Graham, B. The Bible and Dr. Kinsey. In E. Daniels (Ed.), I Accuse Kinsey. Orlando, Florida; Christ for the World Publishers, 1954. P. 103.