A recent controversy on the RCT in Nairobi with a water company threatening nonpaying users to cut their water as one experimental treatment has raised once again ethical concerns on this strategy to produce knowledge (Covide, Yoshida @paul_gertler and @SFGaliani). Here we go 1/n

I first heard about this from @joshbudlender here in this very good thread:
https://twitter.com/joshbudlender/status/1292170843389386761?s=20
Also, this thread by Banuri is pretty good too
https://twitter.com/Sheheryarbanuri/status/1292481028611686401?s=20 @joshbudlender @simondhalliday @Sheheryarbanuri @ValentinaRozoA1 2/n

0. This is not the 1st or last RCT raising eyebrows. We can learn from a frank discussion, so here are some points I find crucial: Nature of the good, harm done, intentions, utilitarianism, north-south research, informed consent, participation of "subjects", gains for science 2/n

1. Water is a vital good or service, with no substitutes within the budget of poor households. The nature of the good matters in experiments, and how vital they are, even as a human right. Creating an experimental setting where such vital good is removed intentionally is key. 3/n

It makes a difference if the good involved in the RCT is receiving/removing fertilizer, a vaccine, a placebo, water or receiving an SMS with financial advise. How vital the good involved in the RCT is increases the ethical considerations. Water is high in my scale. 4/n

2. The "No Harm Principle" (primum non nocere) should also be part of what we, economists, should learn from the medical sciences, just as we learned from their RCT practices. However, how we measure harm and welfare in economics is problematic. 5/n

Utilitarianism and its offspring, cost-benefit analysis, often useful, needs to be used w/ care the more vital the good is (see point 1 above). This is tied to the problem of consequentalism, another ethical tool, used by the authors to argue than no harm was done in this exp 6/n

3. This takes me to next point: Intentions should matter in economics but utilitarianism and consequentalism refrain many to do so. "If it passes the C/B test, it's ok". Intentions should be part of the evaluative criteria in economics as it does in procedural justice. 7/n

In Nairobi, even if no harm done at the end, from a consequentialist lens, there was an intention to do harm by taking away water to poor households. Don´t get me wrong, we do experiments all the time causing harm by taking away information, some cash, but no breathing air. 8/n

4. Who writes the paper, who participates in the experiment. This is yet another major issue. Many people wonder why so many RCTs are approved and conducted with the most vulnerable with so many ethical concerns. Indeed, we need to study the problems of those in need. 9/n

Also, it is a fact that researchers in more wealthy countries and institutions get the funding to do these studies and have access to top RAs and resources. They are well motivated as I think is the case in this particular project. But.... 10/n

But, their access to these teams, resources and methods often make them distant to the places and communities where they helicopter land to design, subcontract to execute, and collect data to then write the paper. This creates some problems: 11/n

One of them is that a dialogue with those involved rarely happens, in this households prone to get their water access cut by force. Not surprisingly experimentalists and RCTers call these people "subjects". I prefer the term "participants" 12/n

Participants in RCTs could have a voice in what happens in the design, implementation and interpretation of the results. This rarely happens and it reinforces the North-South divide between who publishes the paper and who is residual claimant of the RCT 13/n

I can anticipate some arguing that this could "contaminate" the experiment by hinting to those communities what may happen in the RCT and therefore bias the results. Yes, there are trade-offs when we deal with affairs that are as important as water in the life of humans. 14/n

5. Point 4 brings me to this: IRBs and informed consent. This is a frequent major issue and having an IRB approving a design, and having participants "sign" the consent form is not enough in many cases, specially when we deal with highly vital issues like water. 15/n

6. One final point: Does this contribute to science? It could, but at any cost? Many experiments with humans have shaken established knowledge, but some of them have had major ethical issues (2 good examples are Zimbardo's prison experiment, Milgram's obedience study. 16/n

Editorial boards and reviewers of this paper should be aware that once published, a paper becomes in a way "accepted knowledge" and with it, the methodological component, meaning, it has the blessing of the establishment that the methods are ok. This is very important 17/n

Post data: experiments are about reality, also as artistic expressions are. If you are interested in water and ethics, watch this movie, imagine an RCT in Cochabamba in those days.
https://en.wikipedia.org/wiki/Even_the_Rain 18/18