Covid-19: should we deliberately infect volunteers?

In a desperate race to develop a Covid-19 vaccine, it is tempting for scientists to compromise quality control and rigour. But crises are not an excuse for lowering the bar of stringent ethical and scientific standards. Ethicists have warned scientists not to cave into bad science. Can permitting volunteers to be purposely infected with COVID-19 to develop a vaccine be done ethically?

Yes, according to Adair D. Richards, of the University of Warwick, in the UK. This sounds disturbing and reminds us of past ethical disasters, e.g. the Tuskegee study of untreated syphilis amongst poor African-American men in Georgia in the 1930s.

In recent research, Dr Richards designed ethical guidelines to guide researchers on an ethical path to purposely infect participants who have been provided with a vaccine candidate with Covid-19 (known as ‘challenge studies’). The volunteers who are vaccinated are given a dose of the virus so the scientist can determine whether the vaccine works. This… MORE

Unscrupulous scammers are selling stem cell therapies for Covid-19

It is alarming that unsubstantiated stem cell-based treatments for Covid-19 are cropping up everywhere. Bioethicist Leigh Turner, of the University of Minnesota, recently flagged stem-cell-based “therapies” in a leading journal, Stem Cell Stem.

Turner worries that users of these so-called treatments for Covid-19 will be harmed by products that haven't been rigorously tested, or that they'll forgo measures like physical distancing as they believe the product will shield them from being infected.

He notes a business in Colorado selling mesenchymal stem cell exosomes "for patients that need to boost their immune system" or who want "additional defence against the virus" for US$3,000. Clinics in Alabama, Arizona, California, Delaware, Florida and Pennsylvania have made similar claims; some advertise stem cell therapies as a preventive step while others claim it can repair damage from Covid-19.

Other companies offer biobanking of one’s own stem cells. "Having a frozen line of one's own personal mesenchymal stem cells could prove life-saving should someone… MORE

Mass gatherings: OK. Mass: not OK

If you can remember that long ago, the only protesters defying Covid-19 lockdowns in the United States were small crowds of roughnecks from flyover country waving flags and brandishing placards at State capitals.

Nonetheless, petty incidents like this still outraged bioethicists and public health experts. Writing in PennLive, a Pennsylvania blog, four of them, including the nationally-known bioethicist Art Caplan, argued that those protesters were freeloading on the sacrifices made by people who observed lockdown restrictions.

They had little sympathy for them if they fell ill with the coronavirus: “If the protesters can’t be persuaded that they are wrong and their behavior is dangerous, they should own up to their political commitment and sign and carry a pledge stating they decline all medical care to treat Covid-19, should they fall ill if resources are being rationed.”

That was then.

Now, crowds of tens of thousands have gathered to protest the appalling tragedy of the death of George Floyd in cities across… MORE

Is seeking ‘herd immunity’ ethical?

Several health experts have proposed a “herd immunity” strategy for managing the coronavirus pandemic. This would involve allowing the virus to spread in a controlled way so as to achieve population immunity — even though this may expose vulnerable members of the community to an increased risk of infection.

While Australia has managed so far to control the spread of the virus, the number of new infections may increase as state and territory government move to ease social distancing and self-isolation measures. The situation in other regions such as North America and Europe is much worse, and initial strategies of strict containment have in some cases been abandoned in favour of mitigation policies.

In light of this, many commentators argue that governments should officially make herd immunity — rather than containment or virus suppression — the end goal of their COVID-19 policies. Harvard Medical School Professor Martin Kulldorff, for example, recently argued that we have no choice but to allow the virus to spread… MORE

Coronavirus: should frontline doctors and nurses get preferential treatment?

It is mid-March 2020. James is a 29-year-old junior doctor working in a London hospital. Last week, James cared for a man who had become sick after returning from abroad. The man had been treated in isolation and is now improving. However, James has since become unwell. He developed a cough and fever, but then rapidly became breathless.

James has been admitted to his own hospital with signs of severe acute respiratory distress syndrome. Despite intensive treatment, James’ lungs are full of fluid and his oxygen levels are critically low. His kidneys have shut down, and his blood pressure is unstable.

The medical team caring for James has referred him to the regional extracorporeal membrane oxygenation (ECMO) centre – a potentially life-saving treatment that is used for some patients with severe organ failure.

But the ECMO centre has received several referrals. While James is young and fit, he also has features that suggest he may die even… MORE

In defence of Peter Singer

Peter Singer / photo by Leif Tuxen / 

Australia’s most famous – or most notorious – philosopher, Peter Singer, has been de-platformed in New Zealand. He was scheduled to speak about “effective altruism” at an event in Auckland in June. The disability community was outraged.

The venue, SkyCity, a casino and entertainment venue, released a statement saying, "Whilst SkyCity supports the right of free speech, some of the themes promoted by this speaker do not reflect our values of diversity and inclusivity." The organisers are scrambling to find a different venue.

The anger of the disability community is hardly surprising. Singer is a utilitarian ethicist and contends (this is a very rough summary) that consciousness is the touchstone of dignity. This compels him to support the infanticide of disabled infants. In a book that he published in 1979, Practical Ethics, he wrote:

[Being a member of he species] Homo sapiens, is not relevant to the… MORE

The complicity of health and medical personnel in post-9/11 torture is a stain on my profession

As the American psychologist and architect of the Bush-era torture programme, Dr James Mitchell, took the stand last week, I was reminded of Timothy Snyder’s Twenty Lessons on Tyranny. He wrote ‘If lawyers had followed the norm of no execution without trial, if doctors had accepted the rule of no surgery without consent…then the Nazi regime would have been much harder pressed to carry out the atrocities.’

Eighteen years have passed since the opening of Guantanamo Bay and implementation of the (now defunct) US ‘enhanced interrogation’ programme – a clinically friendly name for a torture house that included waterboarding and other forms of abuse. Was Mitchell finally standing trial for his crimes? No. He defiantly gave evidence to a pre-trial hearing in the American military war court; his testimony mirroring one of his earlier justifications: “I’m just a guy who got asked to do something for his country”.

Since 9/11 and the ‘war on terror’, a myriad of human rights abuses have… MORE

India continues to struggle with surrogacy

Indian author and activist Pinki Virani has been given a national award for her book Bitter Chocolate: Child Sexual Abuse in India, which ripped the lid off the extent of this secretive crime in Indian homes across class and gender (40 percent of girls and 25 percent of boys under 18 are sexually abused, 50 percent of this horror being perpetrated upon them in their own homes or by adults in position of the child’s trust). She has assisted on the laws against sexual abuse.

Her fifth book, Politics of the Womb: The Perils of IVF, Surrogacy & Modified Babies, is a meticulously detailed work on the hormonal-medical violence being benignly showered on women the world over by “fertility fairies, even though their failure rate is 75 percent”.

This “worldwide onslaught on the woman’s womb in the name of a child” is “reducing good men to not even realising that they are condoning reproductive slavery”. For “Politics of… MORE

Ethical issues surrounding egg donation in genome editing 

Genome editing enables scientists to modify the DNA, the building blocks of life. Different technologies are used, including an innovative technique called CRISPR-Cas/9, which involves cutting and splicing mutating genes that cause heritable diseases and conditions.

Like any novel technology, there are risks associated with CRISPR. For instance, a scientist may cut at the wrong area, known as off-target effects. Scientists are uncertain as to how this might affect patients. Moreover, mosaicism may also occur where only specific cells carry the edit but not others.

Hence, to develop genetic techniques which are safe and effective to be applied in humans, much research is needed. Primary research is necessary to check the safety and accuracy of genome editing. Clinical applications can then be performed after comprehensive studies have been conducted.

What could be missed in the debate surrounding human genome editing are ethical questions about the research that would precede clinical applications. Say a scientist wishes to experiment with human embryos.… MORE

In defence of conscientious objection

Photo by Hush Naidoo on Unsplash

Over the last few years there has been a vigorous and fascinating debate about the use of conscientious objection (CO) in healthcare. CO is when doctors (and other healthcare professionals) opt-out of providing a medical service because they have serious moral objections—abortion is a widely cited example.

If enough doctors object to abortions, there is a legitimate concern that some patients will have difficulty accessing them—for example in Italy 70% of obstetricians refuse to participate in abortions, even though this isn’t the intention of CO. Some ethicists have argued there is no place for CO at all in healthcare, in the strongest of terms.

Curiously, though—and this is what aroused our interest—these same ethicists usually recognise that there are still some instances when doctors should be permitted to object and withhold their services. But how can they allow some objections and not others? One… MORE

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