In my last post, I looked at some of the ethical considerations an individual might make during a flu epidemic. My focus was squarely on the individual’s decisions: whether to stay in bed or seek medical care, whether to seek aid from others, etc. This is the kind of everyday ethics that crops up for most of us as we try to get through our days.
If you’re someone who is responsible for keeping health care infrastructure or other state resources in good working order, however, the ethical landscape of a major flu epidemic looks quite different.
Category Archives: Medicine
Swine flu outbreaks and the ethics of being sick.
Like a lot of other people, I’m watching the swine flu outbreaks unfold with some interest. As they do, I can’t help but think about the ethical dimensions of our interactions with other humans, since it’s looking like any of us could become a vector of disease.
There are some fairly easy ethical calls here — for example, if you’re sick and can avoid spreading your germs, you should avoid spreading them. But there are some other questions whose answers are not as clear.
Swine flu and air travel.
Probably you’ve been reading about the new swine flu outbreak on Effect Measure and Aetiology. At this stage, public health officials are keeping careful watch on this epidemic to try to keep it from becoming a pandemic.
And this is the news in the back of my mind as I need to arrange air travel in the coming months. Nothing makes me want to book airline tickets more than the project of being in a metal tube with germy humans.
I did some poking around to see what kinds of measures the airlines might be taking to avoid helping spread swine flu and the people carrying it around.
Sniffing out bias in a sea of industry research funding.
One arena in which members of the public seem to understand their interest in good and unbiased scientific research is drug testing. Yet a significant portion of the research on new drugs and their use in treating patients is funded by drug manufacturers — parties that have an interest in more than just generating objective results to scientific questions. Given how much money goes to fund scientific research in which the public has a profound interest, how can we tell which reports of scientific research findings are biased?
This is the question taken up by Bruce M. Psaty in a Commentary in the Journal of the American Medical Association [1]. Our first inclination in distinguishing biased reports from unbiased ones might be to look at the magnitude of the goodies one is getting from one’s private funders. But Psaty draws on his own experience to suggest that bias is a more complicated phenomenon.
A glimpse into how not to conduct an ethical drug trial.
The Independent reports that drug giant Pfizer has agreed to pay a $75 million settlement nine years after Nigerian parents whose children died in a drug trial brought legal action against the company.
It’s the details of that drug trial that are of interest here:
Free ethics advice for the Pope.
When, speaking to journalists about the HIV/AIDS epidemic in Africa, you make a claim that the epidemic is:
a tragedy that cannot be overcome by money alone, that cannot be overcome through the distribution of condoms, which can even increase the problem
those listening who assume you are committed to honesty (because of that commandment about not bearing false witness) and that you are well-informed about the current state of our epidemiological knowledge (because, as the Pope, you have many advisors, and owing to your importance as the head of the Roman Catholic Church, leading scientists will take the time to help you understand scientific findings) may draw the conclusion that the distribution and use of condoms can make the spread of HIV worse.
Science Saturday: Alternative Medicine Edition at Bloggingheads.
This week at Bloggingheads.tv, PalMD and I have a chat about science, ethics, and alternative medicine. Plus, we have a little disagreement about what constitutes paternalism.
Go watch!
Alternative medicine, scientific research, and a clash of world views.
Orac takes issue with a pair of posts I wrote yesterday about the National Center on Complementary and Alternative Medicine (NCCAM). I gather he thinks I’ve been far too trusting as far as the information provided on the NCCAM website, and that I’m misrepresenting the issues the critics of NCCAM have with the center. If my posts communicated that they were giving the straight dope on NCCAM and the objections to it, then I blew it; that wasn’t at all what was intended. Rather, I wanted to have a look at the ethical issues that arise from such an official effort to examine medical treatments that are not part of the mainstream, and to start to tease out how these might be connected to broader issues around the interactions between scientifically grounded health care providers and patients who are not adherents to scientific ways of thinking.
Here, let me reiterate that I am not an expert on NCCAM or the movement to get broad acceptance for alternative medical treatments. Rather, I’m trying to understand the political battles in terms of the divergent ways of understanding the world driving the participants in these battles.
With that in mind, some specific responses to Orac’s post:
Your tax dollars at work: a look at clinical trials supported by NCCAM.
In my last post, I started wading into the question of what kinds of ethical questions arise from clinical trials on “alternative” medical treatments, especially clinical trials supported by the National Center on Complementary and Alternative Medicine (NCCAM). The ethical questions include whether alternative treatments expose human subjects to direct harm, or to indirect harm (by precluding a more effective treatment), not to mention whether the money spent to research alternative modalities would be better spent on other lines of research. I think it’s worthwhile to dip into the NCCAM website to look at some of the clinical trials this federal agency has supported.
From the NCCAM website’s discussion of clinical trials being conducted on complementary and alternative medicine (CAM):
Conventional medicine, ‘alternative’ treatments, and the ethics of research with humans.
A little while ago, PalMD put up a post at Whitecoat Underground about the current state of the National Center on Complementary and Alternative Medicine (NCCAM), especially at a moment in history when the federal government is spending loads of money (and thus maybe should be on the lookout for expenditures that might not be necessary) and when health care reform might actually happen. Pal wrote: