research ethics

Is a Publication Boycott of Chinese Science a Justifiable Response to Human Rights Violations Perpetrated by Chinese Doctors and Scientists?

By Doug McConnell

Recently the editor-in-chief of the Annals of Human Genetics, Prof David Curtis, resigned from his position, in part, because the journal’s publisher, Wiley, refused to publish a letter he co-authored with Thomas Schulze, Yves Moreau, and Thomas Wenzel. In that letter, they argue in favour of a boycott on Chinese medical and scientific publications as a response to the serious human rights violations happening in China. Several other leading journals, the Lancet, the BMJ and JAMA have also refused to publish the letter claiming that a boycott against China would be unfair and counterproductive.

This raises two separate ethical issues: 1. Should journals refuse to publish a letter arguing in favour of a boycott on Chinese medical and scientific publications? 2. Should journals actually establish a boycott on Chinese medical and scientific publications? Continue reading

Cross-Post: Self-experimentation with vaccines

By Jonathan Pugh, Dominic Wilkinson and Julian Savulescu.

This is a crosspost from the Journal of Medical Ethics Blog.

This is an output of the UKRI Pandemic Ethics Accelerator project.

 

A group of citizen scientists has launched a non-profit, non-commercial organisation named ‘RaDVaC’, which aims to rapidly develop, produce, and self-administer an intranasally delivered COVID-19 vaccine. As an open source project, a white paper detailing RaDVaC’s vaccine rationale, design, materials, protocols, and testing is freely available online. This information can be used by others to manufacture and self-administer their own vaccines, using commercially available materials and equipment.

Self-experimentation in science is not new; indeed, the initial development of some vaccines depended on self-experimentation. Historically, self-experimentation has led to valuable discoveries. Barry Marshall famously shared the Nobel Prize in 2005 for his work on the role of the bacterium Helicobacter pylori, and its role in gastritis –this research involved a self-experiment in 1984 that involved Marshall drinking a prepared mixture containing the bacteria, causing him to develop acute gastritis. This research, which shocked his colleagues at the time, eventually led to a fundamental change in the understanding of gastric ulcers, and they are now routinely treated with antibiotics. Today, self-experimentation is having something of a renaissance in the so-called bio-hacking community. But is self-experimentation to develop and test vaccinations ethical in the present pandemic? In this post we outline two arguments that might be invoked to defend such self-experimentation, and suggest that they are each subject to significant limitations. Continue reading

Press Release: UK Approves COVID-19 Challenge Studies

Responses to the UK COVID-19 Challenge Studies: 

“In a pandemic, time is lives.  So far, over a million people have died.

“There is a moral imperative to develop to a safe and effective vaccine – and to do so as quickly as possible.  Challenge studies are one way of accelerating vaccine research.  They are ethical if the risks are fully disclosed and they are reasonable.  The chance of someone aged 20-30 dying of COVID-19 is about the same as the annual risk of dying in a car accident.  That is a reasonable risk to take, especially to save hundreds of thousands of lives.  It is surprising challenge studies were not done sooner.  Given the stakes, it is unethical not to do challenge studies.”

Prof Julian Savulescu, Uehiro Chair in Practical Ethics, and Director of the Oxford Uehiro Centre for Practical Ethics, and Co-Director of the Wellcome Centre for Ethics and Humanities, University of Oxford

“Human challenge studies are an important and powerful research tool to help accelerate our understanding of infectious diseases and vaccine development.  They have been used for many years for a range of different infections.

“The announcement of the UK Human Challenge Program is a vital step forward for the UK and the world in our shared objective of bringing the COVID-19 pandemic to an end.  With cases climbing across Europe, and more than 1.2 million deaths worldwide, there is an urgent ethical imperative to explore and establish COVID-19 challenge trials.

“All research needs ethical safeguards.  Challenge trials need to be carefully designed to ensure that those who take part are fully informed of the risks, and that the risks to volunteers are minimised.  Not everyone could take part in a challenge trial (only young, healthy volunteers are likely to be able to take part).  Not everyone would choose to take part.  But there are hundreds of young people in the UK and elsewhere who have already signed up to take part in COVID challenge studies.  They deserve our admiration, our support and our thanks.”

Prof Dominic Wilkinson, Professor of Medical Ethics, Oxford Uehiro Centre for Practical Ethics, University of Oxford

Further Research

Read more about the ethics of challenge studies:

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Oxford Uehiro Prize in Practical Ethics: Can Science Ethically Make Use Of Data Which Was Gathered By Unethical Means?

This essay was the runner up in the undergraduate category of the 6th Annual Oxford Uehiro Prize in Practical Ethics

Written by University of Oxford student Toby Lowther

In this paper, I discuss the question of whether science can ethically make use of data which has been gathered by unethical means in seeking scientific and medical advances to alleviate future suffering. This is an ever-controversial issue of practical ethics, and although the American Medical Assosciation provides firm guidelines on the matter (AMA, 1995), the ethical question remains complex. I will begin by laying out the core issue: the conflict between the desire to censure unethical practices used in gathering such data and the desire to use all data available to bring about the greatest good for society. I will present arguments either side, leading to an ethical stalemate, before presenting how issues of practical consideration for scientific methodology resolve the conflict. I conclude that science cannot make use of data gathered by unethical means, because such data cannot ethically be replicated, and reproducibility is necessary for the validity of the scientific method. I leave open the question of whether it is ethical for the findings of such unethical experiments to guide future, ethical research. Continue reading

Medical Nihilism: When A Dose Of Scepticism Can Be Healthy

In his 2018 book, the philosopher of science, Jacob Stegenga defends the view “that we should have little confidence in the effectiveness of medical interventions.” (Stegenga 2018) On the face of it, he acknowledges, this position seems unreasonable: most of us can think of myriad ways in which modern medicine has improved – perhaps saved – our own lives and the lives of those close to us. The asthma attack I had as a baby, effectively treated at the time and subsequently managed through the use of seemingly magical medications which relax the muscles around the airways, opening them up and allowing air to pass freely again. Or the schoolfriend whose ruptured appendix could have resulted in a fatal infection, but for emergency surgery and the administration of antibiotics. Or the countless lives made less painful by the availability of cheap and safe painkillers. 

Medical sceptics tend to get a bad rep – anti-vaxxers who risk the lives of children by regurgitating debunked myths about the links between vaccines and autism, leading to dips in herd immunity and disease outbreaks; credulous folk who believe in the mystical powers of homeopathy and eschew conventional therapies in favour of potions that contain little more than water. This is not the sort of company one wishes to associate with. Continue reading

Gene-Editing Mosquitoes at The European Youth Event 2018

By Jonathan Pugh

 

The below is a slightly extended version of my two 5min presentations at the European Youth Event 2018, at the European Parliament in Strasbourg. I was asked to present on the following questions:

 

  1. What are the ethical issues surrounding gene-editing, particularly with respect to eradicating mosquitoes?

 

  1. Should the EU legislate on gene-editing mosquitoes?

 

Continue reading

Guest Post: Consequentialism and Ethics? Bridging the Normative Gap.

Written by Simon Beard

University of Cambridge

After years of deliberation, a US moratorium on so-called ‘gain of function’ experiments, involving the production of novel pathogens with a high degree of pandemic potential, has been lifted [https://www.nih.gov/about-nih/who-we-are/nih-director/statements/nih-lifts-funding-pause-gain-function-research]. At the same time, a ground-breaking new set of guidelines about how and when such experiments can be funded has been published [https://thebulletin.org/new-pathogen-research-rules-gain-function-loss-clarity11540] by the National Institutes of Health. This is to be welcomed, and I hope that these guidelines stimulate broader discussions about the ethics and funding of duel use scientific research, both inside and outside of the life sciences. At the very least, it is essential that people learn from this experience and do not engage in the kind of intellectual head banging that has undermined important research, and disrupted the careers of talented researchers.

Yet, there is something in these guidelines that many philosophers may find troubling.

These new guidelines insist, for the first time it seems, that NIH funding will depend not only on the benefits of scientific research outweighing the potential risks, but also on whether or not the research is “ethically justified”. In defining what is ethically justifiable, the NIH make specific reference to standards of beneficence, non-maleficence, justice, scientific freedom, respect for persons and responsible stewardship.

Much has been made of this additional dimension of evaluation and whether or not review committees will be up to assessing it. Whereas before, it is said, they merely had to assess whether research would have good or bad outcomes, they now have to determine whether it is right or wrong as well! Continue reading

Cross Post: Re: Nudges in a Post-truth World 

Guest Post: Nathan Hodson

This article originally appeared on the Journal of Medical Ethics Blog 

In a recent article in the Journal of Medical EthicsNeil Levy has developed a concept of “nudges to reason,” offering a new tool for those trying to reconcile medical ethics with the application of behavioural psychological research – a practice known as nudging. Very roughly, nudging means adjusting the way choices are presented to the public in order to promote certain decisions.

As Levy notes, some people are concerned that nudges present a threat to autonomy. Attempts at reconciling nudges with ethics, then, are important because nudging in healthcare is here to stay but we need to ensure it is used in ways that respect autonomy (and other moral principles). Continue reading

Video Series: Professor Julian Savulescu argues in favour of an experimental treatment for Charlie Gard

Guest Post: Crispr Craze and Crispr Cares

Written by Robert Ranisch, Institute for Ethics and History of Medicine, University of Tuebingen

@RobRanisch

Newly discovered tools for the targeted editing of the genome have been generating talk of a revolution in gene technology for the last five years. The CRISPR/Cas9-method draws most of the attention by enabling a more simple and precise, cheaper and quicker modification of genes in a hitherto unknown measure. Since these so-called molecular scissors can be set to work in just about all organisms, hardly a week goes by without headlines regarding the latest scientific research: Genome editing could keep vegetables looking fresh, eliminate malaria from disease-carrying mosquitoes, replace antibiotics or bring mammoths back to life.

Naturally, the greatest hopes are put into its potential for various medical applications. Despite the media hype, there are no ready-to-use CRISPR gene therapies. However, the first clinical studies are under way in China and have been approved in the USA. Future therapy methods might allow eradicating hereditary illnesses, conquering cancer, or even cure HIV/AIDS. Just this May, results from experiments on mice gave reason to hope for this. In a similar vein, germline intervention is being reconsidered as a realistic option now, although it had long been considered taboo because of how its (side)effects are passed down the generations. Continue reading

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