Wednesday, August 6, 2014

Ebola Ethics

The Washington Post blog post about "white" Americans getting an Ebola serum reminds me of an old joke about the Post.  The Almighty gave the editors of the Post a call to let them know that the world was ending the next day.  True to form the WaPo headline read: "World to End - Women and Minorities Impacted Most."  Distribution of the serum to Americans has jack to do with the fact that they are white and everything to do with the fact that they are Americans.  The serum is being developed by an American company, Mapp Biopharmaceutical, based right here in San Diego, I am proud to say.
Before this outbreak, ZMapp had only been tested on monkeys. Mapp, the tiny, San Diego based pharmaceutical company that makes the drug stated two years ago: “When administered one hour after infection [with Ebola], all animals survived…Two-thirds of the animals were protected even when the treatment, known as Zmapp, was administered 48 hours after infection.”
Here are the ethics.  American technology and compassion are fighting Eblola and when the disease is brought under control, it will be because of America.  So Americans get first call on the vaccine.  To be fair, Arthur Caplan touches on some of this in the article.  He also asks why there is no process to allow more experimental use of drugs when a new disease is getting started.  Great question.  Our medical bureaucracy doesn't care if it kills a thousand people by withholding a treatment, if one life is saved that might have ended from a new treatment.

Unfortunately, Caplan concludes:
An ethical case can surely be made for an organization that puts health-care workers in harm’s way to acquire access to experimental drugs and bring staff home to get the best possible care. But that is neither a fair nor just policy for deciding what to do when an emergency arises and rationing is the only option.
Have to disagree, protecting the people doing good is always the right answer.

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