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08/12/2014

Big Bad Ebola

by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012)

Last week Ebola came to the United States, it came on a specialized plane in the form of two medical missionaries. The conversation since has revolved around whether or not bringing them home for treatment was wise and/or just.

First, let’s talk about the risk of Ebola transmission, this seems to be the main concern for those who object to the patients being transferred to the U.S. As a nation we are at far greater risk from travelers not yet showing signs of the disease. The two missionaries are being well isolated and every precaution has been taken to ensure the virus does not escape the containment unit. The risk of contamination, transmission, etc. is very low from these patients. It is certainly not zero, a lie I have heard too many times from the media, but it is extremely low.

An argument I simply can’t stomach is: If the missionaries caught Ebola while using the appropriate personal protection equipment (PPE) isn’t the American medical staff at the same risk? Absolutely not. In Africa Ebola is rampant, patients are kept in large wards, the disease is in the communities, and there is no possible way the healthcare providers could have kept their guard up at all times. The risk of contracting the disease while in Africa is high, no matter the protection they used.

Argument 2: They knew the risks and went over anyway, just leave them in Africa to suffer the consequences of their decision. True, they knew the risks and this a viable, though not-so-compassionate response to the problem. Honestly, I think either decision could have been rationalized though I am sure the families of the missionaries appreciate the choice we made to bring their loved ones home and if it had been your family member you would have wanted them home too.

Now that we have unpacked the risk of Ebola spreading in the U.S. I want to talk about the experimental Ebola antiserum. It is reported in the media that the two American missionaries have received this experimental antiserum and I have heard calls to release the drug to all those suffering in Africa. Advocates for release of the drug are particularly intent that it be given to the medical staff who has become infected while treating Ebola patients, since they were infected in the same way as the Americans. I understand the desire and it “feels” compassionate to fight to send this antiserum to Africa. However, there are some very important reasons why this should not happen:

First of all, we don’t know that this drug even works, it’s experimentation in humans is extremely limited, and for all we know it could cause more harm than good. It may seem like the simple solution in an emergency to toss protocol out the window. However, for the safety of the trial participants studies need to be limited in scope and as controlled as possible. If released to the general public or even the medical staff of Africa there would be no way to appropriately monitor for side effects and safety issues. Furthermore, to get the drug to the population as quickly as “demanded” would necessarily violate all study regulations and proper procedure in Africa. This is a huge risk, and if anything were to go wrong with the drug or study who would be blamed? Certainly America and the scientists. It simply isn’t a wise move.

Secondly, the supply of antiserum is extremely limited, there would be no way to make an acceptable amount of antiserum to treat those infected, presuming of course that the drug does what it is intended to do without major side effects.

The scientists have been painted as the bad guys by many of those pushing for the drug’s release and this is simply not true. Those scientists have committed their lives to finding a cure for Ebola and just because they are bound to a process you don’t like right now doesn’t mean that they are evil. If the process is followed and the trial successful perhaps we can have a long term cure for Ebola. Pushing to exempt this project from the scientific process will not help long term progress and could result in short term disaster.

It is easy and feels right to act on emotion, but it is rarely the wise choice.

[The contents of this blog are solely the responsibility of the author and do not represent the views of the Bioethics Program or Union Graduate College.]

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