Tag: resource allocation

Blog Posts (4)

November 2, 2014

Is it Ethical to give Ebola-Sufferers a Placebo?

<p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Recently prominent bioethicists have voiced disagreement over whether it could be ethical to test experimental Ebola vaccines in placebo-controlled randomized trials.  Such trials would involve taking a group of people currently infected with Ebola and randomizing half of them to an arm that receives the experimental vaccine (plus, let us assume, the best current standard of care for Ebola), and the other half of them to an arm that receives a placebo instead of the vaccine (plus the same standard of care).  </span></p> <p style="line-height: 19.0400009155273px;">The main worry with these trials is that it is unethical to give Ebola-sufferers a placebo when an experimental vaccine is available that holds the prospect of benefit. (The prospect of benefit is typically inferred from success in trials with animals; at least one experimental vaccine, ZMapp, has showed <a href="http://www.nature.com/nature/journal/vnfv/ncurrent/abs/nature13777.html">notable efficacy</a> at preventing deadly disease in macaque monkeys inoculated with a virulent strain of Ebola.)  As a prominent group of bioethicists <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61734-7/fulltext">recently pointed out</a>, conventional care for Ebola “does not much affect clinical outcomes,” resulting in a mortality rate as high as 70%.  “When conventional care means such a high probability of death,” they continue, “it is problematic to insist on randomizing patients to [a placebo arm] when the intervention arm holds out at least the possibility of benefit.”  Moreover, they insist, “none of us would consent to be randomized in such circumstances.” </p> <p style="line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
October 9, 2014

Lawsuit Against U.N. on the Spread of Cholera Epidemic in Haiti Advances

[NYTimes] A federal judge in New York has agreed to hear oral arguments in a lawsuit filed against the United Nations by advocates for Haitian victims of the deadly cholera epidemic that first appeared on the island four years ago. The lawsuit, filed last year, argues that United Nations peacekeepers in Haiti were responsible for […]
September 25, 2014

As Doctors Lose Clout, Drug Firms Redirect the Sales Call

[The Wall Street Journal] SAN DIEGO—Kendall French used to pitch drugs to doctors who could prescribe them. But many of those doctors now work for hospitals that don’t give them final say over what is on the menu of medicines they can pick. So when the GlaxoSmithKline PLC saleswoman began plugging two new lung-disease drugs […]
June 24, 2014

Pharmaceutical firms find it hard to exit essential drugs market

[TheEconomicTimes] Pharmaceutical companies having more than a 1% market share for any essential drugs may find it difficult to stop manufacturing those products. Since May, when the government brought into force a new drug-pricing system after a gap of 18 years, the National Pharmaceutical Pricing Authority has denied such requests whenever the market share of […]