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Topic: Resource Allocation
November 3, 2014 | Posted By Luke Gelinas, PhD

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).  

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 notable efficacy at preventing deadly disease in macaque monkeys inoculated with a virulent strain of Ebola.)  As a prominent group of bioethicists recently pointed out, 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.” 

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 website.

October 28, 2013 | Posted By Jane Jankowski, LMSW, MS

With contentious changes afoot in the US healthcare system these days, one old problem seems to be gaining important attention as the public reflects on what will change with the advent of the Affordable Care Act. The cost of prescription medications is often so high; patients are forced to make tough choices in order to maintain their health without going broke. This topic was front page news in the New York Times (New York Times October 2013 ) this month where the focus was on escalating costs of asthma drugs. Compared to other nations, the expense of many common – and even not so common – medications is dramatically higher for consumers in the US. This is hardly news, and studies have been done showing that senior citizens were historically the hardest hit by medication costs given the intersection of age related health problems and fixed incomes with no prescription benefits. Though somewhat ameliorated when Medicare D was added, not all of the medication problems are resolved, particularly when an individual requires skilled nursing care in a nursing home (Medicare D and Nursing Home Residents.)

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 website.

September 24, 2013 | Posted By Jane Jankowski, LMSW, MS

At a Labor Day party earlier this month, I was among the lucky guests filling a plate with an array of tasty picnic food ranging from the traditional cook out items to exotic salads and fruits, all washed down with a blueberry martini. (NO, I do not have the recipe.) Food represents many things in our culture and expresses values in subtle ways – and not so subtle ways. Bidding farewell to summer and enjoying the blessings of some great local produce, I noted that the centerpiece of my meal was a thick grilled hamburger.  Unless otherwise stated, it is presumed to be made of beef. And I had to wonder: will burgers like this one become scarce in my lifetime? With the recent production of meat grown from bovine stem cells, there is speculation that lab-grown meat product will someday replace animal meat as a primary food source. It seems important to consider what is, um, at stake for consumers, for science, and the evolving culture of lab grown food.

As for this new use of stem cell technology, I think we need to question whether or not this was the best use of resources. At  an estimated cost of over $300k, it was terribly expensive to create, but many new technologies come at a price. This Petri dish patty was reported to not taste very good, a shortcoming blamed on the absence of fat in this manufactured patty. However, it was deemed safe to eat and as far as I know, none of the taste testers became ill from ingesting the “schmeat.” Engineered beef might find a welcome in areas where there is mistrust about food safety and where food supply for meat products is limited. Yet, refrigeration needs may still prove a formidable barrier even if cost of manufacture and shipping could be assured. 

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 website.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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