The World Health Organization on Monday announced the outcome of its ethical deliberations. It found that, in certain circumstances, it was ethically permissible to use unproven drugs on Ebola patients.
It then listed ethical criteria. These included transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community.
These are laudable principles but what do they actually mean in practice? The devil is in the detail. If you broke your ankle after slipping on coffee in a hotel, and asked a lawyer if you would win a case against the hotel, you would be frustrated if the lawyer simply recited a legal principle: “the hotel owes you a duty to take reasonable care to see that you are reasonably safe in using the premises”. You want to know whether, in your case, the hotel did take reasonable care. To resolve your problem, the legal principle must be applied to the facts.
Similarly, the WHO’s principles are of limited value in isolation. Take ‘transparency about all aspects of care’. Will there be regular reports presented to the public on patient progress? If so, there is a potential tension with the principle of confidentiality, unless the patients waive their right to confidentiality. Does transparency mean that the identity of the ‘chosen few’ selected to have the drug will be known to others?
How can confidentiality be guaranteed in countries where this principle is not as valued as in the United Kingdom or America? Is it realistic to believe that whoever gets the drug will remain anonymous?
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.