Bioethics Blogs

Use of Unproven Interventions is Never Obligatory

I recently read a paper written by my colleagues at Alden
March Bioethics Institute entitled “
In Particular Circumstances Attempting
Unproven Interventions and Circumstances is Permissible and even Obligatory
”. 

I do not entirely agree with my colleagues. I do not
disagree that there are some very limited circumstances in which unproven
interventions are warranted nearly all of which are in the research or
compassionate use context. The recent Ebola crisis is an example of that where
the use of monoclonal antibodies against the Ebola virus was consistent with
theory and prior scientific precedent. However we must balance that against the
harm done. The consumption of available ZMapp antibody in compassionate use
likely precluded the opportunity to conduct clinical trials in a timely manner
to determine if it actually did provide any benefit. Had it been used to prove
efficacy it could have justified the investment necessary to prepare it large
quantity and let future physicians and patients make informed decisions on its
use. Moreover the manner in which the compassionate use was implemented, nearly
exclusively available to US and European health care workers and barely any
availability to Africans could hardly be considered just. During the next Ebola
outbreak we may be faced with the same circumstances because we still do not
really know its efficacy. There is now enough ZMaap available to conduct trials
and these have been initiated but there may not be enough patients available to
conduct them.

They site as justification for such use that “The fact that
there exists a measure of consensus among able and prudent providers suffices
to make particular innovative interventions permissible or obligatory…” There
have been many such consensuses which have been, when subjected to clinical
trials, found to be wrong.

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.