We pay test pilots to risk their lives to see if a machine can fly properly. There’s a risk - some have died- others will surely die. But it’s all in a good cause - to advance aviation and science.
So, why don’t we allow vaccine testers to be deliberately injected with killer viruses to test efficacy. Obviously they would be volunteers, and obviously they would be handsomely paid. I’m sure there would be takers.
Tried and true vaccines wouldn’t take years to become reality; you’d probably cut the time by an order of magnitude. Maybe we already have an AIDS vaccine but we wait for long double blind tests and the death toll mounts.
Please don’t use the Hippocratic Oath as a defense.
Test pilots have a full understanding of aerodynamics, of the functioning of an aircraft, of how to identify a problem in its earliest stages. They’re not random members of the public. So the equivalent for medical testing would be to ask experts in innoculation and vaccination technology to be subjects for the test.
Correct me if I’m wrong, but the test pilot does not deliberately seek deadly risk, and likely is not motivated by any hint of suicidal self-sacrifice. While some test pilots do die on the job, the great majority survive their occupation. The object isn’t “kill a few so many may live”; it’s to fly new airplanes.
Maybe you ought to try to enlist some suicide bombers.
Well, there are a lot of problems with scientific experimentation on humans. I’m OK with the morality of it, as long as the subject is willing, but in order for it to be accurate, the test subjects would need to be familiar with the diseases and medicine in general. And of course, you’d need a good number of them, plus a control group, and probably a comparison group, to get any valid statistical information. Plus, you’d have to keep them isolated from outside influence (this is one reason why scientific polls of people sometimes turn out to be erroneous - there is an unknown factor that changes the results for a group). Additionally, you don’t know what side effects may occur after the trial, or if exposing these people to the public is safe or not.
Given all that, and if you can find enough volunteers to test an AIDS vaccine (which includes being exposed to the HIV virus), knock yourself (or your test subjects) out.
Even if this became legal, odds are the only people willing to risk their lives and health for money would be the poor and destitute, which just…wouldn’t look good. Medical experimentation on the homeless? Hard to see that going over really well.
Hardly. If the proposed vaccine was one for the HIV virus, I’m sure I’d have no problems finding clerics, humanitarians, etc. who would volunteer just for expenses paid. There really are folks out there who would do this if they thought it could benefit humanity. There are even people who take oaths of poverty to help the suffering. Ever hear of Mother Teresa? She even also took an oath of chastity and obedience. For a Phase II medical trial of such a vaccine, it would only take a few dozen people to take the vaccine, and then later be injected with the HIV virus. If none became infected, then the proposed vaccine would look like a winner. Considering the magnitude of the problem of HIV infection on this planet, even someone as cynical as me has little doubt I could find a few dozen volunteers. (For those unaware, the Phase I test would involve injecting people with the candidate HIV vaccine without exposing them to the HIV virus to prove the vaccine in and of itself was safe and didn’t kill people. The Phase II test would look at effectiveness.)
I’ve never researched this issue before. How in the past did they ever introduce vaccines for smallpox, etc. without having healthy volunteers to make human guinea pigs of themselves? I’d think they’d necessarily have to find such humanitarian volunteers. From a medical ethics standpoint, it isn’t like you could mass innoculate people with a candidate vaccine and cross your fingers it won’t kill lots of people.
Has it occurred to anyone here that doing potentially lethal experiments on the suicidal is beyond laughable from a medical ethics perspective? You can’t use “do no harm” to argue against this? That’s about the cornerstone of ethical medical practice. You take that away, and there are no medical ethics, practically.
Look: People who want to die for you may have very noble reasons, or they may not be of sound mind. Reliably determining the requisite “soundness” for such a grim act of volunteerism presumes almost godlike powers of mental assessment on the part of the screeners. It’s an ethical dead-end. People may elect, themselves, to die for what they deem a just cause, but recruiting doctors and researchers to enable such acts of martyrdom, for even a cause as worthy as finding a vaccine for HIV, would be unconscionable.
Testing in a scientific sense requires double blind methodology. We have enough ethical dilemmas with that, in the case of highly effective drugs being tried in naturally high risk populations. After you have ten or twelve folks on placebos die while the entire first run of the real drug patients survive with minimal and mild infections, you have to decide when you stop being scientific, and start being humane. It’s a tough choice.
You forfiet your entire experiment, or you forfiet a predictable percentage of the placebo recipients. And some of the volunteers are infants, with no hope for life other than your drug.
OP chiming in again:
I question this “requirement”. If there is a reasonable belief that the vaccine candidate is “the one”, why the hell should I concern myself with placebo effect?
There is no point in giving some people sugar water and then injecting them with a deadly virus. We pretty much know where that leads.
My proposal would have none of this. After Phase I is testing is complete, I would only use the candidate vaccine on the volunteers.
If there were 200 volunteers, all get the real vaccine, and all get the live virus.
Because you have to have a reason for your “reasonable belief.” Bwana, you are creating a false dilemna, based upon two errors:
First, you assume that it would take too long/would be too random to simply give a test vaccine to a population to determine efficacy.
Second, you assume that the odds are a particular test vaccine will work. Both assumptions are false.
The first assumption is disposed of by the simple use of actuarial tables. You test a vaccine on 1000 people. If the actuarial tables predict that 20 of the test population would get the disease in a one-year period, and only 2 do, you have a successful vaccine. No need to deliberately infect someone - random chance will take care of that for you.
The second assumption is demonstrated false by history. Do you think no one’s ever tested a malaria or an AIDS vaccine before? Of course they have - and of course the scientists developing the vaccine had a “reasonable belief” it would work - or they wouldn’t have proceeded to testing. Yet we don’t have vaccines for either disease.
The fact is that drug development is very hit and miss, and the large majority of potential drugs and vaccines fail during development and testing. The odds are that the test vaccine isn’t going to work.
So when you give a volunteer a test vaccine, then infect them with a killer virus, you are substantially increasing the volunteer’s odds of death. That is what is unethical. This is not an example of an (allegedly) over-rigid Hippocratic oath getting in the way of science - this is the universal human precept of “don’t kill folks”.
You’re still going to have a sizeable number of people who are able to fight off a deadly virus without any vaccine.
For vaccine research they do have challenge studies, where the vaccine is ‘challenged’ by the virus it’s supposed to protect the subject against.
For instance researchers will conduct a malaria vaccine trial and allow subjects to be bitten by mosquitos that carry a strain of malaria they know they can cure.
These trials still have to follow the rules of sound research and ‘good clinical practice’, though: subject safety (the most pertinent issue here), control groups, sample size that gives the study statistical credibility, and so on.
Well, Brutus, medical studies are notoriously hard to do, because of the vague and sometimes inaccurate feedback from patients/subjects. Results are more accurate and statistically reliable if your subjects know what feedback to give.