The Ebola Ethical Dilemma

Image Courtesy: European Commission DG ECHO 

Having had the U.S. Centers for Disease Control and Prevention (CDC), as well as the FDA as clients in past years as a communications consultant, I feel compelled to comment on the former’s recent decision to treat the two American medical professionals with a "top secret" drug cocktail which appears to have saved their lives from the Ebola virus.

According to this LA Times reporter Monte Morin,  the selective treatment of two Americans has raised “red flags” for medical experts, but not for the reasons you might think. His August 6^th article claims that “these medical experts” (unanimously?) decided that because the drug has not been tested by the FDA through formal clinical trials, it may prove “more harm than good.”

“There's a fairly good chance that it could do more harm than good. The drug could kill you faster, or make you die more miserably,” says Arthur Caplan, a medical ethicist, on the experimental Ebola drug ZMapp.

Really?  More harm than good? I don’t think that’s what the families of Dr. Kent Brantly and Nancy Writebol, the two missionary workers who were treated, would be saying right about now. By most accounts, Brantly was in grave condition, telling his caregivers “I’m going to die,” through labored breath.  Within an hour of receiving the drug he had improved markedly, and was able to walk onto the airplane that took him to the US the next day.

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The FDA has to approve all drugs used on citizens in within the US borders in absence of the  “compassionate use” exemption.  So clearly these two-doses of the drug were flown directly to Africa to help US medical authorities get around their own clunky, bureaucratic approval mechanism. 

Luckily those naysaying experts are not the only experts on the case, as another LA Times reporter, Robin Dixon, points out her article, “WHO to discuss access to experimental Ebola drug amid criticism.” In fact, there are plenty of WHO medical ethicists and other experts who believe this is more of an ethical crisis than a practical one, including the Peter Piot, who co-discovered the Ebola virus in 1976 and is director of the London School of Hygiene and Tropical Medicine.

They argue that even though limited quantities of the drug are available, and they are very expensive to produce, that African governments should be allowed to make informed decisions about whether or not to use the drugs, particularly the healthcare workers who are at high risk for infection.

There may not be enough of the drug to treat the hundreds of Africans infected, but surely there is enough to treat the African nurses and doctors who have been on the frontlines since the beginning, and who are now slowly dying along with their patients. It is especially troubling to note that Patrick Sawyer, the African American doctor treating Ebola patients in Liberia who was infected in early-July and withered away for two weeks before passing, may have died because he was of the “wrong” skin color, as it was only later “discovered” that he was a US citizen.

If we don’t protect these health workers, regardless of their nationality, skin color, or social status, who will be there to treat the desperate, helpless people who have contracted the disease?