Journal Article > CommentaryAbstract
Public Health Ethics. 2014 September 17; Volume 7 (Issue 3); DOI:10.1093/phe/phu030
Calain P
Public Health Ethics. 2014 September 17; Volume 7 (Issue 3); DOI:10.1093/phe/phu030
MSF Ethics Review Board > Publications
Public Health Ethics. 2016 November 1; Volume 10 (Issue 1); 49-61.; DOI:10.1093/phe/phw039
Schopper D, Ravinetto R, Schwartz L, Kamaara E, Sheel S, et al.
Public Health Ethics. 2016 November 1; Volume 10 (Issue 1); 49-61.; DOI:10.1093/phe/phw039
The Médecins Sans Frontières (MSF) ethics review board (ERB) has been solicited in an unprecedented way to provide advice and review research protocols in an 'emergency' mode during the recent Ebola epidemic. Twenty-seven Ebola-related study protocols were reviewed between March 2014 and August 2015, ranging from epidemiological research, to behavioural research, infectivity studies and clinical trials with investigational products at (very) early development stages. This article examines the MSF ERB's experience addressing issues related to both the process of review and substantive ethical issues in this context. These topics include lack of policies regarding blood sample collection and use, and engaging communities regarding their storage and future use; exclusion of pregnant women from clinical and vaccine trials; and the difficulty of implementing timely and high-quality qualitative/anthropological research to consider potential upfront harms. Having noticed different standards across ethics committees (ECs), we propose that when multiple ethics reviews of clinical and vaccine trials are carried out during a public health emergency they should be accompanied by transparent communication between the ECs involved. The MSF ERB experience should trigger a broader discussion on the 'optimal' ethics review in an emergency outbreak and what enduring structural changes are needed to improve the ethics review process.
Journal Article > LetterAbstract
Public Health Ethics. 2013 April 23; Volume 7 (Issue 3); DOI:10.1093/phe/pht014
Wurr C, Cooney L
Public Health Ethics. 2013 April 23; Volume 7 (Issue 3); DOI:10.1093/phe/pht014
Journal Article > CommentaryFull Text
Public Health Ethics. 2009 March 3; Volume 2 (Issue 1); DOI:10.1093/phe/phn042
Hurst S, Mezger N, Mauron A
Public Health Ethics. 2009 March 3; Volume 2 (Issue 1); DOI:10.1093/phe/phn042
Journal Article > CommentaryFull Text
Public Health Ethics. 2009 April 1; Volume 2 (Issue 1); DOI:10.1093/phe/phn037
Calain P, Fiore N, Poncin M
Public Health Ethics. 2009 April 1; Volume 2 (Issue 1); DOI:10.1093/phe/phn037
Outbreaks of filovirus (Ebola and Marburg) hemorrhagic fevers in Africa are typically the theater of rescue activities involving international experts and agencies tasked with reinforcing national authorities in clinical management, biological diagnosis, sanitation, public health surveillance and coordination. These outbreaks can be seen to be as a paradigm for ethical issues posed by by epidemic emergencies, through the convergence of such themes as: isolation and quarantine, privacy and confidentiality and the interpretation of ethical norms across different ethnocultural settings. With an emphasis on the boundaries between public health investigations and research, this article reviews specific challenges, past practices and current normative documents relevant to the application of ethical standards in the course of outbreaks of filovirus hemorrhagic fevers. Aside from the commonly identified issues of informed consent, and institutional review process, we argue for more clarify over the specification of which communities are expected to share benefits, and we advocate for the use of collective definitions of duty to care and standard of care. We propose new elaborations around existing normative instruments, and we suggest some pathways toward more comprehensive approaches to the ethics of research in outbreak situations.
Journal Article > CommentaryFull Text
Public Health Ethics. 2011 December 30; Volume 5 (Issue 1); DOI:10.1093/phe/phr036
Calain P
Public Health Ethics. 2011 December 30; Volume 5 (Issue 1); DOI:10.1093/phe/phr036
For medical humanitarian organizations, making their sources of legitimacy explicit is a useful exercise, in response to: misperceptions, concerns over the 'humanitarian space', controversies about specific humanitarian actions, challenges about resources allocation and moral suffering among humanitarian workers. This is also a difficult exercise, where normative criteria such as international law or humanitarian principles are often misrepresented as primary sources of legitimacy. This essay first argues for a morally principled definition of humanitarian medicine, based on the selfless intention of individual humanitarian actors. Taking Médecins Sans Frontières (MSF) as a case in point, a common source of moral legitimacy for medical humanitarian organizations is their cosmopolitan appeal to distributive justice and collective responsibility. More informally, their legitimacy is grounded in the rightfulness of specific actions and choices. This implies a constant commitment to publicity and accountability. Legitimacy is also generated by tangible support from the public to individual organizations, by commitments to professional integrity, and by academic alliances to support evidence-based practice and operational research.
Journal Article > CommentaryFull Text
Public Health Ethics. 2009 September 22; Volume 3 (Issue 1); DOI:10.1093/phe/php026
Ford NP, Zachariah R, Mills EJ, Upshur R
Public Health Ethics. 2009 September 22; Volume 3 (Issue 1); DOI:10.1093/phe/php026