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Medical Science

Pandemic Ethics

Medical Science

The high esteem for medical science that one finds in Jewish sources contradicts the notion that there is an inherent conflict between religion and science. Any decision that does not take the considered opinions of scientific experts into account cannot be considered ethical. How can Jewish teachings from the past help us apply current scientific knowledge to the urgent problems we face today?

Traditional sources

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Current thinking

Is It Ever OK To Jump Ahead In The Vaccine Line?

By Pien Huang — February 6, 2021

Whether one is eligible for a vaccine may depend not only on age or occupation, but on where one lives, what company one works for, etc. It can all seem pretty unfair. If the system is not working, is it ever fair to cut in line? NPR spoke with three bioethicists to reason out what’s right.

Scientists and Health Experts Need to Be Advocates

By Gaurab Basu — November 13, 2020

Phsycian Gaurab Basu argues that amid multiple crises, science and medicine cannot stand aloof from politics.

“Our current crises challenge us to have the courage to imagine what is possible in a different kind of world. We didn’t need a virus to animate the harmful and unhealthy fault lines in our society. But we must use this moment in history to do the deep, structural work our patients and future generations deserve. Health care professionals and scientists play an essential role in creating the change that will allow that future to manifest.”

If donating a kidney to a stranger is ethical and allowable, taking part in a Covid-19 challenge trial should be, too

By Sam Beyda and Abigail Marsh — September 22, 2020

Sam Beyda is an altruistic kidney donor who has volunteered to take another risk for the benefit of strangers by participating in a Covid-19 human challenge trial. But some scientists are pushing back against trials like these, arguing that they are not ethically justified because volunteers do not stand to gain personally from participating in them.

“Thousands of patients in kidney failure died needlessly because transplant professionals refused to consider the possibility that rational, mentally healthy people who genuinely value helping others were willing to take on some risk to donate their kidneys to strangers. How many Covid-19 patients will die if we fail to consider that possibility now?”

Ensuring an ethical path to a ‘warp speed’ vaccine

By Katherine Unger Baillie — September 4, 2020

As dozens of COVID-19 vaccines enter various stages of clinical trials, what is being done to ensure this process is being conducted ethically? How will a vaccine be distributed fairly? How can public health officials convince people that a vaccine is safe and worth receiving? This article presents the ethical implications of the development and allocation of a COVID-19 vaccine.

“Many take it for granted that you start from a utilitarian framework (…) that it’s about saving the most lives or the most life-years. But in a society such as ours, you can’t take that kind of ahistorical perspective. We have highly unequal access to health care, vast differences in how easy it is for people to live healthily, and, for example, in Philadelphia, a difference of 30 years in life expectancy between economically better and worse off zip codes. These are horrific facts that have to do with social determinants of health, with structural racism. That’s why to me it’s absolutely imperative that any allocation system doesn’t proceed in colorblind fashion.”

The ethics of reopening amidst COVID-19

By Tia Powell — August 18, 2020

Bioethicist Tia Powell recognizes the tension between protecting population health and protecting economic health. But she warns that reopening must be rooted in a rational decision-making process, not one based on fear or idealized aspirations. Irrational responses distract us from getting to work on the crisis itself.

“Transparency, and ultimately honesty, will help Americans make decisions based on data and facts, not on fear and bias. This morally sound approach can protect human life and also preserve the economic opportunities people need to survive. Honest assessment of data and best practices enables people to respond better to changing circumstances, letting strategies shift and evolve as new information emerges.”

‘Morality pills’ may be the US’s best shot at ending the coronavirus pandemic

By Parker Crutchfield — August 10, 2020

COVID-19 threatens everyone. We all must cooperate to lower the chance that the coronavirus harms anyone. However, many people chose not to follow regulatory measures. Professor of Medical Ethics Parker Crutchfield’s research focuses on questions like how to induce those who are non-cooperative to do what’s best for the public good. He suggests that a psychoactive pill might be the solution to this problem.

“The scenario in which the government forces an immunity booster upon everyone is plausible. And the military has been forcing enhancements like vaccines or “uppers” upon soldiers for a long time. The scenario in which the government forces a morality booster upon everyone is far-fetched. But a strategy like this one could be a way out of this pandemic, a future outbreak or the suffering associated with climate change. That’s why we should be thinking of it now.”

The Case for Human COVID-19 Challenge Trials

By Peter Singer and Isaac Martinez — August 5, 2020

Bioethicist Peter Singer and challenge trial volunteer Isaac Martinez argue that regulators should permit and begin to prepare for “human challenge” vaccine trials in order to end the COVID-19 pandemic. In these trials, fully informed volunteers would be injected with potential vaccines (or with a placebo) and then intentionally exposed to the virus.

“It is true that the risks of exposure to COVID-19 are not as well known as the risks of kidney donation. Nevertheless, as long as the volunteers understand this uncertainty, many ethicists have decided that the risks are acceptable. We may compare it with volunteers taking part in a dangerous rescue operation – for example, the mission that freed two trapped miners in the Beaconsfield gold mine in Tasmania, in 2006. The rescuers did not know the exact probabilities of serious harm or death, but they took the risk anyway and were feted as heroes.”

Pandemic Language

By Franklin G. Miller — July 21, 2020

Medical ethicist Franklin G. Miller illuminates the difference between public health and regular medicine. In his diagnosis, the devaluation of public health has severely exacerbated the pandemic.

“Describing life-saving public health interventions as nonpharmaceutical reflects the pervasive undervaluation of public health as compared with medicine. This undervaluation …is displayed more significantly by the fact that public health receives less than 3 percent of the total U.S. funds devoted to promoting health. Failure to invest in and effectively implement appropriate public health interventions goes a long way in explaining the comparatively poor response to the pandemic in the U.S.”

How making a COVID-19 vaccine confronts thorny ethical issues

By Bethany Brookshire — July 7, 2020

Psychologist Bethany Brookshire looks into the ethics of using human immortalized cell lines to make COVID-19 vaccines, raising important questions about what we owe human subjects who wittingly or unwittingly contributed their cells to medical research. While concerns about fetal cell lines that concern Catholic ethicists are a non-issue in Jewish ethics, other issues discussed here are relevant. This article illustrates how ethical outcomes depend on bringing religious  values and science into dialogue with each other. 

“[Yolonda Wilson, a bioethicist at Howard University points out that] ethical considerations are not about weighing an ethical approach against the need to save lives. “That’s false framing,” she says. “It’s not: Be ethical or save lives. Ethics should guide us in thinking how to save lives.”

An Ethical Path to a Covid Vaccine

By Carl Elliott — July 2, 2020  

One potential way to speed up the development of a vaccine for Covid-19 is through a “challenge study,” in which researchers give healthy human subjects a prospective vaccine and then infect them with the coronavirus. Professor Carl Elliott discusses ethical dilemmas arising from medical research and how they relate to race and class.

“The Covid-19 crisis has presented the medical research community with a rare opportunity. At no time in recent memory has the importance of research subjects been so evident. If a nonprofit organization can sign up over 26,000 volunteers for challenge studies in a matter of months, it should be possible to reform the oversight system so that research subjects are treated fairly. But those reforms would entail structural changes that unfortunately neither the research community nor those of us who benefit from medical research have shown any interest in making.”

COVID-19 and Modern Orthodoxy: Is Acceptance of Science a Religious Failing?

By Yitzhak Blau — May 20, 2020

Rabbi Yitzhak Blau, editor of the journal TRADITION and Rosh Yeshivat Orayta, counters the claim that the Modern Orthodox embrace of science is less authentic than the piety of the Haredi Jews. He highlights a long tradition of embracing the natural order alongside a belief in God’s judgment. The pursuit of medical science is part and parcel of Modern Orthodox theology.

“To be fair, many problematic and harmful ideas emerge in the name of science which tend to endorse determinism, fail to appreciate aspects of human experience which cannot be measured in laboratory exploration and precise measurement, and often exhibit a pathological hatred of religion. Nonetheless, accepting a scientific view of the universe does not require us to fall into the trap of scientism. I believe that such acceptance reflects religious authenticity.”

Is It Permitted to Flee the City?

By Tamara Morsel-Eisenberg — April 20, 2020

Tamara Morsel-Eisenberg, a historian of Early Modern Jewry, travels from 21st-century New York in the grips of a pandemic to the world of 16th-century rabbis confronting plague. Examining rabbinic sources about illness and “bad air,” she discovers striking parallels between contemporary experience and earlier generations of Jews. Early modern rabbis navigated epidemics with the same mix of fear, hope and practicality that shapes our decisions today.

“Is it better to stay or to go? The rabbinic answer is, as usual, not straightforward. The Talmud says that one should stay indoors during an epidemic. The 15th-century rabbi says one should flee. The Ashkenazic tradition is known for respecting its local customs as much as its legal texts: “the custom of the Jewish people is Torah.” By inserting this 15th-century advice into a legal code, Rabbi Isserles is bringing it up to par with divine law. He tries to reconcile the contradictory advice: If you can remain isolated and “go inside without anyone leaving,” do so. Otherwise, leave.”

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