The ethics of vaccine trial on humans

It has rather been a serious issue in medical science for long whether any trial of medical invention on humans first is ethically justified. William A Haseltine, scientist and a biotech entrepreneur, reignited the debate once again in his essay titled "Human Covid-19 Vaccine Trials Are Unnecessary, Uninformative, and Unethical" which was published from Cambridge last week. (Project Syndicate, Jun 4, 2020).

Haseltine brings up the issue to assess the effectiveness of potential Covid-19 vaccines. He argued that such experiments on humans before its commercial operation is completely unethical because a human cannot be the subject of trial, as he believes that all lives are invaluable and such trials may have a fatal consequences.

He claimed that "human challenge studies" had gone so mad with panic that they have forgotten the history and horrors of medical experimentation on humans.  I think such fear is entirely well-grounded but it is logically flawed.

When a medical invention or any creation of medical science appears for the first time, it undergoes vigorous laboratory study on animals before clinical testing on humans. But, in many cases, animal studies always do not help to accurately predict the impact of the medical invention on humans.

Many a study have borne out that animal experiments often fail to reach a definite conclusion about the impact of the medication on the human body. Bio-ethicists have been protesting against such studies on animals but they have not been able to come up with an alternative to this method.

Again, medical researchers often find themselves in trouble when a large number of humans die every year by consuming a prescribed drug, even after it has successfully passed the animal testing phase. So, this is a rather important issue but there is another grave issue at hand as well.

The principal target of Haseltine's essay was to bring up an old but important question about whether researchers should run a human test with a vaccine before ensuring its success. Recently, the University of Oxford took a mammoth project on vaccines and the field trial has already been done.

Two volunteers came forward willingly to help the research. One of them is Elis Granato.  During an interview, he told BBC "I am a scientist, so I want to try to support scientific processes wherever I can."

More than 800 people have been included in the study where half of them received the Covid-19 vaccines and the other half was given a control vaccine for meningitis. Sara Gilbert, professor and leader of this pre-clinical research, was very confident about its positive result. The next few months are thus important for reaching a conclusion.

It is important to remember that all these people who volunteered for the experiment came on their own accord. They were not enticed or forcibly taken to participate in the experiment.

Once in England, many innocent civilians were forcibly incorporated in First World War, which was morally unjustified. But in 1971, a huge number of people went to the Liberation War of Bangladesh and sacrificed their lives voluntarily. This was a morally encouraging fact. Therefore, volunteering is certainly beyond question as has happened in the case of the Oxford trial.

It is not necessary to remind the readers of the havoc created by the coronavirus outbreak which has killed more than 4 hundred thousand people across the world while 7 million have been infected. It is very clear that if preventive measures are not invented right away, nobody can predict where the death procession will end finally. That is why the invention of a vaccine is of utmost importance.

Haseltine admitted to the devastation and also said, "The rush to develop a Covid-19 vaccine will definitively end the loss of life and stop the economic devastation that it has already produced".

Nevertheless, he added that "deliberately infecting volunteers with SARS-CoV-2 to test the efficacy of vaccine candidates is unnecessary, uninformative, and unethical". This is utterly confusing because if you truly feel its caused a devastation, then you must definitely feel the need for protective measures.

He argued that many countries have successfully controlled the epidemic in the absence of a vaccine. For example, Wuhan, the epicentre of Covid-19 and some other Nordic countries have succeeded in containing the spread.

The history of medical science is full of trial and error and almost all medicines are introduced with a long process of experimentation on either humans or animals. If you maintain bioethics and give value to each animal equally, you have to attach the same weight to all regardless of their gravity and importance in the world. If you are a die-hard moralist you must agree that all animals in the world are equal, no matter what species they are. Accordingly, you cannot emphasise the protection of particularly on animal like Homo sapiens.  

Dr Siddhartha Shankar Joarder, is Professor, Department of Philosophy, Jagannath University, Dhaka.