a Clinical Center Department of Bioethics, Division of AIDS, National Institutes of Health , Bethesda , Maryland , USA.
Am J Bioeth. 2015;15(4):11-6. doi: 10.1080/15265161.2015.1010996.
The recent Ebola outbreak in West Africa began in the spring of 2014 and has since caused the deaths of over 6,000 people. Since there are no approved treatments or prevention modalities specifically targeted at Ebola Virus Disease (EVD), debate has focused on whether unproven interventions should be offered to Ebola patients outside of clinical trials. Those engaged in the debate have responded rapidly to a complex and evolving crisis, however, and this debate has not provided much opportunity for in-depth analysis. Additionally, the existing literature on access to unproven therapies has focused on contexts like HIV/AIDS and oncology, which are very different than the Ebola epidemic. In this paper, we examine the ethical issues surrounding access to unproven therapies in the context of the recent Ebola outbreak to yield new insights about this controversial and unsettled issue. We argue first that, in this context, the interests of patients in obtaining access to unproven therapies are not fully aligned with the interests of their providers and drug developers. Second, we focus on the resource constraints facing providers, funders, and patients and conclude that they often counsel against the use of unproven interventions against EVD.
最近在西非爆发的埃博拉疫情始于 2014 年春季，至今已造成 6000 多人死亡。由于目前尚无专门针对埃博拉病毒病 (EVD) 的经批准的治疗方法或预防方法，因此争议的焦点是是否应该在临床试验之外向埃博拉患者提供未经证实的干预措施。然而，参与辩论的人迅速对这一复杂和不断演变的危机做出了反应，这场辩论并没有为深入分析提供太多机会。此外，关于获得未经证实疗法的现有文献主要集中在艾滋病毒/艾滋病和肿瘤学等领域，这些领域与埃博拉疫情有很大的不同。在本文中，我们将在最近的埃博拉疫情背景下探讨获得未经证实疗法的伦理问题，以对这一有争议且尚未解决的问题产生新的见解。我们首先认为，在这种情况下，患者获得未经证实的疗法的利益与他们的提供者和药物开发商的利益不完全一致。其次，我们重点关注提供者、资助者和患者面临的资源限制，并得出结论，他们经常不建议使用未经证实的干预措施来对抗 EVD。
