Commentary

Share supportive care while we wait for an Ebola remedy


 

References

While necessary vaccine research proceeds, resource-rich communities need to open their storage closets to send supportive care to where it is needed. Since the outbreak of Ebola in West Africa, and the subsequent introduction of an experimental treatment that may represent a cure for the disease, many have questioned how we expedite this research opportunity, while maximizing the integrity of the data and assisting those who do not have access to treatments.

Both of the Americans and a few others who received the controversial ZMapp treatment have survived. However, two individuals who received it still died. This inconsistency sparked a media campaign that focused on the ineffectiveness of the treatment. The campaign was launched despite the fact that there is currently no way to understand, completely, the reasons some have lived and some have died. That is the purpose of the research.

The accelerated research process sanctioned by the National Institutes of Health and the World Health Organization is an attempt to develop a much-needed vaccine to stop the spread. Unfortunately, research takes time and, if rushed, may result in inaccurate data that may erroneously find the vaccine effective. Exposing people to such a vaccine could cause further harm on many levels (side effects, death, loss of trust in medicine, etc.). Conversely, the hurried research could mistakenly find the vaccine ineffective and prevent entire populations from receiving a lifesaving treatment.

What to do right now

The harmful ramifications of getting this wrong for an already underserved, underprivileged, resource-poor, and extremely vulnerable population would be greater than anyone intends. The panel of experts convened by the World Health Organization determined that expediting the research can be ethically justified due to the emergent nature of the problem. Here we must agree that it should proceed, but insist on it proceeding properly. In the meantime, countries with resources need to determine what actions to take while people are suffering and dying.

The ethically correct action to take is to commit to our responsibilities as members of the global community and offer the supportive assistance that has already been shown to be helpful in managing the symptoms of the disease. Public health workers have enacted preventive strategies to contain the disease and decrease the spread. We in the United States should focus on providing the necessary interventions currently needed to support the masses effectively and less on gearing up to deal with the potential of having one or two people who happen to make it to our borders.

We have the resources in abundance, and it is our ethical duty to play an integral role in protecting others when we can. The media needs to put focus on countries and organizations that are sharing their resources and highlight ways for others to come together in support. We can play an integral part in addressing this crisis while time is taken to work on the research and set a precedent for dealing with such outbreaks in the future, come what may.

Nneka O. Mokwunye, Ph.D., is director of the Center for Ethics, Spiritual Care Department, at MedStar Washington Hospital Center and executive director of its Journal of Hospital Ethics.

hospitalistnews@frontlinemedcom.com

Dr. Nneka O. Mokwunye

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