Ethics in the News: Reopening Schools, Ethics Framework for Vaccine Distribution, Ethics in the Esports Industry, CRISPR Babies, & More – September 4, 2020

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Education and COVID-19

An Ethical Opening for Higher Ed Institutions 
“The job of IRBs is to approve research involving human subjects. The ethicists, scientists and community members who staff the IRBs do risk-benefit analyses before they allow a proposed experiment to go forward. Unlike hospitals — nearly all of which have ethics committees — colleges typically lack any mechanism other than IRBs to make ethical decisions about anything else they do.” 

Ethical issues to consider when reopening schools | COMMENTARY 
“What should schools do about teachers who fall into higher-risk categories? Should they be given a choice between returning to the classroom or working remotely? Even in the absence of choice, some high-risk teachers may decide to retire or quit. Given current teacher shortages, a sudden drop in the workforce of even 10% could be catastrophic. What about school staff in essential areas like sanitation and food services? Some of them will be high-risk as well.” 

“About 10% of all children live with grandparents; they are more likely to be children of color, often from high poverty communities. The legal option of home schooling is a poor fit for the pandemic. For many parents, there will be no meaningful choice unless schools continue to provide the option of full-time home-based instruction.”  

Bioethics and COVID-19 

Bioethics in a Pandemic: Johns Hopkins Offers Ethics Framework to Support Vaccine Distribution Decisions
“The Johns Hopkins University Center for Health Security (the “Center”) has been providing thought leadership related to the novel coronavirus and the COVID-19 pandemic since the beginning of the year. Two of the Center’s recent reports relate directly to our discussion on vaccine distribution.  The first is an interim framework for COVID-19 vaccine allocation and distribution (the “Report”), and the second focuses on the public’s role in COVID-19 vaccination.”

Ethics Consult: Is a COVID Human Challenge Trial Ethical? MD/JD Bangs Gavel 
“On the one hand, ethical norms might suggest choosing individuals at higher baseline risk of contracting the disease outside of HCTs, whether as a result of geography, occupation, or behavior. On the other hand, many individuals at increased risk of exposure belong to demographic groups (racial, economic) that are at higher risk precisely because of earlier discrimination or structural bias — and one may not wish to compound these risks through HCTs. Of course, subjects in HCTs will get vaccinated ahead of others, so if the vaccine does work, participants may benefit substantially. Refusing to allow someone to participate in an HCT also exposes them to risk: namely, the risk of encountering COVID-19 without the potential benefit of a promising but unproven vaccine.”  

These Scientists Are Giving Themselves D.I.Y. Coronavirus Vaccines 
“Each D.I.Y. effort is motivated, at least in part, by the same idea: Exceptional times demand exceptional actions. If scientists have the skills and gumption to assemble a vaccine on their own, the logic goes, they should do it. Defenders say that as long as they are measured about their claims and transparent about their process, we could all benefit from what they learn. 

But critics say that no matter how well-intentioned, these scientists aren’t likely to learn anything useful because their vaccines are not being put to the true test of randomized and placebo-controlled studies. What’s more, taking these vaccines could cause harm — whether from serious immune reactions and other side effects, or offering a false sense of protection.”

Politics  

IRS Chief Makes More Than $100,000 Per Year Off Trump Property, Documents Show
“The commissioner of the IRS—who is responsible for releasing President Trump’s tax returns to Congress—owns two rental properties at the Trump International Waikiki that he profits off of while in office, according to new documents obtained by a watchdog group in Washington, raising new questions about his withholding of Trump’s tax returns as the president goes to court to keep them hidden.”

House Ethics Chair Calls For Political Activity Ban On White House Grounds After RNC 
“House Ethics Committee Chairman Ted Deutch (D-Fla.) slammed the event in a statement on Friday as a “clear violation of the Hatch Act,” as well as a “misuse of taxpayer resources” and a “shameless disregard for the norms that protect the integrity of American democracy.”” 

Scalise hit with ethics complaint over doctored Barkan video
“The House Democratic campaign arm has filed a formal ethics complaint against House Minority Whip Steve Scalise (R-La.), who shared a video doctored to alter the wording of a question posed by activist Ady Barkan to former Vice President Joe Biden.”

Business Ethics

Ethics and economics: The conflicting values of the esports industry
“Fans of the LEC, or “League of Legends” European Championship, voiced their outrage over the partnership with the Saudi Arabian planned city project. Those working on the league’s broadcast organized a unanimous strike. Sixteen hours later, Riot backed out of the deal.

It was perhaps inevitable that a controversial arrangement such as this would occur eventually. In recent years, esports has seen fresh interest from a range of suitors…Moreover, there’s already precedent for partnerships between esports properties and nation states or businesses with close ties to government.”

Medical Ethics

‘CRISPR babies’ are still too risky, says influential panel
Editing genes in human embryos could one day prevent some serious genetic disorders from being passed down — but for now the technique is too risky to be used in embryos destined for implantation, according to a high-profile international commission. And even when the technology is mature, it would initially apply only in a narrow set of circumstances, the panel says.

Too often the basic rights of people with dementia are overlooked
The dilemmas start with diagnosis. With no cure on offer, and diagnostic tools crude and capable of getting it wrong, not everyone thinks people should be told they have early-stage dementia. Some may cope perfectly well with MCI and lose confidence only if given a diagnosis that sounds like a brain-death sentence. But most charities argue that early diagnosis is both their right, and helpful in making care arrangements—and indeed plans to hand over decision-making in good time.

Medical Education Needs Rethinking 
“For example, researchers often cite the individual attribute of race as a risk factor for disease without interrogating the associated environmental experience of racism. Similarly, the lens in medical education is often inclusive of poverty but not oppression, race but not racism, sex but not sexism, and homosexuality but not homophobia. We can see thebiomedical model’s influence in the field of psychiatry in the stark division of labor between the physician who assesses the patient’s neurobiology and treats with prescription drugs, and the therapist who assesses psychosocial factors and treats with therapy.” 

Medical workers, nursing homes top list of who should get COVID vaccine first, says Academy of Medicine advisory group 
“A committee of the National Academies of Sciences, Engineering and Medicine proposed delivering the shots in four phases.  The first group would include medical workers with direct exposure to the virus. This includes people in direct patient care, along with transport and environmental services workers. People who live and work in nursing homes would also be in the first phase, as would first responders. People at especially high risk for serious illness because of chronic health conditions like cancer, Chronic Obstructive Pulmonary Disease, diabetes and obesity would also get priority, but the group did not specify exactly how. There likely won’t be enough vaccine at first for all the Americans who have chronic medical problems that seriously raise risk for serious COVID-19.” 

Research Ethics

New U.S. ethics board rejects most human fetal tissue research proposals 
“The Human Fetal Tissue Research Ethics Advisory Board, appointed by Health and Human Services (HHS) Secretary Alex Azar, reviewed the 14 proposals last month. Its recommendations that 13 of them be rejected, delivered to Azar and Congress today, were the first under a new regime implemented last year by the Trump administration, in which projects by extramural, NIH-funded scientists using human fetal tissue need to pass an extra layer of ethics review.” 

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