Faculty Bibliography

Ethical issues are present at each stage in the vaccine product life cycle, the period extending from the earliest stages of research through the eventual design and implementation of global vaccination programs. Recent developments highlight fundamental principles of vaccine ethics and raise unique issues for ongoing vaccination activities worldwide. These include the 2009-10 H1N1 pandemic influenza vaccination campaign, renewed attention to the potential global eradication of polio, and the ongoing evaluation of vaccine risk controversies, most notably the alleged link between childhood vaccines and autism. These cases present ethical challenges for public health policy-makers, scientists, physicians, and other stakeholders in their efforts to improve the health of individuals, communities, and nations through vaccination.

AIM: Determine predictors of support of a mandatory seasonal influenza vaccine program among health care workers (HCWs). SCOPE: Cross-sectional anonymous survey of 2443 (out of 8093) randomly selected clinical and non-clinical HCWs at a large pediatric network after implementation of a mandatory vaccination program in 2009-10. RESULTS: 1388 HCWs (58.2%) completed the survey and 75.2% of respondents reported agreeing with the new mandatory policy. Most respondents (72%) believed that the policy was coercive but >90% agreed that the policy was important for protecting patients and staff and was part of professional ethical responsibility. When we adjusted for attitudes and beliefs regarding influenza and the mandate, there was no significant difference between clinical and nonclinical staff in their support of the mandate (OR 1.08, 95% C.I. 0.94, 1.26). CONCLUSIONS: Attitudes and beliefs regarding influenza and the mandate may transcend professional role. Targeted outreach activities can capitalize on beliefs regarding patient protection and ethical responsibility.

J. Craig Venter announced in May that he and his colleagues had made a new living bacterium from a genome they decoded, artificially rebuilt and then stuck into the cored-out remains of the bacterium Mycoplasma. When the hybrid bug began to reproduce, it became the first artificial organism, putting to rest the ancient and tenacious conceit that only a deity or some special power can create the spark of life. It was the most dramatic demonstration yet of the power of synthetic biology, a nascent field that promises to solve many of the most pressing problems. Here, Caplan discusses the probable effects of biotechnology

Caplan talks about the need for reexamination of a regulatory system that is not keeping its people safe. Hardly a month goes by without a medication or medical device being identified as having dangerous side-effects, the Food and Drug Administration (FDA) holding hearings, lawyers taking out ads looking for victims, class-action suits getting filed, or patients being left to talk with their equally confused doctors about whether they should stop treatment given the newly identified deaths, risks, recalls, or warnings. These things happened because the regulatory system is too skewed toward looking at the earliest stages of research

Caplan points out that the Internet isn't the only place people can find free-flying hype about genetic testing. They can also find it at their corner drugstore. The reality is that whether they are talking about Internet dietary advice or corner drugstore home testing kits, genetic testing isn't ready for primetime. Not only is genetic testing not ready for sale at the local drugstore, it isn't yet ready for distribution at doctor's office. Genes may be the blueprints of life, but currently it takes a genetic engineer to read and interpret them

Obviously, health-care workers have the duty, proclaimed in their own professional associations' ethical codes, to put patient interest and safety first and get vaccinated. There is also, clearly, an unarguable foundation for insisting that all health-care workers who have regular patient contact get vaccinated as a job requirement. However, when hospitals and health departments have proposed vaccination mandates for health-care workers, they have almost invariably been met with lawsuits demanding the right to choose. Here, Caplan discusses why legal actions against mandates should be stopped

When one thinks of hunger strikes, two images likely come to mind. In 1980, seven Northern Irish Republican prisoners launched a hunger strike in Belfast's Maze prison. They were protesting the revocation of their prisoner-of-war status by the British government. This initial hunger strike led to a series of others, during which Bobbie Sands became the first of ten prisoners to die from starvation. More recently, many prisoners held at the US facility at Guantanamo Bay on the island of Cuba have conducted hunger strikes. The first began in 2005 and involved as many as 130 men. They continue to the present day, with one or two prisoners involved in hunger strikes at any given time. Here, Caplan examines whether state officials should make a move to force-feed prisoners on hunger strikes