Should Ebola-Infected Americans Receive Special Treatment?

PHOTO: This photo provided by Jeremy Writebol shows his parents, David and Nancy Writebol, who are Christian missionaries in Liberia. Nancy Writebol is one of two Americans working for a missionary group in Liberia that have been diagnosed with Ebola.
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Two American humanitarian volunteers, Dr. Kent Brantly and Nancy Writebol, were airlifted out of Western Africa and given an experimental drug while thousands of Africans face the prospect of a terrible death from the Ebola virus. Is this fair?

It is, said experts on medical ethics.

“I strongly believe this was an ethically acceptable thing to do,” said Nancy Kass, the deputy director for public health at the Johns Hopkins Berman Institute of Bioethics in Maryland. “They agreed to help out in an epidemic that has a 60 percent mortality rate for no other reason than the good of other people. If we are going to ask this of doctors and nurses, we must promise them that if something happens we will take care of them.”

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Dr. Arthur Caplan, the head of the division of medical ethics at NYU Langone Medical Center in New York said he agreed that Brantly and Writebol deserved special treatment because they were among the few who waded into the center of a deadly epidemic.

“It’s a contract. If you go into danger and get hurt we will try to bring you back,” he said, adding that if the world had reacted to the outbreak sooner, the two humanitarian workers might not have faced such dangerous conditions.

Kass said she thought it would be unconscionable to tell any Ebola volunteer to get to the back of the line for treatment should they become infected.

“Not only do you risk losing people with important skill sets for fighting deadly diseases, you might also put off others who might be willing to go later,” she said.

Kass also had no problem with the two Americans being given an experimental drug to fight Ebola while it was not yet being offered to sick people in Africa.

“It’s easy to look at this drug they received and call it a treatment, but the fact is it’s been tested on monkeys -- that’s it. It seems to have helped in this case but there is a very different threshold when you are giving it to two people versus thousands of people,” she said.

Caplan too said he had no moral issues with the Americans receiving the experimental drug. However, he said there were larger questions to consider.

“The issue right now isn't those two versus the thousand in Liberia. They won’t get the drug anyway,” he said. “The core question is if we had 10 cases of Ebola here and only two doses, who would get them?”

Kass said that in the past, companies have been criticized for giving unproven, experimental treatments en masse.

In 2011, drug companies compensated the parents of Nigerian children who were given an experimental drug during an outbreak of meningitis in 1996, Kass said. While she admitted the two situations were not exactly parallel, she said it highlighted the dangers and difficulties companies face when immediately starting large human field trials of untested medications.

“No company would be in a rush to take this kind of criticism -- or this kind of risk with human lives,” she said.

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