QuestionQuestion

1. Write one response to this post (1 paragraph) using a scholarly article and reference.   
Normally when testing vaccines, it is best to test the vaccines versus a placebo (sugar pill) in a randomize control trial (RCT). Describe the ethical implications researchers must weigh in consideration to performing a RCT on a disease like Ebola and whether you support or disapprove of using RCTs for vaccination against Ebola (Zandy).
In 2014, hundreds, if not thousands have died from the Ebola virus in West African and other part of Africa and the rest of the world. Health Organization (WHO) declared that it is ethical to offer randomize control trial (RCT) in the case of the Ebola outbreak, as long as the interventions have potential benefits and unknown risks and side-effects (Adebamowo, et al., 2014). It is oaky if the risk is unknown, but what about the lives of those who participate in this randomized trial? Questions about whether untested and undocumented treatment looms even today; and about how they should be deployed and tested randomly. The ethical issue behind this Ebola randomized control trial, is whether it was okay to use humans as guinea pigs, or to use new intervention with convention care or placebo. Advocates against RCT for Ebola argued that (as I would too), if RCT should pass for Ebola and be regularized as ethical, then it would set precedent for future approach in other RCT. On the other hand, even if there is a strong concern about the balance of force of interest (high mortality rate versus conventional), I disagree with potential benefits and the unknown risks. Ethical arguments are not the same for all levels of risk (Adebamowo, et al., 2014). Randomization is not, moreover, the only way to gather reliable information about the safety and effectiveness of potential Ebola therapies. One viable approach is to try different treatments at various locations following observational studies under conventional and standard care. Some form of ethical criteria must guide the provision of all interventions and cures. This includes the transparency of all aspects of care, informed consent, freedom of choice, confidentiality, and respect for all person, preservation of dignity and involvement of the community (World Health Organization, 2014).

2. Write one response to this post(1 paragraph) using a scholarly article and reference.
The first case of the most recent Ebola outbreak in Guinea was reported to World Health Organization (WHO) on the first trimester of that year, but it was not until July that WHO declared the Ebola outbreak . WHO received severe critics, based on the delay on communicating prevention strategies.
World Health Organization (2014) indicates on the guidelines for Ebola epidemics that after further confirmation of cases through positive laboratory testing, the organization should be notified and therefore begin the implementation of an epidemic control strategy following certain objectives such as, establishment of a committee tasked with coordinating epidemic prevention, collaborating and working with the media, setting up of a surveillance system, establishment of a social mobilization and health education program, treat patients in safety and dignity, among others.
Morbidity and mortality rates could be controlled and infections of health care workers could be prevented if communication of this Ebola outbreak had been informed before. A justification to this action by WHO could be explained by the fact that officials where overwhelmed by the severity of this disease, finding the best way to manage uncertainty on the population (Rosenbaum, 2015).

3. Write one response to this post (1 paragraph) using a scholarly article and reference.   
Current data have shown the tremendous negative impact of Ebola in terms of the number of cases it could potentially infect each week, had the past intervention failed to work. In 2014, epidemiologists tracking the spread of Ebola have predicted the exponential rate of increase will reach between 2500 and 5000 cases each week (WHO, 2016). Therefore, Ebola remains to be a troubling threat, particularly in regions where it was originally found. At this point, control and prevention measures have been identified (WHO, 2016). Nevertheless, a stronger emergency preparedness and response should be available.
Data that will inform epidemiologists, researchers, and health care workers about proper case identification and how to promptly interrupt Ebola transmission are important information to avert future public health catastrophe. In particular, identifying and understanding the stages in which Ebola can be considered highly infectious and how each stage can affect disease transmission are relevant to seeking better ways to diagnose and treat Ebola virus disease. Diagnostics research are needed for improved diagnostic tool to detect the virus, provide rapid identification, and one that is easy to deploy at the point-of-care, are needed (National Institute of Allergy and Infectious Diseases (NIAID), 2016). Applied research towards the development of diagnostics, vaccines, and treatments plays a crucial role. The U.S. Army Medical Research Institute and GlaxoSmithKline, a biotech company, have collaborated to investigate a candidate vaccine. The vaccine is based on a chimpanzee virus which will be used to develop a recombinant product to fight against Ebola virus (NIAID, 2016). Early phase clinical research was completed, and the phase 2 randomized, placebo-controlled clinical trial had proven the product to be safe for testing at a large late phase clinical trials. However, the decline in the number of Ebola cases halted the trial. To date, data from advanced studies are still needed to confirm safety and efficacy of the vaccine. Additionally, more research on vaccines that can stimulate protective immune response against Ebola virus is needed. Sufficient data on potential treatment, such as the monoclonal antibodies or ZMapp, are also needed to support the application of ZMapp outside of the context of “emergency use authorization to Ebola-infected patients in Africa” (NIAID, 2016). Making such treatment widely available provides for a faster and wider coverage of treatment, should another Ebola outbreak occur.

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1. Response: Randomized control trials (RCT) are a necessary part of the research process and I agree they are needed. With that being said there are ethical ways to go about conducting these trials. Participants must be voluntary, there must be full disclosure on both parties. Participants must be told possible side effects (if known), if they are not aware of any side effects, etc. Most importantly other than full disclosure participants must have the ability to opt-out at any point during the trial. During the Tuskegee Trials there were no ethical considerations for the participants before during or after the trials were conducted which took place from 1932-1972, (Ogungbure, 2011). The class action lawsuit was filed as a result of the unethical findings of this research in 1973. There is also the Stanford Experiment in which participants in this research study in which participants were not afforded the opportunity to opt-out even though they were told this would be an option leaving some participants with mental issues....

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