Literature DB >> 25150847

Deliberate Microbial Infection Research Reveals Limitations to Current Safety Protections of Healthy Human Subjects.

David L Evers1, Carol B Fowler, Jeffrey T Mason, Rebecca K Mimnall.   

Abstract

Here we identify approximately 40,000 healthy human volunteers who were intentionally exposed to infectious pathogens in clinical research studies dating from late World War II to the early 2000s. Microbial challenge experiments continue today under contemporary human subject research requirements. In fact, we estimated 4,000 additional volunteers who were experimentally infected between 2010 and the present day. We examine the risks and benefits of these experiments and present areas for improvement in protections of participants with respect to safety. These are the absence of maximum limits to risk and the potential for institutional review boards to include questionable benefits to subjects and society when weighing the risks and benefits of research protocols. The lack of a duty of medical care by physician-investigators to research subjects is likewise of concern. The transparency of microbial challenge experiments and the safety concerns raised in this work may stimulate further dialogue on the risks to participants of human experimentation.

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Year:  2014        PMID: 25150847     DOI: 10.1007/s11948-014-9579-z

Source DB:  PubMed          Journal:  Sci Eng Ethics        ISSN: 1353-3452            Impact factor:   3.525


  55 in total

1.  What makes clinical research ethical?

Authors:  E J Emanuel; D Wendler; C Grady
Journal:  JAMA       Date:  2000 May 24-31       Impact factor: 56.272

2.  The ethical challenge of infection-inducing challenge experiments.

Authors:  F G Miller; C Grady
Journal:  Clin Infect Dis       Date:  2001-09-05       Impact factor: 9.079

Review 3.  The ethical analysis of risk.

Authors:  C Weijer
Journal:  J Law Med Ethics       Date:  2000       Impact factor: 1.718

4.  Two studies evaluating the safety and immunogenicity of a live, attenuated Shigella flexneri 2a vaccine (SC602) and excretion of vaccine organisms in North American volunteers.

Authors:  David E Katz; Trinka S Coster; Marcia K Wolf; Fernando C Trespalacios; Dani Cohen; Guy Robins; Antoinette B Hartman; Malabi M Venkatesan; David N Taylor; Thomas L Hale
Journal:  Infect Immun       Date:  2004-02       Impact factor: 3.441

5.  SEROLOGIC ANALYSIS OF A PENITENTIARY GROUP USING RAW MILK FROM A Q FEVER INFECTED HERD.

Authors:  W W BENSON; D W BROCK; J MATHER
Journal:  Public Health Rep       Date:  1963-08       Impact factor: 2.792

6.  Recent Researches concerning the Etiology, Propagation, and Prevention of Yellow Fever, by the United States Army Commission.

Authors:  W Reed
Journal:  J Hyg (Lond)       Date:  1902-04-01

7.  Experimental exposure of human subjects to viruses of influenza.

Authors:  W HENLE; G HENLE
Journal:  J Immunol       Date:  1946-02       Impact factor: 5.422

8.  The Willowbrook hepatitis studies revisited: ethical aspects.

Authors:  S Krugman
Journal:  Rev Infect Dis       Date:  1986 Jan-Feb

Review 9.  Towards a universal influenza vaccine: volunteer virus challenge studies in quarantine to speed the development and subsequent licensing.

Authors:  John S Oxford
Journal:  Br J Clin Pharmacol       Date:  2013-08       Impact factor: 4.335

10.  Federal human research oversight of clinical trials in the United States.

Authors:  Deborah A Zarin; Tony Tse; Jerry Menikoff
Journal:  JAMA       Date:  2014-03-05       Impact factor: 56.272

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  4 in total

1.  Ethical considerations in Controlled Human Malaria Infection studies in low resource settings: Experiences and perceptions of study participants in a malaria Challenge study in Kenya.

Authors:  Maureen Njue; Patricia Njuguna; Melissa C Kapulu; Gladys Sanga; Philip Bejon; Vicki Marsh; Sassy Molyneux; Dorcas Kamuya
Journal:  Wellcome Open Res       Date:  2018-10-29

2.  Money-oriented risk-takers or deliberate decision-makers: a cross-sectional survey study of participants in controlled human infection trials.

Authors:  Marie-Astrid Hoogerwerf; Martine de Vries; Meta Roestenberg
Journal:  BMJ Open       Date:  2020-07-26       Impact factor: 2.692

Review 3.  Human infection challenge studies in endemic settings and/or low-income and middle-income countries: key points of ethical consensus and controversy.

Authors:  Euzebiusz Jamrozik; Michael J Selgelid
Journal:  J Med Ethics       Date:  2020-05-07       Impact factor: 2.903

4.  Expert voices and equal partnerships: establishing Controlled Human Infection Models (CHIMs) in Vietnam.

Authors:  Evelyne Kestelyn; Chi Le Phuong; Jennifer Ilo Van Nuil; Hoai Tam Dong Thi; Nguyet Minh Nguyen; Trung Dinh The; Mary Chambers; Cameron P Simmons; Toan Nguyen Trong; Dung Nguyen The; Le Truc Phuong; Dung Do Van; Dung Duc Anh; Vinh Chau Nguyen Van; Stephen Baker; Bridget Wills
Journal:  Wellcome Open Res       Date:  2019-09-25
  4 in total

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