On the morning of last October, a 26 -year -old medical student, Alexander Lorenson, entered a small white room inside the University of Maryland Medical College, to participate in a human challenge experience to test a new treatment that scientists believe that it may prevent the transmission of malaria, that disease that It harvested the lives of more than 600,000 people annually, according to the New York Times.
Everything is carefully equipped in the room where the experiment will take place to ensure that mosquitoes loaded with malaria are not escaped. Electric traps for insects were placed on the walls, and researchers were provided with electrical speculators as an additional precaution if they can escape. More than 20 volunteers have waited for their role to be prey to these small insects, and then remain under accurate medical surveillance.
Part of the volunteers received varying doses of experimental preventive treatment after the end of the first stage of the experiment, while the participants in the control group did not receive the treatment immediately, as they had to deal with the effects of the infection first before receiving the drug in later stages of the study, to study the effect of the parasite that The disease causes the absence of prevention.
Dr. Kirsten Like, the study supervisor, explained to the volunteers that the symptoms will not appear immediately, but may take at least a week to develop. Initially, everything looked well for Loreson, but on the eleventh day, the headache began to sneak into his head, then the symptoms increased quickly, to feel very nauseous, followed by vomiting. Then, he was sure that he was wounded by malaria.
But he was surprised when the tests revealed that he was not infected with it, but was only suffering from an ordinary intestinal virus, which means that the experimental therapy was successful in protecting it from injury.
In the same month, Oscar Dylani, an artificial intelligence researcher from the University of Oxford, decided to participate in a similar experience, but instead of exposure to mosquitoes, the parasite that causes malaria was injected directly into his blood.
After 9 days, Dylani had sharp attacks from sweating and chills, and he was barely able to eat or get out of his bed, until he was given tablets to treat malaria, and gradually recovered.
Dylani and Loreninson are not the only volunteers. There are dozens of volunteers around the world who are experiencing similar experiences, as part of research known as “human challenge experiences”.
What are these experiences, and why are they taking place despite the controversy around them?
What are the experiences of human challenge?
Human challenge experiences are defined as research studies in which healthy volunteers are deliberately exposed to pathogens, with the aim of studying immune responses to participating people, monitoring how infection is transmitted between individuals, and testing the effectiveness of treatments and vaccines, under careful medical supervision.
These experiences are relatively fast, as they can only take a few months, compared to traditional years that may extend years, due to their dependence on thousands of participants in the disease normally.
A history of scientific and moral controversy
Although these experiences contributed to the development of vaccines for fatal diseases such as smallpox, cholera and typhoid, their history carries dark pages of moral violations.
The first vaccine in history arose from a human challenge experience, when the English scientist Edward Jenner wondered whether the cow chickenpox, a simple disease, could give immunity against smallpox, which was a fatal disease at the time. To test this, Jenner in 1796 vaccinated a small boy with a cow chickenpox, then deliberately exposed him to the smallpox virus. The boy was not affected by the disease, which demonstrated the effectiveness of the vaccine and paved the way for a revolution in the science of vaccination.
A number of challenges have arisen in the following two centuries, many of them involved the injury of weak groups such as prisoners or soldiers without their consent or even their knowledge of the dangers. During World War II, “researchers in the war systems of Nazi Germany and the Japanese Empire transmitted anthrax infection, choleidia, cholera and others to prisoners,” according to the New York Times.
In the United States, health authorities have deprived thousands of black men in Alabama to obtain a cure for syphilis so that researchers can study the disease. These moral violations were the motive behind the establishment of the field of medical research ethics.
How did the ethics of experiences develop human beings?
In the early twentieth century, scientists began to realize the importance of protecting the rights of participants in clinical experiences. The American military doctor Walter Reed was one of the first to set moral rules for research in 1900, when participants in the study of yellow fever in Cuba were granted clear contracts explaining all the risks, as well as financial compensation.
Since then, voluntary approval and ethical controls have become an essential part of all modern clinical studies, including informing them of all possible risks, as well as confirming the availability of rescue treatments.
Although this controversy has not ended, the development of moral standards made these experiences more acceptable in the scientific community, especially with the increasing health crises that require faster and more accurate responses.
New investments in human challenge experiences
As interest in this research increases, specialized research facilities are being developed to support these experiments. In Australia, the University of Melbourne recently opened the first facility dedicated to the experiences of human challenge in the southern hemisphere, and the researchers there are a new vaccine for the AD A (A), which is one of the main causes of deadly bacterial infection.
In Belgium, a facility with 30 beds has been completed as part of a $ 57 million project to develop the next generation of “Coveyd-19” vaccines through human challenge experiences.
Between scientific necessity and moral questions
Some volunteers found the experience more difficult than they expected, and others felt that they were not fully prepared or completely aware of what they might go through during the experiment.
The motivation of all participants was not only scientifically or human, as financial compensation was an influential factor for some, especially those who seek to earn an additional income. This raises moral questions, such as:
- Can volunteers be completely guaranteed? Even with the availability of effective treatments, there is a risk of unexpected side effects, or unexpected responses from the body to the disease.
- Do the volunteers completely realize what they might go through? Although the consent of the volunteers is a prerequisite, some do not understand how difficult it is to experience it actually.
- Is it morally healthy people deliberately exposing the disease, even if it is for scientific research? This question is the essence of the ongoing controversy over the experiences of human challenge. While some see it as a necessity to accelerate medical discoveries, others believe that the search for safer alternatives should be a priority.
Dr. Sima Shah, a biological ethics specialist at Lori Children’s Hospital in Chicago and a professor at North Western University, who specializes in studying human challenge experiences: “Many people are wondering: Doesn’t this conflict with the Department of Hippocrates? ! ”.
For you, if you have the opportunity to join a similar research experience, will you do?