Thomas Kerns, PhD
Preface
Introduction
1. Where stands the pandemic now?
2. It's not just another disease.
2.1 High morbidity and mortality
2.2 Lifelong infectiousness
2.3 Lengthy asymptomatic stage
2.4 Highly mutable
2.5 Effective modes of transmission
2.6 Destroys the immune system
2.7 Viral reservoir expanding
3. Will it ever slow down?
3.1 A cure?
3.2 Behavior Change?
3.2.1 Sex, drugs and human rights
3.2.2 Quarantine?
3.3 A weaker virus?
3.4 A preventive vaccine?
4. Is a vaccine possible?
4.1 Economic disincentives
4.1.1 Costs
4.1.2 Legal liabilities
4.1.3 Financial return
4.2 Scientific challenges
5. The human immunodeficiency virus
5.1 Etiologicity
5.2 Alive?
5.3 Virology and mutability
6. How the immune system works
7. How vaccines work
7.1 Cell-associated transmission
7.2 Animal models
8. Human trials
9. Criteria of Effectiveness
9.1 What does "vaccine success" mean?
9.2 Percent efficacy
9.3 Could a vaccine worsen the epidemic?
9.4 Standards for vaccine licensure
9.5 Urgency: a double-edged sword
10. Ethical principles
11. Real risks
A preliminary disquisition on The Other
11.1 No future protocols
11.2 Immediate systemic reactions
11.3 Potential immune tolerance
11.4 Enhanced infectivity
11.5 Discrimination
11.5.1 The problem
11.5.2 Confidentiality: relativism vs essentialism
11.5.3 Weak protections for confidentiality
11.6 Whole virus vaccines
11.6.1 Inactivated virus vaccines
11.6.2 Live, attenuated virus vaccines
11.6.3 Subunit vaccines
11.7 Being monitored
11.8 Feeling safe
11.9 Immunosuppression
11.10 Autoimmunity
11.11 Malignancies
11.12 Neurological disease of unknown origin
11.13 Learning your antibody status
11.14 Unknown and unanticipated risks
12. Whom do you want for volunteers?
13. Compensating volunteers for injury
14. Informed consent (1)
15. Assessing comprehension
16. Informed consent (2)
17. Ethics review committees
18. Protecting Individual Subjects
18.1 Individual volunteers are protected
18.2 Two levels of ethical review
18.3 High-risk/low-benefit protocols
19. Proxy consent?
20. Undue inducement
21. Motivations to volunteer
21.1 Altruism
21.2 Money
21.3 Medical care
21.4 The chance of protection
21.5 Other motives
21.6 Quitting
22. Still more questions
23. Data from unethical experiments?
24. The great simple solution
25. Thesis / Antithesis : Synthesis?
26. Smallpox and Guinea Worm Disease as metaphors
27. So . . .
Appendices
Selected Bibliography
Curriculum Vita | TK homepage | Public lectures | Jenner homepage |
Philosophy homepage | EVT homepage | EVT Introduction | EVT chapter 11