Allocating Remdesivir Under Scarcity: Social Justice or More Systemic Racism

Weber, Eli; Bliton, Mark J.

doi:10.1080/15265161.2020.1795538

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…The drug approval process and the legal nature of drug use varies internationally ( Box 1 ). For example, hydroxychloroquine, remdesivir and COVID-19 convalescent plasma had an emergency use authorization in the United States [ 13 , 14 , 15 ]. In other countries, these drugs have been given off-label uses or compassionate uses.…”

Section: Results Of the Ethical Analysismentioning

confidence: 99%

“…In the United States, remdesivir obtained emergency use authorization on 1 May 2020, based on preliminary study results [ 37 ]. The actual benefit of remdesivir is so far an open question [ 15 ], as the drug has not gone through the usual safety and efficacy review process that is normally required before a drug is approved.…”

Section: Results Of the Ethical Analysismentioning

confidence: 99%

“…When choosing participants for clinical trials, a selection criteria aspiring to increase the scientific value and the social benefit of the study can be ethically justified [ 52 ]. Making choices to mitigate or minimize the impact of existing health disparities has been discussed [ 15 ].…”

Section: Results Of the Ethical Analysismentioning

confidence: 99%

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Medication of Hydroxychloroquine, Remdesivir and Convalescent Plasma during the COVID-19 Pandemic in Germany—An Ethical Analysis

Voit

Timmermann

Steger

2021

IJERPH

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This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions.

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Section: Results Of the Ethical Analysismentioning

confidence: 99%

Section: Results Of the Ethical Analysismentioning

confidence: 99%

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Medication of Hydroxychloroquine, Remdesivir and Convalescent Plasma during the COVID-19 Pandemic in Germany—An Ethical Analysis

Voit

Timmermann

Steger

2021

IJERPH

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“…As preventable deaths collected in migrant detention centers, prisons (Frois 2020) and care institutions (Cohen 2020), connections between biomedical and carceral regimes became clearer (Chua 2016;Terry 2017;Varma 2020). 8 The pandemic has yielded treatment inequities and exclusions, forms of medical experimentation on formerly colonized populations in the Global South (Bajaj and Stanford 2021, 1; The Straits Times 2020), new techniques of racialized surveillance, 9 and potentially risky relaxations in ethical guidelines around clinical trials, therapeutics, patient triaging, and resource allocations (see Ezekiel 2020;Goold 2020;Maguire 2020;Varma, Vora, Fox, Berkhout and Benmarhnia, 2021;Warren et al 2020;Weber and Bliton 2020). Covid-19 has also reignited fears about nosocomial-or hospital-borne-infections, as healthcare providers and patients alike worry about becoming vectors of community spread.…”

Section: Racialized Iatrogenesismentioning

confidence: 99%

Introduction: medicine’s shadowside: revisiting clinical iatrogenesis

Varley

Varma

2021

Anthropology & Medicine

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Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogenesis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to medical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis' immediate and lingering presences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics.I want my voice to be harsh, I don't want it to be beautiful, I don't want it to be pure, I don't want it to have all dimensions. I want it to be torn through and through, I don't want it to be enticing, for I am speaking of man and his refusal, of the day-to-day rottenness of man, of his dreadful failure. I want you to tell.-Frantz Fanon, Letter to a Frenchman, Toward the African Revolution This special issue is dedicated to Leah M. Ashe (1980Ashe ( -2020. Shadowside medicineThis special issue grew out of our experiences as ethnographers of the clinic who witnessed a number of uncomfortable and distressing situations, which starkly limited our agency and capacities to theorize. One of us watched patients receive electroconvulsive therapy in psychiatric settings without anesthesia or sedatives, in contravention to Indian law and UN human rights guidelines (UN Human Rights Council 2013). The short-circuiting of law was justified as necessary in a resource-poor setting; some care, psychiatrists argued, was better than no care. Another of us was a bedside witness to the cumulative impacts of

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