This is an interesting story that brings me back. I took part in a similar study at the University of Washington in the early 2010s. It was for testing a new way to quantify the parasite burden...
This is an interesting story that brings me back. I took part in a similar study at the University of Washington in the early 2010s. It was for testing a new way to quantify the parasite burden and a new vaccine candidate. I never felt sick, they told me at the outset that they didn't expect people to get symptoms from malaria because the new test was really good at identifying low numbers of parasites (it is a rRNA test). I still don't know if I was vaccinated or not. Getting infected was so annoying. They were in a bucket just like a KFC bucket with mesh over the top. You just sat your arm on the mesh for 5 minutes, then they pooped all the mosquitoes to see how many had a blood meal. My arm was so swollen from being bitten , but they were not good at getting a blood meal. I eventually made it, and we didn't do the sock trick like they did in the story. I was compensated a bit over $1200 for going to the hospital about 20 times as well as an overnight stay on the day of infection. It paid for my laptop for med school with plenty of left over funds.
The way I think about my moral stance on stuff like this has to do with permanence. People should be allowed to consent to anything, even if they're being compensated for it no matter how...
The way I think about my moral stance on stuff like this has to do with permanence. People should be allowed to consent to anything, even if they're being compensated for it no matter how distasteful or uncomfortable it might be as long as it's effects are temporary. That includes things like prostitution, being paid to do fighting sports, having a boring soul sucking job, or volunteering to be infected with an unpleasant, but temporary disease.
We shouldn't generally allow people to be paid to do things to themselves that are very likely to have permanent long term negative consequences. That would cover things like selling your organs, selling tattooed ad space on your body, or an otherwise healthy person agreeing to have your limbs severed for science. I think the capacity for lifelong regret in those situations is incredibly high, and they're extremely unethical because it would ruin the lives of many poor people.
Obviously there are a ton of grey areas here. Prostitution can have negative lifelong mental health implications. Sports in general carry a high risk of CTE. Tattoo removal sort of exists.
All of those minutia should be debated and examined on a case by case basis, but the overall moral framework of "temporary = knock yourself out, permanent = we should probably be protecting your future self from your desperate decision making" generally holds true for me.
I misread the above comment. Broadly I think we agree.
This is unfortunately the argument about banning trans health care.
think broadly we should have the autonomy to do those things. Whether it's ethical for a doctor to amputate a limb would be a question for the AMA and APA likely. Paying someone for their kidney is the exploitation problem, not giving it. We let living donors donate their kidneys all the time, so it's not the autonomy that's the problem. I think the paid tattoo is legal here (maybe it's indirect though) but banning it would be about exploitation, not about the autonomy.
The question seems to be where the line between exploitation and autonomy lies. But your standard would prevent transition surgeries, as well as breast reductions, most cosmetic surgery, etc.
I misread the above comment. Broadly I think we agree.
@papasquat is saying people should not be compensated for permanent changes to their body, but can be compensated for short-term discomfort. That doesn’t mean banning all permanent changes. Under...
@papasquat is saying people should not be compensated for permanent changes to their body, but can be compensated for short-term discomfort. That doesn’t mean banning all permanent changes. Under their framework, getting paid to get a tattoo should be illegal, but getting a tattoo in general is fine.
I don’t think that has anything to do with arguments about trans health care except to say people cannot pay others to undergo transition surgery.
Getting paid for organ donation, which you mention, would very much be illegal if this principle were applied. Personally, I don’t know if I’m okay with people being paid for donating their organs.
Thank you so much for catching me. I fully missed the word paid in one sentence which threw my entire interpretation of the rest of it off. My apologies to @papasquat for the misread and I'll edit...
Thank you so much for catching me. I fully missed the word paid in one sentence which threw my entire interpretation of the rest of it off.
My apologies to @papasquat for the misread and I'll edit my comment appropriately.
It seems a little odd to me that it’s legal to pay poor people to play football, get in a boxing ring, or work as a logger or roofer, or they could get cosmetic surgery in pursuit of an acting...
It seems a little odd to me that it’s legal to pay poor people to play football, get in a boxing ring, or work as a logger or roofer, or they could get cosmetic surgery in pursuit of an acting career, but donating a kidney is out. How do you see the difference in terms of exploitation?
Of note I edited my post drastically since you replied. Some of those jobs can indeed be exploitative, I mean much work is just to different degrees. I don't agree with forced labor in prisons for...
Of note I edited my post drastically since you replied.
Some of those jobs can indeed be exploitative, I mean much work is just to different degrees. I don't agree with forced labor in prisons for example, so some level of choice is important. I also believe in strong worker protections including workers compensation, unemployment insurance, union rights, whistleblower protections, OSHA, and many other things to ensure work is as safe as they can be and that people who are injured have some sense of security that they'll be taken care of.
This is a bit like the argument that all jobs are slavery though, there are obviously lines between enslavement and forced labor and employment. As I've said before, if we lived in a society where an individual who "sells" their kidney did not have to worry about healthcare costs, received not just a single payment but probably also a guaranteed disability pension of some sort should their donation cause ongoing issues, etc. I'd probably be more OK with it. Personally I think if folks didn't have to worry about being disabled, or paying for healthcare, they'd probably donate without that "cash" stipend (or tax credit). Throughout, informed consent would need to be tightly followed. And we're seeing how that isn't consistently occurring with some of the "right to die" legislation, even though I support that too
That sounds like a reasonable framework to start out with, but there are lots of things we allow that have a chance of severe, permanent damage. How do you feel about rock climbing and hang...
That sounds like a reasonable framework to start out with, but there are lots of things we allow that have a chance of severe, permanent damage. How do you feel about rock climbing and hang gliding? Or dangerous professions like roofing?
I think it's about the likelihood for me. Yes, commercial fishing is an extremely dangerous profession. But it's dangerous as in one in two thousand people die doing it, and it can probably be...
I think it's about the likelihood for me. Yes, commercial fishing is an extremely dangerous profession. But it's dangerous as in one in two thousand people die doing it, and it can probably be made safer with better workplace regulations. If you're a commercial fisherman, your chances of dying on the job are still very low. To put that into perspective, in the US, 1 in 107 people die in car crashes. So you're almost 20 times more likely to die in a car crash on the way to the boat as you are to die on the job as a fisherman.
Compare that to something like being a gladiator. They had something like a 1 in 5 chance of dying per fight. Some gladiators did make it to old age, but it was pretty damn rare. It's a career that basically meant certain death.
Paying people to do something like that, that is almost guaranteed in death or maiming is to me, very clearly morally wrong.
Paying someone to take a risk isn't necessarily morally wrong, but it's a gradiant, not a binary. At a certain point of risk, I'm likely to be uncomfortable with it, and at a certain point further than that, I'm going outright condemn it.
Want to hire a roofer? Sure, just equip them with the proper gear and make sure safety standards are being followed.
Want to hire someone to light themselves on fire to test your new fire extinguisher? Nah, you shouldn't be allowed to do that, even if they agree to it.
Trials like this one have long underpinned the development of vaccines for deadly scourges like typhoid and cholera. Today, they are typically undertaken only with diseases that already have fast-acting drugs to ensure recovery. But because of the perceived risk involved, and their significant cost, challenge trials remain rare and, in some cases, controversial.
“A lot of people say, ‘Doesn’t this violate the Hippocratic oath?’ or ‘How can a doctor do this?’” said Seema K. Shah, a bioethicist at Lurie Children’s Hospital and professor at Northwestern University in Illinois who studies challenge trials.
Still, challenge trials have become an area of enthusiasm since the Covid-19 pandemic. Funding for trials has poured in. Countries including India, Canada and Australia are beginning to develop the capacity for conducting them. Some researchers have found it easier to recruit volunteers, who are willing to shiver, sweat, puke and ache all in the name of helping others (and earning a little cash).
...
Researchers have found that challenge trials can be used to observe not just immune responses but also transmission and infection. And by the standards of disease research, they are nimble; the whole process can take as little as a few months. This is in contrast to the years it often takes to run a traditional trial requiring thousands of research subjects to naturally become infected with a disease.
...
In the spring of 2020, as the world scrambled for a coronavirus vaccine, some scientists began to call for a broader approach that they said should include such trials. That June, three prominent scientists argued in the Journal of Infectious Diseases that they might help speed up the development of a vaccine.
A fiery debate broke out among the public health community. In April 2020, 35 U.S. congressional members wrote a letter calling on regulators to permit challenge trials for Covid-19 vaccines. Three months later, 177 prominent scientists, including 15 Nobel laureates, joined their call. But opponents argued that the risks of infecting volunteers with a poorly understood virus were too great. The National Institutes of Health, Food and Drug Administration and Centers for Disease Control and Prevention all refused to allow them. At least one trial, in the Netherlands, was scuttled because of the perceived risk.
And yet, instead of torpedoing the field, the pandemic “revitalized” it, said Dr. Christopher Chiu, an immunologist at Imperial College London. In 2021, after months of deliberation, the world’s first Covid-19 challenge trial began at Imperial College London — one of two that took place between 2021 and 2022 for Covid-19 — and interest grew from there.
...
In recent years, more money has been made available to build the costly facilities that successfully contain dangerous pathogens. The University of Melbourne recently opened the first one dedicated to human challenge trials in the Southern Hemisphere. In Antwerp, Belgium, a facility with 30 beds was completed as part of a $57 million project to develop the next generation of Covid vaccines through challenge trial research.
The aim of the next-generation Covid-19 vaccine is to completely prevent transmission — something previous Covid vaccines have so far failed to do. That hope echoes throughout the challenge trials world. They’re also being used to develop a vaccine for Zika, a virus that is notoriously difficult to study in the field. And in Australia, Dr. Osowicki is pioneering challenge trials to evaluate vaccine candidates for streptococcus A, one of the deadliest bacterial infections in the world.
This is an interesting story that brings me back. I took part in a similar study at the University of Washington in the early 2010s. It was for testing a new way to quantify the parasite burden and a new vaccine candidate. I never felt sick, they told me at the outset that they didn't expect people to get symptoms from malaria because the new test was really good at identifying low numbers of parasites (it is a rRNA test). I still don't know if I was vaccinated or not. Getting infected was so annoying. They were in a bucket just like a KFC bucket with mesh over the top. You just sat your arm on the mesh for 5 minutes, then they pooped all the mosquitoes to see how many had a blood meal. My arm was so swollen from being bitten , but they were not good at getting a blood meal. I eventually made it, and we didn't do the sock trick like they did in the story. I was compensated a bit over $1200 for going to the hospital about 20 times as well as an overnight stay on the day of infection. It paid for my laptop for med school with plenty of left over funds.
The way I think about my moral stance on stuff like this has to do with permanence. People should be allowed to consent to anything, even if they're being compensated for it no matter how distasteful or uncomfortable it might be as long as it's effects are temporary. That includes things like prostitution, being paid to do fighting sports, having a boring soul sucking job, or volunteering to be infected with an unpleasant, but temporary disease.
We shouldn't generally allow people to be paid to do things to themselves that are very likely to have permanent long term negative consequences. That would cover things like selling your organs, selling tattooed ad space on your body, or an otherwise healthy person agreeing to have your limbs severed for science. I think the capacity for lifelong regret in those situations is incredibly high, and they're extremely unethical because it would ruin the lives of many poor people.
Obviously there are a ton of grey areas here. Prostitution can have negative lifelong mental health implications. Sports in general carry a high risk of CTE. Tattoo removal sort of exists.
All of those minutia should be debated and examined on a case by case basis, but the overall moral framework of "temporary = knock yourself out, permanent = we should probably be protecting your future self from your desperate decision making" generally holds true for me.
This is unfortunately the argument about banning trans health care.think broadly we should have the autonomy to do those things. Whether it's ethical for a doctor to amputate a limb would be a question for the AMA and APA likely. Paying someone for their kidney is the exploitation problem, not giving it. We let living donors donate their kidneys all the time, so it's not the autonomy that's the problem. I think the paid tattoo is legal here (maybe it's indirect though) but banning it would be about exploitation, not about the autonomy.The question seems to be where the line between exploitation and autonomy lies. But your standard would prevent transition surgeries, as well as breast reductions, most cosmetic surgery, etc.I misread the above comment. Broadly I think we agree.
@papasquat is saying people should not be compensated for permanent changes to their body, but can be compensated for short-term discomfort. That doesn’t mean banning all permanent changes. Under their framework, getting paid to get a tattoo should be illegal, but getting a tattoo in general is fine.
I don’t think that has anything to do with arguments about trans health care except to say people cannot pay others to undergo transition surgery.
Getting paid for organ donation, which you mention, would very much be illegal if this principle were applied. Personally, I don’t know if I’m okay with people being paid for donating their organs.
Thank you so much for catching me. I fully missed the word paid in one sentence which threw my entire interpretation of the rest of it off.
My apologies to @papasquat for the misread and I'll edit my comment appropriately.
It seems a little odd to me that it’s legal to pay poor people to play football, get in a boxing ring, or work as a logger or roofer, or they could get cosmetic surgery in pursuit of an acting career, but donating a kidney is out. How do you see the difference in terms of exploitation?
Of note I edited my post drastically since you replied.
Some of those jobs can indeed be exploitative, I mean much work is just to different degrees. I don't agree with forced labor in prisons for example, so some level of choice is important. I also believe in strong worker protections including workers compensation, unemployment insurance, union rights, whistleblower protections, OSHA, and many other things to ensure work is as safe as they can be and that people who are injured have some sense of security that they'll be taken care of.
This is a bit like the argument that all jobs are slavery though, there are obviously lines between enslavement and forced labor and employment. As I've said before, if we lived in a society where an individual who "sells" their kidney did not have to worry about healthcare costs, received not just a single payment but probably also a guaranteed disability pension of some sort should their donation cause ongoing issues, etc. I'd probably be more OK with it. Personally I think if folks didn't have to worry about being disabled, or paying for healthcare, they'd probably donate without that "cash" stipend (or tax credit). Throughout, informed consent would need to be tightly followed. And we're seeing how that isn't consistently occurring with some of the "right to die" legislation, even though I support that too
That sounds like a reasonable framework to start out with, but there are lots of things we allow that have a chance of severe, permanent damage. How do you feel about rock climbing and hang gliding? Or dangerous professions like roofing?
Here are some high-risk professions.
I think it's about the likelihood for me. Yes, commercial fishing is an extremely dangerous profession. But it's dangerous as in one in two thousand people die doing it, and it can probably be made safer with better workplace regulations. If you're a commercial fisherman, your chances of dying on the job are still very low. To put that into perspective, in the US, 1 in 107 people die in car crashes. So you're almost 20 times more likely to die in a car crash on the way to the boat as you are to die on the job as a fisherman.
Compare that to something like being a gladiator. They had something like a 1 in 5 chance of dying per fight. Some gladiators did make it to old age, but it was pretty damn rare. It's a career that basically meant certain death.
Paying people to do something like that, that is almost guaranteed in death or maiming is to me, very clearly morally wrong.
Paying someone to take a risk isn't necessarily morally wrong, but it's a gradiant, not a binary. At a certain point of risk, I'm likely to be uncomfortable with it, and at a certain point further than that, I'm going outright condemn it.
Want to hire a roofer? Sure, just equip them with the proper gear and make sure safety standards are being followed.
Want to hire someone to light themselves on fire to test your new fire extinguisher? Nah, you shouldn't be allowed to do that, even if they agree to it.
https://archive.is/zJATs
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