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As the Ebola outbreak in West Africa continues, a growing number of investigational interventions have been proposed and are being implemented. However, competing visions of ‘research’ in this context raise distinct ethical issues and responses. One of the early responses from WHO was the formation of an Ethics Working Group to examine the many moral dimensions and dilemmas that accompany the events and responses to the Ebola outbreak.

 

The complex intersection of public health emergency, humanitarian intervention and research have collectively raised difficult questions such as how to design ethical clinical research in this context? Did this particular outbreak warrant acceleration of clinical trials? How have local and global political histories created the groundwork for a humanitarian crisis? And what, if any, is the obligation to respond across borders and in dangerous, uncertain contexts? We explore these questions and reflect on some of the process and output of the Ebola Working Group.

 

Prof. Lisa Schwartz, PhD, is the Arnold L. Johnson Chair in Health Care Ethics in the Faculty of Health Sciences at McMaster; Associate Professor in the department of Clinical Epidemiology & Biostatistics, Director of the PhD in Health Policy; co-Associate Director of the Centre for Health Economics and Policy Analysis (CHEPA); and associate

 

member of the Department of Philosophy. She is also Vice-Chair of the Standing Committee on Ethics at the Canadian Institutes of Health Research (CIHR), member of the Ethics Committee at the Royal College of Physicians & Surgeons of Canada, and member of the Médecins Sans Frontières (MSF) Ethics Review Board.

 

Dr. Schwartz’s research background is in ethics and human research, evaluation of ethics education in medicine and advocacy in health care. She is the Primary Investigator on CIHR-funded studies examining the ethical challenges faced by health care professionals providing humanitarian healthcare assistance abroad and on ethics and policy development in humanitarian healthcare agencies.

 

Dr. Ross Upshur, MD, is Head of the Division of Clinical Public Health and Professor in the Department of Family and Community Medicine at the University of Toronto’s Dalla Lana School of Public Health. He is also Scientific Director, Bridgepoint Collaboratory for Research and Innovation, Adjunct Scientist at the Institute of Clinical Evaluative Sciences, the Canada Research Chair in Primary Care Research, and member of the Centre for Environment. His research focuses on the intersection of primary care and public health, particularly with respect to the interrelationship between ethics and evidence.

 

He has been active on Advisory Boards for the International Joint Commission, Doctors Without Borders, and Scidev.net, several medical journals and consulted with the World Health Organization and the Bill and Melinda Gates Foundation Grand Challenges in Global Health.