Monday, March 25, 2013

Head Start: Are Anthrax Vaccines for Children Permissible?


According to a story by NPR, the Presidential Commission for the Study of Bioethical Issues has concluded that further testing must be done before a new anthrax vaccine can be tested on children. Because anthrax holds the potential to serve as a dangerous biological weapons, a vaccine against it has already been given to over a million adults in the military. Still, given that its effects are unknown on children, the commission declared that the risk from the vaccine must be demonstrably minimal before it can be tested on children and suggested that the vaccine be tested first on young adults. Assuming that the young adults were not adversely affected by the vaccine, it could then be administered to increasingly younger groups before finally being given to children.

While I do not find the commission’s decision to be objectionable, I do think that one issue that has apparently been overlooked is the consent of the children involved. Assuming that an anthrax vaccine were developed that stood only to pose a “minimal risk” for children, on what basis would test subjects be chosen? Would the children have to provide consent to participate in vaccination trials? Perhaps it can be said that parents should provide consent for their children’s participating in such trials in their stead. The problem with such a proposal, however, is that even though the vaccines would be of “minimal risk” by the time they were tested on children, their being of minimal risk would be known only through tests done on older groups, meaning that they may pose unexpected dangers to children. Hence, the vaccines’ being of minimal risk might not be a helpful indicator of the danger they pose to children.

On the other hand, if we suppose that the children’s consent is necessary, then we are faced with a number of problems. How do we know when a child has really given consent? Is there a certain age limit below which a child’s consent does not really count? These questions are by no means easily answered, and, although it will not be for some time until the vaccine is ready for child testing anyways, formulating solutions to these issues ahead of time (perhaps by drawing on past cases of tests involving child vaccination for dangerous diseases) is essential if the commission’s recommendation is to be taken seriously.

1 comment:

austenm said...

You bring up a valuable point when noting the problems with the phrase “minimal risk.” While I’m sure the Presidential Commission for the Study of Bioethical Issues might claim that the danger of moving from young adults to children is included in this minimal risk, I find it hard to believe that shifting a vaccine from two such different stages of life can really satisfy what they define minimal risk as—they say it is about equal to the risk posed by a yearly check-up visit to the doctor. Thus, I agree that we need to be more honest when assessing the dangers of new medicine, especially to the vulnerable.
It seems that you make a leap in logic after considering this, though. Once you establish that “unexpected dangers” exist, you appear to recoil from the idea of parental consent for experimentation on the child, for you state that the danger posed to the child makes the parental consent problematic. Howso? Parents are allowed, both under law and in general moral consensus, to make decisions for their children, even risky ones (provided the choices show an interest in the child’s wellbeing and are not ludicrous). In light of this, I affirm the question later posed by you as to whether children’s consent cannot be counted below a certain level. I would hope, for instance, that if a small child facing potentially life-saving brain surgery was scared of the procedure, the parents would override the child in this case. Along this same vein, we should attempt to uphold the tradition of parental rights over their children’s medical choices alongside our studies of past medical cases.