Discover and read the best of Twitter Threads about #pandemicethx
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This is a fascinating response from Dr. Miller, from whose work I've learned much over the years!
Some thoughts:
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Some thoughts:
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I agree with Dr. Miller that the utility of ethicists in the #RoomWhereItHappens for public health emergency policy response ought not be assumed. That said, I strongly believe that an appropriately-trained ethicist can be helpful, at least in the following ways:
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(1) Trained ethicists often have facilitation skills, specifically as regards to complex normative and ethical problems unfolding in urgent or emergent contexts. Applied ethicists in practice almost never dictate or pronounce conclusion -- if they are practicing well IMO.
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I see that we are still slavishly worshipping at the idol of RCTs in epidemiologic science as the evidentiary warrant for public health action. I have written LOTS on the foolishness of this, its disastrous ethical & policy implications, & it's role in #ManufactureOfDoubt.
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It's almost as if people have never heard of the #PrecautionaryPrinciple. If we demanded evidence of exposure-harm or intervention-benefit that flowed from RCTs to warrant public health interventions, we would have essentially NO public health action AT ALL.
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More on this, from my 2016 paper on importance of maintaining epistemically reasonable standards for proof of harm (& benefit!) as warrant for public health action:
(The subject of the paper is COIs and lays out my arg for regarding them as ordinary epidemiologic exposures)
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(The subject of the paper is COIs and lays out my arg for regarding them as ordinary epidemiologic exposures)
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