I am worried that many of us are afraid of speaking truth to power. That scientists, many of them excellent, within our national research bodies would not call out outrageous statements and lack of evidence based steps defies me. Isn't that a basic scientist quality?
Are we so afraid of upsetting status quo, our bosses who might have erred, that we would be willing to let the institution and its credibility be marred? Does that not hurt us at some basic level. Does that not trouble you when you reflect on what it means for Indian Science?
I know many of you are being asked questions in emails, phone calls and whatsapp groups and struggling to respond. We hope you will find the strength to rescue the institutions you represent from losing their sheen. Remember credibility takes ages to build, but easy to lose it.
This is a letter which has been sent out by the ICMR DG yesterday. Now that multiple folks have confirmed genuineness, let me raise some issues with this letter on #vaccine#trials during a pandemic, in this case #COVID19
What are the ethical issues in this letter? Read on.
For a vaccine for which pre-clinical development is still ongoing, as per the letter itself, how can clinical trial recruitment be starting on 07th July?
And that the vaccine will be launched on 15th August? A vaccine trial completed in little over a month, efficacy pre-decided?
How were the clinical trial sites mentioned in the appendix chosen--on what criteria? eligibility? From what list? was this selection done by ICMR or by BBIL? Some of these seem to be small nursing homes/hospitals- are they the apt place to run a pandemic #vaccine trial?
This trial was registered on CTRI on 20 May 2020, sponsored by Patanjali.
Trial conducted at National Institute of Medical Sciences Jaipur nationalinstituteofmedicalsciences.com
Seemingly a private medical college in Jaipur
Apparently approved by the local IEC
How Dr Simon, who died of COVID-19 in Chennai, was denied dignity in death
"I dug a space and buried my close friend by pushing in mud with my own hands. He didn't deserve this end," says Dr Pradeep, a colleague of the deceased. thenewsminute.com/article/how-dr…
“We were hit with wooden logs and stones when we tried to bury him,” says Dr Pradeep, a friend of Dr Simon, who was the person who buried the neurosurgeon in the dead of the night after hours of frightening retaliation from people who were spurred by fear, instead of empathy.
“With the help of two hospital staff, I dug a space and buried my close friend by pushing in mud with my own hands. He was a doctor, a philanthropist and the Managing Director of a hospital. He didn't deserve this end," says Dr Pradeep, his voice choking.
Equating the pandemic response to a war equates India’s healthcare workforce to members of the country’s Armed Forces. The same kind of stoicism and public silence that characterises our Armed Forces is now expected of physicians, nurses, CHWs and allied healthcare personnel.
The result is Healthcare Professionals (HCPs) are being subjected to expectations of heroism and supreme sacrifice.
We highlight how its equally if not more important to invest in developing the art and science of, and human resources, for effective contact tracing.
"Ventilators dominate the public discourse, perhaps driven by what Atul Gawande calls the heroic expectation of how medicine works — the image of doctors saving a person from the clutches of certain death is fascinating.
Listen folks. We have a shortage of ICU beds and ventilators, even if you work with the private sector. If & when serious cases surge, you will need to come up with criteria for resource-allocation/priority setting: who of the 4-5 or more clinically eligible, gets the ventilator?
So will you run a lottery, will you allow political pressures, will you choose age (young over old), will you use ability to pay, will you use healthy over those with co-morbidities?, etc?
Italy reportedly chose to preserve ventilators for those <60 and let older patients die!
These are not always clinical decisions, there is a lot of morality at play here. What frameworks do you use, how do you weigh your options? These decisions will take a toll on the involved teams. Its not easy to choose to let someone die for want of a machine.
@UnionConference The reason is the ridiculously expensive registration fees for the conference. For a meeting which focuses majorly on #TB, a disease of poverty, and being held in a #LMIC location, it is atrocious to charge such fees. Even at the discounted rates for #LMICs, it is very EXPENSIVE
@UnionConference I do not have a salaried position which offers such registration fees through the institution, or grant money to cover such fees. I am not going to spend such amounts of money, even if its an important event, as a matter of principle. It is deeply disturbing that this is usual.
The trio have worked in doing some really interesting and innovative RCTs on how to respond to poverty as a #globaldev issue
Focus: randomized evaluations to answer critical questions in fight against poverty.
Also, on areas such as the role of incentives and public provisioning.
Not to say that work done by Poverty Action Lab does not create ethical conundrums. An example of the concerns we raised is outline here: in a Rajasthan project- about what was done in the control group, and lack of local partner involvement academically bmj.com/rapid-response…
A senior economist from the World Bank responded to our concerns on a World Bank blog here:
The ethics of a control group in randomized impact evaluations – the start of an ongoing discussion blogs.worldbank.org/impactevaluati…