[rglullis]

> he, presumably, tries it himself first (how?).

He would be showing a modicum of Skin in the Game if he actually went to infect himself and those close to him with the virus before encouraging others to normalize such a risky experiment.

> Are we afraid of infection from blog posts now?

He is not just "raising awareness" of the idea of variolation. His writing was already trying to argue that government could try a program where volunteers would get paid to be infected.

When asked "if you think this is a good idea, why don't you do it yourself?" he responded with something along the lines of "there is no counterparty to bet with me on it, so what is the point?" Isn't that the answer of someone completely oblivious to the idea of SITG?

[inimino]

> if he actually went to infect himself

Again: How?

He's suggesting a program of trained medical professionals, isolation, observation, and you think he just ought to go off and infect himself in uncontrolled conditions without any medical training or control group? One of the two of you hasn't thought this through, and I'm pretty sure it's you.

[rglullis]

How to infect himself? A short walk in a busy hospital would take care of that quickly... but that really doesn't matter for the argument.

> He's suggesting a program of trained medical professionals, isolation, observation (...) he just ought to go off and infect himself

Yes, that is the point! He is suggesting something that medical experts already consider dangerous and unethical, otherwise it would already be done. He wants medical experts give some veneer of science to something completely immoral just by seeking higher financial compensation to those that might be affected.

So what he is "proposing" involving everyone else taking a lot more risk, without any real consequence for him. This is no display of SITG, quite the opposite. He just sees it as a game of "Heads some might lose their life, but tails we might win a little, so let's find the price point where this is even".

By asking if he is willing to infect himself to do it, it is not a matter of doing it for the science or the economics of betting. It is just a pure ethical filter: "So far your words only risk the lives of others, but if you really think this is the best course of action then you need to demonstrate you are willing to put your ass on the line. Can you?"

[inimino]

> A short walk in a busy hospital

You demonstrate utter failure to understand the idea. A controlled, known, small viral load is the idea. Controlled: not from a random walk through a hospital, but administered under controlled conditions. Known: a measured quantity, not an unknown quantity from a random walk through a hospital, of a known viral strain. Small: maybe 1/50th the kind of load you would get if you were exposed in a busy hospital and someone sneezed on you.

You so spectacularly missed all these points that it's clearly not worth continuing this conversation further.

[rglullis]

You are focusing on the practicality of the whole argument while I am trying to show that the practicality of it is irrelevant if the whole idea is immoral and starts from wrong principles.

Let me try again: there is a reason that no one is doing "small, controlled, small virus load experiments": it is because they are illegal, unethical and potentially bring more harm than benefit. If they are supposed to be done properly, they should be done with the same standards that are adopted for those that want to develop vaccines and other medicines.

What Hanson is proposing requires doctors and scientists to drop already established ethical principles and adopt practices that have unknown risks and can be potentially catastrophic.

He puts it as the whole "we already test vaccines on humans, and vaccines are made from the virus itself, so why not just test the actual virus" was just an issue of testing on dosage/response. He wants to argue that the risk people take is just proportional to the amount of contact they have to the virus.

It is not. Just as an example: suppose that inoculation by a weak version of the virus does not help our immune system to create antibodies and just instead make us more susceptible to a future, more lethal mutation of another Coronavirus? This is a very-tiny-but-plausible possibility, and that alone should stop us from abandoning current safe practices for research.

He wants you and I and other doctors to just squint our eyes and pretend it is okay to do what he is proposing if the participants take a little bit more risk (compared to drug trials conducted ethically) and that just by compensating them properly, it would be fair and ethical.

It is not. Trials for drugs and vaccines go through a bunch of other steps before to try to determine its safety on humans. He sidesteps the whole thing and wants medical practices to go back centuries in time for no good reason other than "economic theory"

---

So, we have this guy who is trying to convince others to take risks of unknown magnitude and to break traditional practices with unknown benefit. We have this guy who is willing to play fast and loose with the rules without ever facing any consequence of the potential downside of these measures.

What do you do with it? What I am saying is that anything he is defending should not have any weight until he shows willingness to face the consequences of his risky proposal. And given that we do not know the behavior of the virus and we do not know what are the "safe" parameters for it, the only way that he can show SITG is by facing the highest possible risk.

This is why I say I don't particularly care about the practicality of it all. There is no way to quantify the risk anyone is being exposed to it, so whoever is asking others to take the risks should give the example by taking the maximum risk possible. And it is not that he is making himself "more right" or "less wrong" (pun intended) if he does show SITG. It is just that I am just allowing myself to take any risky proposal into consideration when those doing the proposal are also facing the risks. It is a simple filter.

I hope at least now I could make myself clearer. Thanks for the discussion anyway.

[inimino]

> the practicality of it is irrelevant if the whole idea is immoral

Agreed.

I didn't read his post as saying that the payment had anything to do with the ethics of it, and we routinely pay participants in clinical trials for their time. I don't see the idea as something that's impossible to do ethically, and you do, but apart from that we are in agreement. Thanks to you too.