[fauigerzigerk]

Look, I don't doubt that there are difficult ethical situations. But the flu situation is not one of them. The danger of not getting a flu jab just isn't severe enough to throw Dr. Mengele into the debate.

And to answer your question, I gather that seasonal flu vaccines have never been tested using a controlled, randomized, double-blind study. If that is not the case, then what are we talking about?

And I fail to see how it can be an ethical problem not to use a vaccine of which we don't know whether it prevents anything or not.

[ikitat]

Perhaps an analogy would help:

Most car accidents don't kill people.

Seat belts have been proven as an effective defense against injury and death in automobile accidents.

It would be unethical to perform a study in which you ask humans to undergo a car accident without a seatbelt.

Anyway, that's how I understand it. I guess you could read up on the Tuskegee syphilis experiment, Belemont Report, Declaration of Helsinki and Nuremburg Code to learn more.

[fauigerzigerk]

Making people not use something that is proven to prevent death and injury is unethical.

Making people not use something that is _not_ proven to prevent death and injury is _not_ unethical.

None of your examples for unethical procedures have any similarity with that second situation. The syphilis sufferers were not treated with penicillin even though it was proven to be effective. The nazis used prisoners, not well informed volunteers.

And your car accident analogy involves making people have accidents that they would not otherwise have, not using preventive measures proven to work. We're not talking about infecting people with the flu, are we?

[ikitat]

I wanted to give a more thorough response, I was attending a birthday party earlier.

Remove "making people have an accident" from the car analogy and it is still unethical since seat belts are proven effective. In order to make the study double blinded with a placebo control you'd have to have something of a mock seat belt that fails to restrain the occupant in a crash or an abrupt maneuver.

The flu vaccine has been proven effective as well. The flu kills approximately 36,000 Americans a year. Therefore, a study which involves a placebo flu vaccine to determine who catches the flu and who doesn't is unethical, since those that received a placebo could potentially die or become injured. It doesn't matter if the study infects the participants or if they become infected by general human contact.

You may argue that the participants fully understand their risks and therefore a trial is ethical, but that is only part of the requirement. Again, you can find it outlined in the documents mentioned above.

[fauigerzigerk]

The flu vaccine has been proven effective as well

The article that started this thread denies that. You need to understand that my rejection of the ethics argument in this case relies on this assumption that the efficacy is not proven. If the flu vaccine were proven to be effective I would agree with all your ethics arguments.

What I find puzzling though is that the proof of efficacy should be prevented by the unproven claim of efficacy. Once a sufficient number of experts is convinced, for whatever reason, that something works, we would be prevented forever from finding out whether that's actually the case. I cannot accept that.

[ikitat]

Jefferson's research doesn't show that the seasonal flu vaccine has no efficacy, just data showing that it has less efficacy for people over 60. He's mostly criticized for dismissing the convergence of independent evidence of efficacy for the vaccine. He has a higher burden to bear if he's to get a review board to approve of a flu vaccine RCT. Oh, and the article comes out just in time for a flu pandemic, promoting fear.

[fauigerzigerk]

Fear caused by truth is very healthy thing. But who is right or wrong on the subject of flu vaccines itself is an entirely different matter on which I have no opinion.

I got the impression that even researchers who are in favor of the vaccine accepted it was uncertain whether it worked, but at the same time found it unethical to test whether it did actually work.

If that is really the argument and not just a distorted picture presented by incompetent journalists, then I think ethics is either an excuse for some vested interests or just incompetence in field of ethics.

I talked to a philosopher yesterday who specialises in ethics. He confirmed my view that _if_ we didn't know whether the vaccine was effective it cannot be unethical to test it on volunteers.

But I think you are right to move on to the question of whether it is actually uncertain that the vaccine works. However that's a debate that I'm not competent to have.

[ikitat]

don't shoot the messenger