Could Covid-19 Challenge Trials be Reasonably Rejected as Morally Impermissible? A Contractualist Perspective

Abstract

"In challenge experiments, research subjects are exposed to a pathogen agent in order to study a certain disease, and/or to determine the amount of infecting dosage, and/or to test the efficacy of a vaccine. General discussions on challenge experiments have already been undertaken in contemporary medical research and these uptakes generate an ongoing debate about their ethical permissibility. Recently, these research issues have focused also on Covid-19 challenge trials in which the determination of the infecting dosage, the efficacy test of vaccines and the immune response of people who already passed through the disease have been investigated. In my paper, I will offer a philosophical perspective on these specific trials, based on T. M. Scanlon’s version of contractualism. I will start by briefly presenting the features of Scanlon’s contractualist ethical theory and by formulating the moral principles which could support Covid-19 challenge trials. Thereafter, I will search for reasonable rejections in order to be able to establish whether this type of trials is ethically permissible or not. In the second part of my presentation, I will tackle Scanlon’s view on medical experimentation in general and his subsequent distinction between direct harm and accidental harm, in order to argue for its relevance for the case of Covid-19 challenge trials. I will demonstrate that according to the general contractualist perspective, these trials are not ethically justifiable. Finally, I will search for a consolidation of my argument, by considering a tighter version of contractualism to be applied to the domain of medical research. Research reported in this presentation was supported by Fogarty International Center of the National Institutes of Health under award number R25TW01051. "