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Monkeypox’s Biggest Threat Might Be to Wild Animals

photograph of two Cape ground squirrels in South Africa

On May 18, a U.S. resident (who had recently traveled to Canada) tested positive for monkeypox, adding the United States to a growing list of countries that have detected cases of a virus normally found primarily in Central and West Africa. Over the following week, suspected cases have arisen in four additional U.S. states, leading President Biden to comment that “it is something that everybody should be concerned about.”

In the wake of the COVID-19 pandemic (which, to be clear, is “most certainly not over,” according to the head of the World Health Organization), it is understandable that reports of another ominous-sounding virus can be unsettling. But, as numerous outlets have shared, there are considerable reasons to be confident about our collective ability to face the unlikely possibility of a monkeypox outbreak: not only does the disease appear to have a generally low mortality rate (of less than 1%), but we already have an effective vaccine and other means to treat monkeypox patients. Also, transmission of the monkeypox virus (which is of a type that evolves comparatively slowly) is importantly more difficult than the coronavirus, requiring close contact with an infected carrier (for example, the CDC has recently warned that monkeypox rashes could be mistaken for symptoms of more common sexually-transmitted diseases). Altogether, the consensus of medical experts is that, though it is a serious disease that should be monitored, the threat posed by monkeypox is not nearly as significant as that posed by COVID-19: at present, we should not worry about a monkeypox pandemic.

However, this might not hold entirely true for one portion of the American population: nonhuman animals.

While the monkeypox virus is relatively rare in human patients, it is endemic in several African environments among a variety of nonhuman animal species: squirrels, rats, mice, and (unsurprisingly) monkeys have all tested positive for monkeypox at different times (its name, in fact, comes from the laboratory creatures in which it was first detected in the late 1950s). Typically, human monkeypox patients contract the disease from close contact with infected nonhumans, such as through a scratch or bite from an animal or from eating undercooked meat from a carrier. While the natural reservoir — the actual animal population that originally sources the virus — is not presently known, experts believe that multiple species could easily serve as regular carriers, potentially placing monkeypox at risk of becoming endemic in new environments (although, again, this is not to say that the virus would automatically therefore be a greater cause for concern, given the state of medical knowledge about it).

But this means that certain nonhuman animals might face a growing risk, if not from monkeypox itself, then from humans intending to prevent the spread of the disease by sacrificing the lives of nonhumans.

Here, we can indeed draw lessons from recent elements of the fight against COVID-19, such as how slaughterhouses “depopulated” during COVID lockdowns via the mass-killings of their stock (sometimes by simply shutting off ventilation systems to suffocate the animals). In a similar way, when a new variant of COVID-19 was detected among the mink population in Denmark, officials ordered that more than 17 million animals be “culled” (killed) to prevent further spread — a tactic mirrored on a more personal level by health workers in China who were killing the pets of people in quarantine. In a different way, the race to find a COVID-19 vaccine resulted in a shortage of animals used in medical laboratory tests (that require a stock of primates to intentionally infect and treat); this was one of several reasons why human vaccine trials were unusually accelerated. And this all is without considering the effects of contracting COVID-19 itself.

Granted, you might argue that at least some of these measures were necessary to stem the tide of the COVID-19 pandemic; furthermore, you might think that, if forced to choose between killing a deer infected with a disease and watching a human potentially die from that same disease, that we have a moral imperative to prefer members of our own species over other creatures. But what is important to note here is that neither of these points seem to properly apply to the present situation we face with monkeypox. By all accounts, although current case reports are unusually high in many places, it is nowhere near the same level of risk (of either morbidity or mortality rates) as the threat that COVID-19 has posed for the last two years:

if people were to start killing animals to prevent the spread of monkeypox, those killings would be far less clearly justified.

So, while the international medical community continues to track the present spread of monkeypox, the rest of us should each do our part to avoid a panic about the currently-unlikely threat of a monkeypox pandemic. Moreover, even though it is true that rodents and other wild creatures are the most common vectors for spreading the monkeypox virus, we should take care to avoid unduly threatening those innocent populations of creatures.

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An End to Pandemic Precautions?

photograph of masked man amongst blurred crowd

I feel like I have bad luck when it comes to getting sick. Every time there’s a cold going around, I seem to catch it, and before I started regularly getting the flu shot, I would invariably end up spending a couple of weeks a year in abject misery. During the pandemic, however, I have not had a single cold or flu. And I’m far from alone: not only is there plentiful anecdotal evidence, but there is solid scientific evidence that there really was no flu season to speak of this year in many parts of the world. It’s easy to see why: the measures that have been recommended for preventing the spread of the coronavirus – social distancing, wearing masks, sanitizing and washing your hands – turn out to be excellent ways of preventing the spread of cold and flu viruses, as well.

Now, parts of the world are gradually opening up again: in some countries social distancing measures and mask mandates are being relaxed, and people are beginning to congregate again in larger numbers. It is not difficult to imagine a near-future in which pumps of hand sanitizer are abandoned, squirt bottles disappear from stores, and the sight of someone wearing a mask becomes a rarity. A return to normal means resuming our routines of socializing and working (although these may end up looking very different going forward), but it also means a return to getting colds and flus.

Does it have to? While aggressive measures like lockdowns have been necessary to help stop the spread of the coronavirus, few, I think, would think that such practices should be continued indefinitely in order to avoid getting sick a couple times a year. On the other hand, it also doesn’t seem to be overly demanding to ask that people take some new precautions, such as wearing a mask during flu season, or sanitizing and washing their hands on a more regular basis. There are good reasons to continue these practices, at least to some extent: while no one likes being sick with a cold or flu, for some the flu can be more than a minor inconvenience.

So, consider this claim: during the course of the COVID-19 pandemic, we have had a moral obligation to do our part in preventing its spread. This is not an uncontroversial claim: some have argued that personal liberties outweigh any duty one might have towards others when it comes to them getting sick (especially when it comes to wearing masks), and some have argued that the recommended mandates mentioned above are ineffective (despite the scientific evidence to the contrary). I don’t think either of these arguments are very good; that’s not, however, what I want to argue here. Instead, let’s consider a different question: if it is, in fact, the case that we have had (and continue to have) moral obligations to take measures to help prevent the spread of coronavirus, do such obligations extend to the diseases – like colds and flus – that will return after the end of the pandemic? I think the answer is: yes. Kind of.

Here’s what this claim is not: it is not the claim that social distancing must last forever, that you have to wear a mask everywhere forever, or that you can never eat indoors, or have a beer on a patio, or go into a shop with more than a few people at a time, etc. Implementing these restrictions in perpetuity in order to prevent people from getting colds and flus seems far too demanding.

Here’s what the claim is: there are much less-demanding actions that one ought to take in order to help stop the spread of common viruses, in times when the chance of contracting such a virus is high (e.g., cold and flu season). For instance, you have no doubt acquired a good number of masks and a good quantity of hand sanitizer over the past year-and-change, and have likely become accustomed to using them. They are, I think, merely a mild inconvenience: I doubt that anyone actively enjoys wearing a mask when they take the subway, for example, or squirting their hands with sanitizer every time they go in and out of a store, but it’s a small price to pay in order to help the prevention of the spread of viruses.

In addition, while in the pre-corona times there was perhaps a social stigma against wearing medical masks in public in particular, it seems likely that we’ve all gotten used to seeing people wearing masks by now. Indeed, in many parts of the world it is already commonplace for people to wear masks during cold and flu season, or when they are sick or are worried that people they spend time with are sick. That such practices have been ubiquitous in some countries is reason to think that they are not a terrible burden.

There is, of course, debate about which practices are most effective at preventing the spread of other kinds of viruses. Some recent data suggest that while masks can be effective at helping reduce the spread of the flu, perhaps the most effective measures have been ones pertaining to basic hygiene, especially washing your hands. Given that we have become much more cognizant of such measures during the pandemic, it is reasonable to think that it would not be too demanding to expect that people continue to be as conscientious going forward.

Again, note that this is a moral claim, and not, say, a claim about what laws or policy should be. Instead, it is a claim that some of the low-cost, easily accomplishable actions that have helped prevent the spread of a very deadly disease should continue when it comes to preventing the spread of less-deadly ones. Ultimately, returning to normal does not mean having to give up on some of the good habits we’ve developed during the course of the pandemic.

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The Quandary of Contact-Tracing Tech

image of iphone indicating nearby infections

This article has a set of discussion questions tailored for classroom use. Click here to download them. To see a full list of articles with discussion questions and other resources, visit our “Educational Resources” page.

All over the country, states are re-opening their economies. This is happening in defiance of recommendations from experts in infectious disease, which suggest that states only re-open after they have seen a fourteen-day decline in cases, have capacities to contact trace, have sufficient personal protective equipment for healthcare workers, and have sufficient testing capabilities to identify hotspots and deal with problems when they arise.

Experts do not insist that things need to be shut down until the virus disappears. Instead, we need to change our practices; we need to open only when it is safe to do so and we need to employ common sense practices like social distancing, mask-wearing, and hand-washing and sanitizing when we take that step. The ability to identify people who either have or might have coronavirus and to contact those with whom they might have come into contact could play a significant role in this process. Instead of isolating everyone, we could isolate those we have good reason to believe may have become infected.

Different countries have approached this challenge differently. Many have made use of technology to track outbreaks of the virus. Without a doubt, these approaches involve balancing the value of public safety against concerns about personal privacy and undue governmental intrusion into the lives of private citizens.

Many in the West were surprised to hear that Shanghai Disney was scheduled to re-open, which it did on May 11th. Visitors to the park won’t have the Disney experience that they would have had last summer. First, unsurprisingly, Disney is restricting the number of people it will allow into the park at any one time to 24,000 people a day. This is down from its typical 80,000 daily guests. When guests arrive, they must have their temperatures taken, must use hand sanitizer, and must wear masks. Crucially, they must open an app on their phone at the gate that demonstrates to the attendant that their risk level is green.

Since the COVID-19 outbreak, people in China have been required to participate in a system that they call the “Alipay Health Code.” To participate, people download an app on their phones which makes use of geolocation to track the whereabouts of everyone who has it. People are not required to have a COVID-19 test in order to comply with the demands of the app. Instead, the app tracks how close people have come to others who have confirmed cases of the virus. The app assigns a person a QR code depending on their risk level. People with a green designation are low risk and can travel through the country and can go to places like restaurants, shopping malls, and amusement parks with no restrictions. Those with a yellow designation must self-quarantine for nine days. If a person has a red designation, they must enter mandatory government quarantine.

At first glance, this app appears to be a reasonable way of finding balance between preventing the spread of disease on one hand, and opening up the economy and freeing people from isolation on the other. China isn’t simply accepting the inevitable—opening up the economy and disregarding its obligation to vulnerable populations. Instead, it is trying to maximize the well-being of society at large.

Things are more complicated than they might originally appear. First, the process is not transparent to citizens. The standards for reassignment from one color designation to another are not made public. Some people are stuck in mandatory government quarantine without knowing why they are there or how long they might expect to be detained.

There are also concerns about regional discrimination. It appears that a person can be designated a particular threat level simply because they are from or have recently visited a particular region. Citizens have no control over how this process is implemented, and the concern is that decision-making metrics might be discriminatory and might serve to reinforce oppressive social conditions that existed before COVID-19 was an issue. We know that COVID-19 disproportionately affects people living in poverty who are forced to work in unsafe conditions. This kind of tracking may make life for these populations even worse.

There are also significant concerns about the introduction of a heightened degree of governmental surveillance. Before COVID-19 hit, the Chinese government had already slowly begun to implement a social credit system that assigns points to people based on their social behaviors. These points then dictate the quality of services for which the people might be eligible. The Alipay Health Code increases governmental surveillance and encroachment. When people download the Alipay app, the program that is launched includes a command labeled “reportInfoAndLocationToPolice” that sends information about that person to a secure server. It is unclear for what purpose that information will be used in the future. It is also unclear how long it will be mandatory for people in China to have this app on their phones.

But China is not the only country that is using tracking technology to manage the spread of COVID-19. Other countries doing this include South Korea, Singapore, Taiwan, Austria, Poland, the U.K., and the United States. There are advantages and disadvantages to each system. Each system reflects a different balance of important societal values.

South Korea’s system keeps its residents informed of the movement of people who have tested positive for COVID-19. The government sends out texts informing people of places these individuals have been so that others who have also been to those places know whether they might be at risk. This information also lets people know which places might be hotspots so they know to avoid those places. All of this information is useful to prevent the spread of the virus. That said, there are serious challenges here too. Information about the location of individuals at particular times leads to speculation about their behaviors that might lead to discrimination and harassment. The information is anonymous in principle; COVID-19 patients are assigned numbers that are used in reports. In practice, however, it is often fairly easy to deduce who the people are.

Some countries, like the U.K., Singapore, and the United States have “opt-in” tracking programs. Participation in these programs is voluntary and there tend to be regional differences in what they do and how they operate. Singapore uses a system called “TraceTogether.” Users of the app turn on Bluetooth capabilities for their devices. Each device is associated with an anonymous code. Devices communicate with one another and store each other’s anonymous codes. Then, if a person has interacted with someone who later tests positive, they are informed that they are at risk. They can then take action; they may be tested or may self-quarantine. This system appears to have established a comfortable balance between competing interests.

One problem, however, is that its voluntary nature results in low participation numbers—only 1.5 of Singapore’s 5.7 million people are using the app. What follows from this is that a person has the peace of mind of knowing that if they have been in contact with another app user who contracts COVID-19, they’ll know about it. However, this kind of system doesn’t achieve that much-desired balance between concerns for public safety and concerns for a healthy functioning economy. If a person knows only about some, but not all, of the people they’ve encountered who have tested positive for COVID-19, they’re no safer out in the world as a consumer in a newly-opened economy. This app also does nothing to prevent the spread of the virus by asymptomatic people who may never feel the need to get tested because they feel fine.

There are other, less straightforward ways of collecting and using data about the spread of the virus. Government agencies are attaining geo-tracking information from corporations like Google and Facebook. Most users don’t pay much attention when an app asks if it can track the user’s location. People tend to provide a morally meaningless level of consent—they click “okay” without even glancing at terms and conditions. Corporations use this information for all sorts of purposes. For example, police agencies have accessed this information to help them solve crimes through a process of “digital dragnet.” Because these apps track people’s movements, they can help the government to see who was present at sites later identified as hotspots and can identify where people at those sites at the time in question went next. This can help governments direct their attention to where it might do the most good.

Again, in many ways, this seems like a good thing. We don’t want to waste valuable time searching for information where there isn’t any to be found. It’s best instead to find the clues and follow them. On the other hand, this method of attaining information highlights something troubling about trust and privacy in the United States. A Pew poll from November, 2019 suggests that citizens view themselves as having very little control over who is collecting data about them and very little knowledge about what data is being collected or the purposes for which it is being used. Even so, people tend to pay very little attention to the fact that they are being tracked. They simply accept the notion that, if they want to use an app, they have to accept the terms and conditions.

People concerned about personal liberties are front and center on the public stage right now as their protests make for attention-catching headlines. People are unlikely to want to be forced by the government to use a tracking app. Their fears are not entirely unfounded—China’s program seems to open the door for human rights violations and a troubling amount of governmental surveillance of private citizens. Ironically, though, these people give that same information without any fuss to corporations through the use of apps. This may be even worse. At least in principle, governments exist for the good of the people, while the raison d’être of corporations is to make a profit.

The case of tracking poses a genuine moral dilemma. There are very good public health reasons to use technology to track and control the spread of the virus. There are also very good reasons to be concerned about privacy and human rights violations. Around 3,000 people died in the tragic terrorist attacks that took place on September 11th, 2001. As a result, Congress passed The Patriot Act, which significantly limited privacy rights of the people. Its effect on the way respect for individual privacy changed at airports is also noteworthy. How much privacy should we be willing to give up in exchange for safety? If we were willing to give up privacy for safety in response to 911, how much more willing should we be to do so when the death count is so much higher?

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Is It Ethical to Extinguish a Species?

photograph of mosquito swarm, blurry from motion

Diseases like malaria, dengue fever, Zika fever, and chikungunya virus are responsible for hundreds of thousands of deaths each year. What is common to all of these illnesses? They are largely spread by mosquitoes who, while not being that harmful in themselves, are considered to be one of the deadliest creatures on the planet because of their ability to transmit disease. For example, one species of mosquito known as Aedes aegypti are mostly responsible for the transmission of dengue fever which kills 10-20,000 people every year. If this species of mosquito is deadly, why don’t we simply eradicate the species? A more important question, however, might be whether it is ethical to do so.

The idea of eradicating several species of mosquito has been proposed multiple times. Bringing about the extinction of Anopheles gambiae, which are prominent in the spread of malaria, could save millions of lives. Biologist Olivia Judson advocates for the use of genetic modification to cause “specicide.” She argues that “It is hard to argue that a targeted, genetic attempt to remove an insect that is clearly harmful to us is worse than the haphazard, expensive, destructive and largely unsuccessful approach we’re using now.” E.O. Wilson, a champion of biodiversity, has also advocated for the extinction of Anopheles gambiae noting, “Anopheles gambiae […] is specialized to live in human settlements and lives on human blood. As a result, it’s a principle conveyer of malaria. That’s one I wouldn’t mind seeing go.”

Many have wondered how the extinction of various species of mosquito might affect ecosystems. While Aedes aegypti is an important source of food for amphibians, bats, birds, fish, insects, and reptiles, it has been suggested that species could adjust to the loss of this food source while other mosquito species could fill the ecological niche. According to entomologist Joe Conlon, “if we eradicated them tomorrow, the ecosystems where they are active will hiccup and then get on with life. Something better or worse would take over.” Because of this, advocates of eliminating certain species of mosquitoes see little downside for the environment if they were driven to extinction. In the meantime, using genetic modification to eliminate the species may be preferred. The use of pesticides can be harmful to human health, and the elimination of mosquito breeding grounds pose greater risks of disrupting ecosystems.

One very prominent attempt to put this thinking into practice takes the form of Oxitec’s OX513A mosquito. Through genetic modification, the males of the species will not be able to produce viable offspring unless they are exposed to the antibiotic tetracycline. In other words, when released into the wild they will still be able to mate with female mosquitoes, but the resultant eggs will not be viable. Field trials of this genetically modified mosquito have been conducted in Brazil, the Cayman Islands, and Malaysia. As a result, the population of mosquitoes in the trial area have fallen by 80-95% and with a reduction of dengue fever cases by 91%. Since the modified mosquitoes are all male they must be replaced over time. However, since males do not bite humans, the immediate risk of a modified mosquito biting humans is minimal.

The prospect of eliminating an entire species carries some significant ethical considerations. One of these concerns is whether these edited genes are controllable. One of the reassurances of using a genetically modified mosquito is that the edited genes should disappear with their death; their offspring will not be viable, so there should be no chance of such organisms spreading. However, according to a study at Yale, mosquitoes captured up to two-and-a-half years after the release of OX513A carried genetic modifications signifying that some of their offspring did manage to survive. In other words, genes from the released OX513A mosquitoes did make it into the general population.

There are other important concerns. First, it is difficult to predict how changes to evolutionary pressures on viruses like dengue fever will affect their virulence. According to David B. Resnick at the National Institute of Health such modifications “might promote malaria resistance but increase yellow fever susceptibility.” In addition, there are concerns that Oxitec has not engaged as much public consultation as they should before releasing their mosquitoes in trial areas. There is also the more general concern about genetic modification. Various groups have opposed genetic modification as “they feel deeply that it is wrong to tamper with the DNA of wild things.”

But there is perhaps a more significant moral issue. Use of genetically modified organisms aside, there is still the question about eliminating a species. The most emphatic proponents of efforts to eradicate these mosquitoes seem to be those who focus on global health ethics. Eliminating certain species that cause great harm to humans will alleviate suffering and potentially save millions of lives, while at the same time their elimination is not likely to seriously harm ecosystems. From a global health perspective, the argument is clear.

Alternatively, from an environmental ethics standpoint there is concern about the unknown environmental effects. Even if the risk is minimal however, there is a more important question to consider: Does a species have inherent value such that it would be morally wrong to eliminate it even if their extinction served our interests? According to philosopher Paul W. Taylor a species is merely a class and only individual organisms within a class have inherent worth. Thus, there is nothing more immoral about eliminating a species like Anopheles gambiae than there is eliminating the individual insects.

Alternatively, JP Sterba emphasizes that species can evolve, become endangered, and go extinct. In effect, a species can be harmed or benefited, and therefore a species has a good of its own. If all species possess this kind of inherent value then eliminating Anopheles gambiae is immoral. This view asks us to look beyond whether we value Anopheles gambiae, or whether Anopheles gambiae is valuable for things we care about (like ecosystems), and consider the question of the value of the species from another vantage.

However, even if we accepted that a species has inherent value, that would not mean that it is more valuable than other considerations. So, perhaps, this very specific case is poignant because as the human species continues to practice ever more control over nature, we need to become better at understanding how and why things should be valued; these answers will be instructive in determining what we should (and should not) do with that control.

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EEE and the Eradication of Mosquitoes

closeup photograph of mosquito

Mosquitoes have continuously posed a threat to humanity because of their ability to transmit dangerous diseases such as dengue, Zika, yellow fever, and others. Eastern equine encephalitis (EEE) is the newest viral epidemic that has hit the United States. EEE has actually been around for years, with an average of 5-10 people per year contracting the disease. However, this year there has been an increased amount of cases with 12 known deaths so far, the most recent being a resident of Elkhart County of Indiana.

EEE is spread through the mosquito species Culiseta melanura which feeds almost exclusively on birds and horses which is why it has been so rare. Transmission to humans requires a “bridge” species which will bite humans like the commonly known Aedes family, responsible for Zika virus transmission. Symptoms of EEE set in approximately 4-10 days after exposure and include headache, fever, chills, and body and joint aches. Typically, the immune system can fight off the infection on its own however 1-20 cases will develop the brain infection, encephalitis. This will result in tremors, seizures, paralysis, and possibly death. There are no current treatment options for this disease to date.

The virus has been predominantly affecting the Midwest and Eastern regions of the United States. Government official and environmental specialists are attempting to find a way to eliminate the risk of the disease for the community by taking preventative steps. For the public, they suggest wearing long sleeve clothing, not going out around sunset, and wearing bug spray. Unfortunately, these methods are only somewhat effective. Mosquitoes will continue to be out at a high density until the first frost. Further, the Connecticut Agricultural Experiment Center recently found data suggesting that the virus can survive over the winter, even if the mosquitoes won’t. This means that the outbreak will not just be limited to this year but next summer we could face another outbreak with more severe consequences. As the data suggests, it is more urgent than ever to find a way to protect people from contracting these terrible diseases spread through mosquitoes. Thus, the question forms, what is the best way to do this?

Scientists have been researching models that work with direct modification of the species to create a more effective form of protection. Recently published was a study done over 2016-2017 on the Islands of the city of Guangzhou, China. It was able to take out 94% of the Asian Tiger mosquito. This study was a combination of two methods: sterilization of the female mosquitoes and infecting the male mosquitoes with a bacterium that hinders the insect’s ability to reproduce and spread disease. Other methods of genetic modification have looked at ways to detect specific species of mosquitoes by wing beat and making them resistant to parasites that cause human diseases. These methods are a promising step towards protecting future generations from EEE and other outbreaks.

There are still limits to methods of genetic modification. None of the methods have yet to be 100% effective. Most of them require releasing millions of modified insects over an area, which makes it hard to set up for entire continents. Although this method was effective, translating it into a scaled-up technique for larger regions requires a lot more. If we genetically modify these species to be unable to reproduce and are able to put it in a wide scale method, the long-term consequences points towards full eradication.

When we look to the past, one of the most effective disease control methods was the eradication of the virus, Variola, which was responsible for smallpox. Is eradication of mosquitoes a justifiable method of disease prevention to protect people from epidemics, like that most recently of EEE?

Mosquitoes do have many negative qualities which would support eradication of a species as a whole. According to Vox, mosquitoes are responsible for killing 52 billion people that have lived on earth out of the total 102 billion. They carry yellow fever, malaria, Zika, dengue, West Nile, and now EEE, which have all taken many lives. Mosquitoes are universal, spread more disease than any other animal, and have been deemed “masters of evolution” because of their invincibility to pesticides and previous prevention methods. Not to mention, with climate change on the rise, there is a proliferation of mosquitoes increasing the risk of disease spread. By eliminating them, you would be protecting many, especially developing countries who are most commonly targets of the outbreaks.

On the other hand, not all mosquitoes are harmful. It is only the female mosquitoes that bite and spread disease. Females and males don’t excrete waste or aerate soil and are pollinators, feeding on plant nectar. They are also food sources for many birds, bats, fish, and frogs. Eliminating all mosquitoes could have effects on the food chain with a bottom up effect. Some say that this niche would be quickly replaced but Phil Lounibos, an entomologist from Florida University, says that this is an even greater risk. It is likely that mosquitoes would be replaced with an insect that is “equally, or more, undesirable from a public health viewpoint.”

While these are all valid considerations for why to protect the species, what really stands in opposition to full eradication is the moral argument that eradication is just wrong. Our justification for eradication is that this is a species that is dangerous to our species (humans), yet we are so dangerous to so many other species in the world. What kind of precedent does it set when we fully kill out a species? Who decides what species remain or die?

According to biologist Olivia Judson, eradication of disease causing mosquitoes, would save approximately 1 million lives and would only decrease genetic diversity of mosquito families by 1%. Although this outcome may sound ideal, there is the unknown of the long-term consequences of these actions. With diseases like EEE advancing, the pressure is on for scientists to find a way to contain disease transmission.

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Pinterest’s Block on Anti-Vaccination Content

Photograph of hands of a scientist, under a sterile hood, preparing a vaccine

Pinterest, the good-natured social media site where users re-pin new ideas and things to try, has made recent headlines for their stance against anti-vaccination propaganda. In fall 2018, Pinterest quietly removed results to vaccination-related questions from the search bar.  Now, when you type “vaccine” or “anti-vax,” a pop-up will relay that there is no related content and will provide a link to the community guidelines. Reported first by the Wall Street Journal, Pinterest finally disclosed their choice to censor the questionable health claims made by anti-vaccination groups.

Pinterest’s decision to block vaccines in their search domain was widely based on the fact that the site had become a hub for anti-vaccination activists. These groups aim to educate parents regarding the dangers of vaccinations but with theories that are unsupported by peer-reviewed, scientific research. The tactics used are typically fear-inducing photographs or stories about harm to children caused by vaccinations without any scientific proof. The groups claim to offer parents the “most transparency” but also don’t mention the dangers of not vaccinating. Pinterest’s response aimed to discontinue the spread of misinformation and falsehoods on their website.

When it comes to vaccines, the spread of misinformation could have a devastating impact on individuals and the society. There has been an increase in confusion and mistrust among the public when it comes to vaccines in general. One of the most noteworthy fear-causing publications was by the doctor Andrew Wakesfield, who suggested a connection between the measles, mumps, and rubella (MMR) vaccine and the development of autism in young children. Although deemed fraudulent, it is considered the beginning of the anti-vaccination movement. This movement is equally seen in the cases of influenza in America. Last year during the 2017-2018 season, there was a record-breaking number of hospitalizations and deaths among children in the US with less than half of Americans receiving the flu shot. It is because of these that World Health Organization (WHO) has recently listed the anti-vaccine movement a top health threat for 2019. When Pinterest decided to curtail vaccine-related content on their site public, it raised the question; should social media censor for misinformation?

Pinterest’s new policy stems from the fear that misinformation can have “detrimental effects on a pinner’s health or on public safety.” The guidelines officially state that the website bans the “promotion of false cures for terminal or chronic illnesses and anti-vaccination advice.” A report found in 2016 claimed that 75 percent of posts on Pinterest referring to vaccines were negative. In addition, other studies have found that 80 percent of mothers and 38 percent of fathers in the US have used Pinterest. It is likely that mothers and fathers, looking for advice regarding their children’s heath, ran across posts on Pinterest with anti-vaccination rhetoric. One could argue that media sites have an obligation to censor this kind of propaganda for public health and safety reasons. On the other hand, even well-intentioned censorship threatens to intrude on our rights protecting free speech (also discussed in this Prindle Post article about the case of Alex Jones).

With a website that is used by mothers and fathers, restricting these groups’ ability to voice their concerns or opinions could be seen as a commentary on parenting styles. Vaccine hesitancy is often caused from worries about side effects, cost, moral or religious obligations, or lack of knowledge about immunizations. There is value in the autonomy that parents have in choosing whether or not to vaccinate their children because they have the right to make medical decisions focused around their own values. In addition, who is to say whose opinion is more valid regarding vaccinations? Who’s to say which opinions deserve censure? Pinterest approached this issue in banning all vaccine-related information, reputable or not. This absolute censorship, while avoiding the bias of what is considered a reputable source, could also be seen as problematic. It is taking the opportunity away from readers to decide for themselves what sources they think are credible or not and through Pinterest they cannot be educated on the subject to any extent. A spokesperson from Pinterest, Jamie Favazza says, “Right now, blocking results in search is a temporary solution to prevent people from encountering harmful misinformation.”

Vaccine misinformation isn’t only a Pinterest problem; other social media outlets like YouTube and Twitter have been infiltrated by vaccination misinformation as well. YouTube’s policy doesn’t allow ads for anti-vaccine videos. Twitter has no specific policy on the matter. A spokesperson for Twitter, Katie Rosborough, said that “We, as a company, should not be the arbiter of truth,” and also added that, “the company was working to surface the highest-quality and most relevant content first.”

Social media represents an open platform for people to voice interests and create spaces that unite beliefs. But should some spaces not exist and should some beliefs not be circulated? In the case of anti-vaccine movement, people continue to adhere to their beliefs which further energizes the movement and polarizes the theories. With our ever-growing reliance on social media for information, social media outlets have a reason to worry about the ramifications of their content, especially in influencing user’s decisions about their health.

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On Gene Editing, Disease, and Disability

Photo of a piece of paper showing base pairs

This article has a set of discussion questions tailored for classroom use. Click here to download them. To see a full list of articles with discussion questions and other resources, visit our “Educational Resources” page.

On November 29, 2018, MIT Tech Review reported that at Harvard University’s Stem Cell Institute, “IVF doctor and scientist Werner Neuhausser says he plans to begin using CRISPR, the gene-editing tool, to change the DNA code inside sperm cells.” This is the first stage towards gene editing embryos, which is itself a controversial goal, given the debates that rose in response to scientists in China making edits at more advanced stages in fetal development.

Frequently the concern over editing human genes involves issues of justice, such as developing the unchecked power to produce humanity that would exist solely to service some population – for example, organ farming. The moral standing of clones and worries over the dignity of humanity when such power is developed get worked over whenever a new advancement in gene editing is announced.

The response, or the less controversial use of our growing control over genetic offspring, is the potential to cure diseases and improve the quality of life for a number of people. However, this use of genetic intervention may not be as morally unambiguous as it seems at first glance.

Since advanced testing was developed, the debate about the moral status of selective abortion has been fraught. Setting aside the ethics of abortion itself, would choosing to bring a child into the world that does not have a particular illness, syndrome, or condition rather than one that did be an ethical thing for a parent to do? Ethicists are divided.

Some are concerned with the expressive power of such a decision – does making this selection express prejudice against those with the condition or a judgment about the quality of the life that individuals living with the condition experience?

Others are concerned with the practical implications of many people making selections for children without some conditions. It is impractical to imagine that widespread use of such selection would completely eradicate the conditions, and therefore one worry could be that the individuals with conditions in the hypothetical society where widespread selection takes place will be further stigmatized, invisible, or have fewer resources. Also, the prejudice against conditions that involve disability might lead to selections that result in lack of diversity in the human population based on misunderstandings of quality of life.

Of course, on the other side of these discussions is the intuitive preference or obligation for parents or those in charge of raising people in society to promote health and well-being. Medicine is traditionally thought to aim at treating and preventing conditions that deviate from health and wellness; both are complex concepts, to be sure, but preventing disease or creating a society that suffers less from disease seems to fall within the domain of appropriate medical intervention.

How does this advancement in gene editing relate to the debate in selective birth? The Harvard example seeks to prevent Alzheimer’s disease, taking sperm and intervening to prevent disease. Lack of human diversity, pernicious ablest expressive power, and negative impact on those that suffer from the disease are the main concerns with intervening for the purported sake of health.

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“Minibrains” and the Future of Drug Testing

Image of a scientist swabbing a petri dish.

This article has a set of discussion questions tailored for classroom use. Click here to download them. To see a full list of articles with discussion questions and other resources, visit our “Educational Resources” page.

 NPR recently reported on the efforts of scientists who are growing small and “extremely rudimentary versions of an actual human brain” by transforming human skin cells into neural stem cells and letting them grow into structures like those found in the human brain. These tissues are called cerebral organoids but are more popularly known as “minibrains.” While this may all sound like science fiction, their use has already led to new discoveries in the medical sciences.

The impetus for developing cerebral organoids comes from the difficult situation imposed on research into brain diseases. It is difficult to model complex conditions like autism and schizophrenia using the brains of mice and other animals. Yet, there are also obvious ethical obstacles to experimenting on live human subjects. Cerebral organoids provide a way out of this trap because they present models more akin to the human brain. Already, they have led to notable advances. Cerebral organoids were used in research into how the Zika virus disrupts normal brain development. The potential to use cerebral organoids to test future therapies for such conditions as schizophrenia, autism, and Alzheimer’s Disease seems quite promising.

The experimental use of cerebral organoids is still quite new; the first ones were successfully developed in 2013. As such, it is the right time to begin serious reflection on the potential ethical hurdles for research conducted on cerebral organoids. To that end, a group of ethicists, law professors, biologists, and neuroscientists recently published a commentary in Nature on the ethics of minibrains.

The commentary raises many interesting issues. Let us consider just three:

The prospect of conscious cerebral organoids

Thus far, the cerebral organoids experimented upon have been roughly the size of peas. According to the Nature commentary, they lack certain cell types, receive sensory input only in primitive form, and have limited connection between brain regions. Yet, there do not appear to be insurmountable hurdles to advances that will allow us to scale these organoids up into larger and more complex neural structures. As the brain is the seat of consciousness, scaled-up organoids may rise to the level of such sensitivity to external stimuli that it may be proper to ascribe consciousness to them. Conscious organisms sensitive to external stimuli can likely experience negative and positive sensations. Such beings have welfare interests. Whether we had ethical obligations to these organoids prior to the onset of feelings, it would be difficult to deny such obligations to them once they achieve this state. Bioethicists and medical researchers ought to develop principles to govern these obligations. They may be able to model them after our current approaches to research obligations regarding animal test subjects. However, it is likely the biological affinity between cerebral organoids and human beings will require significant departure from the animal test subject model.

Additionally, research into consciousness has not nailed down the neural correlates of consciousness. As such, we may not necessarily know if a particularly advanced cerebral organoid is likely to be conscious. Either we ought to purposefully slow the progress into developing complex cerebral organoids until we understand consciousness better, or we pre-emptively treat organoids as beings deserving moral consideration so that we don’t accidentally mistreat an organoid we incorrectly identify as non-conscious.

Human-animal blurring

Cerebral organoids have also been developed in the brains of other animals. This gives the brain cells a more “physiologically natural” environment. According to the Nature commentary, cerebral organoids have been transplanted into mice and have become vascularized in the process. Such vascularization is an important step in the further development in size and complexity of cerebral organoids.

There appears to be a general aversion to the prospect of transplanting human minibrains into mice. Many perceive the creation of such human-animal hybrids (chimeras) as crossing the inviolable boundary between species.  The transplantation of any cells of one animal, especially those of a human (and even more especially those of the brain cells of a human) may violate this sacred boundary.

An earlier entry on The Prindle Post approached the vexing issues of the creation of human-animal chimeras. It appeared that much of the opposition to chimeras was based in part on an objection to “playing God.” Though some have ridiculed the “playing God” argument as based on “a meaningless, dangerous cliché,” people’s strong intuitions against the blurring of species boundaries ought to influence policies put in place to govern such research. If anything, this will help tamp down a strong public backlash.

Changing definitions of death

Cerebral organoids may also threaten the scientific and legal consensus around defining death as the permanent cessation of organismic functioning and understanding the criterion in humans for this as the cessation of functioning in the whole brain. This consensus itself developed in response to emerging technologies in the 1950’s and 1960’s enabling doctors to maintain the functioning of a person’s cardio-pulmonary system after their brain had ceased functioning. Because of this technological change, the criterion of death could no longer be the stopping of the heart. What if research into cerebral organoids and stem cell biology enables us to restore some functions of the brain to a person already declared brain dead? This undercuts the notion that brain death is permanent and may force us to revisit the consensus on death once again.

Minibrains raise many other ethical issues not considered in this brief post. How should medical researchers obtain consent from the human beings who donate cells that are eventually turned into cerebral organoids? Will cerebral organoids who develop feelings need to be appointed legally empowered guardians to look after their interests? Who is the rightful owner of these minibrains? Let us get in front of these ethical questions before science sets its own path.

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CRISPR, Moral Obligations and Editing the Human Genome

A close-up image of a scientist examining DNA test results

As our understanding of the human genome improves, pathways leading in the direction of new and powerful technologies are cleared.  In recent years, scientists have developed a new technique called CRISPR, which allows them to edit the genome—adding, subtracting, or deleting pieces of genetic code.  This process has the potential to bring about significant changes in human health.  CRISPR could prevent children from being born with a wide range of painful or life-threatening conditions.  So far, scientists have used this process in attempts to prevent blood disorders, allergies, heart disease, and to mutate the genome in such a way that the resulting person is less likely to get HIV.   Continue reading “CRISPR, Moral Obligations and Editing the Human Genome”

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Consent to Dying: The Case of Julianne Snow

Recently, a 5-year-old child named Julianne Snow passed away from from a neurological disease known as Charcot-Marie-Tooth, causing nerves in the brain to degenerate and loss in the muscles related to chewing, swallowing, and eventually breathing. Although Charcot-Marie-Tooth disease is one of the world’s most commonly inherited neurological disorders, this story made national headlines due to Julianne’s independent decision to refuse treatment.

Continue reading “Consent to Dying: The Case of Julianne Snow”