Talking About Bioethics & Policy in the United States Under the Trump Administration

Bioethics is an increasingly hot topic, particularly in the wake of dual-use research of concern, drug development, genome editing technology like CRISPR, and even outbreaks of diseases, such as the Zika virus. Vaccine development is a tricky field and has become increasingly relevant as we attempt to stay ahead of diseases and avoid another Ebola 2014/2015.

The new administration has recently raised alarms for much of the science community in terms of funding, support, and even vaccine skepticism. The meeting President Trump had with Robert F. Kennedy Jr. (a reported vaccine skeptic and proponent of the fictitious vaccine-autism link) amplified these fears as a Trump spokeswoman noted that a commission on autism was in the future. Since that fateful meeting, over 350 organizations have written to Trump regarding their “unequivocal support for the safety of vaccines.”

In response to these concerns, the Johns Hopkins Berman Institute of Bioethics put out some of its finest professors for media to contact and discuss “bioethics that relate to actions taken by the new Trump administration.” The institute highlighted the availability of Jeffrey Kahn, PhD, MPH (director of the institute and expert on the Affordable Care Act and other healthcare policy), Nancy Kass, ScD (expert on vaccine policy and human subjects research), Travis Rieder, PhD (expert on climate change), and Leonard Rubenstein, JD (expert on refugee policy, torture of prisoners/detainees, etc.). These topics will continue to grow in relevancy as Trump’s newly appointed US Supreme Court pick, Neil Gorsuch, has spent a great deal of time focused on bioethics.

Emerging infectious diseases carry with them their own bioethical considerations. This marriage was especially relevant during the recent Zika virus outbreak and the role of birth control and infection-related fetal microcephaly. Even Ebola was not immune to bioethical issues, as President Obama supported a Presidential Commission for the study of Bioethical Issues, which was released in February 2015. As a result of the Ebola cases in the United States and the obvious concerns globalization has brought about via travel, the CDC issued a new rule regarding its quarantine power and practices. The new rule has many pointing to the ethical concerns regarding detainment of a traveler without a clear and direct path that would allow it to be challenged.

Kyle Edwards of the New York Times noted that, “unfortunately, the new rules give the CDC. significant in-house oversight of the decision to quarantine, with up to three layers of internal agency review. This internal review has no explicit time limit and could easily stretch on for weeks while a healthy person languishes in quarantine. And since federal courts often wait until an agency has completed its internal process before it will consider hearing an appeal, we won’t know until the next crisis hits whether a federal judge will agree to hear a petition from someone detained before the CDC review is completed.”

Given the historically tenuous relationship with quarantine and fear (from the days of the bubonic plague to the more recent events in New Jersey with a returning Ebola nurse), it’s not unreasonable that many are concerned that not only is this new rule worrisome, but also in the hands of the Trump administration. The new quarantine rule, like all bioethical arguments, is not without argument. As Johns Hopkins professors emphasized, it has become increasingly important we have the means to contact experts in the field to ensure accurate information is getting released.