Ethical Issues in our Pandemic Response
asked in class to focus on ethical issues in health informatics
Informatics involves not only digital infrastructure but also the evidence-based digital data running over that infrastructure, and the standards defining which individuals/populations have privileges to access that data. Discussion of informatics includes discussion of patient-related-data accessibility and the protection of a patient’s private health information, along with issues surrounding censorship versus transparency of qualified research experts and their research data. I’m categorizing “ethical issues in health informatics” using themes defined by Subbian and by Shortliffe in our Informatics class’ assigned reading this week. I’m exploring some of the ethical issues surrounding “the use of informatics to mitigate the spread of SARS-CoV-2, to support COVID-19 care delivery and to accelerate knowledge discovery, bringing to the forefront issues of privacy, surveillance, limits of state powers, and interoperability between public health and clinical information systems” (Subbian, 2021). As Shortliffe (2014) explains in our reading this week, important ethical issues in health informatics include confidentiality/privacy, use of informatics tools in clinical settings, determination of who is eligible to use those informatics tools, the role played by system evaluation, the obligations of system vendors/maintainers/developers, the appropriate standards for industry interaction, and the use of computers to track clinical outcomes to guide future practice. I feel that there are many unethical and non-evidence-based public health interventions that have been implemented in reaction to the SARS-CoV-2 pandemic.
I appreciated reading Subbian, et al.’s perspective on ethics and informatics during the pandemic. Some respected scientists/researchers have a different interpretation of public health data that was provided/observed/published over the course of the pandemic, and I think that we have to acknowledge this in our discussion of ethical implications of health informatics, and that in fact it falls under the category of “Public health reporting and data sharing”.
One of Subbian’s (2021) opening statements, for example:
“Various ‘social distancing’ strategies and economic shutdowns across states curbed the initial spread of the virus in many parts of the country, but the rapid “reopening” in several areas—due to concerns about exacerbating the economic crisis and the public’s desire to return to work and social activities—resulted in infection surges across communities.”
…has no citation, and is contested by data on lockdown effectiveness on the virus’ spread at least from Canada (Allen, 2021), the UK (Berry, 2021), America (Krylova, 2021), Germany (CODAG, 2021), and Sweden (Shahar, 2021). Dr. John P.A. Ioannidis summarized the data in June, 2021: “Compared to Sweden and South Korea which did not utilize draconian measures, other countries which locked down did worse” https://covidcalltohumanity.org/2021/07/20/stanfords-dr-john-ioannidis-destroys-the-covid-lockdown-narrative/ Ioannidis mentions that of the two models Imperial College published with two different assertions on lockdowns (one showing no benefit, and the other showing a benefit), Nature journal “chose to publish the less robust model showing that lockdowns had a benefit”. In order to “inform public health policy with more reliable data and evidence” (Subbian, 2021), we have to be sure we start with all the evidence, and that we properly cite where our evidence originates.
In the beginning precaution is fine, but eventually public health must be driven by data. The precautionary principle—when you don’t know, be careful—is a commonly used framework in public health. During covid-19, this principle was often used to proactively close establishments without characterising the contribution of those closures to overall transmission. But precaution is not an absolute, nor an indefinite, mandate. It is a renewable contract. As more information comes out, such precautions must be revisited and altered. https://blogs.bmj.com/bmj/2021/07/26/what-does-public-health-really-mean-lessons-from-covid-19/
Conveying disease risk accurately in pace with developing information: Evidence-based information should be constantly updated to reflect updates in evidence base. Dr. John P.A. Ioannidis (2021) published a paper back in March, confirming that the global infection fatality rate (IFR) of COVID-19 is significantly less deadly than originally believed, an average around 0.15%. Significant risk factors for COVID-19 disease severity include age https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-Focus-on-Ages-0-18-Yea/nr4s-juj3 and underlying medical conditions including hypertension, disorders of lipid metabolism, obesity, diabetes and anxiety disorders https://www.cdc.gov/pcd/issues/2021/pdf/21_0123.pdf. There is an extreme risk-stratification of SARS-CoV-2 by age and comorbidity that is critical to communicate to the public so they can accurately access their personal risk. Communicating the fact that there is a thousand-fold difference in risk of getting infected faced by elderly relative to young people helps the public understand their risk so they can take appropriate precautions. The elderly, as is a human right, should have the ability not to observe the government recommendations of social distancing that are designed for their own safety. We are talking about a disease with a global IFR of around 0.15%.
Lord Sumption (British historian, author, and retired Supreme Court Judge) in his conversation with Dr. Jay Bhattacharya (Professor of Medicine at Stanford University), describes the risk: “in the UK the average age people die with COVID-19 is 82.4, which is about a year ahead of the average age at which they die of anything. In the United States…the comparison is equally close, somewhere around 78.” https://collateralglobal.org/article/a-conversation-with-lord-sumption/ In Germany, risk of death in all age groups fell in 2020 relative to 2018, even the over-80 age group https://multipolar-magazin.de/artikel/corona-todeszahlen-nicht-plausibel . Communicating the fact that countries are not reporting an average age of mortality that is significantly different from normal, or deaths that are in excess of normal by age group helps the public understand the opinion that it is not ethical to restrict freedoms and infringe on human rights over this.
As soon as information emerged from Dr. John P.A. Ioannidis (2021) back in March, confirming the IFR, public health officials should have been all over that information, working to loosen restrictions, because public health officials should understand best that the impact of lockdown has been devastating on the poor, the young, and minority groups (Aragona, 2020; Kailash Satyarthi Children's Foundation, 2020). Canada has reported 5x greater deaths than expected resulting from lockdown than from Corona.
https://www150.statcan.gc.ca/n1/daily-quotidien/210712/dq210712b-eng.htm
Misrepresenting risk of Covid for kids is not ethical Dr. Marty Makary, a professor at the Johns Hopkins School of Medicine, Bloomberg School of Public Health and Carey Business School, and also Editor-in-Chief at MedPageToday, wrote an editorial in the Wall Street Journal that calls out government agencies, academic medical centers, industry, and much of mainstream media for a non-science-based push to vaccinate all children:
A tremendous number of government and private policies affecting kids are based on one number: 335. That is how many children under 18 have died with a Covid diagnosis code in their record, according to the Centers for Disease Control and Prevention. Yet the CDC, which has 21,000 employees, hasn’t researched each death to find out whether Covid caused it or if it involved a pre-existing medical condition. Without these data, the CDC Advisory Committee on Immunization Practices decided in May that the benefits of two-dose vaccination outweigh the risks for all kids 12 to 15. I’ve written hundreds of peer-reviewed medical studies, and I can think of no journal editor who would accept the claim that 335 deaths resulted from a virus without data to indicate if the virus was incidental or causal, and without an analysis of relevant risk factors such as obesity. My research team at Johns Hopkins worked with the nonprofit FAIR Health to analyze approximately 48,000 children under 18 diagnosed with Covid in health-insurance data from April to August 2020. Our report found a mortality rate of zero among children without a pre-existing medical condition such as leukemia… ” https://www.wsj.com/articles/cdc-covid-19-coronavirus-vaccine-side-effects-hospitalization-kids-11626706868
Misrepresenting our knowledge of the known safety of Covid vaccines including long-term safety for kids after vaccination is not ethical. According to the CDC: “COVID-19 vaccines have been used under the most intensive safety monitoring in U.S. history, which includes studies in adolescents.” https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/adolescents.html Safety monitoring is ongoing and has not been concluded. Myocarditis, pericarditis and blood clots still appear to be rare, but look to appear far more in teens, young adults, and in the case of blood clots adult women younger than age 50.
Coercion tactics to get parents to vaccinate their kids is not ethical: “Getting your child or teen vaccinated can bring you one step closer to enjoying the activities you miss”:
Suggesting that freedom of travel or participation in activities which are fundamentally human rights can be a little closer to a parent’s grasp following immunization of their child I believe is an infringement on rights protected under the Nuernberg code.
Encouraging Fear and Panic in the Public is Not Ethical
Increasing fear and panic through data manipulation and deception in order to drive people to do what they wouldn’t have done otherwise is unethical.
Scientists on a UK committee that encouraged the use of fear to control people’s behavour during the Covid pandemic have admitted its work was “unethical” and “totalitarian”. Members of the Scientific Pandemic Influenza Group on Behaviour (SPI-B) expressed regret about the tactics in a new book about the role of psychology in the Government’s Covid-19 response. SPI-B warned in March last year that ministers needed to increase “the perceived level of personal threat” from Covid-19 because “a substantial number of people still do not feel sufficiently personally threatened…Gavin Morgan, a psychologist on the team, said: “Clearly, using fear as a means of control is not ethical. Using fear smacks of totalitarianism. It’s not an ethical stance for any modern government.” https://news.yahoo.com/scare-tactics-control-behaviour-during-181656377.html
Inducing panic was also leaked to have been done in Germany with the "panic paper" written by the German Department of the Interior: Among other things, the “Panic Paper” calls for children to be made to feel responsible – and Dr. Reiner Fuellmich quoted – “for the painful tortured death of their parents and grandparents if they do not follow the corona rules” http://www.opensourcetruth.com/dr-reiner-fuellmich-begins-legal-litigation-on-the-covid-19-fraud-the-greatest-crime-against-humanity/
The use of computers and computer models to track clinical outcomes to guide future practice. Forecast models have not only had historically a “dubious track record”, their failures actually managed to become even more prominent with COVID-19 according to Dr. John P.A. Ioannidis (2020). The American Institute for Economic Research (AIER) recently provided a good summary of the COVID-19 failures as well as their implications https://www.aier.org/article/imperial-college-predicted-catastrophe-in-every-country-on-earth-then-the-models-failed/ Dr. Ioannidis explained, “COVID has led to many deaths, but it is not the “apocalyptic” predictions made by the early models. Infection fatality rate (IFR) of COVID varies from region to region, but Global IFR is at 0.15%” https://covidcalltohumanity.org/2021/07/20/stanfords-dr-john-ioannidis-destroys-the-covid-lockdown-narrative/ The larger question is asked by AIER: Why is the epidemiology modeling team at Imperial College-London (ICL), led by the physicist Neil Ferguson “who has a long history of absurdly exaggerated modeling predictions, still viewed as a leading authority on pandemic forecasting? And why is the ICL team still advising governments around the world on how to deal with Covid-19 through its flawed modeling approach?” Failure of modeling should lead to scrapping of that modeling rather than its continued use.
Contact tracing and tracking.
The proposal to allow the American government, which arguably is controlled or at least swayed heavily by the priorities of its military intelligence agencies,
…and which has over the course of this pandemic certainly not inspired any particular degree of confidence in its competence, transparency, or concern for public wellbeing
…to track an individual’s movements along with all that individual’s close contacts for any reason should be strongly denounced and ridiculed. No one can verbalize this better than Edward Snowden.
Employing contact tracing in order to track hundreds of thousands of infections cannot be anonymized in any meaningful way. The American Civil Liberties Union stressed the necessity of voluntariness, use limitations, minimization, data destruction, transparency, and prevention of mission creep in order to keep contact tracing from infringing on human rights and becoming normalized. https://coinspice.io/news/civil-liberties-whitepaper-answer-to-apple-and-google-covid-19-contact-tracing-bluetooth-tech/ Legislation such as this, that amounts to mass surveillance, and that is passed under emergency powers, has a history of abuse (the USA/Patriot Act was passed 45 days after 9/11) and never ends despite what we might be told
https://www.cnet.com/tech/mobile/apple-and-google-say-they-will-shut-down-covid-19-tracking-tools-once-pandemic-ends/
Privacy, Confidentiality and Data Sharing
Privacy laws and in particular standards for privacy of individually identifiable health information like the Health Insurance Portability and Accountability Act (HIPAA) and Gramm-Leach-Bliley (GLB) expressly restrict access to collection and monitoring of personal data. https://www.federalregister.gov/documents/2000/12/28/00-32678/standards-for-privacy-of-individually-identifiable-health-information According to the Standards for Privacy of Individually Identifiable Health Information published at the Federal Register in December 2000, although many people believe they “own” their own health records, “current law and practice do not support this view”. The American Medical Association’s Code of Ethics recognizes the right to privacy for individuals, as well as “the need to balance it against societal needs”, and that any conflict between an individual’s right to privacy and a third party’s “need to know” should be resolved in the individual’s favor. But the Federal Register standards explain that this principle does’t apply in many cases, and that many “specific questions about protecting health information” remain without specific guidance;
In general, state statutes and case law addressing consent to use of health information do not support the public's strong expectations regarding consent for use and disclosure of health information. Only about half of the states have a general law that prohibits disclosure of health information without patient authorization and some of these are limited to hospital medical records https://www.federalregister.gov/documents/2000/12/28/00-32678/standards-for-privacy-of-individually-identifiable-health-information
We can’t move forward with further digitalization of health information without addressing these critical questions of privacy and confidentiality of digital health data. It is not ethical to demand people identify their vaccination status as with a vaccine passport. Patient privacy and confidentiality is protected under the law.
Appropriate standards for industry interaction with public health regulatory agencies. Only naming a few examples of inappropriate relationships here.
The FDA which regulates biologics including vaccines, and drugs (for safety and efficacy) was strongly criticized by the editor-in-chief Lawrence R. Huntoon of the Journal of American Physicians and Surgeons last fall (Huntoon, 2020). The FDA is responsible for inspecting FDA-regulated products at clinical trial sites in order to ensure data integrity/quality and the safety of study participants (Huntoon, 2020). Despite the fact that objectionable practices like falsification of data, failure to obtain informed consent, and adverse event reporting violations are “occasionally” revealed, “FDA trial inspection reports have been largely hidden from public view” only sometimes reluctantly presented as a result of Freedom of Information Act (FOIA) request (Huntoon, 2020). The FDA “often approves drugs which do not meet its own criteria for acceptable clinical trials,” and has been responsible for “incorporation of poor quality, fabricated, fraudulent data into publications, meta analyses, review articles, recommendations for ‘evidence-based care’, clinical guidelines, formularies, and standard of care declarations” (Huntoon, 2020). Huntoon (2020) cites reports of the FDA’s failure to disclose conflicts of interest, falsifying data, failure to retract known false data, and failure to disclose sources of contamination. Huntoon (2020) explains that conflicts of interest are “rife” within clinical guidelines, which physicians fail to disclose. Huntoon (2020) cites an example involving Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for COPD treatment, where all GOLD board members except one (91.67%) reported conflicts of interest greater than $10,000, and 100% of the GOLD Science Committee members admitted financial conflicts of interest of undisclosed payment amounts. Pharmaceutical companies producing COPD medications prominently featured as payment sources, according to Huntoon (2020). Huntoon (2020) cited multiple reports of the FDA disregarding safety recommendations of its own inspectors regarding suspicious activity at drug manufacturing plants (“shredding extensive amounts of documents right before our audit”), and high levels of contaminated drug ingredients (up to 210 times the acceptable level of carcinogens).
The NIH says that “there are insufficient data for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19” https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/ Freedom of Information Act (FOIA) requests to the NIH and emails to panel members yielded no answer as to how the committee reached a decision on ivermectin or even whether a vote was ever held on the ivermectin recommendation (Yim, 2021). The NIH did provide 2 names of Panel members (the others were redacted). One of the two was later revealed to be the principal investigator of a clinical trial the NIH had announced $155 million of funding in initial investment (Yim, 2021). This represents a conflict of interest because a positive recommendation on the use of ivermectin in COVID-19 would effectively end the NIH-funded clinical trial. More details from Yim on the difficulty of getting this conflict of interest disclosed are here: https://trialsitenews.com/controversial-ivermectin-researcher-failed-to-report-massive-conflict-of-interest/
The HHS coronavirus response is led by Robert Kadlec who was director for biodefense on the Homeland Security Council in 2002, and was responsible for drafting National Biodefense Policy for the 21st Century that expanded BioShield (“legislation that established a government money teller-window for Big Pharma called the Biomedical Advanced Research and Development Authority (BARDA)), and the Strategic National Stockpile (SNS) program where funding from Congress was earmarked to stockpile pharmaceuticals. From the “bird flu” to the “swine flu”, the biodefense stockpile made a significant amount of money for pharmaceutical corporations “eager to restock the SNS after its large-scale deployment” as well as for government insiders (including Rumsfeld). In 2005, Kadlec joined a subcommittee on bioterrorism and public health where he was staff director on a committee that published the Pandemic and All-Hazards Preparedness Act (PAHPA) which provided expanded directives for BioShield and established Kadlec’s future job at HHS. During his stint in the private sector, Kadlec directly advised pharmaceutical companies like Emergent Biosolutions and Bavarian Nordic, and was a consultant to military and intelligence contractors like NSA contractor Scitor and DARPA-backed firm Invincea. Kadlec also founded a company in 2012 which “advises communities and countries on issues related to the threat of weapons of mass destruction and natural pandemics” called East West Protection, a fact he failed to disclose during his nomination to serve as HHS Assistant Secretary for Preparedness and Response (ASPR) for Trump. Deputy Director of HHS is Tevi Troy who worked with Kadlec on PAHPA and BioShield in his role as the “White House’s lead adviser on health care, labor, education, and other issues with a special focus on crisis management”. Troy’s revolving door with industry as an adjunct fellow of the Hudson Institute (which boasts big donors including Microsoft, The Charles Koch Foundation, Lockheed Martin, Boeing and Emergent BioSolutions) is discussed in this article as well as Kadlec’s interesting history of having long held “doomsday predictions for bioterror incidents.” https://unlimitedhangout.com/2020/05/investigative-series/head-of-the-hydra-the-rise-of-robert-kadlec/ . (quoted and paraphrased)
HHS has shown unprecedented willingness to use taxpayer funds to subsidize vaccine development including up to $144 million for the Phase 2/3 clinical trial involving controversial vaccination of children for a disease that doesn’t pose a risk to them. https://trialsitenews.com/feds-continue-to-fund-moderna-including-144m-injection-into-2-3-kidcove-study-11yr-to-6-months-despite-record-revenues-profits-8b-cash-reserves/ It is disturbing to say the least that legislation has been introduced to allow a regulatory health agency with known conflicts of interest with industry decide which research experts get elevated and which get censored: https://www.lujan.senate.gov/press-releases/lujan-klobuchar-introduce-legislation-to-hold-digital-platforms-accountable-for-vaccine-and-other-health-related-misinformation/
The CDC. Emails exposed that the American Federation of Teachers (second-largest American teacher’s union) successfully lobbied the CDC from recommending school reopening. The AFT donated almost $20 million to democrats during the 2020 election. Although CDC Director Dr. Rochelle Walensky had insisted CDC guidance was “free from political meddling”, two suggestions were included from the AFT almost verbatim. The CDC had been prepared to write that regardless of the virus’ community spread, schools could provide in-person instruction. Schools have long been understood to have little influence on infection rate when hygienic measures are followed https://nypost.com/2021/05/01/teachers-union-collaborated-with-cdc-on-school-reopening-emails/ The CDC’s guidance against school reopening was in direct contradiction to the CDC’s own research earlier in the year which showed opening schools contributes little to coronavirus spread (Honein, 2021). Something similar could have happened with the CDC’s recent reversal (with no justification) on recommending masks for kids and teachers in the Fall, regardless of vaccination status: The AFT was pushing for face masks to be worn:
CDC practices were also roundly criticized by the editor-in-chief Lawrence R. Huntoon of the Journal of American Physicians and Surgeons in an editorial last fall (Huntoon, 2020). Starting in 1983, Huntoon (2020) explains, the CDC was authorized to accept gifts from industry, and then with Congress’s creation of the non-profit CDC Foundation which greatly expanded its capability to accept private funding: “the door to conflicts of interest and corruption was opened wide”. The CDC establishes “research collaborations” with industry and other entities, awards grants, and engages in “collaborative alliances” with single private-sector organizations (Huntoon, 2020). According to Huntoon (2020), the CDC builds a 16% administrative fee into each grant and agreement. Even when the CDC’s source of donation is classified as “prohibited” by its own definition, the CDC can accept any gift that it evaluates “carefully” (Huntoon, 2020). Conditional donations can be gifted to the CDC from entities which include pharmaceutical corporations, and the CDC accepts millions of dollars that are earmarked for specific projects this way (Huntoon, 2020). Huntoon (2020) cites an example from 2012 of Genentech and its parent company Roche which earmarked $600,000 in donations for CDC’s work to expand viral hepatitis testing and treatment. Industry, meanwhile had donated over $26 million to the CDC’s Viral Hepatitis Action Coalition since 2010. Following the CDC’s August 2012 guidelines which recommended expanded cohort screening of the American population born between 1945 and 1965, a BMJ article revealed that 9 out of 34 members that wrote and reviewed the CDC’s August guidelines were financially tied to the manufacturers (Huntoon, 2020). Roche provided conditional funding to the CDC Foundation for the Take 3 flu campaign, after which the CDC recommended influenza antiviral drugs and cited research which the CDC described as an independent study but that instead was sponsored by Roche with all four authors holding financial ties to pharmaceutical corporations benefiting from the campaign (Huntoon, 2020). Huntoon (2020) also cites Carey Gillam’s report on the CDC SPIDER, the anonymous whistleblowers from the CDC who in 2016 “lodged an ethics complaint alleging the federal agency is being influenced by corporate and political interests in ways that short-change taxpayers” and alleging nothing was changing or being done in response to news about its many transgressions https://usrtk.org/food-related-diseases/cdc-spider-scientists-complain-of-corporate-influence-at-health-agency/ Among other revelations, the CDC was accused of misrepresenting data given to Congress, going out of their way to delay Freedom of Information Act (FOIA) responses, obstructing inquiries, and letting other “questionable and unethical practices” become the norm rather than a rare exception. The CDC continues to make decisions impacting public health recommendations and refuses to justify the interventions with supporting data. On the CDC’s recent change of mind on masking, Vinay Prasad, MD, MPH asks “what new evidence is guiding the policy?” in an article featured on MedPageToday. “The CDC cannot "follow the science" because there is no relevant science. The proposition is at best science-y; a best guess based on political pressure, pundit anxiety, and mechanistic understanding…”:
Huntoon (2020) also discusses the CDC’s “questionable” relationship with food industry lobby group International Life Sciences Institute (ILSI), exposed completely by Stacy Malkan in April this year https://usrtk.org/our-investigations/ilsi-is-a-food-industry-lobby-group/ Huntoon (2020) also mentions the CDC’s claim of “no evidence of harm caused by the low doses of thimerosal in vaccines” when “multiple CDC-sanctioned publications show that thimerosal causes tics”. A complaint to the Department of Health and Human Services Office of Research Integrity (ORI) resulted in the ORI handing the issue back to the CDC to “investigate itself.” Huntoon (2020) detailed the alleged CDC data manipulation (formerly reported by his journal in 2017) of a statistically significant association when black male children received the measles-mumps-rubella (MMR) vaccine before 36 months of age. Here is a report by five-time Emmy Award-winning investigative journalist and NYT best selling author Sheryl Attkisson on the topic: https://sharylattkisson.com/2021/06/read-cdc-senior-scientist-we-trashed-data-showing-vaccine-autism-link-in-african-american-boys/ Other media outlets identified by Huntoon (2020) that reported these allegations against the CDC are interestingly among the 12 influencers White House Press Secretary Jen Psaki urged social media outlets to ban two weeks ago.
Limits of state powers
"There's about 12 people who are producing 65 percent of vaccine misinformation on social media platforms,”said Psaki https://reason.com/2021/07/15/covid-19-vaccines-misinformation-jen-psaki-white-house-biden/ Maybe relatedly, these 12 are all proponents of non-toxic medical treatment over pharmaceuticals. These 12 are among only a few media outlets that are interviewing health practitioners reporting adverse health effects of the Covid vaccine, including Dr. Charles Hoffe from Canada. As Dr. Charles Hoffe comments: “One of the basic principles of medical ethics is if you’re doing a clinical trial of some new treatment and in the course of that you start seeing serious harm, ethically you’re supposed to stop the clinical trial; investigate it, pause it, and see what’s going on…in every case [debilitating side effects occurred] within 72 hours of the shot, most within 24 hours…all previously well people” https://childrenshealthdefense.org/defender/rfk-jr-the-defender-podcast-dr-charles-hoffe-adverse-health-effects-covid-vaccine/
Uncertainties surrounding new technology must be communicated to insure informed consent.
Shortliffe (2014) explains that “scientific evidence counsels caution and prudence” with the rollout of any new technology, and this would certainly apply to the mRNA technology used in Covid vaccines. Dr. Robert Malone is inventor of the mRNA technology that is used in Covid vaccines
Dr. Malone speaks here about social media censorship of his vaccine safety concerns, and vicious character smearing : https://www.thelastamericanvagabond.com/dr-robert-malone-interview-inventor-of-mrna-technology-censored-for-speaking-out-on-vaccine-risks/ He details at 12:15min an unethical relationship and conflict of interest of the chairman of the board at Reuters who also sits on Pfizer’s board. Partnerships between social media and industry (like partnerships between social media and the government) must be transparent and declared; partnerships between government health regulatory agencies and industry should be strongly discouraged.
I see some parallels (albeit on a smaller scale), with the chiropractic antitrust case won against the American Medical Association (AMA) in 1987 after 11 years of legal action. https://chiro.org/Wilk/ The possibility is not entirely out of the question that the government’s intent when granting their regulatory agencies such authority over social media outlets is to “decrease competition for financial reasons rather than to protect the public from unethical practitioners…Not coincidentally, the AMA’s efforts resulted in the transformation of American medicine from a modest, even menial profession into one of sovereignty, power, and financial affluence” (Agocs, 2011). The American Medical Association (AMA) engaged in dirty tactics to convince state legislators their profession was scientific while others including the chiropractic profession were “unethical and unscientific.” The chiropractic profession successfully argued that the AMA had attempted to destroy them as a competitor and to eliminate chiropractic as a profession (Agocs, 2011). Quite often we are seeing that the very best choice to support public health is not the choice that is most profitable for industry.
We seem to be at a crossroads, and we need to understand that the ethical choice for digital health information accessibility/management will always be to embrace transparency and open science with no censorship, while individual health data must stay secure and fiercely guarded from outside interests.
Reference List:
1. Agocs, S. (2011). Chiropractic’s fight for survival. AMA Journal of Ethics, 13(6), 384-388 https://journalofethics.ama-assn.org/article/chiropractics-fight-survival/2011-06
2. Aragona, M., Barbato, A., Cavani, A., Costanzo, G., & Mirisola, C. (2020). Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties. Public Health, 186, 52-56. https://www.sciencedirect.com/science/article/pii/S0033350620302936?casa_token=WIRq9XLEd6YAAAAA:kviPph6643tYbcCF9dOXGAiUZre9WksGNRUTQON4Wo0If-7TWsN7rPyI6gpFGGAS9EEmBJGS0Q
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