The Morality of Death-Defying Acts
What distinguishes, for example, mountain climbing, from human challenge trials?
Barney: You know, Homer, I got a great way to make money. I'm a human guinea pig.
Homer: You mean, like, medical testing?
Barney: Yeah. Medical, military, chewing stuff.
Moe Szyslak: Chewing stuff?
Barney: Yeah. Like, you chew on a telephone wire 'til you get a shock.
Moe Szyslak: Oh, oh, right. Okay.
Homer: Yeah, but aren't those experiments dangerous?
Barney: [opening his shirt to reveal extra ears on his chest] Ah, you get a few side effects.
Moe Szyslak: Are those ears?
Barney: [closing his shirt again] Ow! Not so loud!
Dr. Hibbert: These children have been hurt doing stunts they saw on television, movies and the legitimate stage. This little boy broke his leg trying to fly like Superman. His brother hit him with a wrench, mimicking a TV wrestling match. I won't show the horrors of our Three Stooges ward.
Marge: I didn't know TV was a dangerous influence.
Dr. Hibbert: It's tragic, but it's a small price to pay for top-notch entertainment!
Homer: Amen!
My brother and father are big fans of films about daredevil mountain climbers. I certainly can see the appeal. Many of the shots take your breath away:
There is also something to be said for how these films show us what people are capable of achieving.
I had to see what all the fuss was about, so I finally broke down and watched a few of these types of films. I watched Free Solo several months ago and The River Runner more recently, and I enjoyed both movies. But what struck me the most was that it seemed clear that both protagonists had an all-consuming drive for death-defying acts. One might even argue that neither protagonist has the ability to exercise free will and that they are fated to push the envelope as far as they can. In fact, both films hint that the protagonists might lack the capability of feeling fear and/or might have an underlying mental illness that has caused them to pursue these high-risk activities. Setbacks from accomplishing their goals (such as injuries) caused them to spin into deep depression (note: this is also experienced by other elite athletes). At the same time, very few people would argue that mountain climbing or river kayaking should be banned to prevent other people with similar dispositions from choosing these extremely high risk pursuits.
…which brings me to human challenge trials to combat the COVID-19 pandemic. I got acquainted with the idea through the economics blog Marginal Revolution. The idea is that there are people who want to volunteer for high-risk, high-reward medical studies. However, human challenge trials are banned throughout most of the world. Here are the most common arguments I’ve heard against human challenge trials:
Volunteers may not truly understand all of the risks involved;
It’s never morally permissible to intentionally harm innocent people;
A failed human challenge trial would undermine confidence in the medical establishment; and
Uncertainties about the long-term side effects of intentional exposure.
By extension, I would expect people who oppose human challenge trials to favor banning high-risk sports for the following reasons:
Athletes may not truly understand all of the risks involved;
It’s never morally permissible to allow people to intentionally harm themselves (okay, this one is a bit different, but are sins of omission really worse than sins of commission?);
Failing to achieve an athletic goal would undermine confidence in the sports establishment; and
Uncertainties about the long-term side effects of participation (for example, strained personal relationships, mental health issues, etc).
As for the benefits of human challenge trials, advocates argue that human challenge trials could:
Discern the efficacy of vaccines in the important role of preventing infection to the vaccinated person. Field trials and observations can also help to do this, but challenge trials would do so far more reliably and accurately.
Discern the efficacy of vaccines in the crucial role of preventing mucosal infection, a proxy of infectiousness to others.
Measure rapidly the comparative efficacy of different vaccines in these two roles.
Measure rapidly the comparative efficacy of different regimens for proven vaccines, e.g. half-dose, spaced out, etc. in these two roles.
Measure rapidly the efficacy of vaccines against new viral variants in these two roles.
Discern the correlates of vaccine protection (easier to discern in challenge than field trials). Known correlates of protection would serve to triage new vaccine candidates and to assess efficacy in different populations.
Quickly triage for unpromising next generation vaccine candidates, limiting the number of further large field trials needed.
Discern the duration and breadth of vaccine immunity (by challenging participants months after they have been vaccinated).
Discern the quality and duration of post-natural infection immunity (by challenging people previously infected with COVID-19).
So what do you think? Should we ban all high-risk sports as well? Or should we legalize human challenge trials?