British soldiers used as guinea pigs in Afghanistan

I can't see this reported elsewhere on this site after doing a search, however, please feel free to close it down if there's another thread extant

The Guardian last month reported that British troops wounded in Afghanistan were being injected with NovoSeven (activated Factor VII) to stem bleeding from severe trauma.

link

I find this ethically interesting - do you follow the line of 'guinea pigs/gulf war syndrome' or do you accept that it *may* save a life in a severely injured soldier and is therefore worth using?

Where does the need for good pharm trails get trumped by force majeure?

TD

They're clearly using them as guinea pigs. They are saying 'this drug is too dangerous to give to the public, as of yet. But we can force these guys to take it and they can't stop us, so lets do it'. Thats using them as guinea pigs.

I Don't know, I feel bad for those poor soldier's. They and Prisoner's have always been the fed's guiny pigs (srry dont know how to spell is it guiny, or is it guinea?)

I mean imgaine gettin your leg blown of, fightin a war you didn't have anything to do. Then some guy come's up, and say's "here we havn't tested it but it should work...side effects may include...hold on lemee check the list...aa..yes...it may include death"

I dont know it just doesnt seem right...

Oh give over...

NovaSeven has been licensed for use with hemophilliacs since at least the late 90's. This is just a novel application for the drug. If it can stop hemophiliacs from bleeding to death, then why not someone who is actually bleeding to death?

It's hardly "using them as guinea pigs". The drug is already in use and licensed.

Originally posted by stumason
Oh give over...

NovaSeven has been licensed for use with hemophilliacs since at least the late 90's. This is just a novel application for the drug. If it can stop hemophiliacs from bleeding to death, then why not someone who is actually bleeding to death?

It's hardly "using them as guinea pigs". The drug is already in use and licensed.

Well, it's not without risks, which include heart attacks, stroke and pulmonary emboli (blood clots in the lung) from deep vein thrombosis. Most of these incidents happen with off-label use. Here's the pubmed link:

pubmed

Point is, it's *not* licensed for this sort of use, although I can see *why* it's being used. Although when I see the words 'serious morbidity and mortality' associated with off-license use, I start to get twitchy.

TD

[edit on 15-10-2006 by TaupeDragon]

[edit on 15-10-2006 by TaupeDragon]

Originally posted by TaupeDragon

Well, it's not without risks, which include heart attacks, stroke and pulmonary emboli (blood clots in the lung) from deep vein thrombosis. Most of these incidents happen with off-label use. Here's the pubmed link:

[edit on 15-10-2006 by TaupeDragon]

Seen the possible side affects you can get off Neurofen? Or Anadin or any other over the counter pain killer? And thats using it as intended.

I'd say that using the drug to stop someone bleeding to death, which is what it is designed for, is pretty much in the scope of the drugs use.

Seeing as someone is highly likley to die from gun shot wounds and other combat related injuries if left untreated, I think they wont mind an ever so slight risk of an adverse reaction if it meant they didn't lose 6 pints of blood in some god forsaken dust bowl half way round the world.

Point being, have you actually seen soldiers objecting to its use? I know I wouldn't, wether specifically licensed or not. The licensing process takes forever and if they have a drug which is proven to save lives, then why not use it?

Specific licensing is pending for the battlefield application anyhow. I would hardly call this particular application as using the soldiers as guinea pigs, as the drug has been tested for human use, just not specifically licensed as a battlefield anti-coagulant. It's a bit beurocratic to refuse a drug designed to stop bleeding, just because it hasn't had the ok to be used by non-hemophiliacs. If someones bleeding to death, I really don't think they care.

Originally posted by stumason

Seen the possible side affects you can get off Neurofen? Or Anadin or any other over the counter pain killer? And thats using it as intended.

Hello SM

I think that's being a little disingenuous. Ibuprofen is a pretty safe, cheap NSAID with pretty minor effects, and taken orally, as opposed to a very powerful, expensive parenteral drug with more severe side effects - you're really comparing apples with oranges.

I'd say that using the drug to stop someone bleeding to death, which is what it is designed for, is pretty much in the scope of the drugs use.

It's actually designed to stop *haemophiliacs* from bleeding to death - i.e. VIIa helps out people who lack Factor VIII or IX in their coagulation cascade. That's what it's licensed for.

What the Guardian article is talking about, and what has got the veteran groups irritated is the use of VIIa on *non-haemophiliacs* - something it was *not* designed for.

And that's what the second link I posted refers to - effectively excess clotting causing stoke, DVT, MI and pulmonary embolism, with consequent death and disability.

Seeing as someone is highly likley to die from gun shot wounds and other combat related injuries if left untreated, I think they wont mind an ever so slight risk of an adverse reaction if it meant they didn't lose 6 pints of blood in some god forsaken dust bowl half way round the world.

I didn't say I was completely opposed to use in extreme circumstances, and I'm not going to comment on how arid Afghanistan is. I simply stated that it was ethically interesting that a drug was being used 'off the shelf' - it could well save lives, but it hasn't been proven to be effective or safe in non-haemophiliacs, as the second article states.

Point being, have you actually seen soldiers objecting to its use? I know I wouldn't, wether specifically licensed or not. The licensing process takes forever and if they have a drug which is proven to save lives, then why not use it?

Because it may or may not work. Because it may or may not cause more problems than it solves.

As for objecting to treatment - if people are in the condition they appear to be i.e. unconcious from massive trauma, it would be difficult to get consent from them.

Let's say an unconcious soldier is given VIIa, and as a result suffers from a stroke or MI. He didn't give consent - if it happened in the 'real world' he would be able to sue the doc, and probably rightly so. Why should his rights be any less as a non-civilian?

Let's not forget that often people don't get a full listing of the consequences of treatments and would not be in a proper position to object/accept anyway.

There is, after all a habit of using soldiers to test drugs, possibly unethically.

yale

And of course, anthrax vaccine in the 1st gulf war is still controversial (not sure one way or the other, but worth mentioning)

needs further study

Specific licensing is pending for the battlefield application anyhow. I would hardly call this particular application as using the soldiers as guinea pigs, as the drug has been tested for human use, just not specifically licensed as a battlefield anti-coagulant. It's a bit beurocratic to refuse a drug designed to stop bleeding, just because it hasn't had the ok to be used by non-hemophiliacs. If someones bleeding to death, I really don't think they care.

I still say the second link of this thread I posted shows consequencesin non-haemophiliacs, and the first article seems to show a lot of ex-military organisations opposed to it. If people can show it is being done with informed consent, then in life-threatening situations I think is could be argued it is acceptable, but I have yet to see the evidence that consent is being obtained.

TD

Ever seen how a tourniquet works ? Stops the bleeding, but generally destroys the limb from blood loss.
In combat, you do whatever needed to save lives.
Seems to me you lack the life experience. It tends to open your eyes.

My 2 cents,
Lex

Originally posted by Lexion
Ever seen how a tourniquet works ? Stops the bleeding, but generally destroys the limb from blood loss.
In combat, you do whatever needed to save lives.
Seems to me you lack the life experience. It tends to open your eyes.

My 2 cents,
Lex

Ever seen someone stroke out because they've been given inappropriate treatment? It generally destroys the brain from lack of oxygen.

In healthcare, you try to avoid killing the patient by your own actions.

Seems to me you need to open *your* eyes and read the first link properly and accuse the ex-military groups opposed to this of 'lack of life experience'.

My 2 pennies
TD

Originally posted by stumason
If it can stop hemophiliacs from bleeding to death, then why not someone who is actually bleeding to death?

It's hardly "using them as guinea pigs". The drug is already in use and licensed.

I agree. At first, I thought it was administered to all soldiers in the combat zone, the way gamma globulin was during the Vietnam war and apparently still do, but as it is only given to soldiers who are bleeding to death and only after conventional measures have failed, I'd say that I'd be glad to get the drug, as should anyone else in that condition.

Whoops. I thought the gamma globulin shots were to increase the blood clotting factor. Apparently, I was wrong. en.wikipedia.org...

Well, maybe it was Vitamin K, I'm not sure. Maybe someone else remembers.


[edit on 2006/10/18 by GradyPhilpott]

Not trying to provoke an argument, but civilian healthcare is a far, far cry from combat medicine.
If the attempted cure kills the soldier, chances are, the wound would have, too.

Lex

P.S. My eyes are wide open, and have seen too much.