10/7/20
The special treatment President Donald Trump received to access an experimental COVID-19 drug raises fairness issues that start with the flawed health care system many Americans endure and end with the public’s right to know more about his condition, ethics and medical experts say. Regeneron Pharmaceuticals Inc. revealed on Tuesday how rare it was for anyone to get the drug it gave Trump outside of studies testing its safety and effectiveness. The drug, which supplies antibodies to help the immune system clear the coronavirus, is widely viewed as very promising. Trump also received the antiviral Remdesivir and the steroid dexamethasone, and it’s impossible to know whether any of these drugs did him any good. Trump’s doctors asked for the Regeneron drug under “compassionate use” rules, which allow a patient with a life-threatening disease to get an experimental medicine if they can’t enroll in a study testing it and there’s no good alternative. Compassionate use requests are decided on a case-by-case basis, and both the drug company and the U.S. Food and Drug Administration must agree. An FDA spokeswoman refused comment on the FDA’s decision or to say how many others have asked for the drug.
Fewer than 10 of these requests have been granted, said Regeneron spokeswoman Alexandra Bowie. The drug is in limited supply, the priority is using it for the ongoing studies, and emergency access is granted “only in rare and exceptional circumstances,” she wrote in an email. Trump’s doctor has dodged some questions about details of Trump’s illness and cited health privacy rules. He has repeatedly portrayed Trump’s symptoms as mild, and said that oxygen was given to him on two occasions but that he was not short of breath. The steroid Trump was given is only recommended for hospitalized patients who need extra oxygen -- studies suggest it can be harmful in less sick patients. “The White House has an obligation to provide the American people with a clear picture of the health of the commander in chief during a health crisis,” even if it withholds specific details such as his moment-to-moment vital signs, perhaps at Trump’s request, said Dr. Steven Joffe, medical ethics chief at the University of Pennsylvania. Trump’s medical team “has not met their moral responsibility to the American public” to be honest and forthcoming on his health, Bateman-House said. “You forgo much of your privacy when you become president.” Finally, some are dismayed that Trump received special care while flaunting public health advice about wearing a mask and other steps to curb the spread of the virus. “He has an obligation to follow the rules of the United States and he has an obligation to set a good example,” said Alison Bateman-House, an ethicist at NYU Langone Health. “We have problems on both of those counts.”
apnews.com
