Evaluating Novel Therapies During the Ebola Epidemic

The Ebola hemorrhagic fever outbreak inWest Africa poses acute and novel challenges for health policy and researchethics. Facedwith anexceptionally virulent in-fectious agent, limited resources, and danger to health workers, local and international authorities struggle to deployprovenpublichealth techniques thatcan limit the spread of the disease.1 In themidst of the crisis, experi-mental interventions thathaveneverbeenevaluated in human trials have captured professional and public at-tention. The prospect of first-in-human use of these in-terventions during an uncontrolled epidemic raises at least4pressingethical questions. First, is therea role for “compassionate use ” of agents in the absence of hu-man safety, efficacy, or dosing data? Second, given the critical scarcity of these agents, which patients should