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In 1798 Dr Edward Jenner published an account of "vaccination", 1 arguing that this gave safer protection against smallpox than the existing treatment, variolation. Proponents of immunisation, a technique that developed from Jenner's work, often claim that a research ethics committee, had it existed in the 1790s, might have rejected his work.
Is it therefore possible, more than 200 years later, to assess this claim and the ethical standard of Jenner's work in its historical context? This paper looks at a (hypothetical) review of Jenner's experiment and discusses its ethical dimensions.
THE BERKELEY LOCAL RESEARCH ETHICS COMMITTEE 1795
DRAMATIS PERSONAE
Chairman of the Berkeley REC
The rector of Berkeley
Zebediah Cowstock, a local farmer
Mr John Moore
Archibald Turner, the town apothecary
Dr Reginald Arbuthnot, a local doctor
Lady Sarah Wright
Dr Edward Jenner
CHAIRMAN
"Members, thank you for attending. Dr Jenner has kindly agreed to attend and discuss his application."
EDWARD JENNER
"Mr Chairman, my work is designed to explore how we might prevent people contracting smallpox, and I believe cowpox, a disease in our countryside, may hold the answer. What I have suggested in my application may seem dangerous but I would propose it is no more than an improvement of current preventive measures based on our modern experimental methods. Let me place my work in context. Smallpox is a serious threat to our community and our current methods for prevention carry significant risk of death and disfigurement. This technique is called "variolation" and uses fluid from smallpox vesicles. I believe that fluid from cowpox vesicles could protect more safely and that there are persuasive theoretical reasons to believe inoculation for the cowpox will be of greater benefit than current variolation. My modification to this technique is based on a long history of country folklore, supported by my own observations.
Much effort has been spent in trying to prevent smallpox, starting in this country when Lady Mary Montague, wife of our ambassador in Constantinople, brought the technique of inoculation for the smallpox (variolation) to England. Variolation is achieved by placing a small amount of the fluid from a smallpox blister into a small cut on the recipient's skin. It suffered setbacks, the deaths of the Earl of Sunderland's 2 yr old son the...