Nature Medicine
December 2014, Volume 20 No 12 pp1355-1492
http://www.nature.com/nm/journal/v20/n12/index.html

Nature Medicine | Editorial
Principled compassion
oi:10.1038/nm.3772
Published online
04 December 2014
Abstract
Investigational drugs can save or extend lives, and seriously ill patients not able to take part in clinical trials should have access to such drugs whenever possible. In a climate of increased public pressure for this access—often termed compassionate use—five states in the US have passed so-called ‘right to try’ legislation. These laws are ill advised, as they are not likely to substantially increase access and have the potential to compromise the clinical trial system.

Nature Medicine | News
University travel bans and quarantines may impede Ebola response
Cassandra Willyard
doi:10.1038/nm1214-1359
Published online
04 December 2014

Travel to and from West Africa has become increasingly burdensome for researchers and health workers helping to curb the spread of an Ebola outbreak that has killed nearly 5,000 people in the past year. In October, US universities began banning campus-sponsored travel to Liberia, Sierra Leone and Guinea and began strongly discouraging travel to these countries for personal reasons, including volunteer work. As of 29 October, the guidelines set by the US Centers for Disease Control and Prevention advise health officials to monitor the condition of those arriving from Ebola-affected countries for 21 days—the maximum incubation period for the disease. But some institutions are also asking these individuals to stay away from campus during that time, regardless of their exposure to the virus. Although these policies are designed to prevent the spread of Ebola, they may also be hampering the response to the outbreak in West Africa.

“Universities in a time of crisis have historically been able to step up and provide not just research and other resources like that, but really personnel and expertise,” says Phuoc Le, a physician at the University of California, San Francisco (UCSF) who was headed to Liberia on 6 November to work with a nonprofit called Last Mile Health. Whereas UCSF is encouraging doctors and nurses to go to West Africa, Le adds, others are “putting up multiple barriers that are hard for individual faculty or staff to overcome.”

For example, as of early November, when this story went to press, Stanford University School of Medicine is prohibiting Stanford-related travel to the countries affected by Ebola and is adopting the 21-day rule, regardless of whether travelers are symptomatic or came into contact with infected individuals. Columbia University in New York has advised staff and students to avoid traveling to West Africa. Anyone wishing to make the trip must apply for an exception and sign a letter emphasizing that “evacuation of patients with Ebola symptoms may not be achievable.” Travelers must also submit an evacuation plan in case of emergency…