• Suppose her reason for taking—or being given—the treatment was not to avoid the unequivocal evil of a sexual assault but for a morally ambiguous purpose.

The properties of the interventions themselves are important. For each one, what are its benefits and risks? For how long do its effects persist? For how long can one detect that such an intervention had been attempted (in the case of active immunizations, perhaps a lifetime)? Looking beyond mere physiology, might a treated person’s behavior change in ways that would increase or diminish the risks to his or her own health or to others’ safety and well-being?

To have a clear apprehension of the ethical implications of making available interventions like this, the many likely contexts in which they might be used must be anticipated, not merely the most favorable and ethically unambiguous ones. Also to be considered is how we get from here—where we are currently in terms of our scientific understanding of such interventions, especially their clinical effects—to there. As with all potent new drugs and biologicals, the technologies intended to disarm substances of abuse must undergo a thorough evaluation of their benefits and risks via clinical research. To put it another way, both the ethics of research and the ethics of use must be considered.

After a brief discussion of the intervention technologies themselves and the dimensions of these technologies that are most likely to affect our ethical evaluation of them, this appendix considers first the ethics of research. Along the way what makes informed consent ethically significant and what makes it meaningful in practice are discussed. Then the discussion turns to the ethics of use, focusing on one of the most ethically complex possibilities for use—when parents want to administer these technologies to their children in order to discourage or prevent them from engaging in substance abuse.

FEATURES OF THE POSSIBLE INTERVENTIONS WITH SPECIAL ETHICAL RELEVANCE

Immunotherapies or depot medications might be used for three purposes. The first is to treat an overdose by administering passive immunotherapy in the form of mABs. That is, instead of exposing the immune system to a modified form of the antigen and waiting for the body to mount its own antibody response, passive immunotherapy provides ready-made antibodies. Such a therapy could be life-saving. But like all potent interventions, it will have additional effects. One strategy for helping a person through withdrawal from addiction is to use a modified form



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