Scientists who are experts at understanding how the flu works are convening in New York this week to make a very important decision.  They are going to decide whether to restart potentially risky research on flu viruses that has been on hold for many months.

Some argue that before they begin there ought to be a lot more involvement of the public in granting permission for this work.  I completely disagree.  There are plenty of oversight groups in place already that are charged with protecting public health and safety in the U.S. and worldwide.

Still, I think a few strict requirements ought to be in place before the flu manipulators get back in business in their labs.  They are needed to help protect the scientists, you, me and everyone else on this planet should the dangerous bugs they seek to create get in the wrong hands or places.

Last January a huge controversy broke out over the wisdom of publishing two very detailed papers in leading scientific journals that involved the engineering of H5N1 bird flu viruses by labs in Wisconsin and the Netherlands.  H5N1 normally infects ducks, and it can wipe out flocks of chickens. It occasionally infects people – about 600 so far and it’s killed 358 of them. Scientists are afraid slight changes in its genes would make it more infectious to people.

They’ve been tinkering with the virus to see what it would take.  Each study showed how to create flu strains that were easier to transmit than the ones that usually occur in nature.  Ferrets – the animals that most closely resemble humans when it comes to catching flu -- could get infected by one of the engineered viruses simply through breathing and sneezing.

No physical contact was required. 

This work suggested ways in which nasty, highly contagious forms of the flu evolve naturally every once in a while and shows why pandemic flu clobbers human beings every couple of decades.   But, the papers also showed how to artificially gin up highly transmissible strains -- something that might be of keen interest to terrorists and other bad guys. 

Many people, including me, wondered about the wisdom of publishing formulas for making highly contagious types of flu in a world where accidents and attacks are both all too real.  Censorship, however, turned out to make no sense.  By the time a paper is ready to go into a major scientific journal, secrecy has long since left the building.

When the stink over publishing broke out seven months ago, more than 30 of the world’s flu mavens agreed to put a hold on their research until the publication battle had been resolved.  Originally the self-imposed moratorium was to last 60 days. Even though both papers have been published, the moratorium has gone on for more than 6 months.  Many of those who do this work say it is time to get back to the business of understanding the basic biology of the flu virus.

Why do risky research on the flu?  Those who want to argue that it is important to understand how flu viruses can become more easily transmissible, or lethal, or both.  There is a lot of swine flu and avian flu around every year but luckily it comes in forms not easy to transmit from animals to people or among people.  But, with the right mutations, as the two published papers showed, the flu can get a lot more contagious.  Add in a few more changes and you can make the flu much more deadly.  If we knew from lab manipulations what strains of flu were the worst, we could monitor for them and maybe even get a leg up on creating a vaccine if one suddenly popped up someplace.

That makes sense.  What would also make sense would be to restrict the number of scientists and labs and locations doing this risky work, having hyper-strict safety rules that everyone around the world is expected to follow and a system of inspection to make sure no especially awful bugs can escape and that no one can break in to let them out. 

We don’t need public hearings to get this done.  We need specific rules.

There are requirements in place now for doing risky biological work.  But they are not tough enough for mucking around with a killer with a proven history like the flu.  Sadly, more restrictions are needed in a world where terrorists, crazies and accidents happen. 

The moratorium needs to end.  Figuring out more about the flu in the lab makes us all safer.  Ending it means knowing when experts agree that the experiments are needed, all information about such research is encoded and restricted and the labs where risky flu work is done are safe and secure. 

Related links:

How mutant bird flu goes airborne

Second controversial bird flu study shows its dangers

Experts agree to let scientists publish H5N1 studies

A 32-year-old pregnant woman from Massachusetts, known only as Mary Moe, is at the center of a heated battle over abortion and sterilization, in a case so complex you could use it to teach an entire course on bioethics.

Moe suffers from severe schizophrenia and bipolar mood disorder. She has been pregnant before: The first time she had an abortion, and the second pregnancy resulted in a boy now being raised by Moe’s parents. Between her abortion and the birth of her son, she suffered what court papers refer to as a “psychotic break," and had to be hospitalized. She now takes medication, but her diseases are so severe that she is still not in touch with reality.

Forced abortion for mentally ill woman? No way, court says

At a court hearing last December the state Department of Mental Health asked that her parents be made her guardians. The parents wanted their daughter, then two months pregnant, to have an abortion. During that hearing doctors testified that the drugs Moe is taking threatened the health of her fetus. They also said stopping them would place her at serious risk of going "deeper into madness."  

The judge found the argument for an abortion persuasive. She ordered that Moe's parents be appointed as co-guardians, and said they could do whatever was necessary including having their daughter "coaxed, bribed, or even enticed ... by ruse" into a hospital where the abortion could be performed. The judge added that Moe should be sterilized after the abortion so that the same situation did not come up again.

The decision was immediately appealed. Now, a Massachusetts appellate court has overturned the lower court, and sterilization is off the table. The appellate court said that if Moe were competent she would not want an abortion, since she has said she does not want one. So no abortion is in store either.

Did the appellate court make the right decision? I think so -- but for the wrong reasons.

The state of North Carolina just paid out big sums of money to people who had been sterilized without their consent in the 1960s and 1970s. Sterilization has been abused again and again in this and other countries. There is no reversing it. Whatever needs to be done to help Moe, it is not sterilizing her.

If she is not to be sterilized, can severely mentally ill persons like Moe be told never to have sex? The court didn't broach the subject, but it is a key ethical question.

It is probably impossible to prevent Moe from having sex.  But given her mental state she is hardly capable of consent.  I think she needs to be on permanent birth control until and unless she somehow recovers from her mental illnesses. Then, and only then, should she be free to have a child.

What about the abortion? She cannot consent to it. The Massachusetts courts are trying to guess what she would want if she were competent using some of her statements to guide them. That is a hopeless quest. Moe is too sick to tell us anything. And, despite the judges’ efforts, it is pointless to pretend to know her wishes about this pregnancy.

Her poor parents do not want to worry about their daughter, raise one of her children and find themselves with another. But their stake in all this disqualifies them to decide what ought to happen.

What we are left with when autonomy is gone and family are conflicted is trying to do what is best for Moe and her fetus. I do not think an abortion clearly meets that principle.

If Moe’s medicines put the fetus at risk, then try to lower the dose. If Moe herself becomes even more impaired, stop. If Moe cannot possibly raise the baby and her parents cannot either, then adoption is the best road to follow.

Allowing Mary Moe to become pregnant again is not in her best interest. Ending the life of her fetus when she cannot tell us what to do is not in the best interest of the fetus. There is a lot to think about in the case of Moe, but forced sterilization and non-consensual abortion should not be part of that thinking.

What do you think about the case of Mary Moe? Tell us on Facebook.

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The morning-after pill known as Plan B is steeped in controversy again. The Department of Health and Human Services has taken the rare step of overruling the Food and Drug Administration and its science advisors and will not allow the pill to be sold over the counter in drugstores unless a woman can prove she is older than 17. 

The stunning override of the FDA is bad public policy.  This is a case of politics triumphing over science yet again when it comes to matters of reproduction, contraception and abortion in the U.S.

Plan B has stirred strong emotions from the minute its manufacturer sought FDA approval. During the Bush administration, abortion foes tried to stifle the drug on the grounds that it works as an abortion agent even though the drug actually prevents a fertilized egg from implanting in the womb, which is not in the scientific sense of the term an abortion. Some docs and pharmacists made headlines by saying they would not prescribe the pill even in the case of a rape.  Some hospitals will not stock it.

Plan B won't be available OTC for younger teens

But the pill has been shown safe time and time again. The FDA panel that approved it for over-the-counter use simply could not find any scientific reason to worry about its safety. The benefits of preventing unwanted pregnancies and the risks of surgical abortions are significant.

So why not let any woman, even a girl of 14 or 15, have access?  Because, politically at least, saying a young girl can protect herself against an unwanted pregnancy is not the most popular stance to take.

The fact is that many teen girls have sex – and many will not talk about it with their parents.

Sometimes that sex is coerced or forced. Sometimes it is a relative or friend who is the exploiter.

These are not scenarios that we like to admit to. But they are real. That's why the pills should be readily available on drugstore shelves, but include an insert listing resources where young girls can get help.

Making Plan B hard to get doesn't protect these young girls. It puts them in an even worse spot.

Read more columns by Art Caplan:

Shame on school for rejecting boy with HIV

Vatican push for adult stem cells can't ignore good science

Art Caplan, Ph.D., is the director for the Center for Bioethics at the University of Pennsylvania.  Follow him on Twitter @ArthurCaplan.