Archive for category Distributive justice
Distributive Justice – Bioethics in Medical Practice
Posted by admin in Distributive justice on August 15, 2011
Distributive justice concerns the equitable distribution of scarce resources among all socioeconomic groups and population sectors. The question of distributive justice is a key ethical consideration in all aspects of medical care, including assisted reproductive techniques and reproductive genetics.
Access to cancer pharmaceuticals are a prime example of violations of distributive justice. These drugs typically cost tens of thousands of dollars a year. Some costs are stratospherically high. A new drug, Folotyn, manufactured by Allos Therapeutics, is projected to cost about $30,000 per month.(1) Remarkably, Folotyn hasn’t been shown to prolong lives – its effect is to shrink the tumors caused by peripheral T cell lymphoma, a rare disease affecting 5000-6000 Americans each year.
Erbitux, used in the treatment of colon cancer, costs approximately $10,000 per month. Avastin costs almost $100,000 per year when used to treat lung cancer or breast cancer.
Society as a whole bears the burden of these enormous expenditures, reflected in annual increases of 10% or greater in health care insurance premiums. In essence, every taxpayer in the United States is helping to maintain the profit margins of the pharmaceutical companies that impose such high prices. Read the rest of this entry »
Distributive Justice and Assisted Reproductive Technology
Posted by admin in Distributive justice on August 15, 2011
Distributive justice does not imply that everyone should have equal access to everything all the time. This would be an extreme position and lead to severe distortions in availability of medical services. Competing needs must be balanced fairly and opportunities to access medical care must be equitable. In the American health care marketplace, however, the bioethical principle of distributive justice receives lip service only. In America, when it comes to health care, minimal attention is paid to matters of fairness.
For example, assisted reproductive technologies (ART) have been generally available since the early 1980s. In recent years more than 100,000 in vitro fertilization (IVF) procedures are performed annually. But IVF costs – typically ranging between $15,000 and $25,000 – are rarely covered by insurance plans. Infertile couples wishing to have children need to pay for IVF out of their own pockets. National statistics indicate that for women younger than age 35, 41% of IVF procedures result in a live birth. For women between ages 35 and 37, 31% of IVFs result in a live birth. So it’s likely that many couples will need to undergo at least two rounds of IVF, spending a minimum of $30,000 and possibly more than $50,000 in attempts to have a family.
As the median household income in the United States was approximately $50,000 in 2008, it’s obvious that very few families can afford what reproductive medicine has to offer. This harsh reality implies that the vast majority of families that could benefit from ART are denied access because the procedures are out of reach financially. Infertile couples in the middle and lower economic classes may be working two jobs and contributing substantially to the welfare of their communities, but still have no chance to flourish as a family and raise children of their own. Read the rest of this entry »