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The changing world of health care finance has led to a paradigm shift in health care with health care being viewed more and more as a commodity. Many have argued that such a paradigm shift is incompatible with the very nature of medicine and health care. But such arguments raise more questions than they answer. There are important assumptions about basic concepts of health care and markets that frame such arguments.
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The global value of the biotechnology industry is now estimated at 17 billion dollars, with over 1300 firms involved as of the year 2000.(2) It has been said that 'What we are witnessing is nothing less than a new kind of gold rush, and the territory is the body.' As in previous gold rushes, prospectors are flooding into unexplored and 'wide open' territories from all over the world, with possible ramifications for exploitation of Third World populations. These territories are also the Wild West of bioethics insofar as the law has very little hold on them: existing medical and patent law, such as the Moore and Chakrabarty cases, exert little control over powerful economic interests in both the United States and Europe. In the absence of a unified and consistent law on property in the body, the focus is increasingly on refining the consent approach to rights in human tissue and the human genome, with sensitive and promising developments from the Human Genetics Commission and the Department for International Development consultation on intellectual property. These developments incorporate the views of vulnerable genetic communities such as Native Americans or some Third World populations, and should be welcomed because they recognise the power imbalance between such groups and First World researchers or firms. However, they also highlight the continued tension about what is really wrong with commodifying human tissue or the human genome. Where's the injustice, and can it be solved by a more sophisticated consent procedure?
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The commercialization of biotechnology, especially research and development by transnational pharmaceutical companies, is already excessive and is increasingly dangerous to distributive justice, human rights, and access of marginal populations to basic human goods. Focusing on gene patenting, this article employs the work of Margaret Jane Radin and others to argue that gene patenting ought to be more highly regulated and that it ought to be regulated with international participation and in view of concerns about solidarity and the common good. The mode of argument called for on this issue is more pragmatic than logical, emphasizing persuasion based on evidence about the reality and effects of control of genetic research by profit-driven biotech companies.
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Although recent advances in biotechnology have brought with them a raft of ethical issues, other ethical challenges are arising not from new technologies, but rather from the expansion of biotechnology into "commodified" mass consumer applications, non-medical applications with no "purpose" other than entertainment or the satisfaction of consumer demand. In other words, commodity products targeted at a market that biotechnology does not currently exploit--the mass consumer market. This article will discuss two such examples of commodified biotechnology, the use of DNA sequence comparisons to construct genealogies; and the use of such comparisons to derive "ethnic" identities, and will conclude with a discussion of the possible consequences of such applications.
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This article explores the potential impact upon people with disability of some of the technological information being uncovered by the Human Genome Project. While the project has been promoted as promising positive benefits to society, its effect, in our present values climate, is potentially damaging. While we can map impairment, we cannot, as yet, cure it. And, in a society which embraces values such as utilitarianism and economic rationalism, we are choosing more and more to eliminate rather than care. We are seeing a conceptual transformation--the geneticization of self--which has enormous implications for the lives of people with disability. The author argues that scientific endeavor, which has been constructed as occurring within a culture of impartiality and empiricism, actually operates within an uncontested value base which devalues disability. She concludes that the Human Genome Project needs to be reframed within a broadened ethical framework of inclusion.