Many health care systems include programs that allow patients in exceptional circumstances to access medical interventions of as yet unproven benefit. In this article we consider the ethical justifications for—and demands on—these special access programs (SAPs). SAPs have a compassionate basis: They give patients with limited options the opportunity to try interventions that are not yet approved by standard regulatory processes. But while they signal that health care systems can and will respond to individual suffering, SAPs have several disadvantages, including (...) the potential to undermine regulatory and knowledge-generation structures that constitute significant public goods. The “balance” between these considerations depends in part on how broadly SAPs are used, but also on whether SAPs can be made to contribute to the generation of knowledge about the effects of health interventions. We argue that patients should usually be required to contribute outcome data while using SAPs. (shrink)

The Medical Innovation Bill continues its journey through Parliament. On 23 January 2015, it was debated for the final time in the House of Lords and with one final amendment, the House moved to support the Bill, which then moved to the House of Commons on 26 January. It will be debated again on 27 February 2015. The Bill’s purpose is to encourage responsible innovation in medical treatment. Although this goal is laudable, it is argued that the Bill is unnecessary (...) and has the potential to undermine the very cause it aims to advance. More useful for encouraging responsible innovation is the continued education of health-care professionals on how the law already supports practitioners who look to improve care through responsible innovation. (shrink)

Expectations play a major role in ‘driving’ biotechnology research and development. However, their ethical significance has been largely overlooked. This article examines the dynamics and ethics of expectations surrounding biotechnologies, focusing on biobanks and the promise of personalised medicines. It explores the personal and social implications of expectations, especially where technologies fail to eventuate. The article identifies the claims and practices that support the expectations pertaining to biotechnologies and some of the factors that work against the fulfilment of predicted innovations. (...) It is argued that the role of expectations in shaping thinking and action needs to be taken seriously by those who are concerned about the ethical implications of biotechnologies. (shrink)

Research on ethical, legal and social aspects of life sciences and new technologies has mainly been focused on impacts and consequences, while the emerging framework of Responsible Research and Innovation focuses rather on increased involvement and reflexivity in research processes to foster science and technology that better answers the needs of society. I argue that philosophy of science should be a central feature of RRI and demonstrate how the philosophy of science can contribute in this sense. I show how investigating (...) basic assumptions in research, here exemplified by reductive assumptions in causal modeling, can have important ethical and societal implications. (shrink)

Abstract In this essay, a new approach for the ethical study of emerging technology ethics will be presented, called anticipatory technology ethics (ATE). The ethics of emerging technology is the study of ethical issues at the R&D and introduction stage of technology development through anticipation of possible future devices, applications, and social consequences. I will argue that a major problem for its development is the problem of uncertainty, which can only be overcome through methodologically sound forecasting and futures studies. I (...) will then consider three contemporary approaches to the ethics of emerging technologies that use forecasting: ethical technology assessment, the techno-ethical scenarios approach and the ETICA approach, and I considered their strengths and weaknesses. Based on this critical study, I then present my own approach: ATE. ATE is a conceptually and methodologically rich approach for the ethical analysis of emerging technologies that incorporates a large variety of ethical principles, issues, objects and levels of analysis, and research aims. It is ready to be applied to contemporary and future emerging technologies. Content Type Journal Article Category Original Paper Pages 1-13 DOI 10.1007/s11569-012-0141-7 Authors Philip A. E. Brey, Department of Philosophy, School of Behavioral Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands Journal NanoEthics Online ISSN 1871-4765 Print ISSN 1871-4757. (shrink)

The prehistory of science and technology studies -- The Kuhnian revolution -- Questioning functionalism in the sociology of science -- Stratification and discrimination -- The strong programme and the sociology of knowledge -- The social construction of scientific and technical realities -- Feminist epistemologies of science -- Actor-network theory -- Two questions concerning technology -- Studying laboratories -- Controversies -- Standardization and objectivity -- Rhetoric and discourse -- The unnaturalness of science and technology -- The public understanding of science -- (...) Expertise and public participation -- Political economies of knowledge. (shrink)

This introduction begins with two simple case studies that reveal a background of socio-economic complexities that hinder development. The availability of healthcare and the issue of cross-border justice are the key points to be addressed in this study. The chapters consider philosophy, economics, and bioethics in order to provide a global perspective. Two theories come into play in this book—the ideal and non-ideal—which offer insight on why and how things are done.

Disturbing international inequalities in health abound. Life expectancy in Swaziland is half that in Japan. A child unfortunate enough to be born in Angola has 73 times as great a chance of dying before age 5 as a child born in Norway. A mother giving birth in southern sub-Saharan Africa has 100 times as great a chance of dying from her labor as one birthing in an industrialized country. For every mile one travels outward toward the Maryland suburbs from downtown (...) Washington, DC on its underground rail system, life expectancy rises by a year – reflecting the race and class inequities in American health. Are the glaring, even larger, international health inequalities also unjust? -/- All of us no doubt think they are grossly unfortunate. Many of us think they are unfair or unjust. Why should some people be at such a health disadvantage through no fault of their own, losers in a natural and social lottery assigning them birth in an unhealthy place? Others of us are troubled by the absence of the kinds of human relationships that ordinarily give rise to the claims of egalitarian justice that we make on each other – for example, being fellow citizens or even interacting in a cooperative scheme. Who has obligations of justice to reduce these international inequalities? And do those obligations hold regardless of how the inequalities came about? What institutions are accountable for addressing them? (shrink)