Comprehensive Health Care Reform and Biomedical Innovation

Considers ways to control the costs of development, adoption, and diffusion of new technologies as part of comprehensive healthcare reform. Discusses how cost control interventions might affect coverage, physician payments, and care processes

The Obligation to Participate in Biomedical Research

The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The current social norm is that individuals participate only if they have a good reason to do so. The public goods argument implies that individuals should participate unless they have a good reason not to. Such a shift would be of great aid to the progress of biomedical research, eventually making society significantly healthier and longer lived

The ethics of expanding access to cheaper, less effective treatments

This article examines a fundamental question of justice in global health. Is it ethically preferable to provide a larger number of people with cheaper treatments that are less effective (or more toxic), or to restrict treatments to a smaller group to provide a more expensive but more effective or less toxic alternative? We argue that choosing to provide less effective or more toxic interventions to a larger number of people is favored by the principles of utility, equality, and priority for those worst-off. Advocates are mistaken to demand that medical care provided in low-income and middle-income countries should be the same as in high-income countries

What are the potential cost savings from legalizing physician-assisted suicide?

Journal ArticleIN the Washington v. Glucksberg and Vacco v. Quill decisions rejecting a constitutional right to physician-assisted suicide, the Supreme Court allowed each state to decide whether to legalize the intervention.1 In state legislatures rather than courtrooms, factual claims about the probable extent and implications of permitting physician-assisted suicide assume a preeminent role in the debate about legalization.2 Particularly sensitive in these discussions will be the issue of the potential cost savings from legalizing physician-assisted suicide, and how the savings might influence decision making by health care institutions, physicians, families, and terminally ill patients. 3-6 Although we do not agree with each other about the ethics or optimal social policy regarding physician- assisted suicide and euthanasia, we do agree that the claims of cost savings distort the debate. Within the limits of available data, we offer an assessment of the potential cost savings from legalizing physician- assisted suicide, demonstrating that the savings can be predicted to be very small - less than 0.1 percent of both total health care spending in the United States and an individual managed-care plan's budget

What are the potential cost savings from legalizing physician-assisted suicide?

Journal ArticleQuill decisions rejecting a constitutional right to physician-assisted suicide, the Supreme Court allowed each state to decide whether to legalize the intervention. In state legislatures rather than courtrooms, factual claims about the probable extent and implications of permitting physician-assisted suicide assume a preeminent role in the debate about legalization. Particularly sensitive in these discussions will be the issue of the potential cost savings from legalizing physician-assisted suicide, and how the savings might influence decision making by health care institutions, physicians, families, and terminally ill patients