Embryo Research and Equitable Access to Health Care

The ethical principle of justice implies that all people should have equitable access to health care services. However, because of the rapidly increasing costs of medical technology and advanced health care services in different fields of medicine, the question of resource allocation becomes a pressing and sometimes a decessive one. If the country has adequate resources and can provide basic health care services as well as advanced health care service, including embryo research there is no problem. In countries where resources are limited and basic health care services are lacking, implimentation of advanced health care services, though it will benefit a certain sector of the population, will be unjust as it deprives a major sector of the population from the basic health care services. In this context there is a collision between the principles of justice and utility(68 & 80).

In providing advanced technology in developing countries one should not ignore the moral principles which provide an ethical basis for conduct. The principle of liberty which guarantees a right to freedom of action. However, in many countries, there is a scarcity of resources and many of the needy patients in these countries cannot exercise such right of freedom of action. However, rich members of the society not uncommonly have an access either to private centers in the country or they may cross the borders or fly over to one of the developed countries to have the service provided. This certainly violates the principle of justice which requires that everyone has equitable access to necessary goods and services.

In developing countries, when resources are limited and/or available basic health care service is well below accepted standards, one must not forget the moral implication of the principle of utility before establishing such expensive centers. The principle of utility defines moral rightness by the greatest good for the greatest number. Policy makers in these countries would be seriously violating this principle if they give preference of establishment of such expensive centers to implementing basic health care service requirement. The expensive centers would be able to offer service to a relatively small sector of the society. However, this should not be at the expenses of providing basic health care service to the major sector of their population. Consider, for example, the estblishment of private advanced health care centers, such as Assisted Reproduction Technology (ART) centers, embryo research centers or transplant centers. In a study performed in Egypt, it was found that only one out of thirteen patients who were referred to ART centers were able to have the procedure done and achieve their objective of motherhood(3). This certainly constitutes a serious violation of the principle of justice and equitable access to necessary treatment. A mechanism should be found in these countries to allow the needy to have access to such expensive centers. A suggested solution for such situation may be some donations to provide support for the treatment of the poor and needy at these centers. The donations may be provided by those rich who have had successful treatment in these centers, pharmaceutical companies and possibly funding from research projects conducted in these centers(69).