Health Care

1. Health Care

2. What is “health?” • Are individuals deserving of good health? • Entitled to good health? • Deserving of good health care? • Entitled to good health care? • Responsible for maintaining their individual health?

3. What is and isn’t “your body?” • Who owns your body? • Who owns your health? • Who should have access to the technological means to preventillness or to cure illness in the case of disease?

4. Some Questions from Lori Andrews • Certainly the living body has long been exploited as a commercial and marketable entity, as athletes, models, prostitutes, surrogate mothers, and beauty queens are well aware. But there is something new, strange, and troubling about the traffic in body tissue, the banking of human cells, the patenting of genes. (Body Bazaar 6) • What is “new, strange, and troubling” about these phenomena?

5. But what is troubling about the fragmentation and commodification of the body? What is the problem with the growing interest in human tissue? What shouldn’t body parts be economic units of trade? Clearly the business of bodies is driven by instrumental and commercial values; but so too, as Gore suggested, are most technological endeavors. Moreover, much of the body tissue that is useful for biotechnology innovation—hair, blood, sperm—is replenishable. The average person loses two hundred hairs each day. Blood and sperm are constantly regenerated. And body materials such as umbilical cord blood, infant foreskin, or biopsied tissue discarded after surgery are normally regarded as refuse, like bloodied bandages and other medical wastes. Why not, then, view the body as a useful and exploitable resource if these tissues can be used to advance scientific research, contribute to progress, or provide life-saving benefits to others? (Body Bazaar 7)

6. A person’s control over what is done to his or her body, or its parts, is important to his or her psychological development and well-being. It is a way of establishing personal identity and conveying values to others. Our social system recognizes the right of an individual to control what is done to her body, be it an abortion or the termination of a life-saving treatment. This autonomous control, or self-agency, is important to the individual’s psychological health. All individuals need to experience self-agency and self-coherence (the ability to maintain the body as a nonfragmented, integrated whole). For outsiders to take or use tissue without the individual’s knowledge or consent can compromise that person’s psychological development and emotional well-being. (13) • Do you agree that control of the body is important for psychological well-being?

7. “The value of human body tissue in the biotechnology age—and the potential for profitable patents derived from it—encourages doctors and researchers to think about people differently. Some scientists refer to the body as a “project” or “subject,” a system that can be divided and dissected down to the molecular level.” • The language of science is increasingly permeated with the commercial language of supply and demand, contracts, exchange, and compensation. Body parts are extracted like a mineral, harvested like a crop, or mined like a resource. Tissue is procured—a term more commonly used for land, goods, and prostitutes. (Body Bazaar 5) • Are these changes in the “language of science” something we should be concerned about? • How would scientists justify these changes in language and defend themselves against the accusation that they are dehumanizing people?

8. In the United States, over 110,000 patients are on waiting lists for organ transpants • 6,000 US patients each year die waiting for a transplant • Paying donors for organs is prohibited in U.S. • Singapore does not prohibit and is implementing a system of paying donors $36,000-$50,000 for organs. I • Iran began such a system in 1988 and no longer has any waiting lists for organs. • Should the US implement such a system? • Is there an ethical difference between donating a kidney and donating an egg or sperm?

9. Who “owns” your body after you have died? • In the U.S., organs cannot be harvested from a deceased person unless he or she has signed an organ donor agreement prior to death .

10. “No give, no take” system = persons who refuse to sign an organ donation agreement will be lowest priority for receiving a donation, should they need one. • Persons who agree to organ donation will be higher on priority.

11. Who should get priority for organ donation? • Should preference be given to the young who have a longer life to live? To older persons who have contributed to society in substantial ways? To people who can pay the full cost of the transplant procedure? • Should felons who have been sentenced to life without parole be eligible for transplants?