The Case for Resource Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health

Hastings Center Report

Volumn 47, Issue 5, 2017, Pages 17-24

  Persad, Govind C ^a   Emanuel, Ezekiel J ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

DEVELOPING COUNTRY; ECONOMICS; ETHICS; GLOBAL HEALTH; HEALTH CARE PLANNING; HEALTH CARE QUALITY; HUMAN; SOCIAL JUSTICE; WORLD HEALTH ORGANIZATION;

DEVELOPING COUNTRIES; GLOBAL HEALTH; HEALTH RESOURCES; HUMANS; QUALITY OF HEALTH CARE; SOCIAL JUSTICE; WORLD HEALTH ORGANIZATION;

EID: 85029638330     PISSN: 00930334     EISSN: 1552146X     Source Type: Journal    
DOI: 10.1002/hast.764     Document Type: Article

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35. The charge of double standards was also common in debates over the appropriate standard of care in international clinical research. Some defended a single, global standard of care, while others argued that the standard of care could permissibly vary according to local context. For an overview, see D. Orentlicher, “Universality and Its Limits: When Research Ethics Can Reflect Local Circumstances,” The Journal of Law, Medicine & Ethics 30, no. 3 (2002): 403-10. However, in clinical care—rather than clinical research—two of the arguments that the standard of care should be the same worldwide, focused on exploitation and on special duties of researchers to trial participants, do not apply (see Orentlicher, “Universality and Its Limits,” 406–7).
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48. The charge of discrimination is uncharitable: the judgments in plausible resource-sensitive approaches are based on real-world opportunity costs, not on invidious stereotypes.
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53. This is so especially if their suffering is not merely a side effect of the choice not to provide older drugs but also serves as a way of drawing attention to unjust pricing.
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