Medical Econo-ethics

Two recent articles got me thinking about the interplay of economics and ethics in the field of medical research. "The Right to a Trial" is a deeply moving discussion of the ethical problems involved with allowing or refusing to allow terminally ill patients to participate in clinical trials of new disease treatments and the regulatory issues at work in the debate. I found myself torn between my desire for improved access to medical treatment and my general belief in regulation of corporations to protect people.

The second article, written by Columbia University professor Joseph Stiglitz, concerns Intellectual Property rights when it comes to medical breakthroughs. Stiglitz proposes a medical "prize system" funded by industrial nations to encourage medical innovation while keeping the cost of vital pharmaceuticals low. It's not exactly a new idea, but Stiglitz provides some specifics as to how exactly the prizes would be funded and awarded.

Medical ethics is a particularly sticky field because it regularly concerns life-or-death situations. Our general desire to see hard work rewarded is tempered by our compassion for others. It seems impossibly unfair to say "medical researchers ought to make money off their innovations at the expense of human life when patients can't afford their treatments," but it is also difficult to imagine financially rewarding Pedro Almodovar for his cultural innovations while withholding those same rewards from scientists who make consistent breakthroughs in cancer research.

Back to "The Right to a Trial" for a moment. Imagine you're 31, you have two kids under age five, and you've been diagnosed with late-stage ovarian cancer. You've tried every traditional treatment to no avail, and because you are also diabetic, you are ineligible for Phase III clinical trials for a drug that had an 80% effectiveness rate in Phase II trials. You've been given a year to live, tops. If you were willing to take chances with an experimental drug because it had a good chance (or so it appeared) to save your life, wouldn't you have trouble understanding the importance of "regulation"? On the other hand, if you're a company that has produced a promising drug with the potential to seriously lower the fatality rate of an extremely deadly strain of cancer, would you really want to risk losing FDA approval because you had to list "pancreatic failure" as a possible side-effect? And would it be worth it for the thousands of other patients who could be helped?