Online Exclusives

The lack of “global justice” in the distribution of the world’s enormous economic and public health resources has led bioethicists to examine the ethics of the relationship between resource-rich and resource-poor countries. Although virtually all of the world’s poorest countries are indeed benefiting from globalization on an absolute scale, the unfairness lies in the relative distribution of this immense wealth of resources. Taking into consideration the tradeoffs presented by four basic ethical perspectives and the role of social determinants of health on the ethics of resource allocation, the author argues that public health resources should be allocated primarily to improving existing health care systems while limiting funding for basic science research. A case study analysis of malaria treatment campaigns illustrates the benefits of focusing on improving access to existing technologies instead of investing in future public health-related technologies.

At present, the large majority of parents in the United States who use gamete do not tell their children that they were conceived through gamete donation. Competing interests and different views of what is in the child’s best interest complicate the situation. While parents attempt to protect family cohesiveness, they risk psychologically harming their child, depriving her of important medical information, and infringing on her right to know her genetic origins. In this paper, I explore the arguments for and against disclosing information about the gamete donation to the child. I then conclude that parents have an obligation to tell the child about the gamete donation; however, they do not have an obligation to reveal identifying information about the donor. It may be suitable to institute a law allowing donor gamete children to gain access to non-identifying information about the gamete donor when they turn 18.

A great number of people suffer from obscure and unknown diseases for which there have been few attempts to create treatments prior to the Orphan Drug Act of 1983. Today, the Act has helped improve the quality of life of many afflicted individuals and has enabled multiple companies to achieve financial success for creating treatments to combat rare diseases. Our analysis focuses on how the ODA has helped lower barrier of entry to orphan drug research and development with the effect of making orphan drugs economically feasible for companies involved. Based on the health needs of rare disease patients and our analysis of the marketability of orphan drugs, companies are advised to pursue orphan drugs research for not only ethical reasons but financial ones.

Many Asian societies have become known for a notorious unwillingness to discuss sexual health, sexual education or gender equity in public. This has led to increasing personal and public health problems for many Asian and Asian American people, including higher rates of abortion and elevated risk of cancer due to lack of early diagnosis,and conflicts with Western styles of medical treatment. However, a case study of Taiwan’s recent gender equity and sexual health education reforms reveals that conservative, traditional Asian societies may still be open to policy change that is influenced through such channels as Western media and increased Western immigration. It is likely that Taiwanese public policies have shifted toward liberalization due to growing interconnectivity with the Western world, providing a useful model for other Asian societies and for Western doctors through which to provide culturally-sensitive medicine.