By Shadi “Sophie” Heidarifar When a patient requests a procedure shaped under constraints, including oppressive ones, we tend to evaluate the preference itself: whether it is autonomous, whether it reflects internalized norms, whether it has been formed under coercive conditions. This framing presumes that the central bioethical question concerns the status of a preference. In […]
Category: equality/inequality
Equity and ethnicity in the ICU: considering a reserve system when resources are scarce
By: Elizabeth Fenton, Esther Willing, Neil Pickering, Wenna Yeo, Sophie Barham The COVID-19 pandemic highlighted the ethical limitations of ‘save the most lives’ as a prioritisation principle for intensive care (ICU) resources during times of scarcity, such as pandemics. A key problem is that following this principle can disadvantage patients with worse overall health, often […]
Would a generational smoking ban create a discriminatory, ‘two-tier’ society?
By Johannes Kniess In the year before the 2024 election, few would have predicted that PM Rishi Sunak’s flagship policy wouldn’t be about taxes or Brexit, but about cigarettes. Under the ‘smoke-free generation’ bill, people born in or after 2009 would never be able to legally buy cigarettes. Those born before that year would remain […]
Health inequity is a problem, universal basic income could be a solution
In May 2023, academic and policy experts in social protection, economics, public health, history, and ethics gathered at the Brocher Foundation in Geneva to consider the potential for Universal Basic Income (UBI) to contribute to health equity. Health inequities have long been a recognised global problem. In 2013, a review of countries covering 74% of […]
Connecting the Dots: COVID-19, BAME Communities, and Racial Injustice
By Aileen Editha The COVID-19 pandemic impacted England (and the world) in ways that no one could have imagined. One that is incredibly disappointing, however, is the disproportionate impact of the pandemic on Black, Asian and minority ethnic (BAME) communities in terms of exposure and mortality rates, as well as the recent data on vaccination […]
NICE’s wrong turns: opportunity costs and missed opportunities
By Jonathan Michaels. The National Institute for Health and Care Excellence (NICE) is consulting on its methods for health technology evaluation, seeking ‘public’ views on over two thousand pages of highly technical supporting material. NICE was established to promote “clinical and cost-effectiveness through guidance and audit” and address ‘postcode prescribing’ and has led the world […]
Ensuring equity in vascularized composite allotransplantation
By Laura L. Kimberly, Elie P. Ramly, and Eduardo D. Rodriguez Vascularized composite allotransplantation (VCA) can be considered the innovative cousin of solid organ transplantation. VCA is the transplantation of multiple tissues, such as skin, muscle, nerve, and bone as a functional unit. This includes facial, upper and lower extremity, uterine, penile and abdominal wall […]
Lockdown is not levelling down
By Jonathan A Hughes In their article “Why lockdown of the elderly is not ageist and why levelling down equality is wrong” and their related JME Blog post, Savulescu and Cameron argue for selective isolation of the elderly as preferable to a continuation of general lockdown. Central to their argument is the claim that the […]
The public provision of ARTs in England: old arguments, new inequalities
By Laura O’Donovan and Sacha Waxman Criticism of the disparities in the public provision of fertility treatment in England is nothing new. The so-called ‘IVF postcode lottery’ emerged due to widespread divergence in local commissioning policies restricting access to treatment services. Unfairness in that process results not only from the different amounts of treatment available in […]
People with disabilities are worth saving, too: Ensuring healthcare equity during the COVID-19 pandemic
By Molly M. King Before we face another swell of the pandemic, we have the opportunity as a country to take stock of early lessons learned about the vulnerabilities of our nation’s healthcare system. As our nation celebrates the 30th anniversary of the Americans with Disabilities Act, we have other shortcomings to reflect on, as […]