What moral weight should patient-led demand have in clinical decisions about Assisted Reproductive Technologies?
Wendy Lipworth1, Craig StanburyIan KerridgeNarcyz GhineaAinsley Newson Macquarie University Sydney 1Macquarie University, Sydney, NSW, Australia
Abstract
Medicine has always existed in a marketplace, and there have been extensive discussions about the ethical implications of commerce in health care. For the most part, this has focused on health professionals’ interactions with pharmaceutical and other health technology industries, with less attention given to other types of commercial influences, such as corporatized health services and fee-for-service practice. This is a significant lacuna because in many jurisdictions, some or all of healthcare is delivered in the private sector.
Using the exemplar of Assisted Reproductive Technologies (ART), this paper asks: what, if any, responsibilities do doctors have to challenge the distorting influence of commerce in healthcare, other than those arising from their own interactions with health technology companies? ART provides a good focus for this question because it is an area of practice that has historically been provided in the private sector.
First, we show that there are a range of concepts that can offer helpful heuristics for capturing how and when doctors can reasonably be said to have responsibilities to push back against commercial distortion. These concepts include complicity, acquiescence, wilful ignorance, non-wilful ignorance, and duplicity. Second, we present ways that individual doctors can speak up/act to stop questionable behaviour on the part of their colleagues, clinics/corporations, and their profession. Third, we note that there are many situations in which individuals can still achieve very little, so we therefore also consider the responsibilities of health professionals as collectives as well as the role that professional bodies and regulators should play.
Biography
Wendy Lipworth (MBBS MSc PhD) is Professor of Bioethics in the Department of Philosophy, Macquarie University, Sydney. Her research sits at the intersection of ethics and epistemology, with a focus on the ethics of health innovation. She is particularly interested in devising ways to maintain and improve the rigour and integrity of research, policymaking and practice in the face of rapid scientific, commercial and socio-political change.
Other bios to come