Social contract theory and just decision making: lessons from genetic testing for the BRCA mutations
Burgess, Michael M.
Kennedy Institute of Ethics Journal 2004 June; 14(2): 115-142
Decisions about funding health services are crucial to controlling costs in health care insurance plans, yet they encounter serious challenges from intellectual property protection- -e.g., patents--of health care services. Using Myriad Genetics' commercial genetic susceptibility test for hereditary breast cancer (BRCA testing) in the context of the Canadian health insurance system as a case study, this paper applies concepts from social contract theory to help develop more just and rational approaches to health care decision making. Specifically, Daniels's and Sabin's "accountability for reasonableness" is compared to broader notions of public consultation, demonstrating that expert assessments in specific decisions must be transparent and accountable and supplemented by public consultation.
Accountability; Breast Cancer; Cancer; Consultation; Decision Making; Genetic Testing; Genetics; Health; Health Care; Health Insurance; Health Services; Health Services; Insurance; Intellectual Property; Patents; Property; Philosophical Ethics; Social Control of Science and Technology; Genetic Screening / Genetic Testing; Economics of Health Care;
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Caulfield, Timothy A.; Burgess, Michael M.; Williams-Jones, Bryn; Baily, Mary Ann; Chadwick, Ruth; Cho, Mildred; Deber, Raisa; Fleising, Usher; Flood, Colleen; Friedman, Jan; Lank, Rhoda; Owen, Terrance; Sproule, John (2001-09)