BIOE 5720 Global Bioethics

According to the WHO, around 30 million people with HIV/AIDS should receive anti-retroviral treatment. But only 10 million do. Drugs containing tenofovir--the standard of care in developed countries are expensive. Stavudine-based treatments are much cheaper but have worse side-effects. Is it ethical to use stavudine-based rather than tenofovir-based treatments in sub-Saharan Africa? Smoking rates have decreased drastically in most developed countries. But they are increasing in many developing countries. Established public health measures are not implemented, and the tobacco industry pursues a range of marketing activities that would be unacceptable in developed countries. As a consequence, global deaths from smoking are expected to increase to 1bn by the end of the 21st century, with 80% of deaths in developing countries. Is industry s behavior immoral or normal in a global market? ARDS is a disease of premature newborns. Is it ethical to test a new ARDS drug in Bolivia if the drug--if proven to be effective-- will be very expensive and accessible only to the richest people in Bolivia and other developing countries? An overarching question that these different cases raise is whether there are universal ethical standards that should apply to all people, or whether regional variations should be acceptable. Universalists typically argue that there must be no double standards, and that people should be treated the same regardless of where they live. Pragmatists raise concerns about moral imperialism, neo-colonialism, or insufficient respect for cultural or other differences. Increasing globalization fuels debates about which of competing sets of moral standards is the right one. Looking at a range of diverse cases including healthcare research, health policy, flu pandemics, family planning, smoking and obesity policy, and genetically modified crops, this course explores controversies in the cross winds of market forces, politics and ethics, and examines the roles and responsibilities of key actors and international policy guidance.