The spectacular development of medical knowledge over the last two
centuries has brought intrusive advances in the capabilities of
medical technology. These advances have been remarkable over the
last century, but especially over the last few decades, culminating
in such high technology interventions as heart transplants and
renal dialysis. These increases in medical powers have attracted
societal interest in acquiring more such knowledge. They have also
spawned concerns regarding the use of human subjects in research
and regarding the byproducts of basic research as in the recent
recombinant DNA debate. As a consequence of the development of new
biomedical knowledge, physicians and biomedical scientists have
been placed in positions of new power and responsibility. The
emergence of this group of powerful and knowledgeable experts has
occasioned debates regarding the accountability of physicians and
biomedical scientists. But beyond that, the very investment of
resources in the acquisition of new knowledge has been questioned.
Societies must decide whether finite resources would not be better
invested at this juncture, or in general, in the alleviation of the
problems of hunger or in raising general health standards through
interventions which are less dependent on the intensive use of high
technology. To put issues in this fashion touches on philosophical
notions concerning the claims of distributive justice and the
ownership of biomedical knowledge.
General
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