A recent New York Times article cast a critical eye on one of the latest entries in the high stakes, high technology medical arms race. Proton beam therapy, the procedure under discussion, purports to treat cancer. But even though not a single randomized clinical trial has been done, Medicare is still willing to shower 50,000 scarce Federal dollars to providers for proton beam therapy for prostate cancer.

Considering that there are no studies evaluating the long-term outcomes, and no studies evaluating potential serious side effects of proton beam therapy, Medicare might just as well be burning $25,000 every time it pays for such a procedure. Worse, this is not an isolated scenario.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

The United States spent $2.5 trillion on health care in 2009. That's "trillion". With a "T". This expenditure represents outlays of $8100 per person and 17.6% of our gross domestic product (GDP). Exactly what are we getting for these prodigious sums? Not very much. Infant mortality, for example, is a key marker of how wisely a nation is spending its health care dollars. The U.S. ranks a dismal 41st. These statistics tell a very sad tale. Despite spending huge amounts of ever-scarcer personal dollars on health care, the key metrics for U.S. residents continue to demonstrate how badly America is underperforming.  Where are the U.S. monies actually going, if not toward developing and providing effective means of health care delivery?

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

The overarching ethical concern related to preimplantation genetic diagnosis/human leukocyte antigen (PGD/HLA) testing is the moral status of the embryo. Many books have been written on this topic and many more are being contemplated. The ongoing public discussion of this and related issues continues to be breaking news, as most recently exemplified by the "personhood amendment" proposed to Mississippi voters who will "decide" the matter on November 8th, 2011.

The question of distributive justice is a key concern in all aspects of reproductive genetics and genetic medicine generally.  Moral and ethical considerations demand equitable distribution of these resources.  Ongoing nationwide campaigns should be directed toward functional medical and scientific education of the citizenry.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

Distributive justice concerns the equitable distribution of scarce resources among all socioeconomic groups and population sectors. The question of distributive justice is a key ethical consideration in all aspects of medical care, including assisted reproductive techniques and reproductive genetics. Access to cancer pharmaceuticals provides a prime example of violations of distributive justice.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

Distributive justice does not imply that everyone should have equal access to everything all the time. This would be an extreme position and lead to severe distortions in availability of medical services. Competing needs must be balanced fairly and opportunities to access medical care must be equitable. In the American health care marketplace, however, the bioethical principle of distributive justice receives lip service only. In America, when it comes to health care, minimal attention is paid to matters of fairness.

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Dr. Vandana Shiva, renowned environmentalist, is the author of Staying Alive: Women, Ecology, and Development and Earth Democracy. She is the recipient of the 2010 Sydney Peace Prize and is listed by Forbes magazine as one of the "seven most powerful women in the world".

Dr. Shiva is the founder of Navdanya, a national movement to protect the diversity and integrity of living resources. She leads an international movement of women working in food, agriculture, patents, and biotechnology called Diverse Women for Diversity and chairs the Commission on the Future of Food launched in Tuscany, Italy in 2002.

Dr. Shiva has been awarded the 1993 Alternative Nobel Prize and the Lennon Ono Grant for Peace.

“Dr. Vandana Shiva makes a profound difference in diverse communities, societies, and nations on a daily basis,” said David Lemberg, editor of BIOETHICS TODAY. “She is a true environmental hero, championing the rights of each and every one of us. Our conversation with Dr. Shiva focuses on a range of issues and concerns of critical importance to a global audience.”

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.