DISTRIBUTIVE JUSTICE ISSUES RAISED BY GENETIC INTERVENTION

The genetic revolution in molecular biology will not benefit all equally, and some may in fact be greatly disadvantaged by particular applications of genetic science. The fairness of the distribution of benefits and burdens is a matter of social justice, and has appropriately received considerable attention in bioethical writing on the Human Genome Project. Many of the distributive issues are near-term and quite tangible. They include:

• Whether it is just to exclude individuals from employment or from health, life, or disability insurance if they are known to have genetic diseases or genetic factors that predispose them to diseases

• Whether it is just for only those who can afford genetic services to have access to them, especially since much of the initial research that led to these services was publicly funded

• Whether the right to health care includes entitlements to genetic enhancements as well as treatment and prevention of diseases

• Whether international distributive justice requires that the fruits of genetic science (in medicine and agriculture in particular) be shared with those in poorer countries that cannot afford to develop the technology, as opposed to leaving the distribution of these benefits to the global market

• Whether the direction of genetic research and development should be shaped by expected market demand, as opposed to having ethical principles determine priorities (e.g., channeling funds to cure devastating diseases that afflict large numbers of people rather than to the enhancement of normal traits for the rich or the discovery of treatments for less serious conditions, such as male baldness) (Murphy and Lappé, 1994)