June Carbone

Ethics, Patents and the Sustainability of the Biotech Business Model

Private investment in biotechnology, a growth industry over the last 20 years, has depended on the combination of large, risky investments in research and development with monopoly profits secured through patent protection of the successful products. This business model, which has made pharmaceuticals first in profits on the list of Fortune 500 global companies, is everywhere under assault. The article begins by explaining the relationship of the importance of the business model to the success of the biotech industry. The changing nature of innovation in the biological sciences and the growing importance of incremental discoveries are then examined. The challenges posed by the escalating costs of pharmaceutical expenditures, the crumbling health care infrastructure in the USA, and the global unavailability of lifesaving medications are also considered. These changes are linked to the legal infrastructure, explaining the role of patent protection in encouraging and potentially deterring further innovation. The ethical obligations of the industry to address the needs of a global citizenry are considered, and the question is raised of whether the relationship between public and private partnerships in the development of biotechnology needs to be reconsidered.

Legal Applications of the “Best Interest of the Child” Standard: Judicial Rationalization or a Measure of Institutional Competence?

This article explores the use of the best interest standard in the context of third-party interventions in ongoing parent-child relationships. I start by examining the history of the best interest standard and show that it has had different meanings in different eras. I then address the nature of the family and the question of whether interests beyond those addressed in the child’s best interest standard are a legitimate part of family decision-making. I conclude that ongoing families are entitled to at least a measure of deference in their decisions about their children. Third-party interventions, such as those of doctors or judges, should require something more than simply a difference of opinion about where the child’s interests lie.

The Triple System for Regulating Women's Reproduction

Analysis of ART and abortion must include the experiences of women at the emerging center of American life, as well as those at the top and bottom of the socioeconomic scale. Our contribution explores the triple system of fertility regulation, analyzing the intersections between fertility and class and using the experiences of women in the middle to add depth to our understanding of womens exercises of autonomy.

Peer commentary: in vitro gametogenesis: just another way to have a baby

Sonia Suter1 provides a rigorous legal and ethical analysis of in vitro gametogenesis (IVG), that is, the ability to derive new human gametes in the lab. What the article does not address is the commercial and political context in which these developments are likely to occur. Suter’s uses the notion of ‘relational autonomy’ to provide a bioethical framework for critiquing the developments. While bioethics discusses the individual’s ability to reachhis or her own reproductive decisions, Suter appropriately argues that ‘our “moral identity” is shaped by our “membership in communities such as those of the family, the neighborhood, the city and the tribe”’.2 She accordingly maintains that the propriety of the new developments and suitable regulation of them depends on their relational context. Suter admirably develops this situational notion of autonomy with attention to the personal relationships that givemeaning to the decisions, but she does not devote comparable attention to the political and commercial contexts likely to inform the decisions in similarways.Theomission is understandable: in a short piece, Suter has chosen to focus on the most immediate and general implications of the new technology.This commentary will add to the analysis she provides by describing the global networks that will influence development of IVG and arguing that it may change the contexts—and therefore the social and ethical meanings—of IVG. This commentarywill, first, review the commercial, legal, andpolitical landscape that currently exists for reproductive innovation. Second, itwill describehowIVGfitswithin

Red v. Blue Marriage

Marriage has long been a symbol of union – between husband and wife, a compact between the couple and the community concerning support for children, and an institution that, even as it changed or cloaked inconvenient facts about sexuality or paternity, forged shared meanings about family life. Today, however, marriage has increasingly become a symbol of disunion. The disunion involves divorce and the disappearance of permanence as a defining feature of marriage. It extends to a dramatic increase in non-marital births, as marriage has become an optional rather than mandatory aspect of childrearing. And, in the United States today, marriage is increasingly a symbol of what divides us: regionally, economically, racially, politically and ideologically. This chapter first will examine the process of family change and its connections to the changing economy. Second, it will describe the way that family changes play out along regional and class lines. Third, it will consider the relationship between family changes and ideological divisions, describing the differences between strategies that seek to link women to men through control of sexuality versus those that would promote women’s autonomy and insist on neutrality toward family form. Finally, the chapter will conclude that changes in the family magnify the increasing inequality in society, and that the class-based nature of changes in marriage will guarantee increasing disinvestment in the next generation as a whole.

Autonomy to Choose What Constitutes Family: Oxymoron or Basic Right?

Alasdair MacIntyre, Michael Sandel and other critics have argued that liberalism is living off the borrowed capital of Western civilization. That is, to the extent that liberalism requires neutrality among theories of the good, the state cannot ensure that the generation of values - of strong families, hard workers, honest people, engaged citizens, and devout church members - necessary to liberalism itself will occur. William Galston responded to this critique by arguing that liberalism does not require neutrality toward the creation of values central to liberalism itself. A liberal democratic state should be able to foster liberal virtues, and, indeed, liberal states have historically done so through the regulation of sexual morality, family stability and educational quantity and content. The issue then arises how a liberal state promotes such values in the absence of consensus not just on the values themselves, but on the institutions necessary to inculcate them. With respect to education today, for example, the United States permits its citizens to choose between public and an array of private institutions, including home schooling. On issues such as traffic regulation, however, the state must elect a single choice; it cannot have its drivers choose on an individual basis between the right or the left side of the road. Historically, the idea of autonomy with respect to the creation of family form would have been considered an oxymoron. The traditional family of biological mother, father and child was often treated as prior to the state, if not foundational to society itself. Nor has the state been neutral among the possible forms of marriage. When the Supreme Court confronted the issue of polygamy as an expression of Mormon religious practice in the Utah territories during the nineteenth century, it had no trouble declaring the organization of a community for the spread and practice of polygamy is, in a measure, a return to barbarism. It is contrary to the spirit of Christianity and of the civilization which Christianity has produced in the Western world. The basis for these decisions, for the denial of autonomy with respect to the choice of institutions, and not just individual behavior, bears revisiting. What if, on questions basic to the organization of family, no consensus exists? What if different demographic and economic circumstances create different family traditions among different states? What if fundamentally different values in different parts of the country produce polarization rather than agreement on the family values appropriate for a liberal democracy? This paper will address these issues by, first, examining the debate about the regulation of morality and distinguishing the control of individual behavior from the selection of basic institutions. Second, it will examine the polarization now taking place on the definition of family values among the states and argue that these differences reflect different challenges produced by the nature of the interaction among marriage, childbearing and the adult life cycle. Third, it will maintain that these differences, while the product of different approaches to family institutions consistent with historic efforts at secular family regulation, interact with religious as well as secular beliefs. Finally, the paper will consider what some measure of autonomy and respect for others might entail in a system in which different states adopt fundamentally different approaches toward the definition and regulation of family values.

The politics of marriage policy

Marriage and the family mark the fault lines of a growing political and class divide throughout the developed world. With rising inequality, family structure increasingly correlates with class. Two...

Unequal terms: Gender, power, and the recreation of hierarchy

Abstract This paper explores the relationship between feminist theory and rising economic inequality. It shows how greater inequality reflects the valorization of the stereotypically male qualities of competition and hierarchy, producing a greater concentration of wealth among a small number of men at the top, shortchanging men more than women through the rest of the economy, and altering the way that men and women match up to each other in the creation of families. By creating a framework for further research on the relationship between the norms of the top and the disadvantages of everyone else in more unequal societies, the paper provides a basis for feminists to develop a new theory of social power. The paper demonstrates how the development of winner-take-all income hierarchies, the political devaluation of families and communities, and the terms of the family values debate diminish equality and community. The paper addresses how to understand these developments as they affect both the structure of society and the allocation of power within our families in ways that link to the historic concerns of feminist theory. It accordingly ends by asking the “woman question” in a new way: one that revisits the stereotypically masculine and feminine and asks how they connect to hierarchy, one that considers whether the inclusion of women changes institutional cultures in predictable ways, and one that wonders whether the values that today are associated with more women than men offer a basis for the reconstruction of society more generally.