Biomedical Innovation in Fertility Care: Evidence Challenges, Commercialisation and the Market for Hope
By Professor Manuela Perrotta
Published by Bristol University Press
ISBN-10: 1529236746, ISBN-13: 978-1529236743
Buy this book from Amazon UK
Building on the 2016 BBC Panorama documentary 'Inside Britain's Fertility Business', which exposed the use of controversial fertility treatment add-ons in private fertility clinics (see BioNews 880), Manuela Perrotta's book, Biomedical Innovation in Fertility Care, unveils regulatory inadequacies that expose patients to abuse by the profit-driven medical industry. Perrotta makes a case for more ethical biomedical innovation in this book and proposes changes that put patients' interests and moral behaviour ahead of business interests.
In doing so, Perrotta explores the commercialisation of reproductive therapies, concentrating on the moral, practical, and legal problems that both experts and patients must deal with. The book criticises the marketing of reproductive treatment add-ons like EmbryoGlue and time-lapse imaging, which are portrayed as potential therapies for supporting pregnancies notwithstanding the lack of solid data proving their efficacy clinics (see BioNews 1240). This system presents serious ethical issues, especially when patients are asked to pay exorbitant costs for experimental procedures.
While reading the book, I found myself reflecting on how Perrotta highlights the restricted role of regulating authorities such as the Competition and Markets Authority (see BioNews 1072 and 1161) and the Human Fertilisation and Embryology Authority (see BioNews 1212 and 1217) as one of the most important issues. Although these organisations guarantee openness about the accessibility of reproductive treatments, they do not control the methods of pricing fertility clinics use. Consequently, clinics can charge patients for exorbitant add-ons without providing adequate proof of effectiveness, resulting in a system that takes advantage of the financial and emotional weaknesses of those seeking reproductive care.
Perrotta also masterfully highlights the moral problems that fertility specialists encounter, since many of them find the economic considerations of these issues highly complex. The perspectives of medical professionals who are interviewed for the book are one of its strongest points. These specialists express their dissatisfaction at patients being overcharged for therapies that have no evidence of value. As an example, a medical director takes issue with the real-time billing of patients for clinical trials, and an embryologist discloses that clinics frequently mark up the cost of EmbryoGlue by several hundred pounds, even though there is little scientific evidence to justify its use. These instances highlight the conflict that arises when a private healthcare system's profit-driven considerations are met with the moral issues inherent in medical practice.
The book also takes aim at the larger healthcare system, namely at the way the biomedical innovation paradigm commercialises hope. Perrotta contends that the rise of the 'hope market,' where patients are viewed more as customers than as people in need of medical attention, is a result of privatisation, where patients are frequently persuaded to undertake exorbitant treatments which lack scientific backing. The healthcare system exacerbates inequality by putting the burden of payments on individuals for potentially unknown treatments, which benefits private companies at the expense of individuals' vulnerability. In explaining these issues, Perrotta also highlights that these controversial fertility add-on treatments should be seen as a 'neoliberal model of biomedical innovation within a hope market'.
I could not help but ponder on Perrotta's criticism of the application of evidence-based medicine in a commercialised system that I find as one of the book's most striking features. In particular, when private firms pay for the randomised controlled trials intended to prove the treatments they stand to profit from, the book shows the shortcomings of evidence-based medicine. Important concerns concerning the validity of medical evidence in a profit-driven system are brought up by this conflict of interest. As a result, patients might not be able to believe that the therapies prescribed for them are actually in their best interests in a healthcare setting.
Perrotta makes a valid and timely argument for regulatory reform. She contends that in order to guarantee moral behaviour and fair treatment, healthcare institutions need to assume greater accountability. By controlling the organisational forms that are used to deliver medical services, the abuse of weaker patients may be reduced, and confidence in the biomedical innovation process may be restored.
I found Biomedical Innovation in Fertility Care to be both disturbing and thought-provoking as a reader. Perrotta's thorough examination of the moral dilemmas facing the fertility industry is highly relevant to the broader concern about the over-commercialisation of the medical profession and field. Importantly, the book reveals how patients are steered through a system that puts profit before the welfare of the patient, especially those who are emotionally vulnerable. Professionals in the field are simultaneously torn between the demands of the commercialised healthcare models and their ethical obligations.
The book presents strong arguments demanding a consideration of the broader implications for the healthcare sector. The lack of trust between patients and providers, fuelled by commercialisation, is not just a problem for fertility care but also a symptom of a wider issue in global healthcare systems.
The commodification of hope – 'hope-market', as Perrotta describes it – challenges the very core of medical ethics, forcing us to ask a pertinent question. How can patients trust a system that often seems more interested in profit than in healing?
The book makes a good argument for the need for a sense of urgency for stronger regulatory measures to protect patients from being exploited in their most vulnerable moments. Perrotta's work serves as a critical call to action for healthcare reform, not just in fertility care, but also across all sectors where profit-driven practices risk undermining patient trust and well-being.
Buy Biomedical Innovation in Fertility Care: Evidence Challenges, Commercialization, and the Market for Hope from Amazon UK.
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