The Principle of Justice and Access to Nanomedicine in National Healthcare Systems

The focus of this article is fair access to nanomedicine, which refers to the application of nanotechnology to medicine. By use of nanotechnology improved diagnostics and therapy are expected in medicine and health care. Researchers, however, warn that nanomedicine products may be so expensive when they go on the market that they may provisionally make health inequalities worse both nationally and internationally. If this is true, it raises specific questions of justice as to whether we should accept these inequalities and accept that some persons may not have access to health care.This article argues that a promising approach to the ethics of nanomedicine is given with the ethics of the American ethicists Tom L. Beauchamp & James F. Childress. The article introduces the basic ethical principles of these authors: respect for autonomy, beneficence, nonmaleficence, and justice. Specific attention is dedicated to the principle of justice and fair access to national health care. The principle of justice of Beauchamp & Childress is discussed and with the aim of creating fair access to nanomedicine, this article suggests an appropriate principle of justice to evaluate this field.Accordingly, this article defends a national health care system based on an egalitarian principle of justice, which requires equal access to health care including long-term and chronic care services. Also, it is argued that, contrary to the suggestion by Beauchamp & Childress, persons are entitled to social coverage of health care even though they suffer from a disease caused by personal autonomous activities. If it is economically feasible, nanomedicine should be included in the national health care system and it should be accessible to all citizens.