by Ubaka Ogbogu
While preparing a consulting report on ethical issues associated with priority setting (a.k.a. resource allocation, rationing) in the stem cell research context, I was surprised to find that there are no published Canadian studies of priority-setting matters pertaining specifically to stem cell research or stem cell-based technologies. A search of the Canadian Institutes of Health Research grants database produced 47 research projects (concluded and ongoing) on priority-setting issues, but none focused on the (potential) integration of stem cell technologies into health care (Note: see update at bottom). Emerging biotechnologies are not well represented either; I found only a 2004 study of priority setting for genetic services led by Fiona Miller and Rosanna Weksberg and a 2003 study on a similar topic by Mita Giacomini.
Experts generally agree that new and cutting edge health care technologies give rise to acute issues of priority setting. This is because such technologies often emerge at high cost (in a bid to recoup research and development expenses), and corresponding high public demand places significant constraints on the resources needed to integrate them into health care. Stem cell therapies will likely follow this trend, and considering the interplay of revolutionary promise and persistent controversy attending the field, may even generate novel priority-setting challenges for health care decision makers.