Public health ethics and intellectual property policy.

The articles in this issue of the Bulletin describe some of the challenges posed by notions of intellectual property in areas as diverse as genetic testing, genomic epidemiology, pharmaceuticals and vaccines. The constructive practical solut tions suggested include royalty clearing houses, comprehensive research colt laboration policies, and modified DNA patenting regimes. All of the articles address and respond to moral duties and potential ethical consequences of the policies they discuss, but conspicuously refrain from more explicitly describing the values and principles that underlie and motivate their reasoning. As in the article by Chokshi et al.,1 their ethical dilemmas are usually manifest as a tent sion between a vague moral imperative to ensure universal “access” to downt stream health benefits while maintaint ing or developing incentives for further “innovation”. While their proposals are laudable, and they do cite articles on the ethical dimensions of their work, the unique, potentially guiding voice of ethical discourse is almost silent. Basic science research and public health practice once flanked clinical medicine at opposite extremes of the health intervention continuum. Now these emerging technologies, broadly applied, threaten to bring these two dist tant cousins together with the promise of enhancing our ability to detect and treat disease. While the field of clinical medical ethics is as robust as ever, and the field of public health ethics has undergone considerable development in the past decade, the ethical aspects of some applied basic sciences have been explored but have not yet spawned a genre of consistent and appropriate ethical frameworks. Clinical trials must pass rigorous research ethics boards before studies begin, and public health interventions are increasingly subjected to thorough analyses which may include explicit ethical dimensions. In the area of cuttingtedge research into potentially patentable technologies, however, the