When Medical Breakthroughs Leave People Behind: The Concept of Translational Justice
They say there's a new drug," Maria sighed, scrolling through the online support group. But when the clinic that offers it is three states away, and her insurance doesn't cover new 'specialty' treatments, her hope quickly turns to frustration.
This vignette illustrates the stark disparity between the promise of medical advancement and the reality of equitable access that lies at the heart of a new concept: Translational Justice.
This concept and the argument for evolving our understanding of medical progress is presented in a recent publication in external page The American Journal of Bioethics. The collaborative work, authored by a group of leading scholars from institutions including ETH Zurich (with contributions from our lab members, Kelly Ormond and Kirsten Riggan), Mayo Clinic, University of Toronto, University of Miami, Case Western Reserve University, University of Pennsylvania, and Stanford University, urges a critical examination of how medical innovations reach those who stand to benefit most, and whether our current systems inadvertently create or exacerbate inequalities.
Translational Justice
At its core, Translational Justice moves beyond just asking "Does this medical innovation work?" to the more profound inquiry: "Does it work for everyone, in a way that is fair and just?"
This requires a fundamental shift in perspective, focusing on:
- Inclusive Development: Ensuring that the diverse needs and perspectives of all potential beneficiaries, particularly marginalized communities, actively shape research priorities and the design of interventions from the outset.
- Prioritizing Equitable Access: Strategically addressing the multifaceted barriers – financial, geographical, social, and cultural – that can prevent individuals from accessing beneficial medical innovations.
- Value-Driven Implementation: Ensuring that treatments align with the real-world concerns and values of the communities they aim to serve, moving beyond purely clinical endpoints.
- Just Outcomes: Evaluating the ultimate impact of medical advancements on health equity and actively striving to reduce, rather than perpetuate, existing disparities.
Translational Justice is not merely a theoretical ideal; it is a call to action. It demands a fundamental re-evaluation of our research, development, and implementation processes to ensure that the journey from scientific discovery to tangible benefit is one paved with equity, leaving no one behind in the wake of medical progress.
Read the article in full:
Allyse, M. A., Agam, P., Bombard, Y., Feys, R., Horstmann, M., Kokayi, A., … Yap, J. Q. (2025). Building Better Medicine: Translational Justice and the Quest for Equity in US Healthcare. The American Journal of Bioethics, 1–15. external page https://doi.org/10.1080/15265161.2025.2457713