From Hippocrates Triangle to Post-Modern Square: The New Role of Bioethics

The new era imposes modern strategies in the health care that change the Hippocrates triangle to the post-modern square. Then a new approach to bioethics rules is requested. This paper is focused on drugs production and distribution. With the assurance that ethical theories can solve moral quandaries. Egalitarianism defines health care as a right. This is a right of equal access to all that is available, which would include dialysis, transplantation and other advances in treating ESRD which may be developed. Including drugs stopping the decline of renal disease. But what does it happen when these drugs are too expensive? For the single and for the society? Guaranteeing everyone a right to treatment for ESRD, as is in EU, may in fact be so costly and deprive the populace of other basic needs, both medical and non-medical. As egalitarian point of view resonates with ethic tradition which eschews social worth judgment for allocation, we favor the use of expensive renal drugs, unless of proved efficiency. In this context we report the use of inhibitors of p-cresol, a strong nephrotoxic and cardiotoxic agent, and of drugs developed by precision medicine to treat progression of ESRD, such as tolvaptan in Polycystic Kidney Disease and sofosbuvir for HIV and its renal consequences.