06.02.2026The Ambivalence of Medical Expansion

Medicine has significantly expanded its diagnostic and therapeutic possibilities over the past decades, leading to continuous growth of the healthcare sector and creating hope for patients with conditions once considered untreatable. At the same time, these advances push economic and social challenges to new levels. Healthcare systems worldwide face increasing costs, and inequalities among patients persist or even grow. Patients living with a rare disease illustrate this ambivalence. On the one hand, some rare diseases patients benefit from improved diagnostics and innovative therapies, such as the gene therapy Zolgensma. One the other hand, they are frequently used as examples of high-cost cases that challenge the financial integrity of the healthcare sector. Additionally, despite the medical progress, many patients remain disregarded, especially those without a treatment option or access to innovative therapies.

This webinar will explore the tension between the expanding capacities of modern healthcare and the persistent challenges faced by many patients – not only those living with a rare disease. Three experts will provide complementary perspectives on the ambivalence of medical expansion.

• Bjørn Hofmann (Professor of Philosophy of Medicine, University of Oslo)
  Bjørn will offer an analytical overview of the expansion of medicine, examining how its goals have shifted from reducing suffering to actively enhancing well-being. He will discuss the broadening definition of disease, the disruptive impact of technology, and the emergence of low-value care. He will present a framework for delimiting medicine to address the challenges created by medical expansion.
• Tanja Krones (Professor of Clinical Ethics, University of Zurich)
  Tanja will address the ethical challenges arising from these developments by discussing two central questions: What constitutes an ethically well-founded allocation of resources? And: What defines a just healthcare system? Using illustrative cases, she will show how current structures can reinforce injustice and will propose a patient-centred care paradigm as an approach to enhance fairness and equity in healthcare delivery, without necessarily increasing costs.
• Jasmin Barman-Aksözen (Molecular biologist, patient and patient advocate, University of Zurich, International Porphyria Patient Network)
  Jasmin will share her lived experience as both a researcher and a rare disease patient. She lives with the ultra-rare disease erythropoietic protoporphyria (EPP) and has first-hand experience of what it means to navigate between therapeutic advances that significantly increase patients’ quality of life and structural constraints that hinder access to beneficial therapies. She will highlight how patients carry the weight of healthcare’s structural ambivalences and navigate the resulting challenges in their daily lives.

Following the presentations, all participants are invited to engage in an open discussion on the future direction of the healthcare sector, focusing on rare diseases, marginalised groups, and opportunities to improve patent centred care in practice. Attendees will gain insights relevant for research, clinical practice, policy, and patient advocacy.

The webinar is a cooperation between the two University Research Priority Programs ITINERARE and Human Reproduction Reloaded in collaboration with the European Association of Centres of Medical Ethics.

Date: Friday, 6 February, 10:00–12:00 (CET)
Participation: Free of charge; registration required (see below)
Moderator: Sebastian Wäscher, Institute for Social Ethics, University of Zurich, ITINERARE Ethics&Society Platform, EACME Bureau
Registration Zoom link

For support or questions related to the webinar, please contact Sebastian Wäscher (sebastian.waescher@uzh.ch)