As access to biomonitoring technology has increased and as human biomonitoring programs continue to gain funding and institutional support, the development of a bioethical framework is increasingly important. Currently (May, 2006), as California prepares to implement the largest, most statistically significant human biomonitoring program to date, no such framework exists. The following important questions remain dangerously unanswered.
What will we do if we discover damaging toxics in our bodies?
If a group of people or one person has dangerously high concentrations of certain substances in their bodies, does the testing program have a responsibility to provide counseling and/or medical treatment? Is it ethical to tell someone without health insurance that he/she has dangerously high levels of a toxic substance without providing treatment?
Who is liable to pay for potential remediation?
When a direct connection between a dangerous test result and an existing or future health problem can be seen, is anyone responsible for paying the cost for health services? Should the manufacturer of the substance be forced to pay? Should the government agency that failed to regulate the substance be forced to pay? Should the unhealthy person be considered responsible for putting him/herself in harm's way?
How much say should everyday people/non-scientists have in the testing of and use of data from their bodies?
Biomonitoring requires that our bodies become laboratories. How much control should potential human test subjects have in how their bodies are tested and analyzed? What sort of background information should human test subjects have before they are allowed to consent? Do human test subjects retain any rights to the data generated from their bodies?
How can results be kept confidential? How confidential is necessary?
Will the identities of test subjects be kept secret? Will test results be published by geographic location or will they aggregated on statewide, regional, and national levels?
Does biomonitoring have the potential to justify discrimination by health insurers?
is framed as a human health issue and has the potential
to discover persistent harmful substances in humans,
will health insurance companies use biomonitoring results
to limit or deny health insurance to unhealthy, toxic
Red blood cells,oil immersion 1200x magnification.
Image 10. Polluted waterway.
Taking a blood sample.