The Estonian healthcare system and the genetic database project: from limited resources to big hopes.

Abstract

This article focuses on healthcare ethics discussions in Estonia. We begin with an overview of the reform policies that the healthcare institutions have undergone since the region regained independence from the Soviet Union in 1991. The principles of distributing healthcare services and questions regarding just what ethical healthcare should look like have received abundant coverage in the national media. An example of this is the exceptionally public case of V—a woman with leukemia whose expensive drugs the national health insurance fund refused to compensate. In our subsequent discussion, we focus on a grand-scale local healthcare and research project—the Estonian Genome Project—that attempts to include 1 million DNA samples into one database.The following article has benefited from the participation in the projects “The Ethical, Legal and Social Aspects of Human Genetic Databases: A European Comparison,” financed between 2002 and 2004 by the European Commission's Fifth Framework Programme (#QLG6-CT-2001-00062), and “The Ethics of Genetic and Medical Information,” financed between 2002 and 2004 by the Nordic Academy for Advanced Study (NorFa). We gratefully acknowledge their support.