Major breakthroughs in biotechnology are leading to the emergence of novel methods to select and alter future individuals’ genomes. Genetic intervention technology is evolving from the medical practice of screening for life-threatening congenital malformations to the selection against embryos that might develop mild disabilities. Scientific research suggests that heritable genome-editing technology would enable the custom alteration and the enhancement of human biological characteristics, including appearance, athletic and intellectual abilities. These novel developments and their potential long-term impacts raise the question of how effective are the laws on genetic interventions in setting limits to rapidly evolving biotechnologies. This thesis examines genetic intervention laws in the United Kingdom and France and shows it exhibits a pattern of continuous legal changes over the past several years to permit a broadening range of genetic interventions that were previously prohibited. This pattern is characterized by the regulatory licensing of genetic interventions that specific legal restrictions have sought to disallow, such as screening against conditions that are mild, treatable and not predominantly determined by genes. Moreover, governments are currently considering replacing their bans on inheritable human genetic modification with regulations that will allow the alteration of genes linked to conditions deemed “serious” and for “therapeutic” purposes. This proposed regulatory model would enable licensing the very same type of genomic alterations intended to be prohibited – genetic enhancements of human physiological and cognitive capabilities. This legal change pattern is prima facie inconsistent with the key legislative objectives and relevant international instruments, which seek to restrict these particular genetic interventions. The overarching objectives underpinning the restrictions are to prevent a pattern in which the legal boundaries would become gradually laxer, attempts to improve human heredity and the associated human rights, societal and medical impacts. Furthermore, the pattern in which the legal boundaries are becoming laxer over time stems from drawing the lines between permissible and impermissible genetic interventions using language that is vague, subjective and places few limits on the rules’ scope. A law reform can address the current limit-setting challenges by employing clearer conceptual and normative distinctions and by articulating them using language that gives greater attention to clarity, reduced subjectivity, and explicitly delimits the rules’ scope. The thesis offers a blueprint for such a reform, which includes suggestions for specific legislative amendments, clearer conceptual distinctions and newly developed legal tests. The proposed law reform aims to offer a new avenue to advance towards the key policy goal of preventing the misuse of genetic intervention technologies by strengthening its governance.

This thesis aims to explore the challenges of Medical Devices sector in their innovative activities with the use of qualitative and quantitative methods. The specific subject of analysis is the Turkish Medical Device industry. Throughout the thesis the convergence of Medical Devices with pharmacy and its role in healthcare is mentioned in addition to the institutional regulations of the sector due to their effect on the firms innovative activities. The main focus of this thesis is the innovation in medical devices as vital components of healthcare supply with an important share in health expenditures. Even though Medical Devices are considered to be heterogeneous and classified in many other sectors such as chemicals, textiles and electronics, they have common features sufficient to be considered as a special product group and being an important part of the healthcare system, they are subject to common regulations. Sectoral Systems of Innovation approach is used to investigate Medical Devices Sector in Turkey. Medical devices sector also suffer from regulations that put cost on innovative activities, reimbursement policies that aim at cost containment, lower degrees of consumer support (in terms of user-producer relationship), high marketing costs due to the specific market they act in, in addition to the general obstacles such as scarce finance and human resources. Nonetheless, the ambiguity in entrance and allowance to reimbursement lists is also found to be a blocking factor on innovation.The studies on this aspect of the medical devices sector are limited and this thesis aims to fulfil the gap in this respect.

This thesis is a result of more than a three year long ethnographic research of a resuscitation unit of a Czech hospital where I have been employed as a general nurse. I describe the character of provided care and show that medical care is not simply an answer to patient's needs and interests but it is shaped by wide range of different motives and factors which are often in mutual conflict. Not infrequently it is the case that interests of health care providers are preferred to patient's interests. I discuss situations when doctors are forced to act more as good accountant managers than physicians, which might often be in conflict with the idea of good care, and I show how care is negotiated in these situations. I also focus on relationship of medical technologies and its users, some ritualized elements of care and in conclusion explain an apparent paradox that care can be evaluated as successful even if it didn't lead to improvement of the patient's condition or her survival. Keywords: health care, medical technologies, objectification, medicine, rituals in health care