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Lifting the Veil of Ignorance

In 1971, American philosopher John Rawls devised a thought experiment, the “Veil of Ignorance,” to explore human ideas on justice and society when people were stripped of the capacity to be self-serving (1). Subjects were asked to describe the types of societies they would choose to build without knowing the demographics of the people who would eventually live in them.

In the five decades since it was first proposed, many have come to the conclusion that societies should be fair and equitable to ensure the best outcomes for all. But in a world, driven by self-interest, how easy is it to truly ensure equality – particularly in healthcare? In recent weeks, and in light of recent international childbirth pain relief shortages (2, 3), this question has been on my mind.

Women have historically been left in the shadows of healthcare and pharmaceutical innovation. Though attitudes have certainly changed and women, particularly in Western nations, have better access to healthcare than ever before, there is still work to be done. The global shortage of epidurals is only a drop in the ocean of unmet women’s healthcare needs. According to the WHO, 810 women die every day from “preventable causes related to pregnancy and childbirth” (4) – and, as a result of an endemic culture of violence in many countries, women fall victim to infectious diseases, mental health conditions, and the physical consequences of such acts – all of which require pharmaceutical intervention (5).

With so many opportunities to create meaningful change for these patients, it is difficult to understand why women’s health – an area ripe with therapeutic promise – remains ignored by some in industry.

Though it would be unreasonable to suggest that the burden of finding solutions to the broad spectrum of women’s health needs is for the pharma industry alone to fix, it’s clear that the sector’s interests align with supporting patient needs. Pharma companies can’t realistically intervene in the decisions made by national healthcare authorities or prevent violence against women, but they can use their influence and connections to better engage with stakeholders and ensure that women have access to the best, most pertinent therapeutics possible.

In our July/August cover feature, industry leaders share their views on the topic of womens’ health and what pharma is doing about it. If you have your own views to share on the topic, get in touch at [email protected].

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  1. K Huang et al., “Veil-of-ignorance reasoning favors the greater good,” Proc Natl Acad Sci USA, 116, 23989 (2019). DOI: 10.1073/pnas.1910125116.
  2. The Guardian, “‘Difficult discussions’ as NHS faces shortage of childbirth pain relief” (2022). Available at:
  3. ABC News, “There’s a global shortage of epidurals – and Australian hospitals are feeling the pinch” (2022). Available at:
  4. WHO, “Women’s Health” (2022). Available at:
  5. WHO, “Violence against women” (2022). Available at:
About the Author
Maryam Mahdi

Deputy Editor

After finishing my degree, I envisioned a career in science communications. However, life took an unexpected turn and I ended up teaching abroad. Though the experience was amazing and I learned a great deal from it, I jumped at the opportunity to work for Texere. I'm excited to see where this new journey takes me!

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