Using ideas gleaned from the philosophy of technology of Martin Heidegger and Hans Jonas and the philosophy of health of Georges Canguilhem, I argue that one of the characteristics of emerging medical technologies is that these technologies lead to new conceptions of health. When technologies enable the body to respond to more and more challenges of disease, we thus establish new norms of health. Given the continued development of successful technologies, we come to expect (...) more and more that our bodies should be able to respond to ever-new challenges of environment and disease by establishing ever-new norms of health. Technologies may aim at the prevention and treatment of disease, but they also bring about modifications of what we consider normal for the human being. Thus, new norms of health arise from technological innovation. (shrink)

This collection of essays emphasizes society s increasingly responsible engagement with ethical challenges in emerging medical technology. Expansion of technological capacity and attention to patient safety have long been integral to improving healthcare delivery but only relatively recently have concepts like respect, distributive justice, privacy, and autonomy gained some power to shape the development, use, and refinement of medical tools and techniques. Medical ethics goes beyond making better medicine to thinking about how to make the field (...) of medicine better. These essays showcase several ways in which modern ethical thinking is improving safety, efficacy and efficiency of medical technology, increasing access to medical care, and empowering patients to choose care that comports with their desires and beliefs. Included are complimentary ethical approaches as well as compelling counter-arguments. Together, the articles demonstrate how improving the quality of medical technology relies on every stakeholder -- not just medical researchers and scientists -- to assess each given technology s strengths and pitfalls. This collection also portends one of the next major issues in the ethics of medical technology: developing the requisite moral framework to accompany shifts toward patient-centred personalized healthcare.". (shrink)

Digital twinning in medicine refers to the idea of simulating a person’s organs, muscles or perhaps their entire body, in order to arrive more effectively at accurate diagnoses, to make treatment recommendations that reflect chances of success and possible side-effects, and to better understand the long-term trajectory of an individual’s overall condition. Digital twins, in these ways, build on the recent movement toward personalised medicine,1 and they undoubtedly present us with exciting opportunities to advance our health. Of course, the opportunities (...) are accompanied by newfound challenges—a common refrain in discussions surrounding emerging technologies. In a recent article, Matthias Braun surveys numerous problems, including the precision of simulations, ownership and consent to the use of digital models, and issues of justice in assuring equitable access to novel medical systems.2 In particular, he places special emphasis on the notion of representation. According to Braun, proper representation naturally calls for correspondence—namely a precise model offering dynamic, real-time feedback as well as transparency, both for the patient and the practitioner, in terms of the data being employed. While technical challenges remain, these goals are quite clear and relatively uncontroversial. Where a host of questions arise, however, is in the discussion on the interaction between the represented persons and their simulations. Alongside questions regarding ownership of one’s digital twin, Braun raises the concern that ‘giving …. (shrink)

The field of medicine is generally greeted with great enthusiasm. This can be witnessed in the immense support for medical progress, which is widely hoped to lead to a realization of idealized goals. Indeed, with the help of medicine the human body would be controllable and constructible, human nature perfectible. However, enthusiasm in favor of medical progress is first and foremost a sentiment and, like all sentiments, not necessarily a product of rational contemplation. People are capable of enthusing (...) about the realization of utopian notions, such as life without disease or with the perfect body, without requiring any concrete arguments to back them up. Enthusiasm alone is not a guarantee of ethical desirability, however. Hence, this book takes a closer look at four research fields often referred to in medical utopian literature: 'tissue engineering', 'bioelectronics', 'germ line genome modification' and 'interventions in the biological aging process'. They serve as a basis for analyzing whether ethical arguments can be found to support the euphoric advocacy of the further development of these fields. (shrink)

Against the backdrop of emerging medical technologies that promise transgression of temporal limits, this paper aims to show the importance that an individual lifetime’s finitude and fugacity have for the question of the good life. The paper’s first section examines how the passing of an individual’s finite lifetime can be experienced negatively, and thus cause “suffering from the passing of time.” The second section is based on a sociological analysis within the conceptual framework of individualization and capitalism, (...) which characterizes many modern individualized and consumerist societies and explains how the described problem of time’s passage is particularly relevant today. The paper then proceeds to show and discuss how individuals employ various, primarily medical, enhancement-technologies like social egg freezing, anti-aging-medicine and physical- and neuro-enhancement in an attempt to overcome time’s passing. Finally, the paper seeks to explain why such attempts fail and, moreover, why it is exactly the awareness of time’s passing that can constitute a prerequisite for a good life. (shrink)

Summary This volume undertakes to determine the fundamentals and limits of an ethical assessment of the methods of modern medical technology with regard to the concepts of human dignity and human image, which are particularly important for this purpose. It shows that the philosophical-legal foundation of the term human dignity has not yet been clearly clarified; one even has to ask whether the term is (still) suitable for assessing ethical problems in medical technology. The term human image also (...) needs clarification and clarification in order to be taken seriously as a topos in the medical ethical discussion. The volume emerged from the work of an interdisciplinary and international research group at the Center for Interdisciplinary Research (ZiF), Bielefeld. It deals primarily with the theoretical foundation of the terms human dignity and human image and is supplemented by a volume, the contributions of which illustrate the problems of practice using examples from different areas of medical technology. (shrink)

This book brings phenomenology, the main player in the continental tradition of philosophy, to bioethics. Medical science and emerging technologies are examined as endeavours that bring enormous possibilities in relieving human suffering but also great risks in transforming our fundamental life views.

New health technologies are rapidly emerging from various areas of bioscience research, such as gene editing, regenerative medicine and synthetic biology. These technologies raise promising medical possibilities but also a range of ethical considerations. Apart from the issues involved in considering whether novel health technologies can or should become part of mainstream medical treatment once established, the process of research translation to develop such therapies itself entails particular ethical concerns. In this paper I use (...) synthetic biology as an example of a new and largely unexplored area of health technology to consider the ways in which novel health technologies are likely to emerge and the ethical challenges these will present. I argue that such developments require us to rethink conventional attitudes towards clinical research, the roles of doctors/researchers and patients/participants with respect to research, and the relationship between science and society; and that a broader framework is required to address the plurality of stakeholder roles and interests involved in the development of treatments based on novel technologies. (shrink)

Emerging medical biotechnology, with its dual‐use nature, presents both unprecedented opportunities and challenges for human society. As we benefit from technological innovation, it is crucial for Chinese academics and policymakers to effectively identify and address potential risks. However, the current framework for evaluating dual‐use research faces multiple challenges, including difficulties in identifying dual‐use issues, a lack of consideration for broader impacts in assessments, and a lack of consensus on balancing benefits and risks. Furthermore, inadequacies in the review mechanism, (...) such as uneven progress among institutions, insufficient review capabilities, and lacking specialized knowledge among assessment personnel, hamper the effectiveness of evaluation efforts. This article aims to explore these challenges and propose practical recommendations for strengthening the evaluation and governance mechanisms of dual‐use research. By effectively mitigating the risks associated with dual‐use research, it facilitates the promotion of responsible scientific progress in emerging medical biotechnologies in China and internationally. (shrink)

This issue of Christian Bioethics explores theological, metaphysical, and ethical questions surrounding emerging reproductive technologies. Narratives concerning such technologies are often manipulated via “language games.” Language games involve toying with language to ensure that one’s vision of the good gains or retains political prominence. Such games are common in academic discussions of “artificial womb” technologies. Abortion proponents, for example, are already using language to dehumanize subjects within “artificial wombs.” This is unsurprising. Were relevant subjects considered persons, (...) then abortion access (and other forms of “reproductive autonomy”) might be curtailed. Here, I show that abortion proponents’ language games often depend on dubious metaphysical claims. Second, I argue that Christians should oppose dehumanizing language games, since those games undermine “neighbor-love,” which Christians are commanded to show others. I also highlight how discussions of other technologies—such as medication abortion—are affected by confused (or manipulative) language. Ultimately, the language games I critique aim to preserve and expand the “rights” of the powerful to dehumanize, control, and kill vulnerable human beings. Since neighbor-love commands Christians to provide for “the least of these,” however, Christians must expose these manipulative language games, refute them, and resist the corrupt ideologies from which they flow. (shrink)

Healthcare expenditures account for approximately 9% of GDP in OECD countries and are on an upward trajectory (OECD, 2017). This significant financial burden, combined with an aging global population and increasing demand, emphasizes the imperative for sustained research and innovation to enhance health system efficacy. Key to this transformation are technological advancements, including digital health, which presents novel opportunities for improvement. Emerging digital health technologies, such as virtual consultations, complex imaging procedures, and electronic medical records, are fundamental (...) to modern healthcare infrastructures. However, significant gaps remain in the evaluation and understanding of these innovations, especially for nascent technological areas. This thesis addresses this subject, aiming to delineate how individuals and institutions can bolster their evaluative capabilities, strategic decision-making, and planning for the deployment of emerging digital healthcare technologies. The research methodology amalgamates theoretical exploration, literature scrutiny, and empirical examinations, presenting an integrated perspective that intersects the disciplines of Management & Decision Science, Technology & Innovation, and Health Economics & Outcomes Research. From an applied perspective, this research focuses on developing evidence within the context of pediatric healthcare in Canada — a context notably underrepresented in healthcare management research, despite its disproportionate per capita expenditure. Technologically, the predominant focus is on applications in virtual reality (VR) and three-dimensional (3D) printing and virtualization, though with the aspiration of ensuring the generalizability of results. The current thesis is structured to parallel the progression of the research itself, as three distinct phases; this begins with a comprehensive Background that contextualizes the initial intent, exploring the relationship between technology, innovation, and health outcomes. In this phase, each academic discipline is analyzed to identify base theoretical underpinnings for the research. The second phase of this work includes five empirical studies, each preceded by context-specific literature reviews for the respective technological domain, providing insight into the current state of evidence related to value-based assessment and economic evaluation in that area. Empirical studies included a randomized controlled trial and a cost consequences assessment of VR for pre-procedural preparation for medical imaging. Additionally, novel applications of 3D printing and virtualization are critically analyzed, accompanied by a multi-case study on the implementation of 3D printing in pediatrics, a cost-consequences study of applications for thoracoabdominal surgeries, and an outcomes study on the use of 3D virtualization in medical education during the COVID-19 pandemic. The final phase of this research includes the critical analysis and synthesis of findings into a proposal for a novel value-based assessment and decision-making framework specific to emerging health innovations; this framework integrates insights and resources for clinicians, administrators, and policymakers. The outcomes of this research are skewed toward Knowledge Users, but also aims to advance the theoretical basis for health technology assessment (HTA). (shrink)

The politics of epidemics in Chinese history not only involves competing interpretations about the meanings of disease, but also includes dynamic tensions between socio-political factors and the participants involved in emergency responses. This article examines three cases-the plague epidemic of 1949, the cholera epidemic of 1961-1965, and the meningitis epidemic of 1966-1967-to reveal the entangling political, technological, and epidemiological factors involved in ending epidemics in the People's Republic of China, while also illustrating the difficulty of charting the end of an (...) epidemic when data on disease prevalence and disease control are collected, reported, framed, and archived by political authorities. (shrink)

Emerging technologies such as artificial intelligence are actively revolutionizing the healthcare industry. While there is widespread concern that these advances will displace human practitioners within the healthcare sector, there are several tasks – including original and nuanced ethical decision making – that they cannot replace. Further, the implementation of artificial intelligence in clinical practice can be anticipated to drive the production of novel ethical tensions surrounding its use, even while eliminating some of the technical tasks which currently compete (...) with ethical deliberation for clinicians’ limited time. A new argument therefore arises to suggest that although these disruptive technologies will change the face of medicine, they may also foster a revival of several fundamental components inherent to the role of healthcare professionals, chiefly, the principal activities of moral philosophy. Accordingly, “machine medicine” presents a vital opportunity to reinvigorate the field of bioethics, rather than withdraw from it. (shrink)

Global governance of emerging, disruptive biomedical technologies presents a multitude of ethical problems. The recent paper by Shoziet alraises some of these problems in the context of a discussion of what could be themostdisruptive (and most morally fraught) emerging biomedical technology—human germline genome editing. At the heart of their argument is the claim that, for something like gene editing, there is likely to be tension between the interests of specific states in crafting regulation for the technology, and (...) disagreement about what would be necessary to meet the requirements for responsible translation of gene editing into the clinic. This complicates hopes for a tidy, algorithmic process of crafting global governance via frameworks for regulation built around core ‘ethical values and principles’ (as they are called in the WHO Framework), and also forces us to confront deeper philosophical questions about biotechnology and global health. (shrink)

Technology shapes every aspect of human experience and it is the primary driver of social and ecological change. Given this, it is surprising that we spend so little time studying, analyzing, and evaluating new technologies. Occasionally, an issue grabs public attention--for example, the use of human embryonic stem cells in medical research or online file sharing of music and movies. However, these are the exceptions. For the most part, we enthusiastically embrace each new technology and application with little (...) critical reflection on how it will impact our lives and our world. What is more, when an issue raised by an emerging technology is attended to, we often lack the language, concepts, and critical perspectives to thoroughly address it. The aim of this textbook is to introduce students and other readers to the ethical issues associated with a broad array of emerging technologies--including nanotechnology, synthetic genomics, robotics, genetic engineering, geoengineering, synthetic meat, virtual reality, information technologies, sex selection, and many more--and to help them develop analytical skills and perspectives for effectively evaluating novel technologies and applications. (shrink)

The use of wireless, electronic, medical records and communications in the prehospital and disaster field is increasing. Objective: This study examines the role of wireless, electronic, medical records and com- munications technologies on the quality of patient documentation by emergency field responders during a mass-casualty exercise.

A growing literature addresses the ethical implications of electronic surveillance at work, frequently assigning ethical priority to values such as the right to privacy. This paper suggests that, in practice, the issues are sociologically more complex than some accounts suggest. This is because many workplace electronic technologies not designed or deployed for surveillance purposes nevertheless embody surveillance capacity. This capacity may not be immediately obvious to participants or lend itself to simple deployment. Moreover, because of their primary functions, such (...) systems embody a range of other features which are potentially beneficial for those utilising them. As a result, more complex ethical dilemmas emerge as different desired goods compete for priority in the decision-making of individuals and groups. From a sociological point of view this raises interesting questions about the way ethical dilemmas arise in the context of the ongoing social relationships of work. The paper explores these issues using data from a study of the development and implementation of a computerised instructional package in a maternity setting. This medical setting illustrates clearly how seeking to assign ethical priority to a particular concern, such as the right to privacy, cannot but oversimplify the real day to day dilemmas encountered by participants. At the same time,the example of the instructional package demonstrates that it is difficult to predict in advance what ethical issues will be raised by technologies that almost always turn out to have a range of capabilities beyond those envisaged in their original design specification. (shrink)

Recent progress in synthetic biology has enabled the development of novel therapeutic opportunities for the treatment of human disease. In the near future, first-in-human trials will be indicated. FIH trials mark a key milestone in the translation of medical SynBio applications into clinical practice. Fostered by uncertainty of possible adverse events for trial participants, a variety of ethical concerns emerge with regards to SynBio FIH trials, including ‘risk’ minimization. These concerns are associated with any FIH trial, however, due to (...) the novelty of the approach, they become more pronounced for medical applications of emerging technologies like SynBio. To minimize potential harm for trial participants, scholars, guidelines, regulations and policy makers alike suggest using ‘risk assessment’ as evaluation tool for such trials. Conversely, in the context of emTech FIH trials, we believe it to be at least questionable to contextualize uncertainty of potential adverse events as ‘risk’ and apply traditional risk assessment methods. Hence, this issue needs to be discussed to enable alterations of the evaluation process before the translational phase of SynBio applications begins. In this paper, we will take the opportunity to start the debate and highlight how a misunderstanding of the concept of risk, and the possibilities and limitations of risk assessment, respectively, might impair decision-making by the relevant regulatory authorities and research ethics committees, and discuss possible solutions to tackle the issue. (shrink)

The Direction of Medical Ethics The direction bioethics, and specifically medical ethics, will take in the next few years will be crucial. It is an emerging specialty that has attempted a great deal, that has many differing agendas, and that has its own identity crisis. Is it a subspecialty of clinical medicine? Is it a medical reform movement? Is it a consumer pro tection movement? Is it a branch of professional ethics? Is it a ra tionale (...) for legal decisions and agency regulations? Is it something physicians and ethical theorists do constructively together? Or is it a morally concentrated attack on high technology, with the prac titioners of scientific medicine and the medical ethicists in an adversarial role? Is it a conservative endeavor, exhibiting a Frankenstein syn drome in Medical Genetics ("this time, they have gone too far"), or a Clockwork Orange syndrome in Psychotherapy ("we have met hods to make you talk-walk-cry-kill")? Or does it suffer the afflic tion of overdependency on the informal fallacy of the Slippery Slope ("one step down this hill and we will never be able to stop") that remains an informal fallacy no matter how frequently it's used? Is it a restricted endeavor of analytic philosophy: what is the meaning of "disease," how is "justice" used in the allocation of medical resources, what constitutes "informed" or "consent?" Is it applied ethics, leading in clinical practice to some recommenda tion for therapeutic or preventive action? This incomplete list of questions indicates just how complex. (shrink)

This review analyzes the social perspective of patient safety and how pharmacists should consider these elements when adopting health information technology (HIT) into their practice.

This book explores the scope, application and role of medical law, regulatory norms and ethics, and addresses key challenges introduced by contemporary advances in biomedical research and healthcare. While mindful of national developments, the handbook supports a global perspective in its approach to medical law. Contributors include leading scholars in both medical law and ethics, who have contributed specially commissioned pieces in order to present a critical overview and analysis of the current state of medical law (...) and ethics. Each chapter offers comprehensive coverage of longstanding and traditional topics in medical law and ethics, and offers dynamic insights into contemporary and emerging issues in this heavily debated field. Topics covered include: Bioethics, health and human rights Medical liability Law and emerging health technologies Public health law Personalized medicine The law and ethics of access to medicines in developing countries Medical research in the genome era Emerging legal and ethical issues in reproductive technologies This advanced level reference work will prove invaluable to legal practitioners, scholars, students and researchers in the disciplines of law, medicine, genetics, dentistry, theology, and medical ethics. (shrink)

This article explores the moral significance of technology, reviewing a microfluidic chip for sperm sorting and its use for non-medical sex selection. I explore how a specific material setting of this new iteration of pre-pregnancy sex selection technology—with a promised low cost, non-invasive nature and possibility to use at home—fosters new and exacerbates existing ethical concerns. I compare this new technology with the existing sex selection methods of sperm sorting and Prenatal Genetic Diagnosis. Current ethical and political debates on (...) emerging technologies predominantly focus on the quantifiable risk-and-benefit logic that invites an unequivocal “either-or” decision on their future and misses the contextual ethical impact of technology. The article aims to deepen the discussion on sex selection and supplement it with the analysis of the new technology’s ethical potential to alter human practices, perceptions and the evaluative concepts with which we approach it. I suggest that the technological mediation approach can be useful to ethically contextualize technologies and highlight the value of such considerations for the informed deliberation regarding their use, design and governance. (shrink)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have (...) either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

Assistive reproductive technologies are increasingly used to control the biology of fertility and its temporality. Combining historical, theoretical, and socio-empirical insights, this paper aims at expanding our understanding of the way temporality emerges and is negotiated in the contemporary practice of cryopreservation of reproductive materials. We first present an historical overview of the practice of cryo-fertility to indicate the co-production of technology and social constructions of temporality. We then apply a theoretical framework for analysing cryobiology and cryopreservation technologies (...) as creating a new epistemic perspective interconnecting biology and temporality. Thereafter, we focus on the case of ‘social egg freezing’ to present socio-empirical findings illustrating different reproductive temporalities and their connection to the social acceptance of and expectations towards the practice. SEF is a particularly interesting case as it aims to enable women to disconnect their reproductive potential from their biological rhythms. Based on 39 open interviews with Israeli and German SEF users, the cross-cultural comparative findings reveal three types of attitudes: postponing motherhood/reproductive decisions ; singlehood and “waiting” for a partner ; and the planning of and hope for multiple children. For theory building, this analysis uncovers temporality formations embedded in gender and reproductive moral values; including the ‘extended present’, ‘waiting’, and ‘reproductive futurism’. We conclude by discussing the contribution of our findings by advancing the theoretical framework of ‘cryopolitics’ highlighting the theoretical implications and importance of gendered and cultural imaginaries constructing medical technological innovations and related temporalities. (shrink)

Recent advances in digital technology including internet, email and smartphones has revolutionised clinical photography and medical record data storage. The use of smartphones is becoming ubiquitous among medical professionals and the use of clinical photography has become an integral component of the management of patients in a variety of visually orientated specialties. Although clinical photography has its benefits, with this evolving technology also emerge new ethical, legal and social issues, which clinicians must be aware of.

The introduction of new medical technologies into a developing country is usually greeted with enthusiasm as the possible benefits become an object of great anticipation and provide new hope for therapy or relief. The prompt utilization of new discoveries and inventions by a medical practitioner serves as a positive indicator of high standing in the professional community. But the transfer of medical technology also involves a transfer of concomitant values. There is a danger that, in the (...) process of adopting a particular technology, the user takes for granted the general utility and desirability of the implements and procedures under consideration without recognizing the socio‐cultural peculiarities of the adopting country. A sensitivity to the social conditions and cultural traditions is important so that the emergence of new values can be examined critically and the transfer of necessary technology can be effected smoothly. In the Philippines, efforts to boost patronage of transplant technology appear to have overlooked this need for socio‐cultural sensitivity. Legislative fiat cannot be used to override deep‐seated values. There is a need to be more sensitive to the possible confrontation of values that the transfer of technology brings in order to avoid the erosion of indigenous socio‐cultural values and minimize the intrusiveness of beneficial medical technology. (shrink)

This paper outlines the background and significance of philosophy of technology as a focus of inquiry emerging within nursing scholarship and research. The thesis of the paper is that philosophy of technology and nursing is fundamental to discipline development and our role in enhancing health care. It is argued that we must further our responsibility and interest in critiquing current and future health care systems through philosophical inquiry into the experience, meaning and implications of technology. This paper locates nurses (...) as important contributors to the use and integration of health care technology and identifies nursing as a discipline that can provide specific insights into the health experience of individuals, cultures and societies. Nurses are encouraged to undertake further examination of epistemological, ontological and ethical challenges to arise from technology as a focus of philosophical inquiry. The advancement of philosophy of technology and nursing will make a profound contribution to inquiry into the experience of technology, the needs of humanity and the development of appropriate health care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Medical MishapAngela MooreIn western society we live in an environment where image is valued and sought after. Acquiring Spastic Cerebral Palsy through no fault of one’s own directly challenges and contradicts this. We tend to base our judgments of other people on the way they “look” before we even speak to them or get to know them. For many centuries western society has valued and aspired to (...) having the “perfect” image and body shape. The children’s nursery rhyme “Humpty Dumpty” illustrates that as far back as the 1600’s when something was broken people felt there was a “need” to correct the damage and fix the problem. Maybe “Humpty Dumpty” was an obese person who fell off the wall, maybe he was an intoxicated soldier, maybe it was a name of a large cannon that was sitting on the wall of Colchester (Wright, 2008) which was set up to protect the city. No matter what the situation, the reader is left with a feeling that whenever there was something wrong with Humpty Dumpty, there was a need to correct the error and fix what was broken. Because he was “different” or “not normal” in one way or another he was not valued for his role by members of his local community. The reader is left to form his or her own opinion. Society continues to hold those views to this very day.I am a secondary emergency teacher, have completed a Masters in Special Needs along with having a permanent acquired physical disability, Spastic Cerebral Palsy, affecting my four limbs. This was caused after an initial medical examination was “botched” by an unsupervised intern—the specialist left the theatre during the procedure when I was 14 weeks of age, over forty years ago. Further medical testing was arranged because there was a belief that I may have had hydrocephalus—swelling and excess fluid buildup around my brain causing it to be unnecessarily enlarge for my age. In my family’s case this seems to be an hereditary trait that has passed from my father who has a large head. It’s interesting to note that an obstetrician made a comment to my sister on the size of her toddler’s head. [End Page 213]Since 1970 I have had a range of both positive and negative medical experiences. As a child who wasn’t able to comprehend what and why things were happening I was very frightened and often very upset. As an adult I am able to understand what and why something is going on and I ask questions when needed.“Normal” has always been completing the same things but in a different way to other people while intending to reach the same outcome of “success.” There are many ways to skin a cat and “normal” is a term that has a very broad definition which is dependent upon the individual and the situation at hand. What is “normal” for me will be “different” for someone else. What is “normal” for another person will be “different” for me. It’s the differences between individuals that we come to value later on in life. That I cope in a different manner from others has clearly been aided by being able to make use of information technology—laptop, mobile phones, printers, etc.—along with a feeling that the acquired physical disability that I have is a small part of the overall person that I am. Before I became a person with an acquired disability I was a normal, happy, healthy baby and even now although I will always have a disability I have excellent health and choose not to be defined by having acquired a disability. Unlike some other people I consider myself to be a person who “acquired” a disability instead of being a “disabled” person. Having an acquired physical disability is a small part of the person I am. The manner in which I acquired a severe physical disability is what I have come to value along with the fact that I have done well in many areas of life while having such a severe condition.Unlike people who had disabilities in the 19... (shrink)

The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different (...) forms of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future. (shrink)

The diffusion of medical technology is largely determined by the marketplace demands supported by national and historical contexts. Using the cases of cesarean delivery and newborn intensive care in the United States, this article presents the argument that the interaction of four factors accounts for the rapid diffusion of untested technologies. These factors are economic expansion in an unrestricted market, the vulnerability of the patient population, a social disposition towards emergency medicine, and the vested interest of medical (...) specialists. (shrink)

Like nuclear energy, most technologies could have dual use—for health and well being and disaster and terror. Some research publications have brought to the forefront the tragic consequences of the latter potential through their possible use. Monitoring life science research and development (R&D) to prevent possible misuse is a challenging task globally, more so in developing economies like India, which are emerging as major biotech hubs. As a signatory to the Biological and Toxin Weapons Convention, India has put (...) in motion a process of evolving a series of measures to manage dual-use technology. The Indian Council of Medical Research (ICMR) has taken a lead in drafting model codes of conduct, ethics and practice for use by other S&T agencies to tailor them as per their requirements. Taking cue from the discussions held by the editors of the various medical and science journals in the developed world, the Indian Journal of Medical Research, the official publication of the ICMR, is working on policy and uniform practice of publication of dual-use research results. The Government of India too has promulgated legal provisions to minimize the risks of misuse of technology, like the Weapons of Mass Destruction Act. Clearly, no single agency would be able to manage the dual-use of technology effectively. Multiple agencies have to come together to work in tandem for effective implementation of various measure and also like Janus, ensure that they are neither too restrictive nor intrusive to discourage the development of science. (shrink)

The emerging concept of systems medicine (or ‘P4 medicine’—predictive, preventive, personalized and participatory) is at the vanguard of the post-genomic movement towards ‘precision medicine’. It is the medical application of systems biology, the biological study of wholes. Of particular interest, P4 systems medicine is currently promised as a revolutionary new biomedical approach that is holistic rather than reductionist. This article analyzes its concept of holism, both with regard to methods and conceptualization of health and disease. Rather than representing (...) a medical holism associated with basic humanistic ideas, we find a technoscientific holism resulting from altered technological and theoretical circumstances in biology. We argue that this holism, which is aimed at disease prevention and health optimization, points towards an expanded form of medicalization, which we call ‘holistic medicalization’: Each person’s whole life process is defined in biomedical, technoscientific terms as quantifiable and controllable and underlain a regime of medical control that is holistic in that it is all-encompassing. It is directed at all levels of functioning, from the molecular to the social, continual throughout life and aimed at managing the whole continuum from cure of disease to optimization of health. We argue that this medicalization is a very concrete materialization of a broader trend in medicine and society, which we call ‘the medicalization of health and life itself’. We explicate this holistic medicalization, discuss potential harms and conclude by calling for preventive measures aimed at avoiding eventual harmful effects of overmedicalization in systems medicine (quaternary prevention). (shrink)

Few empirical studies have explored how different types of knowledge are associated with diverse objectivities and moral economies. Here, we examine these associations through an empirical investigation of the public policy debate in Israel around medical cannabis, which may be termed a contested medicine because its therapeutic effects, while subjectively felt by users, are not generally recognized by the medical profession. Our findings indicate that beneath the MC debate lie deep-seated issues of epistemology, which are entwined with questions (...) of ethics and morality. Whereas some stakeholder groups viewed evidence-based medicine and mechanical objectivity as the only valid knowledge base, others called for recognition of a particular experience-based knowledge, championing regulatory, administrative, or strong objectivity. Stakeholders’ interpretations of what should be considered as ethical courses of action corresponded to their epistemological views, with most criticizing the regulators for relying on regulatory subjectivity instead of objectivity. Our in-depth mapping of this arena allowed us not only to shed light on the emergence of the new entity called “medical cannabis” but also to reexamine the link between epistemology, ethics, and action and to elucidate how heterogeneous groups view the validity and objectivity of knowledge and the interface between medicine, science, and policy. (shrink)

The locked-in syndrome is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for (...) simple medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS. (shrink)

New pharmacological therapies, often dubbed `lifestyle drugs', demonstrate the enactment of yet another interface between technologies and bodies that promises a re-fashioning of the body with transformative, life-enhancing results. This article analyzes the emergence of one lifestyle drug, Viagra, from a technoscience studies perspective, conceptualizing Viagra as a new medical technology of the body. Through an analysis of promotional materials for Viagra, we argue that this pharmaceutical device performs ideological work through its discursive scripts that serves to reinforce (...) and augment dominant cultural narratives in relation to material bodies, particularly those of hegemonic masculinity and male (and female) sexuality. We conclude that Viagra carries the potential to reify and reinforce these dominant and hegemonic narratives, while at the same time, through ensuring an open market for heterogeneous users, it provides spaces for alternatives to these normative ideals and assumptions. (shrink)

The emergence of ethical concerns surrounding artificial intelligence (AI) has led to an explosion of high-level ethical principles being published by a wide range of public and private organizations. However, there is a need to consider how AI developers can be practically assisted to anticipate, identify and address ethical issues regarding AI technologies. This is particularly important in the development of AI intended for healthcare settings, where applications will often interact directly with patients in various states of vulnerability. In (...) this paper, we propose that an ‘embedded ethics’ approach, in which ethicists and developers together address ethical issues via an iterative and continuous process from the outset of development, could be an effective means of integrating robust ethical considerations into the practical development of medical AI. (shrink)

In the Technology Age, innovations in medical, communications, and weapons technologies have given rise to many new ethical questions: Are technologies always value-neutral tools? Are human values and human prejudices sometimes embedded in technologies? Should we merge with the technologies we use? Is it ethical to use autonomous weapons systems in warfare? What should a self-driving car do if it detects an unavoidable crash? Can robots have morally relevant properties? -/- This is Technology Ethics: An (...) Introduction provides an accessible overview of the sub-field of philosophy that focuses on the ethical implications of new technologies. Requiring no previous background in the subject, this reader-friendly volume explores ethical questions concerning artificial intelligence, robots, self-driving cars, brain implants, social media and communication technologies, and more. Throughout the book, clear and engaging chapters describe and discuss key discussions, issues, and themes while inviting readers to develop their own perspectives on a wide range of moral and ethical questions. -/- * Discusses how various technologies influence and shape individuals and society both positively and negatively * Illustrates how emerging technologies affect traditional ideas about ethics and human self-understanding * Addresses the ethical complications of creating technologies that may lead to morally problematic consequences * Considers if the benefits of new technologies outweigh potential drawbacks, such as how people interact online through social media * Explores how established moral and ethical theories relate to new questions concerning advanced technologies -/- Part of the popular This is Philosophy series published by Wiley-Blackwell, This is Technology Ethics: An Introduction is a must-read for undergraduate students taking a Technology Ethics course, researchers in the field, engineers, technology professionals, and general readers looking to learn more about the topic. (shrink)

Introduction. The increasing mediation of human life by medicine necessarily raises the question of philosophical understanding the phenomenon of culture medicalization, since today the vector of growing powerful influence of medicine on forming sociocultural processes has clearly emerged. Along with the positive phenomena of the medicalization of life, the volume of “excessive” phenomena of its medicalization is growing. The purpose of the article is to clarify the philo- sophical foundations of the progressive medicaliza- tion of modern culture. Methods. The methodological (...) basis of the study is presented by dialectical, epistemological, axiologi- cal, philosophical-anthropological, and socio-phil- osophical approaches. The study is based on E. Cassirer’s transcendental philosophy, the phenom- enological transcendentalism of E. Husserl; V.S. Stepin’s concept about the system of informational social codes; and P.D. Tishchenko’s concept on the transformation of bio-power in modern culture. Scientific novelty of the research. The author outlines fundamental foundations of modern cul- ture medicalization as a result of mutually similar processes of transforming bio-power and the progress of biomedical sciences. Results. Unfolding, culture compensated for the bodily weakness of a person with the power of his technical inventions, but today they have surpassed the intellectual capabilities of their creator - the individual has to permanently adapt to the grow- ing volume of mass technogenic innovations. The historically formed human need to master the world through its “humanization” is suppressed, and, as a result, the problem of a modern indi- vidual’s request for self-realization through the creative transformation of the social environment is actualized. In this regard, one of the philosophi- cal and anthropological foundations of modern culture can be recognized as a technogenically determined desire of a person to transform his own corporeality, aimed at expanding the capabili- ties of a natural person. Biomedical sciences, as a result of biotechnological progress, turned out to be exactly the social and scientific sphere, which, building up practical activities within the framework of healthcare, considers the person to be both the subject and the object of the biosocial transforma- tion demanded by cultural evolution. Conclusions. The process of medicalization of culture occurs on the basis of two reciprocal fundamental processes: first, the strengthening of the principles of bio-power as “care for all forms of life”; secondly, the progress and technologization of scientific medicine, which in practice provides a socio-cultural demand for a modern prosperous individual. (shrink)

Assisted reproductive technology is a complex medical intervention with many potential social sensitivities. Within this domain, oocyte cryopreservation has emerged as an important research area for preserving female fertility. Against the backdrop of the hotly debated first legal case in China of a single woman wishing to freeze her eggs, and the implementation of the ‘three‐child policy’ in China, there is an urgent need to evaluate policies and address ethical considerations surrounding oocyte cryopreservation for non‐medical reasons. This review (...) examines current policies, explores China's practices and research, and examines the latest ethical challenges surrounding non‐medical oocyte cryopreservation. It develops strategies and recommendations that will be relevant in China and other developing countries seeking to navigate this complex landscape. (shrink)

Brain–Computer Interface (BCI) technology is a promising research area in many domains. Brain activity can be interpreted through both invasive and non-invasive monitoring devices, allowing for novel, therapeutic solutions for individuals with disabilities and for other non-medical applications. However, a number of ethical issues have been identified from the use of BCI technology. In this paper, we review the academic discussion of the ethical implications of BCI technology in the last five years. We conclude that some emerging applications (...) of BCI technology—including commercial ventures that seek to meld human intelligence with AI—present new and unique ethical concerns. Further, we seek to understand how academic literature on the topic of BCIs addresses these novel concerns. Similar to prior work, we use a limited sample to identify trends and areas of concern or debate among researchers and ethicists. From our analysis, we identify two key areas of BCI ethics that warrant further research: the physical and psychological effects of BCI technology. Additionally, questions of BCI policy have not yet become a frequent point of discussion in the relevant literature on BCI ethics, and we argue this should be addressed in future work. We provide guiding questions that will help ethicists and policy makers grapple with the most important issues associated with BCI technology. (shrink)

The article aims at reconstructing how pain is used in contemporary societies in the process of engraving power. Firstly, a social phenomenological analysis of pain is conducted: Husserl’s and Merleau-Ponty’s ideas are used for clarifying the experience of pain itself; Elaine Scarry’s analyses are overviewed in order to reconstruct how pain contributes to the establishing of power. Secondly, this complex approach is applied in early modern context: the parallel processes of the decline of a transcendental and the emergence of a (...) medical interpretation of pain is introduced, along with the marginalization of violence. Thirdly, the era characterized by the triumph of medical pain management is analysed: it is argued that the constitutive role of pain in establishing power does not cease to exist with the emergence of technologies of discursive governance ; it is an open question, what sort of power is engraved through pain understood in strictly medical frames. (shrink)

In this article, we examine the emergence of a concept of medical feeding that emphasizes artificiality and medical technology. We discuss how this concept has been created in specific contrast to the daily provision of food and water; medical definitions retain clear disjunctures with cultural and religious beliefs surrounding food, gendered aspects of eating and feeding, and the everyday practices of social and family life in the United States. We begin with an examination of the historical processes (...) involved in creating artificial nutrition and hydration as a medical concept, including the evolution of terminology and practices in relation to technology advancement, legal cases, and public discourse. We.. (shrink)

The coupled growth of population aging and international migration warrants attention on the methods and solutions available to adult children living overseas to provide distance caregiving for their aging parents. Despite living apart from their parents, the transnational informal care literature has indicated that first-generation immigrants remain committed to carry out their filial caregiving obligations in extensive and creative ways. With functions to remotely access health information enabled by emergency, wearable, motion, and video sensors, remote monitoring technologies (RMTs) may (...) thus also allow these international migrants to be alerted in sudden changes and remain informed of their parent’s state of health. As technological solutions for caregiving, RMTs could allow independent living for older persons while any unusual deviations from normal health patterns are detected and appropriately supported. With a vignette of a distance care arrangement, we engage with concepts such as filial piety, in-absentia caregiving distress, and the social exchange theory, as well as the upholding of shifting cultural ideals to illustrate the complex dynamic of the satisfaction and quality of the informal caregiving relationship. This paper extends the traditional ethical issues in technology-aided caregiving, such as autonomy, privacy, and justice, to be considered within the context of distance care. We also posit newer ethical considerations such as consent in power imbalances, harm to caregivers, and stigma. These known and new ethical issues aim to encourage further ethically conscious design and use of RMTs to support distance care for older persons. (shrink)

This article applies a theoretical framework developed by the late American sociologist Anselm Strauss to the discovery of a new resuscitation technique, closed-chest cardiac massage. The discovery, which took place in the laboratories of Johns Hopkins University between 1956 and 1960, is analyzed as the collective management of a trajectory over time. The article follows the discovery trajectory from its origins in defibrillator research to the establishment of closed-chest cardiac massage and cardiopulmonary resuscitation as a universal life-saving method. The analytical (...) focus on the experimental, clinical, and promotional activities performed by the different actors interacting with the emerging technology allows one to critically question the value of concepts such as closure, stabilization, and black boxing in sociology of science and technology. Instead of prematurely freezing the analysis of technoscience, a trajectory conceptual framework emphasizes the ongoing dynamic between actors and medical technology to define the scope, effectiveness, and multiple interpretations of the technology-actor interaction. (shrink)

Discussion of a “duty to recontact” emerged as technological advances left professionals considering getting back in touch with patients they had seen in the past. While there has been much discussion of the duty to recontact as a matter of theory and ethics, there has been rather little empirically based analysis of what this “duty” consists of. Drawing on interviews with 34 professionals working in, or closely with, genetics services, this paper explores what the “duty to recontact” means for healthcare (...) professionals involved in genetics. Using a discourse analytic framework, the paper identifies three system generated discourses on recontact (governance, legal and responsibilizing discourses) and three lifeworld discourses (situating recontact as a formal duty; more loosely as an obligation; and as a personal sense of responsibility). In summary, the paper shows that the “duty” to recontact involves a complex interplay of system responsibilities with professional duties, responsibilities and obligations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to (...) those with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

Artificial intelligence is changing healthcare and the practice of medicine as data-driven science and machine-learning technologies, in particular, are contributing to a variety of medical and clinical tasks. Such advancements have also raised many questions, especially about public trust. As a response to these concerns there has been a concentrated effort from public bodies, policy-makers and technology companies leading the way in AI to address what is identified as a "public trust deficit". This paper argues that a focus (...) on trust as the basis upon which a relationship between this new technology and the public is built is, at best, ineffective, at worst, inappropriate or even dangerous, as it diverts attention from what is actually needed to actively warrant trust. Instead of agonising about how to facilitate trust, a type of relationship which can leave those trusting vulnerable and exposed, we argue that efforts should be focused on the difficult and dynamic process of ensuring reliance underwritten by strong legal and regulatory frameworks. From there, trust could emerge but not merely as a means to an end. Instead, as something to work in practice towards; that is, the deserved result of an ongoing ethical relationship where there is the appropriate, enforceable and reliable regulatory infrastructure in place for problems, challenges and power asymmetries to be continuously accounted for and appropriately redressed. Data sharing not applicable as no datasets generated and/or analysed for this study. (shrink)