Vaccinations Antiseptic surgery Antibiotics Organ transplants
Based on these costs, difficult choices often have to be made Bryan Jennett British neurologist Focused research on “appropriateness” of certain medical technologies Appropriate Technologies 4 categories a medical technology could be deemed inappropriate: Unnecessary Unsafe Unkind Unwise
Appropriate Technologies, cont. Unnecessary: Patient has a condition too advanced to respond to treatment (advanced stages of certain types of cancer or similar terminal illness) Unsafe: The likelihood of complications outweigh the possible benefits
Appropriate Technologies, cont. Unnecessary: Patient has a condition too advanced to respond to treatment (advanced stages of certain types of cancer or similar terminal illness) Unsafe: The likelihood of complications outweigh the possible benefits
Appropriate Technologies, cont. Unkind: The quality of life after treatment is not good enough or its duration long enough to have justified the procedure Unwise: It diverts resources that would yield greater benefits to other patients
Appropriate Technologies, cont. Unkind: The quality of life after treatment is not good enough or its duration long enough to have justified the procedure Unwise: It diverts resources that would yield greater benefits to other patients
Kidney Dialysis Kidneys regulate acid-base concentration & water balance Kidney failure results in pre-mature death Dialysis cleans the blood via artificial kidney Dialysis “generated a host of non-medical problems” Kidney Dialysis, cont. Demand far outstripped supply of dialysis machines No choice but to accept some patients for dialysis, and reject others How do you choose? What criteria do you use?
Kidney Dialysis, cont. Problem eventually solved itself: Number of machines increased More user-friendly At-home dialysis Covered under Medicare, as of 1972, as a result of aggressive lobbying Yet, costs continue to soar ($4.8 billion as of 1991)
Halfway (medical) Technologies Somewhat similar to technological fix, from Unit 1 Treat symptoms while waiting for permanent solution, not the cause: Dialysis, Heart bypass Other examples? “ The development of new medical technologies will force us to grapple with increasingly difficult choices concerning their application.”
Genetic Fix Gene = basic unit of heredity Humans have about 80,000 genes in every cell Some are defective, and cause medical problems “ Genetic screening …offers revolutionary new ways of diagnosing, curing, and even preventing the emergence of many disorders.” Genetic Fix, cont. Both a solution and a problem: “ It is possible that in a few years an expectant mother will be told that her unborn child will have a 75% chance of developing colon cancer before he or she turns 50. …would this be an adequate reason to terminate the pregnancy?” Results of genetic screening could theoretically be used against a person: Bar from certain types of jobs Bar from certain education paths (SAT vs. DNA) Increase insurance premiums Limit potential marriage partners What else?
Gattaca (1997) Sci-fi, set in near future Rampant genetic screening from conception Determines everything : life expectancy, career / education level, social status, marital status Not that far-fetched Volti’s Perspective Huge potential for unanticipated problems Equally huge potential for abuse “ Misguided efforts to address a large number of illnesses solely through genetic manipulation are only one troubling aspect of an overly enthusiastic application of genetic science.” [It] exemplifies a naïve belief that science has all the answers and that technology offers the best solutions for what troubles us as individuals and as members of society.” Basically techno-enthusiasm rather than technorealism
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