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Health & Medical Technologies

Chemicals and JarsTechnological advances in the medical and healthcare domains are considered by many to be critical in finding effective diagnostic and therapeutic tools for curing conditions that have hitherto proved elusive. At the same time, innovations in healthcare also offer the prospect of improvements in both clinical quality and efficiency, thereby potentially reduce burgeoning healthcare costs, concerns which have intensified in times of economic austerity. But while the potential for promoting human well-being is undeniable, whether particular technological innovations deliver on this promise cannot be assumed. At the same time, new health technologies also pose a number of ‘risks’. Although these risks are typically focused around concerns about the safety and efficacy of these new developments, the nature of these risks also extends to risks of a less tangible nature, including cultural and ethical concerns that are implicated in the way in which we treat our bodies and the bodies of others.

Digital Health Technologies and the M-Health Revolution

The continuing trend towards truly ubiquitous and pervasive computing -- made possible through networked digital communications technology -- is having a major impact on healthcare. The term ‘digital health’ is used with increasing frequency to refer to a wide range of technologies related to health and medicine. Claims abound in both the popular press and medical periodicals concerning the potential of the ‘digital health revolution’ to radically transform healthcare. In particular, the widespread adoption of smart phone and tablet technology has been accompanied by an explosion in the development and availability of ‘health and medical apps’, mobile software applications that are mass marketed and available for easy download to individuals’ smartphones that are claimed to offer users the ability to better manage their health. For example, some apps are designed to assist individuals in the management of specific medical conditions, while other facilitate self-diagnosis. Proponents of m-health technologies focus on their potential to fulfil the so-called ‘Holy Trinity’ of mobile health technology’s ambitions: 

  • To improve the quality of health care and reduce medical error
  • To reduce the cost of healthcare
  • To increase access to care by democratising and demystifying medicine

But whether m-health technologies are capable of delivering on these promises is far from certain. At the same time, little is known about their implications for the practice of medicine, the experience of patients, and their impact upon the quality of clinical and health outcomes.

Academics Working in this Area:

Professor Karen Yeung

Professor Barbara Prainsack

Dr Federica Lucivero

Dr Claire Marris

 

Participant Led Health Research

Increasing access to digital technologies and proliferation of online social networks have enabled individuals to become more active in managing their personal health. These trends have also facilitated the formation of communities of individuals engaged in establishing and pursuing health research projects. The type of research conducted by these communities includes self-experimentation, self surveillance, analyses of genomic data, and genome-wide association studies. These ‘‘citizen driven’’ or ‘‘participant driven’’ research projects involve participants themselves providing the driving force in the initiation or conduct of research projects.  Whilst participant led research has the potential to offer medicine which is personalised, predictive, preventive, and participatory, it poses a number of challenges, including concerns about its scientific rigour and questions concerning adherence to ethical standards -- concerns which also apply to more conventional forms of medical research.

Academics Working in this Area:

Professor Roger Brownsword

Professor John Tasioulas

Professor Barbara Prainsack

Dr Claire Marris

Human Genetics and Healthcare

Continuing advances in human genetics and reproductive technologies open up potentially exciting opportunities to treat disease and reduce the incidence of disability. But while there are good reasons to welcome these developments in light of their potential to enhance human well-being, advancements in human genetics vividly demonstrates that such developments are often double-edged: these advances generate new risks and concerns, not just in terms of risks associated with reliability, effectiveness and safety, but also with legitimate concerns about their ethical dimensions, their social implications and the collective values they might threaten.

Yet the extent to which these ethical concerns are made visible is highly variable. For example, in public debate preceding the UK Parliament’s high publicized decision in 2015 to permit a genetic technique known as mitochondrial replacement therapy, this technique was portrayed as controversial primarily because it involved “three parent” IVF. Yet in ethical terms, the decision to allow interventions of this kind rests primarily in the fact that the technique involves an intervention into the human germ-line, thereby effecting an intentional genetic manipulation into human DNA, creating a permanent genetic alteration that would be passed on to future generations. In essence, it is a permanent form of human genetic manipulation – albeit one engaged in for the explicit purpose of seeking to prevent specific heritable disease from being passed on through generations.

In other contexts, the ethical and social dimensions of human genetic interventions may be more subtle. In particular, advances in human genetic technologies have been accompanied by the rising interest in ‘personalised medicine’. The core idea of personalised medicine rests on an attempt to provide medical care that is customized for each patient, drawing on the unique genetic make up of every individual. Hence, it is claimed that through our growing understanding of genetics, it becomes possible to tailor medical treatment to the individual characteristics, needs, and preferences of a patient during all stages of care, including prevention, diagnosis, treatment, and follow-up. Not only has personalised medicine attracted considerable criticisms on the basis that is over-claims and under-delivers on its promises, but it also raises deeper questions about our individual and collective values and implications for our understanding of human person-hood.

Academics Working in this Area:

Professor Roger Brownsword

Professor Bronwyn Parry (SSHM)

Professor Barbara Prainsack

Professor Rosamund Scott

Dr Claire Marris

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