The neglected role of technology in quality of care crisis
The quality of care crisis (QCC) is one of the most crucial crises the modern medicine is confronting, as the existential and psychological needs of patients have not been addressed and satisfied. Several attempts have been made to find solutions for QCC, e.g., the Marcum's recommendation to make physicians virtuous. Most of the existing formulations for the QCC have regarded technology as one of the causes of this crisis and not part of its solution.Although the authors agree with the role of technology in creating the crisis of care to some extent, in this article we try to present the crisis of care so that medical technology is an important part of its solution. For this purpose, we analyzed QCC from the philosophical perspectives of Husserl and Borgmann and put forward a novel proposal to take account of technology in QCC. In the first step, it is discussed that the role of technology in causing the crisis of care is due to the gap between the techno-scientific world and the life-world of the patients. This formulation shows that the crisis-causing role of technology is not inherent. In the second step, it is tried to find a way to integrate technology into the solution to the crisis. In the proposed reframing, designing and applying technologies based on focal things and practices make it possible to develop technologies that are caring and are able to mitigate QCC.
Hofmann B. "On the Value-Ladenness of Technology in Medicine". Medicine, Health Care and Philosophy. 2011: 335-46.
Marcum J. The Virtuous Physician. Springer, 2012.
Held V. Justice and Care: Essential Readings in Feminist Ethics. Boulder: CO: Westview Press; 1995.
Pettersen T. Comprehending Care: Problems and Possibilities in the Ethics of Care. Lanham: Lexington Books; 2008.
Mayeroff M. On caring. Journal of Philosophy. 1972; 69(4):114-7.
van Hooft S. Caring: An essay in the philosophy of ethics; Boulder: University Press of Colorado, 1995.
van Hooft S. Bioethics and caring. J Med Ethics. 1996 Apr;22(2):83-9. doi: 10.1136/jme.22.2.83. PMID: 8731533; PMCID: PMC1376919.
Marcum, J. The Virtuous Physician, Springer; 2012.
Carraccio C, Englander R, Wolfsthal S, Martin C, Ferentz K. Educating the pediatrician of the 21st century: defining and implementing a competency-based system. Pediatrics; 2004 Feb;113(2):252-8. doi: 10.1542/peds.113.2.252. PMID: 14754935.
Larkin GL, McKay MP, Angelos P. Six core competencies and seven deadly sins: a virtues-based approach to the new guidelines for graduate medical education. Surgery; 2005 Sep;138(3):490-7. doi: 10.1016/j.surg.2005.03.013. PMID: 16213903.
Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA; 2002 Jan 9;287(2):226-35. doi: 10.1001/jama.287.2.226. PMID: 11779266.
Ahlzén R. Medical humanities - arts and humanistic science. Med Health Care Philos. 2007 Dec;10(4):385-93. doi: 10.1007/s11019-007-9081-3.
Peabody, F. "The care of the patient," Journal of American Medical Association; p. 88:877–882, 1927.
Svenaeus, F. "Heidegger’s Philosophy of Technology and the Perils of Medicalization," in Existential Medicine: Essays on Health and Illness, London.New York, Rowman & Littlefield International Ltd; 2018, pp. 131-144.
Lee, K. "Technology and Dehumanization of Medicine," in handbook of the philosophy of medicine, Netherlands, springer; 2017, pp. 661-675.
Wright, H. G. Means, Ends and Medical Care, Springer; 2007.
Topol, E. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Agian, New York: Basic Books; 2019.
Wachter, R. The Digital Doctor, Mc Graw Hill Education; 2015.
Kwiatkowski, W. "Medicine and technology. Remarks on the notion of responsibility in the technology-assisted health care," Medical Health Care and Philosophy; 2018, pp. 21 (2): 197-205.
Reiser, S. Medicine and the Reign of Technology, New York: Cambridge University Press; 1978.
Jonsen, A. R. The New Medicine and the Old Ethics, Cambridge MA: Hraward University Press; 1990.
Carel, H. The phenomenology of illness, Oxford: Oxford University Press; 2016.
Jennett, B. "Medical Technology, Social and Health Care," in Principles of Health Care Ethics, New York, John Wiley & Sons; 1994, pp. 861-8721.
Heidegger, M. Zollikon seminars: Protocols-conversations-letters. F. Mayr and R. Askay (trans.), Northwestern University Press; 2001.
Glover, J. Causing Death and Saving Lives, Harmondsworth: Penguin; 1977.
Pellegrino ED. Medicine, science, art: an old controversy revisited. Man Med; 1979;4(1):43-52. PMID: 470449.
Cassell EJ. The sorcerer's broom. Medicine's rampant technology. Hastings Cent Rep; 1993 Nov-Dec;23(6):32-9. PMID: 8307745.
Svenaeus, F. "The phenomenology of empathy in medicine: an introduction," Medicine, Health Care and Philosophy; 2014, pp. 245-248.
Halpern, J. From detached concern to empathy: Humanizing medical practice, Oxford: Oxford University Press; 2001.
Canguilhem, G.The Normal and the Pathological, NEW YORK: ZONE BOOKS; 1991.
Conrad, P. The medicalization of society. On the transformation of human conditions into treatable disorders, Baltimore: The Johns Hopkins University Press; 2007.
Brown, W. M. "On Defining “Disease”," Journal of Medicine and Philosophy; 1985, pp. 311-328.
Hofmann, B. "Technological Invention of Disease," in Encyclopedia of Creativity, Invention, Innovation and Entrepreneurship; 2013, p. 1786–96.
Agich GJ. The importance of management for understanding managed care. J Med Philos. 1999 Oct;24(5):518-34. doi: 10.1076/jmep.24.5.518.2515. PMID: 10614734.
Anspach, R."Prognostic Conflict in Life-and Death Decisions: The Organization as an Ecology of Knowledge," Journal of Health and Social Behavior; 1987, pp. 28, 215–231.
Aron H., Schwartz, W. The Painful Prescription: Rationing Health Care; Washington DC: Brookings Institution, 1984.
Beyer C., Zalta, E. N. (ed.), "Edmund Husserl," Winter 2020 Edition. [Online]. Available URL = https://plato.stanford.edu/archives/win2020/entries/husserl/
Husserl, E., _The Crisis of European Sciences and Transcendental Phenomenology an Introduction to Phenomenological Philosophy_. Northwestern University Press; 1970.
Scambler, G. "Habermas and the power of medical expertise," in Sociological Theory and Medical Sociology, London, Tavistock; 1987.
Kelleher, D. "New social movements in the health domain," in Habermas, critical theory and health, Routledge, 2001; pp. 119-142.
Gadamer, H. G. The enigma of health. J. Gaiger and N. Walker (trans.), Stanford, CT: Stanford University Press; 1996.
Borgmann, A. Technology and the Character of Contemporary Life_ A Philosophical Inquiry, CHICAGO: THE UNIVERSITY OF CHICAGO PRESS; 1984.
|Issue||Vol 15 (2022)|
|Philosophy of medicine Medical technologies The quality of care crisis Borgmann ; Life-world|
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