As modern technology becomes a more
common feature of healthcare and is used in new and unprecedented ways, ethical
issues also arise regarding healthcare technology.
modernist view of technology assumes that there is one governing rationale and
that technology can be used accordingly to further the wellbeing of patients.1 Doctors
use technology to help and heal patients. This overlooks that modern societies
are much more complex. It is possible that a utilitarian philosophical position
might be comfortable with the fact that use of technology leads to improvement
in average health status that does not necessarily result in a narrowing of
differentials by socioeconomic status. So long as health gains are maximized
(“the greatest good for the greatest number”), a person hewing to such a
position would express few reservations about policies that widened health
differentials. However, technology also can widen the access to health services
as it also leads to bureaucracy, which produces costs and, thus, is not always
desirable from the utilitarian point of view.
different philosophical position might view health as such an important asset
(as an end in itself) that gross inequalities in its distribution would be
regarded as intrinsically problematic.2 In
this light, poor health is one of the most important causes of restricted
opportunity and limited personal freedom.
also exists the philosophical debate between egalitarians and so-called
prioritarians, who favor giving higher priority to the worst-off. Doing the
best we can for the worst-off usually reduces their deficit relative to those
doing better, but sometimes it increases it. For example, in a given instance
it may be that the intervention that would result in the greatest improvement
in the health of the worst off would be to curtail air pollution but that the
benefit this would confer on the better off would be greater still. The
widening of the gap in this case would not be a step away from justice,
according to prioritarians. Moreover, any effort to reduce the gap by trying to
limit the health improvement enjoyed by the better off would be morally wrong.3
For surely we should curtail air pollution when there is no cost to anyone.
a just health care system and eliminating health inequality is primarily a
moral concern. How is the problem best conceived within the broad framework of
“morality”? The answer to this question is “justice,” that
is, that the ethical principle of justice (individuals’ obligations to treat
one another fairly) is the moral basis for health care reform4.
In exploring the moral justifications for use
of technology in eliminating health inequality, in our opinion, there should be
the removal of barriers to access to health care. We are equally concerned with
the nature and distribution of innovative health services to all, including the
‘underserved’ and the vulnerable. A just health care system provides universal
coverage in the form of affordable and effective health care for all residents.
The use of technology in healthcare has a myriad of benefits, the binding constraints are seldom technical but instead related
to the political and economic choices, which determine how innovations get
funded, resourced and supported, by whom and for whom.
1 Soraj Hongladarom. (2007) Information Technology Ethics: Cultural
Perspectives. (Idea Group Reference, USA)
2 Sen A.
(1992) Inequality re-examined. (Harvard University
Press, Cambridge, MA)
3 Nir Eyal, Samia. A.
Hurst, Ole F. Inequalities in Health:
Concepts, Measures and Ethics. Oxford University Press; 2013
4 Beauchamp TL, Childress JF. Principles of biomedical ethics. 6th ed.
New York (NY): Oxford University Press; 2009