TECHNOLOGY, MEDICINE, AND ETHICS 1

Technology, Medicine, and Ethics

Joaquin Alberto

California State University of Long Beach

Health Care Administration 417

November 15, 2019

(Word Count: 2027)

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ABSTRACT:

Technology has created vast opportunity for mankind to advance and thrive. Major health

characteristics such as life expectancy, infant mortality rate, immunity, and much more, are all

greatly attributed and impacted by the rapid development and cultivation of medical technologies

and its research. The existence of such new practices and medications available to the public,

although beneficial to an individual’s health, can raise ethical implications if abused and put into

the wrong hands. The preservation of ethics in the field of healthcare and modern medicine

therefore is highly reliant on the morality and ethcis of those practicing or providing such

modern medicines and techniques.

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Technology has paved the way for vast advancement in medical procedures, equipment,

and research. Major health characteristics such as life expectancy, infant mortality rate,

immunity, and much more, are all greatly attributed and impacted by the rapid development and

cultivation of medical technologies and its research. While it is clear that innovation and

technology are detrimental to the quality, length, and advancement of human life, the morality of

using such tools and procedures is left up to us, or in this case, the individual practitioners or

providers. The preservation of ethics in the field of healthcare and modern medicine therefore is

highly reliant on the morality of those practicing or providing such modern medicines and

techniques. In order to ensure that ethical implications are avoided, laws and regulations must be

established. In the field of healthcare, morality and ethics go hand in hand, and are highly

important virtues that must be established. This promotes efficient and safe application of

advanced medical procedures and technologies in a healthcare environment, as well as prevent

its abuse and manipulation.

Morality, more specifically morals, describes one’s own conclusion that something is

right or wrong, based on their own principles that they follow in their own lives. Morality is

developed by an individual over the course of their lives and is usually dependent on the type of

environment one grew up in, as well as how they were raised. John C. Moskop, author of Ethics

and health care: An introduction, goes in to further detail regarding the aspect of morality and

how it is attained and influenced. Moskop states, “Many credit their parents or teachers for

providing this guidance, some cite the role of their religion and its doctrines, others recognize the

influence of their peers and their cultural communities” (Moskop, 2016). An individual’s morals

do not determine what is right or wrong based on social norms and rules, instead, the individual’s

morality determines whether something is wright or wrong based on their own perception of the
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situation. When placed in a healthcare perspective, morals are of high importance, as determined

by the following scholarly journal titled, “The ethics of applying new medical technologies”, by

Kenneth V. Iserson and Patrick M. Chiasson, available on the National library of Medicine

National Institutes of Health website. The article places an ethical perspective on world of

healthcare and the rapid advancement of technology surrounding it. Iserson and Chiasson state,

“Medical technology itself, including minimally invasive surgery, has no morals; our morality

revolves around when and how we use technology. This often involves the individual clinician's

assessment of their own abilities and an awareness of two aspects of the technology: its proven

efficacy and its safety. (Iserson, K. V., & Chiasson, P. M. 2002). In healthcare situations, the

morality of care provided is determined by the provider or practitioner themselves, which is why

it is important that a code of ethics is established to promote and regulate public safety in the

healthcare field.

Ethics is a highly important aspect of healthcare, without the concept of ethics,

healthcare institutions would be free to operate under their own agendas and without regulation.

In a perfect world, healthcare institutions such as hospitals and rehabilitation centers put their

patients first without question; however, our world is not perfect. Brooke Deterline shares in her

TED talk at Presidio, the many instances of corruption and greed in the world of business, not

just healthcare, such as “ENRON, the Wells Fargo foreclosure crisis, and the Madoff Ponzi

scheme” (Deterline, 2012). The U.S. government, and its people, have learned from these

failures and have created guidelines, regulations, and laws that protect the consumer or patient,

as well as promote honest and ethical business practices regardless field of expertise. On the

healthcare perspective, the same is true when regarding ethics. The application of ethical rules,

theories, guidelines, and principles in a healthcare setting are of high value in order to promote
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public health and safety. A scholarly journal by Robert M. Taylor delves into ethical concepts in

medicine, as well as the different approaches to ethical clinical medicine that exist. Taylor states,

“The most common approach to clinical ethical analysis is principlism. According to principlism,

the medical practitioner must attempt to uphold four important principles: respect for patient

autonomy, beneficence, nonmaleficence, and justice. When these principles conflict, resolving

them depends on the details of the case.” (Taylor, 2013) To go into further detail on the concept

of principlism, Warren T. Jhan enumerates and explains the four basic principles of ethics in his

article, “The 4 basic ethical principles that apply to forensic activities are respect for autonomy,

beneficence, nonmaleficence, and justice”. Jhan enumerates the principles as, “Respect for

autonomy- a norm that obliges us to respect the decisions (self-determination) of adults who

have decision-making capacity, beneficence - a moral obligation to act for the benefit of others,

nonmaleficence – a principle that holds that there is an obligation not to inflict harm on others,

and justice – a principle that obliges us to equitably distribute benefits, risks, costs, and

resources. (Jhan, 2011) Respect for autonomy, beneficence, nonmaleficence, and justice are all

principles that a health care provider must attain in order to promote ethics and thus the safety

and protection of all patients.

The rapid growth of these innovations, as well as the growing access and availability of

such practices to the public is raises ethical implication that need to be addressed to avoid

malpractice and threats to public health. This is where laws and regulations established at the

federal, state, and administrative levels come into play, in hopes of ensuring a safe and efficient

environment for both healthcare providers and their patients. the government is a key factor in

ensuring that businesses and healthcare practices and institutions prioritize the health and safety

of its consumers, as well as protecting them from harm and manipulation. Laws and regulations
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guide healthcare advisers to giving their patients the most beneficial care they can and protect

them from separate agendas healthcare providers may have. This is where the components of

moral intensity can be used to provide a clearer view of a situation in an ethical perspective.

Craig Johnson, author of “Ethical Decision-Making and Action”, defines moral intensity as; “the

magnitude of consequences, social consensus, probability of effect, temporal immediacy,

proximity, and concentration of effect” (Johnson, 2019). There must be a compromise between

all parties of the situation involved, to ensure that the best possible care is given, and that all

parties can come to an agreeable decision under the components of moral intensity.

Legislation is created to promote safety and peace; however, it is important to consider

the many possible situations, perspectives, and conflicts that arise over time. Over time,

legislation should adapt to these changes in society, to ensure that all parties are represented and

work together for the common good. What was once banned but is now legal, the topic and

practice of abortion have been highly controversial since it’s conception. Now that abortion is

now a legal practice in some states, there are many ethical implications that arise. However,

according to an article on the Planned Parenthood website, ever since the precedent of Roe v.

Wade, abortion has become very advanced and efficient, stating; “it’s become one of the safest

medical procedures in the United States - with a safety record of over 99%. Also, because

abortion is legal, people who decide to have an abortion can receive support throughout the

process from medical professionals.” (PlannedParenthood, 2019). Despite this, there are many

that believe that abortions should be illegal, for example, many states like Alabama, Georgia, and

Ohio have enacted laws that prevent abortions once a fetus has detectable cardiac activity, a

point in which some women might not even be aware they are pregnant yet. With this, Governor

of California Gavin Newsom and other democratic governors have come together to urge the
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passage of laws protecting abortion rights. In an article in The New York Times, Phil Willon

writes, “On Friday, Newsom signed a proclamation “welcoming women to California” for the

procedure and reaffirming the right of women to terminate a pregnancy, a protection enshrined in

the state’s Constitution.” (Willon, 2019). Only going to show how important government

involvement is, not only in establishing the rights of individuals but protecting them as well.

One vital aspect of the healthcare industry is its use, retrieval, sharing, and protection of

medical records and personal health information, otherwise known as PHI. What was once

recorded on paper and files - which take longer to retrieve, process and not to mention the space

requirement for storage, the introduction of computers has created a great convenience for

medical records to be stored in and used. This new era of ‘digitization’ of health care is one that

is very fascinating and interesting, but also has its own ethical implications. Kenneth Robertson

of journalofethics.ama-assn.org, for example, is captivated by just the sheer thought of the

extensive networks of electronic medical records available today. He says, “EHR, EMR, HIT,

HIE. The letters themselves evoke emotion. The young find their pulses quickening with

excitement about the new world order. Members of the older generation of doctors are more

likely to experience tachycardia when they read these letters, due to the dread they evoke. One

thing is certain: the digital age is invading health care and not about to retreat.” (Robertson,

2011). Robertson goes into detail just how intertwined each aspect of healthcare is with just

medical records alone. The health care industry is heavily reliant on medical records, and now

that they are being automated and ‘paperless’, the system is now a lot more complex than paper

medical records used to be. With this, the risk of losing or having this information stolen is also

increased and can have drastic consequences if not attended to.

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Another modern medical innovation available to the public today due to technological

advancements and research is genomic medicine, a subset of precision medicine. Personalized

genomic medicine and its key functions are described by Giuseppe Novelli as, “Personalized

medicine provide to physicians a molecular makeup of each patient. Looking at the patient on

this level helps the physician get a profile of the patient's genetic distinction, or mapping.”

(Novelli, 2010) Novelli goes into detail on how genetic profiles can be used by healthcare

providers to plan out treatments in much more accuracy and efficiency than ever before. This can

help people figure out the best and most efficient way to go about treating anything they come

across in regard to health. It is therefore clear that personalized genome medicine is beneficial,

but ethical implications like cost and resource conservation, to name a few, should still be

prioritized in order to avoid abuse of the technology and harm to others. Rules and regulations

should be set in order to prevent such instances from occurring and thus promoting a healthy

environment for patients and further progression of the technology and procedures. However, it

is important to note that at the end of the day, the patient has the right to decide what they want.

In retrospect, modern technology such as electronic medical records and modern

medicine (abortions, genomic medicine, etc.) should be used for the benefit of all, but under the

consent and agreement from the individual. The advanced technology and procedures we have

available today, gives many people the chance to live longer, bear children, and much more.

However, people reserve the right to choose to or choose not to undergo a procedure, regardless

of controversy or public speculation. With the example of death, many people would say that

prolonging life would be the first priority; however, those that have been suffering for a long

time, not to mention their families, may sometimes see that passing away would be much more

humane than living through the pain. Though controversial, euthanasia is becoming more
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common, with some countries already having its practice made legal. The same is true regarding

birth although not as controversial. Reproductive advancements such as frozen embryo transfers

(FETs), fertility medications, and in-vitro fertilization-embryo transfers (IVF-ETs) have

provided those who suffer from infertility the ability to bear children, not to mention relieve

them from the physical and emotional toll infertility one experiences when suffering from

infertility. Modern medicine gives society opportunities and choices that may promote and

prolong their health, but it is still up to the patient to make the final decision as to whether they

want the treatment or medication. Cases ranging from in-vitro fertilization, euthanasia, abortions,

and even personal medical records, all should be left up to the individual themselves to decide

what is best for them and what is not.

(Word Count: 2027)

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WORKS CITED:

Iserson, K. V., & Chiasson, P. M. (2002). The Ethics of Applying New Medical Technologies.

Surgical Innovation, 9(4), 222–229. doi: 10.1177/155335060200900407

Jahn W. T. (2011). The 4 basic ethical principles that apply to forensic activities are respect for

autonomy, beneficence, nonmaleficence, and justice. Journal of chiropractic medicine,

10(3), 225–226. doi:10.1016/j.jcm.2011.08.004

Johnson, C. E. (2018). Organizational ethics: A practical approach. Thousand Oaks, CA:

Sage Publishing. ISBN: 9781506361758

Moskop, J. , C. (2016). Ethics and Health Care. Cambridge University Press.Pg. 19

Novelli, G. (2010, October). Personalized genomic medicine. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/20865479.

Parenthood, P. (2019). Roe v. Wade: The Constitutional Right to Access Safe, Legal Abortion.

Retrieved from https://www.plannedparenthoodaction.org/issues/abortion/roe-v-wade.

Robertson, K. (2011, March 1). Mindful Use of Health Information Technology. Retrieved

from https://journalofethics.ama-assn.org/article/mindful-use-health-information-

technology/2011-03

Speaker, B. Deterline. (2012) Creating ethical cultures in business [Video file]. Retrieved from

https://www.youtube.com/watch?v=wzicXbnmllc
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Taylor, R. M. (2013). Ethical principles and concepts in medicine. Ethical and Legal Issues in

Neurology Handbook of Clinical Neurology, 1–9. doi: 10.1016/b978-0-444-53501-

6.00001-9

Willon, P. (2019, May 31). Newsom to women seeking abortions: California welcomes you.

Retrieved from https://www.latimes.com/politics/la-pol-ca-gavin-newsom-california-

abortion-restrictions-20190531-story.html.