Riley, M.
http://medicalstudentblog.co.uk
Introduction & Background
One of the chief concerns in the debate over healthcare reform is the universal need to contain healthcare costs while still providing reasonable healthcare services to the millions of uninsured. As technology advances, tests and treatments are newly available; however, there are only minimal cost controls in place for dictating when and how a patient becomes a candidate for expensive procedures. With the advent of advances in medical technology, sometimes the cost may outweigh the perceived benefit. While there are no laws to currently dictate the application of these expensive medical technologies, ethical concerns may address their use in context of addressing patient concerns while maintaining reasonable expenditures.
Medical technology allows for early disease detection and has improved the treatment and outcomes of many conditions; however, the use of medical technology is also a significant driver in the drastically increasing healthcare costs that have significantly impacted the economic state of the country on personal, political and societal levels. Medical technology represents an approximate 20% of total healthcare cost growth (Beever & Karbe, 2003, p. 2).
While some medical technologies contribute to the growth of healthcare costs, others are arguably cost-reducing (Williams & Torrens, 2009). Due to the nature of the new technology, it may be difficult to assess whether the short-term cost of the technology outweighs the long-term outcome involved with its use. Early disease detection resulting from new imaging or other medical technologies may reduce long-term healthcare costs resulting from later diagnosis and resulting treatments of conditions. When conducting an ethical evaluation of the use of technology, it is important to consider both the outcome and the economic impact of the technology. The debate for the use of medical technology focuses on both the cost and the value of its use (Williams & Torrens, 2008).
Evaluating the limits and use of medical technology
Do to the unknown nature of the long-term outcome of the use of many new medical technologies: I would argue that their ethical value is maintained through the medical necessity involved with each use. If the technology is medically necessary, it may be considered as a reasonable application of technology. However, if the procedure or technology is excessive, duplicated or unjustifiable on medical evidence, it should be considered an unethical use of medical resources. For example, in the context of fetal “keepsake” ultrasounds, “obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence” (Lai Yin & Mei Che, 2009, p. 1).
While advancements in medical technology may improve long-term outcomes, their overuse also significantly contributes to the rising healthcare costs. In some cases, the use of medical technology is inappropriate because it is a duplication of previous procedures; the additional testing only serves to confirm an already suspected diagnosis as imaged in previous tests (Beever & Karbe, 2003). Other issues arise when more expensive technologies are used over equally effective but less expensive technology, generating additional cost without added value. Again, this would be an inappropriate use of healthcare dollars; there must be a balance maintained between cost and value return.
Conclusions
Medical technology, in its own standing, is an amoral entity; however its application and utilization may indicate benefit or detriment. The ethical and controlled use of technology may improve the quality of life for millions; the misuse of such technology has a social and economic impact that may negatively affect the entire nation. Appropriate limits, such as medical necessity without duplication of previous medical diagnostics, are necessary to control costs while meeting patient needs. By cutting recreational or unnecessary medical treatments while maintaining life-saving technology, our society will reap the most benefit from healthcare services.
References
Beever, C. & Karbe, M. (2003). The cost of medical technologies. Retrieved 08 November 2009 from: http://www.boozallen.com/media/file/137991.pdf
Lai Yin, J. L., & Mei Che, S.P. (2009). ETHICAL ANALYSIS OF NON-MEDICAL FETAL ULTRASOUND. Nursing Ethics,16(5), 637-646. Retrieved from Academic Search Premier database.
Williams, S. & Torrens, P. (2008). Introduction to health services (7th ed.). Clifton Park, NY: Delmar Cengage Learning.
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