When researchers are conducting studies of health technology, the first question they might ask is “What problems can this technology solve?” But perhaps an equally important question is “What problems might this technology create?”
“Researchers should consider unintended effects of technologies, and how these could be mitigated,” asserts Sarah Ogilvie, DNP, APRN, FNP-C, PHN, CPHQ, assistant professor of nursing at Minnesota State University.
Generally, studies on health technology cover research ethics related to conducting the study. However, Ogilvie and colleagues noticed paper authors never seemed to elaborate on the ethical implications of the technology itself. “We feel that this gap is important to consider in an era of dramatically advancing technology,” Ogilvie says.
Ogilvie and colleagues analyzed 227 studies published over the last decade that referred to ethics in relation to health technology.1 They learned 52.9% of those studies did not refer directly to ethical principles of justice, autonomy, beneficence, and nonmaleficence. “Even if research is carried out ethically, the new technology can have unintended or undesirable ethical effects,” Ogilvie warns.
Regarding papers about technology and ethics, the focus usually was on the intent of the research. The actual effect of the health technology on patients could be unexpected. “When potentially unintended effects are overlooked by researchers, this is a major gap,” Ogilvie says.
This is not just a hypothetical idea; it is something that has happened multiple times with health technology. For example, if recovery or transplant are not possible with left ventricular assist devices or extracorporeal membrane oxygenation, the technology has prolonged patients’ lives — at lower quality. Devices to monitor if a patient falls can invade privacy by revealing details about other private aspects of behavior. Medical devices linked to the internet put patients at risk of hacking that could affect functionality.
Researchers in the pharmaceutical industry are required to study unintended effects of new medications by studying side effects. “There is a clear regulatory effort to identify side effects that could impact the patient in an unintended way,” Ogilvie says.
But in medical device research, this is not required. Researchers often do not examine the unintended effects, or ethical implications, of the new technology. “When a patient receives a new medical device, there should be the same transparency, as with a new medication,” Ogilvie argues.
REFERENCE
1. Steerling E, Houston R, Gietzen LJ, et al. Examining how ethics in relation to health technology is described in the research literature: Scoping review. Interact J Med Res 2022;11:e38745.
Health technology studies usually cover research ethics related to conducting the study. However, paper authors often seem to omit details about the ethical implications of the technology itself. This gap is important to consider in an era of dramatically advancing technology.
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