Medical Ethics: Non Negotiable Yet Misunderstood Medical Technology Success Requirement
Medical ethics is core to the success of medical technology as a business. Most successful medical technology companies exist in partnership with physicians. The latter, who are in leadership positions, hold medical ethics in the highest esteem of professional priorities.
Operationalizing compatible and required values in a technology context can happen through world leading accredited standards and certifications.
Medical technology success including for information security requires adopting and demonstrating with competence, those values that are compatible with medical ethics. While acing certifications and implementation of technical standards and related audits doesn’t guarantee competence in all situations; it does signal a floor of knowledge, competence, conscientiousness, and commitment to the relevant technology fields.
Most Western medicine follows the “four principles” approach to medical ethics, put forward by Tom Beauchamp and James Childress in their book “Principles of biomedical ethics” (Beauchamp, T. L. et al 2013). This is also known as principlism. The lack of understanding this fact is a huge source of strain and mistrust between insiders and outsiders to medical communities. Note: if you don’t buy into the principles of medical ethics, you and your organization shouldn’t be working in the medical ecosystem including technology due to extreme misalignment.
The four pillars of medical ethics are:
- Beneficence (doing good)
- Non-maleficence (to do no harm)
- Autonomy (giving the patient the freedom to choose freely, where they are able)
- Justice (ensuring fairness)
By contrast, segments of the tech sector workforce seem to rail against ethics and the morality that underpins it. This PLoS One study, academic paper provides a partial explanation for how a set of values can lead to the denigration of morality as a desirable trait. This is for when there is a lack of values compatible with medical ethics such as sanctity of life, care, empathy, and conscientiousness: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0042366
Medical ethics represent virtues that get transformed into duties and related rules that must consider consequences including harm to patients.
As an aside, this post further explains the history of those values or lack of values and its relationship to the history of the web and the culture of technology: https://sherridouville.medium.com/the-origins-of-a-pandemic-clash-humanists-vs-ec98c3b0950e
World leading university and professional certification accreditation body, BCS addresses ethics. In that way, ethics is operationalized into related accredited curriculum: https://www.bcs.org/media/9006/course-accreditation-guidelines.pdf
World leading technology standards also led by the British such as ISO 27001 for cybersecurity and ISO 9001 for quality respectively also help to operationalize the values of competence, safety and reliability, in addition to operationalizing technical controls for managing risk.
This post explains why I believe that the fastest path to trust in technology for medicine is through the development and adoption of accredited and credible standards, certifications, and assurances of their competent implementation.
Common gaps in understanding the criticality of accreditation, practices, and culture are well covered in chapter 9 of our book, Advanced Health Technology: Managing Risk While Tackling Barriers to Rapid Acceleration.
Further, my coauthors provide an analysis of all relevant ethical frameworks for engineers to consider in the healthcare context in our chapter titled “How Can We Trust in IoT? The Role of Engineers in Ensuring Trust in the Clinical IoT Ecosystem” (Platt, J., Douville, S., Mongoven, A. (2022).
In summary, belief in and respect for ethics diverges widely in tech and medicine, neither fields of which are totally homogenous in their levels of alignment and misalignment with well understood medical ethics that governs the practice of medicine. Violation of ethics is a complex cultural, psychological, social, and intellectual issue.
Side note: “Abstract thinking allows one to see connections between seemingly divergent aspects of life, to solve problems in more creative ways (thinking “outside of the box”). Without the ability to think abstractly, people generally have difficulty making conceptual decisions, moral judgments or solving complex problems.”
We do not attempt to solve for this complexity; we simply intend to clarify when parties are compatible for a productive working relationship both professional and personal. It’s not to judge and label, in fact it’s to also foster compassion, in part when there is just a sheer lack of capacity for abstract and moral reasoning, thus consideration for medical ethics.
Lastly, I want to thank esteemed colleagues, William C. Harding, Ph.D. and Mike Ng for inspiring this article along with my better half, Dr. Art Douville whose commitment to and drive for medical ethics is both inspiring and humbling.
Parker et al. “Leveraging Information Technology Frameworks: Enabling Successful Deployment of Advanced Technologies,” Douville, S. (Ed.). (2023). Advanced Health Technology: Managing Risk While Tackling Barriers to Rapid Acceleration (1st ed.). Productivity Press. https://doi.org/10.4324/9781003348603
Platt, J., Douville, S., Mongoven, A. (2022). How Can We Trust in IoT? The Role of Engineers in Ensuring Trust in the Clinical IoT Ecosystem. In: Hudson, F.D. (eds) Women Securing the Future with TIPPSS for Connected Healthcare. Women in Engineering and Science. Springer, Cham. https://doi.org/10.1007/978-3-030-93592-4_5
By Sherri Douville, CEO at Medigram, the Mobile Medicine company. Recognized in 8 categories of top CEOs by Board Room Media (Across SMS, mHealth, iOS, IT, Database, Big Data, Android, Healthcare). Top ranked medical market executive worldwide and #1 ranked in mobile technology categories (mhealth, iOS, Android), #1–2 (on any given day) for the cybersecurity market in the U.S. on Crunchbase. Best selling editor/author, Mobile Medicine: Overcoming People, Culture, and Governance & Advanced Health Technology: Managing Risk While Tackling Barriers to Rapid Acceleration, Taylor & Francis; Series Editor for Trustworthy Technology & Innovation + Trustworthy Technology & Innovation in Healthcare.