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Medical technologies and ethics
by Dr. Ronald Ng, Clinical Haematologist, ICON Haematology at Mount Elizabeth Hospital, Singapore
For centuries, in the West, the ethics that have guided the practice of the medical arts have been those of the Hippocratic Oath. In the East, the concept is that a physician should treat patients with care like that of a parent towards his or her children (医者父母心). In short, the physician must do no harm. These ideas seem to be sufficient guidelines in the days of limited technology, but with the explosion of the pharmaceutical industry, genetic studies, computer technology and Artificial Intelligence (AI), the ethical issues that are raised by the use of these technologies can no longer be simply addressed with those well-accepted dictums.
With advancing technology, other issues of ethics began to arise. The main concerns of the ethical review boards, internationally referred to as Institutional Review Boards or IRBs, are the protection of the patients’/subjects’ safety. With developments in genetics and understanding of the metabolism of cells, new classes of drugs are being developed that raise issues beyond that of patients’ safety. Their rights to their own data and the confidentiality of that data are now an added concern.
Our understanding of the genetics and metabolism of cancer cells led to the development of what are known as targeted therapies. Drugs are developed targeted at the specific genetic or metabolic requirements of the cancer cell. These are expensive drugs. How many people can afford them? The former CEO of Bayer, Marijn Dekkers, once, in answer to the question of the prohibitive cost of a new medicine for lung cancer, actually said in an interview where the issue of cheaper generics being developed in India was raised, “We did not develop this medicine for Indians. We developed it for western patients who can afford it.” That raises the question: does it mean only the rich can benefit from such treatment? This also leads to the impression that pharmaceutical companies are there just to make money, and this could be one of the many reasons for the distrust of so-called Big Pharma, and the distrust of the COVID vaccine.
*The above is an excerpt from an article published in the latest issue of THINK (“Tomorrow’s Technology Today”), a publication of The HEAD Foundation.
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