Throughout history, we have been much better at developing technology than thinking through the consequences of it. I think there’s a danger of that happening in relation to health care.
An example is the diagnostic revolution. It has enormous potential. Indeed, it would be great to live in a world where most diseases are diagnosed before we even have any symptoms. But that’s going to rely on three big shifts in the public’s relationship with their health.
First, it depends on people wanting to monitor their health status continuously. There’s often an assumption that we all want to receive daily, weekly, or monthly readouts of our health. Actually, a lot of people feel that continually interrogating their health would be a source of anxiety.
Second, there is a probabilistic element to the diagnostic revolution, meaning most individual diagnoses will contain an element of probability. What do you do with that information? How do you decide what you need to do in terms of seeking treatment or how worried you should be about a possible diagnosis? This is a complex issue.
Take blood tests for cancer. People often talk as if it’s as simple as detecting cancer and getting treatment for it. But the reality is that blood tests will only give you a certain probability that you might have early-stage cancer. We won’t know how the cancer is going to develop or if we should wait or seek treatment, which might be invasive and have side effects. So the science of diagnosis is only one part of a deeper and broader diagnostic shift.
The third issue is the problem of health equality. It’s great that technology can empower people, but, broadly speaking, empowering people in an already unequal society usually means that the people who have time, money, and networks are the ones grabbing those opportunities.
Often there’s a distinction made between medicine and care: Medicine is kind of technocratic and scientific, while care is human and relational. Generally, care is what matters most to people. When you ask people whether they are satisfied with their treatment, they’re much more likely to talk about the care they received than the technical medical proficiency. In the end, medicine will fail us all, but care can be victorious right up to the end.
End of life is a huge challenge for us. The number of people reaching the final year of their lives is going to rise by about 25 percent over the next decade. That final year is usually when we use more health resources. Still, a lot of people don’t get the end-of-life treatment they want. They might receive expensive care when they would rather have cheaper care that’s more humane, at home, with loved ones. We need to have a conversation about how we can help people plan for that moment and decide what really matters to them at the end of their lives.
The same applies for virtual care. As an example of how quickly the conversation can change, for years the UK encouraged more doctors to do virtual appointments, and then Covid came along, and suddenly that became the main way of doing things. But afterward there was a backlash, and the Secretary of State said that general practitioners needed to return to face-to-face appointments. We need to have a much deeper conversation with the public about these changes, be clear about risks and upsides, and act on the basis of consent and agreement.
This article appears in the July/August 2023 edition of WIRED UK magazine.
This article was originally published by WIRED UK
