Disruptive innovation in healthcare requires disruptive innovation in medical ethics (DIME)
Several recent medical innovations do not conform with the way medicine traditionally operates, but rather blur the boundaries of medicine and/or side-line the doctor-patient relationship as an essential aspect of healthcare. Examples of this are healthcare apps, direct-to-consumer genetic testing, disease surveillance, electronic patient records, telehealth and certain types of clinical decision support systems. I postulate that several of these new innovations will fundamentally change the very concept of medicine and thus turn out to be disruptive innovations. Given that medical ethics are tailored to U+2018traditionalU+2019 medicine, we should be critical about its current ability to cope with these changes and question whether the discipline of medical ethics is sufficiently equipped to guide new, disruptive innovations in healthcare towards their great potential in terms of improving patientsU+2019 access to good quality healthcare, while also safeguarding patients/users for the risks that come with them, not only in terms of health, but also in terms of infractions against firmly rooted values such as patient autonomy, the duty of care, confidentiality or privacy. If the medical ethics toolbox is ill-equipped to deal with these challenges, we urgently need to rethink or replace procedures, principles or theories in order to remedy this problem.
DIME will address these challenges by focusing on three main objectives:
- To establish where the most prominent ethical disruptions are located and therefore in which areas re-orientations of ethical principles are most urgently needed.
- To develop normative arguments regarding which fundamental procedures, principles or theories in medical ethics ought to be reinforced, adapted or replaced in the face of disruptive innovations to better cope with the challenges ahead.
- To critically analyse the shifting moral responsibilities in healthcare as a consequence of disruptive innovations.