Skip to main content
Log in

On the value-ladenness of technology in medicine

  • Published:
Medicine, Health Care and Philosophy Aims and scope Submit manuscript

Abstract

The objective of this article is to analyse the value-ladenness of technology in the context of medicine. To address this issue several characteristics of technology are investigated: i) its interventive capacity, ii) its expansiveness and iii) its influence on the concept of disease, iv) its generalising character, v) its independence of the subjective experience of the patient. By this analysis I hope to unveil the double face of technology: Technology has a Janus-face in modern medicine, and the opposite of its factual face is evaluative.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Anspach, R.R.: 1987, 'Prognostic Conflict in Life-and Death Decisions: The Organization as an Ecology of Knowledge', Journal of Health and Social Behavior 28, 215–231.

    Article  PubMed  CAS  Google Scholar 

  • Aron, H. and Schwartz, W.: 1984, The Painful Prescription: Rationing Health Care. Washington DC: Brookings Institution.

    Google Scholar 

  • Bennett, I.L.: 1977, 'Technology as a Shaping Force', in: J.H. Knowles (ed.), Doing Better and Feeling Worse. New York: Norton & Co, pp. 125–133.

    Google Scholar 

  • Bijker, W.E.: 1990, The Social Construction of Technology.Cambridge MA: Ph.D. Thesis, MIT.

    Google Scholar 

  • Black, W.C. and Welch, H.G.: 1993, 'Advances in Diagnostic Imaging and Overestimation of Disease Prevalence and the Benefits of Therapy', New Engl. J. Med 328, 1237.

    Article  PubMed  CAS  Google Scholar 

  • Blume, S.S.: 1992, Insight and Industry. On the Dynamics of Technological Change in Medicine. Cambridge Mass: The MIT Press.

    Google Scholar 

  • Bove, E.L. and Lloyd, T.R.: 1996, 'Staged Reconstruction for Hypoplastic Left Heart Syndrome. Contemporary Results', Annals of surgery 224, 388.

    Article  Google Scholar 

  • Brown, W.M.: 1985, 'On Defining “Disease”',Journal of Medicine and Philosophy 10 (4), 311–328.

    PubMed  CAS  Google Scholar 

  • Bruke, G.: 1994, 'High Tech, Low Yield: Doctor's Use of Medical Innovation', J Am Health Policy 4 (1), 48–53.

    Google Scholar 

  • Canguilhem, G.: 1991, The Normal and the Pathological. New York: Zone Books.

    Google Scholar 

  • Cassell, E.J.: 1993, 'The Sourcer's Broom.Medicine's Rampant Technology', Hastings Center Report 23 (6), 32–39.

  • Chevenak, F.A and McCulloch, L.B.: 'Ethical Dimensions of Ultrasound Screening for Fetal Abnormalities', Ann NY Acad Sci. 847, 185-190.

  • Cooper, M.W.: 1996, 'The Gastroenterologist and His Endoscope: The Embodiment of Technology and the Necessity for a Medical Ethics', Theoretical Medicine 17, 379–398.

    Article  PubMed  CAS  Google Scholar 

  • Davidson, S.N.: 1995, 'Technological Cancer: Its Causes and Treatment', Healthcare Forum J 38 (2), 52–58.

    Google Scholar 

  • Delkeskamp-Hayes, C. and Cutter, M.A.G.: 1993, Science, Technology, and the Art of Medicine: European-American Dialogues. Dordrecht: Kluwer Academic.

    Google Scholar 

  • Ellul, J.: 1964, The Technological Society. New York: Alfred A.Knopf.

    Google Scholar 

  • Evans, A.S.: 1991, 'Causation and Disease: Effect of Technology on Postulates of Causation', The Yale Journal of Biology and Medicine 64, 513–528.

    PubMed  CAS  Google Scholar 

  • Feinstein, A.R.: 1967, Clinical Judgment. Baltimore: The Williams and Wilkins Company.

    Google Scholar 

  • Ferkiss, V.: 1969, Technological Man. New York: Braziller.

    Google Scholar 

  • Fischer, E.S. and Welch, H.G.: 1999, 'Avoiding the Unintended Consequences of Growth in Medical Care', JAMA 281, 446–453.

    Article  Google Scholar 

  • Gadamer, H.G.: 1987, Gesammelte Werke. Tübringen: Mhor, Vol.4.

    Google Scholar 

  • Glover, J.: 1977, Causing Death and Saving Lives. Harmondsworth: Penguin.

    Google Scholar 

  • Gorovitz, S. and MacIntyre, A.: 1976, 'Toward a Theory of Medical Fallibility', Journal of Medicine and Philosophy 1, 51–71.

    Google Scholar 

  • Green, J.M.: 1990, 'Prenatal Screening and diagnosis: Some Psychological and Social Issues', Br J Obs and Gyn 97, 1974–1976.

    Google Scholar 

  • Hagemo, P.S., Rasmussen, M., Bryhn, G. and Vandvik, I.H.: 1997, 'Hypoplastic Left Heart Syndrome Multiprofessional Follow-up in the Mid-term Following Palliative Procedures', Cardiol Young 7, 248–253.

    Article  Google Scholar 

  • Hanson, M.J. and Callahan, D.: 1999, The Goals of Medicine: The Forgotten Issues in Health Care Reform. Washington: Georgetown University Press.

    Google Scholar 

  • Heidegger, M.: 1962, Die Technik und die Kehre. Stuttgart: Verlag Günther Neske.

    Google Scholar 

  • Hellerstein, D.: 1983, 'Overdosing on Medical Technology', Technol Rev 86 (6), 12–17.

    PubMed  CAS  Google Scholar 

  • Helman, C.G.: 1985, 'Disease and Pseudo-disease: A Case History of Pseudo-angina', in: R.A. Hahn and A.D. Gines (eds.), Physicians of Western Medicine. Anthropological Approaches to Theory and Practice. Dortrecht: D. Reidel Publishing Company.

    Google Scholar 

  • Hollander, R.D.: 1997, 'The Social Construction of Safety', in: K. Schrader-Frechett and L. Westra (eds.), Technology and Values. New York: Rowman & Littlefield Publishers, pp. 107–114.

    Google Scholar 

  • Ihde, D.: 1990, Technology and the Lifeworld: From Garden to Earth. Bloomington: Indiana University Press.

    Google Scholar 

  • Illich, I.: 1975, Medical Nemesis: The Expropriation of Health..London: Calder and Boyars.

    Google Scholar 

  • Jennett, B.: 1986, High Technology Medicine - Benefits and Burdens. Oxford: Oxford University Press.

    Google Scholar 

  • Jennett, B.: 1988, 'Variations in Surgical Practice: Welcome Diversity or Disturbing Differences', British Journal of Surgery 75, 630–631.

    PubMed  CAS  Google Scholar 

  • Jennett, B.: 1994, 'Medical Technology, Social and Health Care Issues', in: R. Gillon (ed.), Principles of Health Care Ethics.New York: John Wiley & Sons, pp. 861–872.

    Google Scholar 

  • Jonas, H.: 1985, Technik, Medizin und Ethik. Frankfurt a.M: Insel Verlag.

    Google Scholar 

  • Jonsen, A.R.: 1990, The New Medicine and the Old Ethics. Cambridge MA: Harward University Press.

    Google Scholar 

  • Kass, L.R.: 1975, 'Regarding the End of Medicine and the Pursuit of Health', Public Interest 40, 11–42.

    Google Scholar 

  • Kern, J.H., Hayes, C.J., Michler, R.E., Gersony, W.M. and Quagenbeur, J.M.: 1997, 'Survival and Risk Factor Analysis for the Norwood Precedure for Hypoplastic Left Heart Syndrome', Am J Cardiol 80 (2), 170–174.

    Article  PubMed  CAS  Google Scholar 

  • Kevnanagh, A.M. and Broom, D.H.: 1998, 'Embodied Risk: My Body, Myself?’ Soc Sci Med 46, 437–444.

    Article  Google Scholar 

  • Leape, L.L.: 1994, 'Error in Medicine', JAMA 23, 1851–1857.

    Article  Google Scholar 

  • Le Fanu, J.: 1999, The Rise and Fall of Modern Medicine.London: Little Brown.

    Google Scholar 

  • Lewis, T.: 1977, 'On the Science and Technology of Medicine', in: J.H. Knowles (ed.), Doing Better and Feeling Worse. New York: Norton & Co, pp. 35–46.

    Google Scholar 

  • Malone, P.S.J.: 1996, 'Antenatal Diagnosis of Renal Tract Anomalies: Has it Increased the Sum of Human Happiness?’ J R Soc Med 89, 155–158.

    Google Scholar 

  • McWhinney, I.R.: 1997, A Textbook for Family Medicine.Oxford: Oxford University Press.

    Google Scholar 

  • Mitcham, C.: 1994, Thinking Through Technology. The Path Between Engineering and Philosophy. Chicago: The University of Chicago Press.

    Google Scholar 

  • Mitcham, C.: 1995, 'Philosophy of Technology', in:W.T. Reich (ed.), Encyclopedia of Bioethics. New York: MacMillan, pp. 2477–1484.

    Google Scholar 

  • Monti, J.E., Wood, D.P., Pontes, E., Boyett, J.M. and Levin H.S.: 1989, 'Adenocarcinoma of the Prostate in Cytoprostatectomy Specimens Removed from Bladder Cancer', Cancer 63, 531–538.

    Google Scholar 

  • Moss, R.W.: 1991, The Cancer Industry: The Classic Exposé on the Cancer Establishment. New York: Paragon House.

    Google Scholar 

  • Muraskas, J., Marshall, P.A., Tomich, P., Myers, T.F., Gianopoulos, J.G. and Thomasma, D.C.: 1999, 'Neonatal Viability in the 1990s: Held Hostage by Technology', Camb Q Healthc Ethics 8 (2), 160–170.

    Article  PubMed  CAS  Google Scholar 

  • Paul, N.: 1998, 'Incurable Suffering from the “Hiatus Theoreticus”? Some Epistemological Problems in Modern Medicine and the Clinical Relevance of Philosophy of Medicine', Theoretical Medicine and Bioethics 19, 229–248.

    Article  PubMed  CAS  Google Scholar 

  • Payer, L.: 1992, Disease Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick. New York: John Wiley & Sons.

    Google Scholar 

  • Pellegrino, E.D.: 1979, 'Medicine, Science, Art: An Old Controversy Revisited', Man Med 4 (1), 43–52.

    PubMed  CAS  Google Scholar 

  • Pickering, W.G.: 1996, 'Does Medical Treatment Mean Patient Benefit?’ Lancet 347 (8998), 379–380.

    Article  PubMed  CAS  Google Scholar 

  • Ponder, B.: 1997, 'Genetic Testing for Cancer Risk', Science 278, 1050–1054.

    Article  PubMed  CAS  Google Scholar 

  • Reiser, S.J.: 1977, 'Therapeutic Choice and Moral Doubt in a Technological Age', in: J.H. Knowles (ed.), Doing Better and Feeling Worse. New York: Norton & Co, pp. 47–56.

    Google Scholar 

  • Reiser, S.J.: 1978, Medicine and the Reign of Technology. New York: Cambridge University Press.

    Google Scholar 

  • Robinson, D. and Bevan, E.A.: 1993, 'Defining Normailty - Art or Science?’ Methods Inf Med 32 (3), 225–228.

    PubMed  CAS  Google Scholar 

  • Rothman D.J.: 1991, Strangers at the Bedside. History of How Law and Bioethics Transformed Medical Decision Making.New York: Basic Books.

    Google Scholar 

  • Rothman, D.J.: 1997, Beginnings Count: The Technological Imperative in American Health Care. New York: Oxford University Press.

    Google Scholar 

  • Räikkä, J.: 1996, 'The Social Concept of Disease', Theoretical Medicine 17 (4), 353–361.

    Article  PubMed  Google Scholar 

  • Schneidermann, L.J. and Jecker, N.S.: 1995, Wrong Medicine: Doctors, Patients and Futile Treatment. Baltimore: Johns Hopkins.

    Google Scholar 

  • Schrader-Frechett, K. and Westra, L.: 1997, Technology and Values. New York: Rowman & Littlefield Publishers.

    Google Scholar 

  • Sharpe, V.A. and Faden, A.I.: 1998, Medical Harm. Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness.Cambridge: Cambridge University Press.

    Google Scholar 

  • Skrabanek, P.: 1994, The Death of Humane Medicine and the Rise of Coercive Healthism. Suffolk: The Social Affairs Unit.

    Google Scholar 

  • Smith, M.R. and Marx, L. (eds.): 1994, Does Technology Drive History? The Dilemma of Technological Determinism. Cambridge: MIT Press.

    Google Scholar 

  • Stewart-Brown, S. and Farmer, A.: 1997, 'Screening Could Seriously Damage your Health. Decisions to Screen Must Take Account of the Social and Psychological Costs', BMJ 314, 533.

    PubMed  CAS  Google Scholar 

  • Sundström, P.: 1998, 'Interpreting the Notion that Technology is Value-Natural', Medicine, Health Care and Philosophy 1, 41–45.

    Article  Google Scholar 

  • Tatum, J.S.: 1997, 'The Political Construction of Technology: A Call for Constructive Technology Assessment', in: K. Schrader-Frechett and L. Westra (eds.), Technology and Values. New York: Rowman & Littlefield Publishers, pp.

    Google Scholar 

  • Temkin, O.: 1963, 'The Scientific Approach to Disease: Specific Entity and Individual Sickness', in: A.C. Crombie (ed.), Scientific Change: Historical Studies in the Intellectual, Social and Technical Conditions for Scientific Discovery and Technical Invention from Antiquity to the Present. New York: Basic Books, pp. 629–647.

    Google Scholar 

  • Temkin, O.: 1977, The Double Face of Janus. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Thomas, L.: 1977, 'On the Science and Technology of Medicine', in: J.H. Knowles (ed.), Doing Better and Feeling Worse: Health in the United states. New York: W.W. Norton.

    Google Scholar 

  • Toulmin S.: 1986, 'How Medicine Saved the Life of Ethics', in: DeMarco, R.M. Fox (eds.), New Directions in Ethics: The Challenge of Applied Ethics. New York: Routledge and Keagan Paul, pp. 265–281.

    Google Scholar 

  • Twaddle, A.: 1993, 'Disease, Illness and Sickness Revisited', in: A. Twaddle and L. Nordenfelt (eds.), Disease, Illness and Sickness: Three Concepts in the Theory of Health, Studies in Health and Society 18, Linköping University, pp. 1–18.

  • Tijmstra, T.: 1989, 'The Imperative Character of Medical Technology and the Meaning of “Anticipated Decision Regret”', Int J of Technology Assessment in Health Care 5, 207–213.

    Article  Google Scholar 

  • Veatch, R.M.: 1985, 'Against Virtue: A Deontological Critique of Virtue Theory in Medical Ethics', in: E.E. Shelp (ed.), Virtue and Medicine. Dordrecht: Reidel Publishing Company, pp. 329–345.

    Google Scholar 

  • Vos, R.: 1991, Drugs Looking for Diseases: Innovative Drug Research and the Development of the Beta Blockers and Calcium Antagonists. Dordrecht: Kluwer Academic Pbulishers.

    Google Scholar 

  • Wahl, P.W., Savage, P.J., Psaty, B.M., Orchard, T.J., Robbins, J.A. and Tracy, R.P.: 1998, 'Diabetes in Older Adults: Comparison of 1997 American Diabetes Association Classification of Diabetes Mellitus with 1985 WHO Classification', Lancet 352 (9133), 1012–1015.

    Article  PubMed  CAS  Google Scholar 

  • Whittle, M.: 1997, 'Ultrasonographic “Soft Markers” of Fetal Ultrasound. Detecting Them may do More Harm Than Good’ (Editorial). BMJ 314, 918.

    PubMed  CAS  Google Scholar 

  • Winner, L.: 1977, Autonomous Technology. Cambridge MA: MIT Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hofmann, B. On the value-ladenness of technology in medicine. Med Health Care Philos 4, 335–345 (2001). https://doi.org/10.1023/A:1012069919089

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1012069919089

Navigation