High-Tech Medicine and the Physician-Patient Relationship
Kapocsi, Erzsebet, Ethics & Medicine
Modern medicine has its foundations in natural science and technology. It holds the complete control over the human body as its ideal. Its achievements are fascinating, and its perspectives are boundless. The evolution of what we may call techno-medicine did not start in recent days, but rather it has just reached the level at which it is capable of opening whole new dimensions of medical thinking and a new spectrum of possible actions to be taken-as opposed to orthodox medicine.1 In the older days, a physician had to rely on the five senses and a few simple devices to form a diagnosis, whereas today there are hundreds of biochemical tests, ECG, EEG, various types of X-rays, ultrasounds, CTs, and PETs at his disposal. He may measure all quantifiable parameters and can then summarize and store his results in computer databases. After having set up a scientifically precise diagnosis, he can pick out the optimal available therapy and suggest it to the patient. If an invasive method or surgical operation is required, laparoscopes, endoscopes, computerized microscopes, laser technology, and even robot-surgeons are there to aid the medical team. Terminally ill body parts can be replaced with transplants or artificial implants (heart valves, pacemakers, joints, bones, etc.). Hereditary diseases, genetic abnormalities can be screened with prenatal tests. There are specialized technological methods and special devices to deal with specific problems, from kidney dialysis to artificial insemination and cosmetic surgery. In an acute crisis the patients, from infants to the elderly, can be placed in intensive care units, where machines constantly monitor all vital body functions, and artificial respiration, as well as nutrition, is provided as needed.
The patients who are referred to the hospital or clinic with symptoms of an uncertain background find themselves in a mammoth medical plant. They are transferred from one department to the next, where they are examined with all sorts of instruments and devices they know nothing about, and they meet various doctors and technicians they have never met, and will probably never see again, if they are lucky enough. During these short examinations, lasting maybe from five minutes to half an hour, they are hardly talked to, and receive no feedback as to their results. They feel lost and alienated, and the anxiety caused by the sickness itself is compounded by a fear of the unknown technical apparatus.2
High-tech medicine is the level of medicine where the use of modern technical instruments and devices is not considered an exceptional occasion, but a part of the everyday routine. It results in a change of quality as opposed to traditional medical practice, both in diagnostics and in the field of therapy. Techno-medicine became a part of everyday practice by the end of the 20th century. Understanding of this particular type of medicine begins not with the patient or the doctor, but with comprehension of the technology involved. He who wishes to understand modern medicine should know its instruments.3
Tools, Instruments, Technology
Medical tools are exact, precise, and able to provide much useful information in a very short time. With their help it becomes possible to minimize stress, pain, and time spent hospitalized. These wonders of technological achievement never tire, and are devoid of any margin for subjective error. The technical arsenal of modern medicine possesses a built-in knowledge, primarily not medical, but of natural science, engineering, and information technology.4 This means these devices were designed or modified to suit the needs of human medicine. Their advanced state of development doesn't in itself guarantee their success in practice, for the medical knowledge of the users-technicians and doctors-is also required. The machine only becomes a tool to help in diagnosis and the patients' convalescence when it is in the hands of the skilled doctor. In itself it "behaves" like other machines do-it wears out, breaks down, and is subject to the technological race, since newer and better versions may appear on the market. …