Evidence, truth, reality and power: A Foucauldian analysis of the ethics of testing and using novel medical devices
Year: 2018
Type: dissertation
Abstract: ENGLISH ABSTRACT: From the onset of time, human beings have used substances in all forms and \nshapes to promote health. Prior to the nineteenth century, traditional folk medicine, \nreligious ceremonies, magical practices, herbs and the balancing of the ‘humors’ \nwere popular methods of healing amongst others practiced by the Greeks. The \nvarious earlier Egyptian papyri detail the ancient Egyptian concepts of disease and \ncures, various ailments and anatomical observations. Informed consent was \nsimplistically manifested by patient trust and cooperation. The nineteenth and \ntwentieth centuries witnessed significant medical advancement is all spheres of \nmedicine i.e. opening of hospitals, training of doctors, era of antibiotics, development \nof universities and research centres. Since the quest for science and health was a \npriority, doctors earned a high social standing and began to enjoy the privileged \nstatus in society. \nThis resulted in the birth of a heavily professionalized discipline. Developing Michel \nFoucault’s ideas, we may regard that discipline is a specific technique of power, \nwhich aims to objectify human beings using three main practices i.e. dividing \npractices (e.g. birth of hospitals and asylums), scientific classification (medicine \nregarded as a discipline) and subjectification of human beings (humans considered \nas subjects). Using Foucauldian ethics, this thesis aims to deconstruct the power \nversus knowledge relationship between physicians and the healthcare industry in \ncontext of adopting novel medical devices. \nThe last century has been challenged by the invention of medical devices by the \nhealthcare industry. Some of these medical devices have raised both scientific and \nethical issues because patients suffered harm. The use of transvaginal mesh for \npelvic organ prolapse is currently a global topic questioning how harm came to \nwomen. The rationale for mesh development, regulatory clearance and \ndissemination to society, and conflict with the four ethical principles is discussed. \nThree other gynaecological devices will also be the focus of this thesis. \nThe power of regulatory authorities to clear medical devices using a substandard clearance mechanism, and the power of the healthcare industry to employ vicious marketing strategies to physicians is critically analysed. Physicians as bodies of knowledge adopt these procedures with noble intentions. The implications of using novel medical devices are significant as physicians represent the final point of care for patients during which informed consent is finalized. The interplay between physicians and the healthcare industry illustrates the clash between the urge to ‘develop’ and market new technology (medical devices in this case) and the ethics of responsibility espoused by physicians to protect against harm, notwithstanding the role of regulatory authorities. Medical device innovation will continue to expand. Physicians aided by sound science and ethical principles have the responsibility to implement safe and efficacious treatment. As this may be not sufficient to prevent harm, the addition of virtue ethics and shifting of the power balance toward physicians is proposed.
Author: Zeelha Abdool
Language: English
Topic: Foucault, Power, and Ethics
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2944883465