The New Face of Bioethics
It’s Time to Align Medicine and Humanity
Where are the important questions about the human side of healthcare being asked today? In the early years of medical ethics, the primary focus of discourse was the clinical setting, where patients and their loved ones would decide on treatment plans. At the same time, physicians and hospital boards navigated the terrain of newly developed and, at times, controversial treatment methods. These early forays in the field produced internal hospital guidelines and regulations to ensure responsible patient therapy.
As the face of medicine and politics changed with time, bioethics became the business of legislators. Regulation became the primary method for tangibly shaping the ethics of medical care, with state-level and federal commissions charged with formulating policy for lawmakers and regulators.
Regulatory Bodies Struggle to Keep Up
But regulation has its limits. This has already been noticed by leaders in global health, where international law lacks the teeth to enforce any actionable standards. The same holds for the health tech sector: as emerging technologies introduce new ways of envisioning how we support human wellness, regulatory bodies aren’t in any position to keep up. At a technical level, the issue lies in the slow pace of policymaking- the crafting, approval, and implementation of legal oversight all take a long time. With start-ups introducing new tech models at lightning speed, regulators aren’t positioned to keep up with the pace.
Yet there’s a deeper concern at play, too. It’s easy to see where a bona fide ethical problem arises when talking about ‘pulling the plug’ on a patient or harvesting organs. But emerging health tech is changing the face of medicine in ways that are often at once both subtle and wide-reaching, where the possibility of wrongdoing is not to be found in any individual use but in the integration of the technology on the grand scale and its influence on individual humans and broader communities and societies.
When AI Meets the Medical Marketplace
The ethical questions at hand today need to be simplified for our legal systems to respond to them adequately and efficiently. Concerns for long-term risk factors, global market competition, entrenched biases hiding out in black box AI systems, and so on are issues that don’t lend themselves to a simple yes or no for lawmakers to enforce.
For bioethics to have a say that counts in today’s ever-changing world of healthcare, the field needs to adjust its focus away from regulation and towards the innovators and investors who are bringing about the medical care revolution. It’s time for ethicists (or at least some) to move their offices from hospitals and governmental health departments to tech hubs, start-ups, and investment firms.
We need new bioethics, one that sees itself as an exercise in human strategy. Rather than standing alongside regulators, presenting ethics as a barrier or hindrance, ethicists need to conceive of ethics as an integral part of the health tech sector’s strategy building. They should bring insight from the humanities, philosophy, and sociology to explore what the long-term consequences, and opportunities, of new technologies, might be. Bioethics, committed to thinking deeply and predictively about the present and future of human flourishing, can and must be a player in tech development, offering a voice to ensure the full range of human wellness remains at the forefront of tech development and investment.
Pick Up the Pace
A spirit of innovation drives the healthcare ecosystem, and that competitive energy means a fast-paced environment. While there’s value to placing cautious stop-gaps on innovation to ensure the next health tech unicorn doesn’t turn out to be a Frankenstein-ian monster, ethicists — to have their voices heard — will need to pick up the pace.
The rate of change in the health tech sector is rapid, and bioethical voices need to keep up. For this to happen, making space for individual voices is crucial . There isn’t enough time in a competitive market setting for research centers and advisory boards to reach a broad consensus.
Institutional ethics guidelines don’t get produced fast enough for the folks expected to adhere to them to consider those guidelines seriously. Instead, individual ethicists need to zone in on areas of study and work fast at constructing relevant frameworks and models for implementing ideas of value. For this to happen, ethicists will need stronger tools and platforms for collaborative work to engage more advanced thinking across disciplines.
Let’s Get Technical
The new face of bioethics will need to be interdisciplinary. At times, ethicists look for the low-hanging fruit, where the human side of the story is easy to see. For issues like abortion, medical aid in dying, and gender-affirming care, one need not have a deep knowledge of the technical elements of the technology to way in on questions of right and wrong. But electronic medical records, health insurance coverage, automated health delivery systems, robotic care assistants, polygenic risk scores — all of these are essential elements of healthcare too, and ethicists need to develop thinking around these technologies as well.
The human-centered questions may not be as easy to spot; instead, attention to the technical details of a technology’s make-up or usage will be crucial for those who want to speak intelligently on emerging tech. We don’t need everyone in the humanities to be a programmer. Still, we need avenues for symbiotic discourse, where people from different fields can learn from one another to develop effective, ethical solutions.
What Ethicists Offer
Bioethics is not a sideshow. On the contrary, bioethicists are producing cutting-edge thinking on what human wellness is all about. Beyond familiarity with legal and regulatory considerations as well as the history of medical innovation (with its many successes and pitfalls), bioethicists bring a depth of knowledge in the art of being human — drawing on philosophy, literature, and spiritual traditions to offer big-picture perspective on the individual choices and medications and gadgets that are shaping the humanity of tomorrow.
Clinical ethicists, who have spent their time in hospital wards, assisting patients, loved ones, doctors, nurses, and social workers navigate the most vexing questions regarding medical treatment options, have firsthand knowledge of the advantages and limitations of innovative technologies in the medical landscape.
Bioethics scholars, like investors and innovators, are imaginative, even what some have termed ‘prophetic,’ looking ahead to the various possible worlds that await us and charting pathways to the one that looks best. For the health tech sector to flourish, it will take more than connecting programmers to capital. We need collaboration, imagination, and innovation — with the best minds and hands working together.
Matthew Nitzanim advocates for the human story in the wellness field. Bringing together a background in philosophy and health policy (BA, Princeton University), bioethics (MA, Bar-Ilan University), and hospital chaplaincy (Penn Medicine), as well as experience in health tech VC, he believes in the need for cross-discipline conversations in the ever-changing landscape of human health.
